Students in Psychological Distress and/or with Mental Illnesses
During their time at Skidmore, students will typically make huge strides in their intellectual and psychological development. They may fall in love for the first time, with a person or a subject matter or a cause. They will likely experience failure and rejection on a scale that is new to them. They will struggle, we hope, to understand who they are and what matters to them in a world that looks more complicated than they ever realized. They will move to a new place, make new friends and build a life for themselves, and four years later they will be expected to repeat that process. They may not always recognize themselves, nor will their friends and families. All of this change, challenge and turbulence is ultimately usually a good thing.
Most college students make their way through these challenges and changes without serious incident. Some however, struggle more, suffer more and need help. There is growing evidence that the incidence of serious mental illness on American college campuses is increasing. More students are arriving on campuses already taking psychiatric medications, and Counseling Centers are reporting both an increased demand for services and an increase in the severity of student symptoms. Here at Skidmore, we are no exception to those national trends. Over the last eleven years, we have experienced a significant increase in both the number of students seen at the Counseling Center and in the number of appointments offered to those students. During the 2010-2011 academic year, 18% of the student population, almost 500 students, sought help at the Counseling Center for difficulties ranging from trouble sleeping to roommate conflicts to anorexia, depression and bipolar disorder.
The Role of Faculty and Faculty Advisors
Faculty members, because of their close contact with students, are in a unique position to notice students who might be distressed and struggling. An expression of interest and concern from the right person at the right time can make all the difference in the world. College should be, at different points, exciting, overwhelming, challenging and stressful. Ideally that stress is balanced with support, in the forms of teaching, advising, friendship, mentorship and other kinds of help. The vast majority of students with psychological difficulties will be able to have successful and productive academic careers, with appropriate support and intervention. We offer the following guidelines about helping students:
How to help
- Trust your gut. If you experience a sense of unease or concern about a student, it is important to pay attention to your inner signals.
- Use your common sense. You don't need to be able to officially diagnose someone with Major Depression to know that they are in trouble.
- Listen carefully. It takes time and close attention to determine that the student who comes in ostensibly to talk about changing their major also wants to talk about their sense of confusion and/or isolation at Skidmore. Sometimes important information will emerge over time as the student begins to know and trust you.
- Intervene sooner rather than later. It is tempting to hope that difficult situations will resolve themselves. Some do, but in our experience, early intervention is both easier and more effective.
- Know your limits. Different faculty members will have different roles in students' lives. Being a teacher, advisor and mentor does not mean being a therapist or caretaker.
- Consult with colleagues. As more college students appear to be suffering from more serious types of mental illnesses, they will present with more acute needs, more overwhelming symptoms and more complicated family and life circumstances. We all need support and help to work with these students. The Counseling Center encourages and welcomes calls and contacts from faculty members about situations of concerns.
When to Refer
Any of the following signals would be reasonable grounds for suggesting to a student that he or she come in to the Counseling Center for an initial consultation. The Counseling Center is located on the first floor of Jonsson Tower, across from Health Services. We are open Monday through Friday from 9:00 a.m. to noon and 1:00 p.m. to 5:00 p.m. Our services are confidential and free of charge to all currently enrolled Skidmore students. Students are welcome to call (580-5555) or stop by to set up an initial appointment.
- Urgent concerns. Urgent concerns are mental health emergencies where you are worried about the student's health and safety or the health and safety of others. Examples include any clear threat of violence to others, severe confusion, disorientation or hallucinations, and an inability to take care of the basic tasks of daily life, such as eating and hygiene. Another clearly urgent situation is when a student expresses some intent to hurt him- or herself. Most, but not all, individuals who attempt suicide make some communication about their state of mind before acting. These types of communications can range from direct threats to kill themselves, "goodbye letters" and giving away possessions, to vague statements about life not being worth living. Any communication about suicide or potential for self-harm should be taken very seriously. While the types of situations listed above are not frequent, they do require immediate intervention. You can contact the Counseling Center at 5555 and/or Campus Safety after hours at 5566. Someone from the Counseling Center is always on call during the fall and spring academic terms and can assist you immediately.
- Marked behavior changes. These types of changes might include withdrawal from a student who is typically very engaged in class, excessive tardiness, exaggerated emotional responses that are not appropriate in a classroom context or high levels of anxiety that interfere with academic performance. While it is normal for stress to occasionally interfere with a student's academic life, if the interference stretches out over more than two weeks, or if it involves a dramatic drop in performance or presentation, intervention is definitely warranted. Your own nagging sense of concern about a student or a sense that "something is not quite right" is a potentially important indicator here as well.
- Personal communication. Many students confide directly in faculty members, either in person or through journals or other communication, that they are in distress and struggling. Other types of communication are less direct, and might involve repeated requests for personal conferences, vague descriptions or references to "personal problems" or visible signs of self-injury such as recent cuts. Depending on your relationship with the individual student, the context in which you interact, and your own philosophy and personal limits, you may choose to engage the student directly in a conversation about what is troubling them or you may choose to simply suggest that they consult with the Counseling Center to get additional support.
- You feel over your head. Different faculty members will have varying levels of comfort discussing more personal issues with students. However, if you find yourself having the same conversation over and over again with a student, if you find yourself feeling stressed out or overwhelmed about the situation they are describing to you, if you feel angry or afraid of the student or if you find yourself wanting to adopt or rescue the student, you have probably overextended yourself. Professional staff at the Counseling Center can help you sort through the situation, determine what is most appropriate and helpful and consult with you about various options.
How to Talk with Students about Your Observations and Concerns
If you have contact with a student that you believe may benefit from professional assistance, the following suggestions can make that conversation, or series of conversations, as productive as possible.
- Communicate in private. If you can, set aside time during office hours or after class to speak with a student. Doing so maximizes the chances that you will actually be able to help the student talk about what is most important and also communicates to the student that you take their situation seriously.
- Try not to beat around the bush. Use simple and direct language to let the student know that you are worried about them. Often, listing the different changes you have observed and their impact on the student's classroom performance is a good way to start the conversation. Describing the problems in behavioral terms will avoid sounding judgmental and it may mean the student will be less defensive and more receptive. It's hard to argue or avoid the facts. "I notice you have been missing a lot of classes lately" or "you have stopped contributing to class discussion" or "I wanted to talk with you about what you wrote in your last journal entry" are potentially good opening statements. Most distressed students will be relieved and appreciative that someone has noticed them.
- When in doubt, listen. Typically, in situations where individuals are suffering and struggling, it is tempting to rush in to reassure, advise, diagnose or "fix" the problem. Often, however, such actions can seem premature, condescending or ill-fitting. It is usually more helpful to be a sympathetic sounding board, someone who can help a student discuss their situation in a mature and considered way.
- Know some facts about the Counseling Center. Giving students concrete information about our services makes accessing help easier. Many students can be hesitant about seeing a therapist, so your positive and matter-of-fact attitude can help de-stigmatize mental health services. You can let them know where we are located (first floor of Jonsson Tower) and that a high number of Skidmore students use our services for a range of difficulties. The Counseling Center is accessible, free of charge, and our services are confidential. We cannot share information with anyone, including information about whether a student has made an appointment with us, without that student's permission. We can generally see students for a full initial appointment within a few business days of their coming in initially. We also have urgent appointments daily, for those students who are in crisis. If you are concerned about a student who you believe is in crisis, please call ahead and let us know that student may be coming in to see us. If a student is currently seeing one of our staff members, we cannot share specific information with you about them without their permission, but we welcome information, concerns and questions from you.