Speaker 1: Thank you for joining us for a short video regarding how to go about making a counseling referral to a student. My name is Robin Davenport and I'm the Executive Director of Colville University's Counseling Services.

Speaker 2: And I'm Alex Thompson, Counselor and Substance Awareness Educator.

Speaker 1: We created this video to help staff and faculty feel comfortable making a counseling referral. It includes signs and symptoms you should look out for, steps in making a referral, alternative referrals, and additional training and resources available to you. Our hope is that you'll view us as your partners in handling the kinds of emotional and personal matters that might come up for students.

Speaker 2: There are many signs that are connected to a mental health struggle. This list is limited to signs that you may notice or that a student communicates to you. Let's start with signs that need an immediate referral. Hallucinations. If your student is seeing or hearing things that you do not see or hear, and they seem scary or otherworldly, please connect them to counseling services as soon as possible. Currently intoxicated. If a student is coming to class or office hours with alcohol in their breath or smelling of marijuana, this may indicate a serious substance use issue and requires an immediate evaluation. They inform you that they are a threat to others. Threats can be vague or clear. In this instance, assistance from a counselor and security is needed to keep the campus safe. Suicidal thinking and self-harm behavior. This can include vague statements like, I want to go to bed and never wake up, or my life is over, I don't want to go on anymore, or it can include very clear statements of whether they want to harm themselves. In this instance, you don't want to leave this person unattended, and if they are an imminent risk, call 911. If they're not an imminent risk, then you can call the counseling services or Clara Mass Mobile Response with the number below if we're not available. In all of these situations, it's a good idea to call 911 or security for assistance. They can be contacted outside of our office hours and will be able to connect the student to necessary services. If that student is an imminent risk to themselves or somebody else, please call 911 immediately. Less immediate signs and symptoms to watch out for. Here are some additional signs that may not need immediate attention, but could benefit from a counseling referral. Please note that having more than one of these signs does not mean that they need immediate attention from a counselor. A dramatic change in behavior. Examples include work that's come in half-finished or regularly late, when they usually come in on time and well done, a person usually dressing conservatively but now dressing very eccentrically, or you notice an extreme change in hygiene standards. These can indicate major life stressors. Hyperactive behavior. They seem to be moving a lot, fidgeting, or speaking at a rapid rate without a clear cause. Aggressive behavior. They seem constantly argumentative with you or others. Compulsive behavior. They feel a need to do or repeat an action or phrase that doesn't make sense for the situation. Behaviors indicating low self-esteem. This can include a regular need for reassurance or excessive self-criticism about their academic work. Body image issues. In conversation, you may learn that a student has an excessive preoccupation with their appearance. This may lead to concerning behaviors such as extended exercise regimes, excessive calorie counting, or constant disparagement of their appearance. Substance use reliance. A student may inform you of an increased use of legal or illegal substances. You may want to ask them in this situation how much and how often they use, and whether it interferes in their life. If their answers indicate a problem, inform them of our services. Life crises. A student may be dealing with a significant life stressor that goes against their usual coping strategy and overwhelms them. This may include a role transition, grief, family tragedy, or interpersonal dispute. Panic attack. If you notice a student hyperventilating, shaking, sweating excessively, or saying their heart is racing too fast, or that they're experiencing feelings of being overwhelmed or fearful, you may want to bring this person to counseling services if initial efforts to soothe the person has failed. Efforts might include asking them to take deep breaths, providing reassurance, or giving them the room to process their feelings. Displaying a strong emotional response. Assess whether the student's emotional response fits the situation. For example, if a student cries after being told that they might fail a class, that seems pretty appropriate for the situation. However, if someone's reaction is excessive, like they're kicking down your office door or slapping themselves, that might necessitate a counseling referral. Asking for help. A student may indicate to you that their emotional symptoms are difficult to manage and that they're looking for a solution. As a known and trusted figure, you are in the perfect position to encourage them to go see counseling. So remember that there are signs that on their own mean that there needs to be an immediate referral, and there are signs that may just need an encouragement to go to counseling.

Speaker 1: Making a referral. Some of us may feel hesitant about making a referral because it feels intrusive or we're less comfortable with mental health concerns. We may also feel worried that a student will feel offended by our suggestion. However, when communicated in a caring manner, a counseling referral can display our genuine concern for a student's well-being. In general, it's always best when the referral comes from the person who's witnessing the concerning behavior and has some kind of relationship with the student. Such a person is best positioned to provide the referral information. It's not uncommon for our office to receive requests from staff and professors asking us to reach out to a student who, for example, revealed in an email that he's having family problems and has been feeling depressed. The expectation seems to be that a counselor will make a cold call to a student to see if they're interested in counseling. Such outreach efforts are often ineffective and unwanted by the student. I think we can see why. Imagine for a moment revealing to your friend that you've been feeling down lately and then receiving a random phone call from a counselor offering you assistance. It might feel like an invasion of privacy, especially if you did not request that your friend have a counselor reach out to you. The better and more effective approach is for you to meet with the student and have a conversation about your concerns. In the case of the student's distressing email, you might begin by scheduling a time to meet with the student. Next, note your concerns by referring to the behavior. You might say, Em, I saw your email and I was concerned that you indicated that you're having some family problems and are feeling depressed. Next, generalize about the behavior you're witnessing. Em, when I receive emails like that, it's often a sign that a student may need some extra assistance. Might this be the case for you? Suggest a referral to counseling services. Em, were you aware that there's a counseling service here on campus that provides free and confidential counseling to students? They're located right in the Newman Center on the second floor of the Wellness Center. Normalize the referral for the student. You might say, Many students find it very helpful and relieving to share their personal concerns with a professional counselor who's a trained listener and can assist you in brainstorming ways of approaching your difficulties. Offer to assist students in connecting them with a counselor. You may begin by simply giving them one of our brochures or you can refer them to our website. With their permission, you might offer to call over to our office so they can schedule an appointment immediately. And if the student matters seems a little more pressing, you can even offer to walk over to the center with them. In such cases, please call us as a heads up. A counselor can do an outreach to a student and that's something you can offer to facilitate. We just strongly encourage you to obtain the student's permission first before we try to contact them. We wanted to say a few words here about mandated counseling. Our experience tells us that if a student is not voluntarily seeking counseling, but merely going through the motions because of a mandated requirement, little headway will be made. We've heard many stories from students whose parents required them to go to counseling in high school and the experience was negative because they didn't feel like they had a say. True change generally occurs when a student is invested in the process. Our philosophy is to value the free agency of our clients and promote their autonomy. We believe this to be in accordance with the mission of an institution of higher education. Consequently, we do not endorse mandated counseling referrals.

Speaker 2: Alternative Referrals Imagine a student who tends to fidget in their seats, assumes they'll do poorly in your class, and has lower than average grades. Then the student emails you during midterms and tells you that they aren't doing well because they have difficulty concentrating and the family circumstances are making things more difficult for them. They end up emailing asking for an extension on the midterm. From my experience, this student might benefit more from the Academic Success Center or from their academic advisor. This is despite having poor symptoms on my previous list. This is because their main concern seems to be more on the academic side rather than mental health related. Their lack of confidence in their academic skills or poor performance may lead to nervousness, low self-esteem, and other emotional symptoms. To help this student, the Academic Success Center can provide academic advice, evaluate students for necessary accommodations, and provide targeted skills training. I provided their information on the screen right now. Other Resources There are additional resources on our website that you can suggest to your students. These include apps, articles, support groups, screening tools, hotlines, and much more. You may want to note some of these hotlines or apps on your phone or download the apps on your phone for easy reference for those students you might be concerned about. Other Trainings Available For more details on helping someone who is dealing with suicidal ideation, I strongly recommend taking the online course, Ask, Listen, and Refer. It can give you information about what to say and how to interact during these delicate situations. A few times a semester we provide suicide and prevention training specifically for non-mental health professionals. Check your email about announcements regarding this training.

Speaker 1: We appreciate your taking the time to view our short video. Counseling Services remains your partner in ensuring that our students have a fulfilling college experience. Please don't feel like you have to grapple with any concerning student issue on your own. We invite you to contact our office at any point for consultation and guidance. For immediate assistance, call 973-618-3307. For less immediate needs, email us at counseling at caldwell.edu.