Promoting Well-Being: Supporting Students in Distress

While there is no single best approach for responding to distressed students, there are some broad principles that can guide you. Below you will find information about how to recognize warning signs, express concern, listen, and make a referral to counseling.

In addition, please refer to the university’s Helping Students in Distress page for more information on what to do in specific situations and detailed information on services for WashU students.

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Recognizing Warning Signs

Recognizing the warning signs of distress does not require special training or expertise. It does, however, require awareness.

Physical

• Sudden increase or decrease in weight
• Lethargy, lack of energy
• Falling asleep in class
• Frequent illness

Cognitive & Emotional

• Changes in concentration or motivation
• Irritability or anger
• Apathy or hopelessness
• Emotional outbursts, crying
• Direct statements about family or personal issues
• Papers expressing despair or rage
• Mention of harming self or others

Behavioral

• Poor hygiene
• Withdrawal from interactions
• Disjointed or incoherent speech
• Procrastination

Academic

• Large changes in academic performance
• Increased tardiness or absences
• Missed assignments
• Repeated requests for special consideration (e.g., deadline extensions)

Expressing Concern and Listening

• Explain your concerns. Comment on specific, observable behavior. Then wait silently for a moment to see if the student offers a response. (e.g., “I noticed that you seemed tired during class. Is everything okay?”)
• Don’t assume that a mental health concern is the reason for the behavior, just open a dialogue.
• If a student shares their concerns, it is important to listen patiently and receptively. You are providing support for a student when they feel heard and understood.
• It may be difficult for the student to find the right words to explain; be okay with the silence and give them space to think.
• Communicate your understanding by repeating back the essence of what the student has said.
• Offer privacy, but don’t promise complete confidentiality. You will need to report if you believe the student or someone else is at risk of harm. Also, if a student tells you of an incident of sexual harassment or violence then you need to report this to the Gender Equity and Title IX Compliance Office.
• Validate what the student says (e.g., “It sounds like you have a lot going on.” “That sounds hard.” “It’s understandable that you would feel that way.”) and show that you appreciate them reaching out (e.g., “Thanks for letting me know.” “I’m glad that you came to talk to me about this.” “I appreciate you sharing this with me.”).

Things to Avoid

• Minimizing the student’s concerns (e.g., “Your grades are so good.” “You’re doing fine.” “I think you’re overreacting.”).
• Providing so much information that it overwhelms the student.
• Sharing your own experiences in a way that might be triggering or might take focus away from the student.
• Making negative judgments or implications about character or personality:

Don’t say:	Do say:
“Why are you coming to me just as the assignment is due?”	“I’m glad that you came to talk with me about this.”
“Why have you missed so much class lately?”	“I’ve noticed that you missed a few classes. How are you doing?”

Making a Referral to Counseling

It is important to be realistic and open about your own limits of time, energy, and training. You do NOT need to take responsibility for the student’s problem and try to solve it for them.

You do NOT need to act as a therapist. Instead, your goal should be to help students find the professional help that they need.

For example, it is ok to say, “I can help you work out a plan to catch up on the course work, but I’m not the best person to help you manage the other things you are dealing with at the moment. Let’s talk about who might be able to help you with that…”

When to Make a Referral

In addition to recognizing warning signs, consider referring a student when:

• the student’s distress seems to be increasing, and/or if it has been going on for more than a couple of weeks.
• you feel you have reached the limits of your ability to help the student.
• you identify too closely with the student and/or the problem.
• a student expresses thoughts of suicide. Ethically, intervention on your part is necessary.

Tips for Making a Referral

• Suggest options, gently encourage them to seek support.
• Assure them that seeking counseling is a sign of strength.
• Ask what help they would prefer and support the student’s agency.
• Tell the student why your observations have led you to believe that talking with a counselor may be helpful.
• Share your knowledge of campus counseling services, a simple description may alleviate the student’s anxiety about the process.
• Talk about making one appointment rather than “going to counseling.”
• Respect the student’s right to reject or to think about the referral suggestion first, unless there has been talk of suicide. The student needs to be motivated and ready to accept help – this cannot be rushed or forced. The student may have a variety of reasons that you are not aware of for deferring or declining formal support.

Don’t say:	Do say:
“You need to see a psychiatrist or counselor.”	“It sounds like it might help to talk with someone about this; what do you think?”
“Some types of students just need help to get through the semester.”	“I’m glad you’re thinking about this, your health is important.”
“I’ll just call Habif for you now.”	“Would you like me to call someone for you?”

Referral Contact Information

Below are printer-friendly handouts with information about counseling services available to students:

• Danforth Campus
• Medical Campus