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Faculty and Staff Resources

How To Identify and Refer a Distressed Student  

University students often encounter a great deal of stress during the course of their academic experience. While most students cope successfully with the challenges that these years bring, an increasing number of students find that the various pressures of life are unmanageable or unbearable. As members of the university community, you often encounter these distressed students in your classrooms, offices, or living environments. Many of these students have not sought or even considered seeking psychological intervention. Thus, your role is a crucial one in identifying and referring students who are in distress. The following guidelines might be useful:
 

SOME SIGNS AND SYMPTOMS OF A STUDENT IN DISTRESS

• Excessive procrastination and very poorly prepared work, especially if this is inconsistent with previous work.
• Infrequent class attendance with little or no work completed.
• Dependency, e.g., the student who hangs around you, or makes excessive appointments to see you during office hours.
• Listlessness, lack of energy, or frequently falling asleep in class.
• Marked changes in personal hygiene.
• Repeated requests for special consideration, e.g., deadline extensions.
• 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 (this may be noticeable in the student’s writings, statements, or actions).
• 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 define the limits of your involvement with a particular student’s problem. It is important not only to hear what the student 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:
 

1. When a student asks for a referral. However, you need some information from the student to know the best referral for his/her needs. It is also a good idea to explore with the student the urgency of the need. It may be that the student is feeling quite upset and some exploration with you will help the individual feel more comfortable being referred.
    
2.  When a student presents a problem or requests information which is outside your range of knowledge.
    
3. A person contemplating suicide. This has the potential of being the most severe of all crises dealt with herein. Although there are wide differences in the seriousness of suicidal thoughts, anytime a student is thinking of it seriously enough to discuss it with you, he or she is probably pretty upset. Although it is important for you to help deal with immediate feelings, a threat to self or others ethically requires strong intervention on the part of the university personnel. 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 then offer to walk with the student to UCS. It is possible to save a life by taking quick, effective action.
    
4. When you believe that you have not been able to adequately assist a student. 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 the student and suggest a specific person or agency that would meet the student’s needs.
    
5. Lack of objectivity on your part. You may have a relationship with the student that would make it awkward for you and/or the student to know personal information about the student. For example, you may be in a role which requires you to provide supervision for or evaluation of the student. You may know the parents of the student or be related to an individual about whom the student wishes to speak. You may also be struggling personally with similar issues. Any of these may interfere with your ability to be a nonjudgmental listener and in some cases may even put you in ethical and legal conflicts. It would be better for you and for the student that a referral is suggested.
6. If a student is reluctant to discuss a problem with you for some reason. You may sense that the student may not feel comfortable or at ease discussing the problem with you. If the student feels uncomfortable, it is best not to pressure him/her into disclosing information. It would be better to suggest that others are available with whom the student might feel more comfortable sharing certain types of information.
7. If a student 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 professional, possibly the Student Health Center.
    

GUIDELINES FOR INTERACTION

• Talk to the student in private.
• Listen carefully.
• Express your concern and interest.
• Paraphrase the essence of what the student has told you.
• Avoid criticizing or sounding judgmental.
• Consider UCS as a resource and discuss a referral with the student.
• If the student resists help and you are concerned, contact UCS to discuss your concern.

Involve yourself only as far as you feel competent to go. Extending yourself can be a gratifying experience when kept within realistic limits.
 

HOW TO MAKE A REFERRAL TO UNIVERSITY COUNSELING SERVICES

1. Suggest the student call or come in to make an appointment. Provide UCS’ telephone number and location at that time.
   
2. If you wish to assist the student directly, call the secretary at UCS while the student is in your office. Allow the student to speak to the secretary to make an appointment. Write down the appointment information (time, date, location) for the student.

If the situation is an emergency, follow #2 above, but state that “the student needs to meet with a counselor today.”

Sometimes it is useful or necessary for you to walk with the student to UCS.
If you are concerned about a student but are uncertain about the appropriateness of a referral, do not hesitate to call UCS for a consultation.