How to recognize distressed students
What can you do? Referral for the student, consultation for you. In the future, there will be a CARE FORM link here for you to fill out, but at this time you may email the counselor at email@example.com for non-urgent needs. In the event of an emergency or situation that elicits immediate intervention, please dial 911. The Behavioral Intervention Team and Counseling Services play a secondary role to all urgent circumstances and should be contacted only after initial notifications are made in urgent situations.
Behavioral Intervention Team
The Behavior Intervention Team or (BIT) is a group of representatives from across campus that work in departments with high levels of student contact. This group discusses students who are mentioned as concerns either via incident report, reports directly to them made by faculty and/or reports made through Campus Safety. This team monitors students of concern and discusses care plans for referrals to campus resources and other resources that may help the student. Faculty may also be contacted with recommendations on management of the student in the classroom. Again, the information becomes protected via HIPPA and FERPA, so those who refer students will not be able to be given any specific information on interventions taken.
At one time or another everyone feels upset or distressed. However, there are three levels of student distress which, when present over a period of time, suggest that the problems are more than the "normal" ones. (This is adapted from NaBITA threat assessment tool):
- Changes in academic performance in the classroom
- Significant drop in examination scores
- Change in pattern of interaction
- Changes in physical appearance
- Problems concentrating and remembering things or making decisions
- Repeated request for special consideration
- New or regularly occurring behavior which pushes the limits and may interfere with class
- Management or be disruptive to other students, faculty or staff
- Unusual or exaggerated emotional responses
- Persistent sadness or unexplained crying
- High levels of irritability or inappropriate excitement
- Highly disturbed behavior
- Outbursts of anger
- Inability to communicate clearly
- Irrational conversation or speech that seems disconnected
- Loss of contact with reality (seeing/hearing things that are not there, beliefs or actions at odds with reality)
- Suspiciousness, irrational feelings of persecution
- Statements related to death or dying or feelings of hopelessness
- Threats of harming self or harming others
WHAT YOU CAN DO TO HELP
Responses to Level 1 and 2 Behavior
- Talk to the student in private when you both have time
- Express your concern in non-judgmental terms
- Listen to the student and repeat the gist of what the student is saying
- Identify options available to the student
- Clarify the costs and benefits of each option for handling the problem from the student's point of view
- Respect the student's value system
- Ask if the student is considering suicide
- Make appropriate referrals if necessary
- Make sure the student understands what action is necessary
- Call appropriate University resources for guidance or to refer
Responses to Level 3 Behavior
- Stay calm
- Find someone to stay with the student if possible
- Call 911 if there is an immediate risk of harm to self or others.
- Call Campus Police after calling 911 to advise when situation is high risk
- After crisis level needs responded to, refer to Behavioral Intervention Team (a link will be provided here in the future). At this time, you may contact Counseling Services at firstname.lastname@example.org to provide information regarding the student and the situation which will be relayed to the BIT.
Communicating with Distressed Individuals
- Express your authority with non-verbal cues…be confident in your approach.
- Sit or stand erect.
- Make direct eye contact with the individual.
- Conduct yourself in a serious manner.
- Speak clearly and distinctively.
- Utilize your reflective listening skills.
How and When do I Refer a Student to the Behavioral Intervention Team?
Referrals should be made to the BIT for level 2 and 3 behaviors. Essentially, any behavior that concerns you for the students’ safety or those around them would warrant a BIT referral. Faculty and staff can make a referral/report to the BIT team by filling out the referral form found on the homepage of Apache Access. The link is located on the left side navigation below “Employee Links” and is called “TJC Advocate System: Online CARE Report."
The BIT team meets weekly throughout the long semesters and will review your referral at the next meeting. The multidisciplinary panel of professionals will determine, based on reasonable judgment that relies on current knowledge or the best available objective evidence, whether a student may pose a direct threat to themselves or the campus community. Be assured that BIT exists to assist students and will handle all referrals professionally in an effort to best meet the needs of students and the TJC community.
How do I make a counseling referral to a student?
- Talk to the student in a private area.
- Listen to thoughts and feelings, allowing the student to talk.
- Be supportive and avoid criticizing, judging, and/or giving advice outside of the academic arena.
- Explore options instead of trying to "fix it" for the student.
- Emphasize that seeking help is a sign of courage, health and maturity, not weakness.
- Contact counseling services for consultation if the student resists help and you are concerned about what to do.
- Encourage the student to fill out the online counseling request form at www.tjc.edu/counselingappointment. You may want to do that together in your office.
What types of services are offered by Counseling Services?
- Consultation to Faculty, Staff and Administrators (while protecting client privacy)
- Crisis intervention
- Individual personal counseling – short term, solution-focused
- Couple counseling – also short term, solution focused
- Group counseling of various kinds (may change by semester).
- Referral to a ETMC Campus clinic for consideration of medication
- Referral to a psychiatrist as needed for consideration of more complex psychiatric medication
- Educational presentations, consultations and outreach programs
- Other referrals as appropriate, both in the community and on campus
If I refer a student for Counseling, should I follow-up by calling or emailing Counseling Services?
We understand that you will be interested in the well-being of the student and making sure they took your referral, but we are bound by the principles of CONFIDENTIALITY as defined by the Code of Ethics & Standards of the American Counseling Association, American Psychological Association, state and federal laws (such as HIPAA laws). If the student wishes; he or she may give us permission to release certain private information to you by signing a "release of information" form in our office.
Responding to Suicidal Concerns
When a student makes any reference to suicide, threat of suicide, or attempt at suicide, a judgment should be made by a mental health professional about the seriousness of a possible suicidal thought or behavior. Suicide attempts are first and foremost a medical emergency.
1) Stay calm and 2) Call 911. 3) Call Campus police at 903-510-2222
- To Save a Life Remember QPR (Question, Persuade, and Refer)
- Question the person about suicide • Persuade the person to get help
- Refer for help – students can report locally to either emergency room to be evaluated for mental health needs. They may also report to ETMC Behavioral Health or the Andrews Center (the local mental health authority). The best chance for immediate and guaranteed response is reporting to the emergency room. Mental Health Professionals will assess and determine the level of needed treatment. For personal safety of yourself and the student, and to avoid legal liability for yourself or the college, you should NOT transport the students. Allow a family member or Campus Safety to provide the transport.
Please inform either the Counselor or the Behavioral Intervention Team of any suicidal statements or actions of students. This should be done even if the student appears to have stabilized and/or sought treatment. Please email email@example.com with this information.