Erratic moods in class. Struggles to complete assignments. Essays that describe thoughts of self-harm or suicide.
Students in the grip of mental distress often show signs of it in their academic work and classroom behavior. Faculty members, especially those who interact frequently with them, are well placed to pick up on warning signs. But professors often need help figuring out how to respond.
“What they tell us is, ‘Students come to us and tell us things, but we’re not quite sure what to do next,’ " says David R. Reetz, director of counseling services at Aurora University, near Chicago.
Almost all colleges now have some kind of rapid-response team that will intervene when there’s an immediate emergency — a campus shooter, a bridge jumper. Beyond that, many colleges offer training to equip faculty and staff members to identify and handle students’ mental illness.
Mr. Reetz coordinates the annual survey done by the Association for University and College Counseling Center Directors, which has 830 institutional members in the United States and abroad. In the 2014 survey, 58.5 percent of the colleges said they offered formal or informal faculty training. The proportion hasn’t changed much since 2007, when 59 percent of respondents said they did. That’s not enough, says Mr. Reetz. “The unfortunate piece is that many institutions of higher education do not see the value in this training.”
Training, when it does happen, takes many forms. Orientation for new faculty members often includes presentations on mental-health issues and services; most colleges make how-to-help brochures and other basic resources freely available through health or counseling centers. The University of California at Berkeley’s University Health Services website, for example, lists “indicators of distress,” phone numbers to call for advice and assistance, and a protocol chart to consult “when faced with a disruptive or distressed student.”
Some institutions rely on general emails distributed at the beginning of the semester. At Columbia University, faculty members receive messages that list warning signs and what to do if they encounter a student in mental distress, says Rachel Adams, a professor of English and American studies and director of the university’s Center for the Study of Social Difference. . “But then you get thousands of emails, and by the time you might need that help, most people have lost sight of that,” she says. The information in the email is accurate, she adds, “but it’s far from adequate.”
25% OF STUDENTS SEEKING SERVICES ARE TAKING PSYCHOTROPIC MEDICINE
The emails represent only one part of the university’s strategy, says Richard J. Eichler, executive director of counseling and psychological services at Columbia. All undergraduates must take a core-curriculum humanities course, and those instructors are offered basic training in how to spot students in distress. “It’s not mandatory, but attendance is pretty good,” he says.
Most important, Mr. Eichler says, is for the counseling staff to maintain strong relationships with residential-life and academic-advising staff members and with administrators. Advisers and deans are often in a position to spot and refer distressed students, or to help faculty members do so. “So we’re there in an ongoing way,” Mr. Eichler says.
At Columbia and elsewhere, administrators and other interested parties stand ready to help — but first someone has to alert them to signs of distress. Ms. Adams has written about how difficult it can be to find effective ways to intervene on behalf of students who suffer from depression, which along with anxiety is one of the top two mental-health issues on campus. “The deans are allegedly keeping an eye on the students,” she says. But “if the student is already doing self-destructive things, they’re not going to call the dean.”
Many colleges rely on a layered approach — what Sharon Kirkland-Gordon, director of the counseling center at the University of Maryland at College Park, calls “safety nets all across campus.” Maryland has about 12,000 resident students; each dormitory includes an affiliated psychologist, and each college dean has a working partnership with a psychologist as well.
As is true almost everywhere, Maryland’s faculty and staff members aren’t required to undergo training in how to respond to students in distress, but individual departments or programs can request it. Ms. Kirkland-Gordon’s staff runs voluntary workshops on how to identify and deal with the most common problems that students may demonstrate in the classroom. Declining performance and mood changes can signal depression.
Faculty members have also made good use of what she calls “the warm line” in worrisome situations. “What triggers the call is that they’ve noticed something very different in the behavior of the student,” she says. “Sometimes faculty will call us — and this is pretty common — where there’s a journal entry or paper where there’s a mention of suicide. Mostly they want to know if what they think they’re seeing is what they’re seeing, and if they should be concerned.”
Often faculty members will call when “they’ve established some kind of relationship with the student that gives them leverage,” she says, “and we just give them the words.”
A lot of colleges use so-called gatekeeper-training programs, a kind of suicide-prevention equivalent of CPR. These programs usually offer both classroom-based and online components, with advanced sessions for people who want to train others. In the survey by the counseling-directors group, 480 respondents noted that their institutions use such training, which is available through a number of companies; 32.5 percent reported using a program called QPR, for Question, Persuade, and Refer (terms that outline the basic approach), while 22.5 percent used locally developed models.
Suicidal intent doesn’t always manifest itself overtly, says Paul Quinnett, president and chief executive officer of the QPR Institute, which developed the program, and a clinical assistant professor of psychiatry and behavioral science at the University of Washington. Bystanders have to overcome a natural reluctance to pry and ask awkward questions. “People use polite language when they talk about self-destruction,” he says. “So we have to train people to read between the lines.”
If the training contains one central message, it’s this: Do something. “If a professor’s reading an essay and it talks about things that alarm him or her, they should at least clarify what it means,” Mr. Quinnett says. “The marker is when the hair comes up on the back of your neck. When you experience a flash, just a flash, of ‘Something could be wrong here,’ you need to act.”
Some strategies invite faculty members to be active participants in bringing mental-health issues into the open. One approach, called curricular infusion, can be adapted to many academic settings. At the University at Buffalo, counseling-staff members worked with visual-studies professors to arrange class presentations, inviting students to enter an art contest on the theme of mental health. Marketing-and-communications classes came up with a campaign for campus mental-health services.
A three-year suicide-prevention grant in 2006 “really forced us to forge relationships with academic departments,” says Sharon Mitchell, director of counseling services. “Now faculty are familiar with us, and they come to us.”
She and her staff tailor training sessions to different preferences: “Some people like group things. Some people don’t want to devote a lot of time. You have to be flexible and meet people where they are.”
The personal touch, and making it OK to talk about mental illness, can go a long way. At Aurora, which has about 4,400 students, David Reetz encourages professors to build into their syllabi the possibility that someone in the class will end up struggling during the semester. That way, he says, “the faculty member is openly acknowledging that they are ready, willing, and able to respond to any difficulty that might evolve.”
Mr. Reetz suggests that professors have students answer a few questions early on about their expectations for the course. If a student subsequently has problems, the professor can refer back to that exercise and use it as a starting point for a frank chat and, perhaps, a referral to the counseling center.
Has that strategy paid off? He thinks so. In the 2011-2012 academic year, 26 percent of students who used the counseling center’s services had been referred by a faculty or staff member; in 2013-14, that share rose to 50 percent.
Patrick Dunn, an associate professor of English at Aurora, has put that training to work in his classroom every semester. He asks his students to answer five or six short questions, including what expectations and other time commitments they have.
“I try to find something I can connect with,” like a love of music, he says. Sometimes he can spot potential difficulties ahead of time. A student who reports working many hours a week, for example, might be vulnerable to stress by midsemester. Sometimes Mr. Dunn will sit down with Mr. Reetz and go through the questionnaires with him.
One of Mr. Dunn’s courses, “Being Human,” gets students to think about the ethics of the decisions they make. The subject matter can provoke “very revealing papers,” he says. If students write that they’re depressed or having a hard time, “I always take it a little bit seriously.”
When the situation seems to call for a consultation with the counseling center, he says, “I don’t couch it as, ‘You need therapy,’ but as,› ‘Here’s someone who’s available.’ "
Mr. Dunn hasn’t encountered any students who might pose immediate danger to themselves or others. “Not yet,” he says. “But I keep David’s card in my desk and security on speed dial, because I know it’s a real danger.”
Correction (9/1/2015, 12:11 p.m.): After this article was published, the Association for University and College Counseling Center Directors updated its membership count. It has 830 members, not 670. The article has been updated to reflect this correction.
Jennifer Howard writes about research in the humanities, publishing, and other topics. Follow her on Twitter @JenHoward, or email her at jennifer.howard@chronicle.com.