Resources for Friends

How To Help and Refer a Friend

Signs and Symptoms
When to Refer
Guidelines for Interaction
How to Refer

It takes a lot of courage and strength to help a friend with mental health difficulties. Thanks for your concern for their welfare. Below are some signs that you may need to take action to get them help. A comprehensive list of signs would be too long so trust your instincts and don't be afraid to let your friend know of your concern.

SOME SIGNS AND SYMPTOMS OF A STUDENT IN DISTRESS

Lack of interest in engaging in activities.
Listlessness or lack of energy.
Marked changes in personal hygiene.
Withdrawing from others or sleeping all the time.
Impaired speech or garbled, disjointed thoughts.
Homicidal threats.
Behavior which regularly interferes with the decorum or effective management of your class or living environment.
Overtly suicidal thoughts, e.g., referring to suicide as a current option.
High levels of irritability, including unruly, aggressive, violent or abrasive behavior.
Inability to make decisions despite your repeated attempts to clarify and to encourage.
Dramatic weight loss or weight gain.
Bizarre or strange behavior which is obviously inappropriate to the situation, e.g., talking to “invisible” people.
Normal emotions that are displayed to an extreme degree or for a prolonged period of time, e.g., fearfulness, tearfulness, nervousness.

WHEN TO REFER

Aside from the signs or symptoms that may suggest the need for counseling, there are other guidelines which may help you determine when to take action. It is important not only to hear what your friend is saying, but to be attentive to the non-verbal behaviors as well as the feeling underlying the message. A referral is usually indicated under the following circumstances:

When your friend asks for help. However, you need some information to know the best referral for his/her needs. It is also a good idea to explore with your friend the urgency of the need. Some exploration and support from you will help your friend feel more comfortable being referred.
A person contemplating suicide. Although there are wide differences in the seriousness of suicidal thoughts, anytime someone is thinking of it seriously enough to discuss it with you, he or she is probably very upset. In order to assess the severity of the suicidal thought, University Counseling Services (UCS) should be contacted. Call UCS, inform the secretary of the situation, and ask to speak with a counselor. After hours call 665-5621 and ask to speak to a Truman Counselor. It is possible to save a life by taking quick, effective action. PLEASE NOTE that if you give us the name of the person and we are concerned for their safety, we may be required to take action.
When you believe that you have not been able to adequately assist your friend. None of us can help everyone we try to help because of personality differences, lack of experience, or a variety of other reasons. When you have the feeling that you have not been helpful, try to be honest with your friend and suggest a specific person or agency that would meet the student’s needs. UCS can help you find appropriate resources.
If your friend is reluctant to discuss a problem with you for some reason. You may sense that your friend may not feel comfortable or at ease discussing the problem with you. If this is the case, suggest that your friend talk to a counselor.
If your friend has physical symptoms. Headaches, dizziness, stomach pain, insomnia can be physical manifestations of psychological states. If students complain about symptoms they suspect (or you suspect) may be connected with their problems, it would be in their best interest to refer them to a medical professional, possibly the Student Health Center. After the physical symptoms are assessed, the medical professional may refer them for psychological services.

GUIDELINES FOR INTERACTION

Talk to your friend in private.
Listen carefully.
Express your concern and interest.
Avoid criticizing or sounding judgmental.
Consider UCS as a resource and discuss a referral with your friend.
If your friend resists help and you are concerned, contact UCS to discuss your concern.

HOW TO MAKE A REFERRAL TO UNIVERSITY COUNSELING SERVICES

Suggest your friend call or come in to make an appointment. Provide UCS’ telephone number and location at that time. Feel free to attend the session with your friend if it is okay with him or her.
If your friend seems nervous about calling, you may call UCS while your friend is with you and say that you have a friend that wants to make an appointment. Then hand your friend the phone to make the appointment.

Eating Disorders: How to help a friend

Do:

Learn about eating disorders so that you will know the signs when you see them.
Recognize that eating disorders are potentially fatal diseases; treat them accordingly.
Listen to your friend with understanding, respect and sensitivity.
Be consistent; insist that your friend needs help; provide your friend with a list of sources of professional help.
Be available when your friend needs someone; be supportive.
Share your own emotions and struggles with another if you feel the need.
Focus on your friend’s unhappiness as the reason s/he could benefit from help.

Don’t:

Take any action alone; get help.
Try to solve your friend’s problem for him/her; your friend needs a qualified professional.
Blame your friend for doing something wrong or tell your friend s/he is acting silly.
Gossip about your friend.
Be afraid to upset your friend; talk with him/her.
Reject or ignore your friend; s/he needs you.
Be deceived by your friend’s excuses.
Talk about your friend’s eating habits.

CONFRONTING SOMEONE YOU BELIEVE HAS AN EATING DISORDER**

When confronting a person with an eating disorder, it is important to have a plan. A confrontation can be difficult due to denial seen in those with the problem. However, if a person does deny the problem, the initial seed has been planted. At some point in the future, the problem will be recognized and admitted. The following outline is helpful to use when confronting someone.

Concern: The reason you are doing the confronting. You care about the mental, physical and nutritional needs of the person.
Organize: Decide WHO is involved, WHERE to confront, WHY concern, HOW to talk, WHEN - a convenient time.
Needs: What will the person need after the confrontation? Professional help and/or support groups need to be available.
Face: The actual confrontation. Be empathetic but direct. Do not back down if the person initially denies the problem.
Respond: By listening carefully.
Offer: Help and suggestions. You may want to encourage the person to contact you when s/he needs someone to talk.
Negotiate: Another time to talk and a time span to seek professional help.
Time: Remember to stress that recovery takes time and patience. However, the person has a lot to gain by the process and, also, a lot to lose if s/he chooses to continue with these behaviors.

*Adapted from “Food for Thought,” Randolph-Macon Women’s College.

** This plan has been written and explained at lectures given by Heather L. Howard, former Administrator for ANAD, Highland Park, IL.