Connections: Identifying and Referring Students in Difficulty
McMaster University appreciates the concern that faculty and staff have for the well being of students and values the role they play in identifying students who are in difficulty. Recognizing the signs of emotional distress and responding with interest and concern may be a critical factor in helping students resolve the problems that are interfering with their academic achievement. The booklet, upon which this folder is based, was designed to assist faculty and staff in this important function.
Identifying and Referring Students in Difficulty
To prevent possible over-interpretation of a single or isolated behaviour, it is useful to consider everything you know about the student and to look for clusters of signs.
1. Stated Need for Help
2. Marked changes in Mood or Behaviour
Changes in normal behaviour may indicate psychological distress. Examples include withdrawal from social interactions and academic work, disruptive behaviour in class, notable changes in energy levels or appearance and unexplained outbursts and irritability.
3. Difficulties Communicating and/or Apparent Distortions of Reality
These may be symptomatic of more severe psychological problems that require professional assessment and treatment. Examples include irrational conversations, disturbing material in academic assignments and paranoid behaviour.
4. Significant Changes in Personal or Cultural Relationships or Identity
Examples include break-ups, changes in family circumstances, illness or death of a family member or close friend, exploration of personal, sexual or cultural identity.
5. Learning Problems
6. Health Concerns
Acute and chronic health issues may impede a student’s progress and increase stress levels.
7. Serious Academic Concerns
Research suggests that counselling is effective in combating student attrition. Students who are considering dropping out, transferring or who are in jeopardy of failing may find assistance beneficial in their decision-making process.
Who is a Student in Difficulty?
A student in difficulty is any student who encounters major obstacles to the successful completion of their academic program. How to Intervene With a Student Who Appears to be in Difficulty: What can you do? If you decide to approach a student you’re concerned about, or if a student reaches out to you for help, the following suggestions might make the opportunity more comfortable for you and more helpful for the student. LISTEN to the student in private when both of you have the time. Give the student your patience, undivided attention, and let them talk with minimal interruption. Often just a few minutes of effective listening is enough to help the student feel cared about and more confident about what to do. ACKNOWLEDGE the student’s thoughts and feelings in a sensitive, compassionate way. Let the student know you understand what they are trying to communicate by reflecting back the essence of what they’ve said. (“It sounds like you’re not used to such a big campus and you’re feeling left out of things.”) EXPRESS CONCERN without making generalizations or assumptions about the student. Be specific about the behaviour which gives you cause for concern. For example, “I’ve noticed you’ve been absent from class lately and I’m concerned,” rather than “Where have you been lately? You should be more concerned about your grades.” OFFER HOPE Reassure the student that things can get better. Help them realize they have options and resources, and that things will not always seem hopeless.
10 Steps to Making an Appropriate Referral
- Listen carefully to the student as they describe their situation.
- Ask questions to clarify that you understand their specific needs.
- If you’re not sure that a particular resource or referral would be appropriate (e.g. counselling) ask.
- Research available material for suitable resources.
- If you can’t find exactly what you’re looking for, try contacting a similar resource and asking if they can refer you to other resources.
- Ask your colleagues or supervisor for help and ideas as needed.
- Offer your best suggestions to the student, and encourage them to choose which options they wish to pursue.
- If the student appears hesitant, or reluctant to access the resources, you can:
- Offer to contact the resource yourself while the student is still in your office.
- Offer to sit with the student while they place the initial contact call themselves.
- Offer to accompany the student to the appointment, if appropriate, and if you feel comfortable doing so.
9. Give the student printed information on the resource to take with them. If you don’t have the printed material, write down the pertinent information for the student to take with them.
10. Offer to follow-up with the student to ensure the referrals were effective, but don’t insist on knowing what the student has done. Don’t hesitate to ask for help when dealing with a student in difficulty. You may wish to consult with one of the offices listed below to sort out the relevant issues, explore alternative approaches and identify other resources. Ask for a consultation:
- If you are concerned about a student and unsure whether or not to intervene.
- If you are uncertain about how to respond to a student’s request for help.
- If a student resists your efforts to assist/refer and you are uncomfortable with the situation.
Situations Requiring Immediate Referral
1. Direct or Indirect Reference to Suicide
- Regardless of the circumstances or context, any reference to committing suicide should be taken very seriously and a mental health professional should be consulted.
- Indirect references to suicide may include the following:
- expressed feelings of worthlessness, hopelessness, or helplessness
- feelings that the world, family, friends would be better of without them
- unreasonable feelings of guilt
- In the event of an actual suicide attempt immediately call McMaster Security, ext 88 (from an internal phone) or (905) 522-4135 to request an ambulance.
2. Threats and Disruptive Behaviours
- Intervention varies with the severity of the offending behaviour.
- Physical violence causing bodily harm and specific threats must be reported immediately to McMaster Security Services (ext. 88) (from an internal phone) or (905) 522-4135.
3. Disordered Eating
- If a student shares concerns regarding disruptive eating patterns such as excessive dieting, uncontrolled binge eating, and induced vomiting after eating, it is important that professional treatment be accessed as soon as possible.
4. Drug and Alcohol Misuse
- If a student appears to be inebriated or you suspect drug use, it is important to attempt to refer the student for counselling.
- In the case of an apparent drug overdose or severe drug reaction call McMaster Security Services (ext. 88) (from an internal phone) or (905) 522-4135 and ask them to call an ambulance.
Security should be called for students requiring immediate help because of life-threatening or severe psychological difficulties:
- Security Services CUC 201 Ext 88 (from an internal phone) or (905) 522-4135
After hours Emergencies
- McMaster Security Services Ext 88 Campus (if calling from on-campus, from an internal phone) or (905) 522-4135
- Hamilton Police Services 905-546-4925 if student is acting in a manner which seems likely to endanger themselves or others and is unwilling or unable to seek help on their own. (if calling from off campus)
When inviting a student to discuss their concerns with you, it is important to be clear about the limits of your ability to keep that information confidential. Even if a student insists, never promise absolute confidentiality. Rather, let them know that you will respect their privacy to the best of your ability, but that certain situations require you to inform others. For example, you should not withhold information about a student if you have serious concerns about their physical safety or the safety of others, or if you have reason to believe they are not competent to care for themselves. Also, you are required by law to report any cases involving the possible neglect or abuse of a minor. If you have any confidentiality concerns, consult Student Affairs or the Student Wellness Centre (SWC) to ensure that the situation is handled appropriately.
More Helpful Hints on Making a Referral
- In making a referral it is important to point out that help is available and seeking help is a sign of strength and courage rather than a sign of weakness or failure. It may be helpful to point out that seeking professional help for other problems (medical, legal, car problems, etc.) is considered good judgment and an appropriate use of resources. For example, “If you had a broken arm you would go to a doctor rather than try to set it yourself.”
- Be direct in letting the student know that you believe it is important to access professional assistance in this situation.
- Restate your concerns and recommendations simply and clearly to qualify what has been said. Make it clear that your suggestions to seek additional resources represents your best judgment based on your observations of the student’s behaviour.
- Point out that a situation does not need to reach crisis proportions in order to benefit from assistance.
- Inform students that there is no charge for student services (covered by compulsory incidental fees) and that all counselling is confidential.
- Disclosure and records can only be released with the student’s written permission, within the limits of the law.
- Ensure the student has the contact name, number, and location of the referral.
- If the student is receptive, suggest they make an appointment.
- Except in emergencies, the option must be left open for students to accept or refuse assistance. If the student takes a defensive posture, don’t force the issue and don’t attempt to deceive or trick the student into going. Try and leave the door open for possible reconsideration at a later time.
- Give the student an opportunity to consider other alternatives by suggesting they might need some time to think it over.
- If you can, prepare the student for what they might expect if they follow your suggestion. Tell them what you know about the referral person or service.
- If the student emphatically says “no”, then respect that decision, and leave the door open for possible reconsideration at a later time.