Recognize

You may notice one or several indicators that could suggest that a student is experiencing difficulty. You may have a gut-level feeling that something is amiss. A simple check-in with the student may help you get a better sense of their situation.

It is possible that a student exhibiting just one of the signs of distress is only having an off day. However, any single safety risk indicator (e.g., a student writes a paper expressing hopelessness and thoughts of suicide) or a cluster of lesser signs (e.g., emotional outbursts, repeated absences, and noticeable cuts on the arm) indicates a need to take action to support the student. It is important to also recognize that while these indicators could signal struggling, each indicator could also mean something else. Distress manifests itself differently in different people, so these indicators are not a checklist. Trying to understand and perceive the student as a whole person will be helpful in figuring out how and whether to take action.

Indicators

Academic Indicators of Distress

  • Repeated absences
  • Missed assignments, exams, or appointments
  • Deterioration in quality or quantity of work
  • Extreme disorganization or inconsistent behavior
  • Written or artistic expression of unusual violence, morbidity, social isolation, despair, or confusion; essays or papers that focus on suicide or death
  • Continual seeking of special provisions (extensions on papers, make-up exams) outside of formally-obtained academic accommodations
  • Patterns of perfectionism (e.g., can’t accept themselves for not getting an A+)
  • Overblown or disproportionate response to grades or other evaluations

Physical Indicators of Distress

  • Deterioration in physical appearance or personal hygiene
  • Excessive fatigue, exhaustion; falling asleep in class repeatedly
  • Statements about changes in appetite
  • Statements about changes in sleep
  • Noticeable cuts, bruises, or burns
  • Frequent or chronic illness
  • Disorganized speech, rapid or slurred speech, or confusion
  • Unusual inability to make eye contact
  • Arrival to class bleary-eyed or smelling of alcohol

Behavioural and Emotional Indicators

  • Direct statements indicating distress, family problems, or loss
  • Difficulty controlling emotions
  • Expressions of anger or hostile outbursts, yelling, or aggressive comments
  • More withdrawn or animated than usual
  • Expressions of hopelessness or worthlessness; crying or tearfulness
  • Expressions of severe anxiety or irritability
  • Excessively demanding or dependent behaviour
  • Lack of response to outreach from course staff
  • Shakiness, tremors, fidgeting, or pacing

Safety Risk Indicators

  • Written or oral statements that mention despair, suicide, or death
  • Severe hopelessness, helplessness, depression, social isolation, and withdrawal
  • Statements to the effect that the student is “going away for a long time”
  • Written or oral expressions of a desire to injure or kill someone else

If a student is exhibiting any of the safety risk indicators above, they may pose an immediate danger to themselves. In these cases, you should contact professional resources on your campus (such as counselling, health, and emergency services) and ask for assistance.

Emergency Indicators

  • The student is behaving in a physically or verbally aggressive manner toward themselves, others, property, or animals
  • The student is unresponsive to the external environment. For example, if they are:
    • Incoherent or passed out
    • Demonstrating a severe disturbance of cognitive, behavioural, or emotional functioning
    • Displaying disruptive behaviour that appears to be out of control
  • The situation feels threatening or dangerous to you.

In these or similar situations, call the campus security/local police and ask for immediate assistance.

Other Factors

  • Expressions of concern about a student by their peers, teaching assistant, or other colleagues
  • A hunch or gut-level reaction that something is wrong

Students who are expressing themselves in a verbally aggressive and potentially violent manner

When a student is faced with a frustrating, seemingly insurmountable challenge, they may express anger toward others. Additionally, enhanced access to drugs or alcohol may increase some students’ propensity for behaviour that is aggressive. Certain social situations may also elicit aggressive responses. In some cases, the aggression may be indicative of the onset of a mental health challenge. It is worth noting that—in spite of recent high-profile tragedies—students rarely act out violently.

Violence cannot be predicted, but there are some observable indicators that suggest a person may pose a danger of becoming violent. These include difficulty controlling emotions or behaviour, or difficulty controlling aggressive impulses. Since instructors will not always know the historical or immediate background of a particular student, it is important for them to be aware of “concerning behaviours” and to respond appropriately.

Misperceptions about the relationship between mental health challenges and violence contribute significantly to stigma, discrimination and social exclusion. Studies indicate that people living with mental health conditions are no more likely to engage in violent behaviour than the general population (September, 2011)

People living with mental health conditions may experience stigma, discrimination and social exclusion that significantly impacts on their lives. Misperceptions about the relationship between mental health challenges and violence contribute significantly to these experiences. Studies have shown that people living with mental health conditions are no more likely to engage in violent behaviour than the general population. However, public perceptions, often influenced by the media, are contributing to attitudes that have a significant impact on the lives of people with mental health challenges.

There is minimal research on the victimization of individuals with mental health challenges. One in four individuals with a mental health challenges are likely to be a victim of violence in a given year. People with mental health challenges often face socio-economic deprivation, such as unemployment, poverty, lack of social supports and inadequate housing and/or homelessness. These factors increase vulnerability to victimization. The stress and trauma of being victimized can heighten an individual’s sense of vulnerability and anxiety, which can exacerbate symptoms of the mental health challenges, increase the likelihood of homelessness, and diminish quality of life.

Recent victimization is a risk factor for violent behaviour within the general population, as well as among people with mental health challenges. In a vicious circle, victimization, past history of crime, and acute psychiatric symptoms in turn increase the risk of further victimization. Thus, when examining the research on the prevalence of violence among individuals with mental health challenges, it is also important to consider the rates of victimization faced by such a vulnerable group.

What you can do:

  • If you are concerned that a student may be violent, do not arrange to meet with them until you have consulted senior personnel or campus security to determine if this is an appropriate course of action.
  • If a student seems to become angry during a meeting, ask the student to reschedule a meeting with you after they have taken more time to think about their response.
  • Stay calm and set limits by explaining clearly and directly what behaviours are acceptable. For example, you could say, “You certainly have the right to be angry, but using abusive language is not OK.”
  • Avoid meeting alone or in a private office with the student by enlisting the help of a co-worker.
  • If you feel it is appropriate to continue meeting with a distressed student, remain in an open area with a visible means of escape. Remain at a safe distance, sit closest to the door, and keep a phone available to call for help.
  • Assess your level of safety and be cognizant of your intuition. Call the campus security/local police if you feel the student may harm themselves, someone else, or you.
Calls to Action: Recognize, Respond, and Refer