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Referral guide for faculty and staff

As Augustana faculty, staff, or residential hall personnel, you often encounter distressed students. Therefore, you are critical in identifying students who would benefit from counseling services or other supports.

We offer warning signs and distress indicators below as well as how to communicate concern within your role and how to refer students to additional supports if necessary. The No. 1 priority is for you to trust your gut-reaction when you believe something is wrong. It will not damage your relationship with a student to express your concerns in private and to ask if the student needs additional support.

It is also important to note that asking someone directly if they are going to kill themselves does not increase the chances of them killing themselves; however, it may help them get the support they need to get through this difficult time in their lives.

Five big warning signs

The following warning signs are indications that a student is experiencing distress and is unable to cope with that stress appropriately. It is important to express your concerns in private and listen for other indicators of distress or disability that may warrant further action. See “Guidelines for interaction” and “How to make a referral” below for more information.

  1. A change in personality
  2. Uncharacteristic anxiety, anger, or moodiness
  3. Social withdrawal and isolation
  4. Lack of self-care or risky behaviors
  5. A sense of hopelessness or feeling overwhelmed

Safety risk indicators

The following indicators are signs that the student may pose an immediate danger to self or others. If you believe the student is imminent danger or you feel unsafe, immediately call public safety at 309-794-7711 or dial 911. These indicators are adapted directly from the University of California’s “Promoting Student Mental Health.”

• Written or verbal statements that mention despair, suicide, or death
• Severe hopelessness, depression, isolation, and withdrawal
• Statements to the effect that the student is “going away for a long time”
• Physical or verbal aggression that is directed at self, others, animals, or property
• The student is unresponsive to environment; he or she is incoherent or passed out.
• The student is disconnected from reality/exhibiting psychosis.
• The student is displaying unmitigated disruptive behavior.
• The situation feels threatening or dangerous to you.

Other indicators of distress

Students that exhibit a combination of the following indicators should be of particular concern and warrant further action. See “guidelines for interaction” and “how to make a referral” below for more information.

Academic indicators
Repeated absences
Missed assignments
Extreme disorganization
Erratic performance
Written/artistic expression of unusual violence
Written/artistic expression of despair or isolation
Essays on suicide or death
Continual seeking of special provisions
Patterns of perfectionism

Behavioral/emotional indicators
Direct statements of distress, conflict, grief, or economic hardship
Angry/hostile outbursts
Aggressive comments
Unusual withdrawal behavior
Unusual animated behavior
Expressions of severe anxiety or irritability
Excessive demanding or dependent behavior
Lack of response to outreach
Shakiness or tremors
Fidgeting or pacing

Physical indicators
Deterioration in physical appearance
Lack of self-care or personal hygiene
Excessive fatigue or exhaustion
Falling asleep in class repeatedly
Visible changes in weight
Statements about change in appetite or sleep
Noticeable cuts, bruises, or burns
Frequent chronic illness
Disorganized, rapid, or slurred speech
Unusual inability to make eye contact

Guidelines for interaction

Oftentimes, you are the gatekeeper to a student seeking mental health treatment or support; however, your role is not to treat the student or process their distress. It is to show genuine concern and to help them seek services. The following guidelines will help you communicate effectively with a distressed student and keep the interaction focused on seeking treatment instead of providing treatment.

• Speak to the student in private, at a time when you have adequate time talk (ex: after class, not right before).
• Listen carefully and show genuine interest and concern.
• Reflect back to the student what you hear him/her saying.
• Refrain from critical or judgmental comments or questions.
• Offer specific, non-judgmental descriptions of behaviors that concern you (ex: "I'm concerned that you've slept through class three times this week").
• Try to determine if student has a support system (friends, family) and if so, are they reaching out to those people.
• Involve yourself only as much as you feel comfortable; be careful about getting overly involved.
• Describe the resources available on campus (Dean of Students, Counseling Service, Campus Ministry, Reading/Writing Center, etc.).
• Give the student a sense of hope that things can improve with a new plan of action

If a student resists help and you are worried, contact either the Student Counseling Service (309-794-7357) or Dean of Students (309-794-7533) for a consultation.

How to make a referral

Talking with faculty or staff often helps students work through minor problems; however, if a student has a problem that is outside of your area of knowledge or if a student does not improve after several meetings, you should consider referring that student to counseling services. Of course, if a student is a potential danger to himself or others, you should call counseling services immediately at 309-794-7357. The following guidelines will help you in making a referral:

• Suggest in a straightforward fashion that the student make an appointment; explain that your referral is based on what the student has told you or what you have observed about their behavior.

• Reassure the student that it is normal to experience some problems during the college years and tell them that a large percentage of Augustana students seek help at counseling services.

• Ask the student to call counseling services at 309-794-7357. Note: some students may feel more comfortable calling to make the appointment from your office or having you call to make the appointment for him/her. This is fine.

• If the situation is an emergency bring the student to Founders Hall 206 immediately.

• If you are concerned about a student but are uncertain about the appropriateness of a referral, feel free to call one of our staff for a confidential consultation at 309-794-7357.

• After referring a student, it is a good idea to have follow-up contact with that student to show your continued interest in their welfare and to check in on the student.

How to respond to a volatile student

Below is some helpful advice in the event a student becomes agitated, out-of-control, or violent. This handout also provides tips on how to handle a crisis: “Ten Tips for Crisis Prevention from the Crisis Prevention Institute.”

• If you feel unsafe or are concerned about the student's safety, contact Campus Security at 309-794-7711.
• If you feel comfortable and safe, ask the student to meet with you outside the classroom so you may speak privately.
• Remain CALM during the interaction; your demeanor can prevent the situation from escalating and may actually help the student calm down.
• Be respectful in your interaction, but set clear and firm limits: "I can see you are upset and I want to help you, but in order to do that I first need you to ..."
• Be patient and listen carefully to both the verbal and non-verbal message the student is conveying; acknowledge that you understand their concerns and feelings.
• Be concrete in identifying the presenting issue and suggesting an immediate plan of action.<
• Encourage the student to accompany you to the Counseling Service or to the Dean of Students Office to further discuss the situation.
• Respectfully inform the student of possible consequences should he/she continue to behave or act inappropriately (dismissal from class, contact security, etc.).