Pizza Campus from the Water

Information For Faculty, Family & Friends

Signs and Symptoms of Distress in Students
Guidelines for Responding
Consultation and Referral

Faculty, staff, parents, and friends of students are often among the first to notice students who are encountering overwhelming amounts of stress in their lives. This stress can seriously disrupt academic progress, personal relationships, and daily behavior.

Below are some guidelines to follow if you are concerned about a student. While they were written specifically for faculty, they can be applied to a variety of situations. There are also a number of excellent online resources available for persons who are concerned about the well-being of another. An excellent starting place is the "For Concerned Others" section of the University of Chicago Virtual Pamphlet page (see our Self-Help Links section.)

Signs and symptoms of distress in students:

  1. Your Observations:
    • Social isolation, withdrawal, lethargy.
    • Inability to focus on a specific topic in a conversation or activity.
    • Disorganized thinking and speech, feelings that are inappropriate to the situation, lack of affect, or other evidence that student is "out of touch with reality."
    • Expression of feelings of persecution, strong mistrust of others.
    • Violent outbursts.
    • Signs of excessive alcohol or drug use.
    • Expressions of general unhappiness over a period of several weeks.
    • Frequent class absence or "disappearance" over extended periods.
    • Gain or loss of significant amounts of weight.
    • Abrupt change in manner, style, or personal hygiene.
    • Increasing dependence on you (by making excessive appointments, hanging around your office or after class) or others.
  2. Student's Complaints:
    • Marked anxiety, extreme restlessness, inability to concentrate or relax.
    • Marked decrease or increase in appetite.
    • Marked decrease or increase in sleep.
    • Loss of interest in formerly pleasurable or meaningful activities, such as classes, social life, intimate relationships.
    • Expression of irrational fears.
    • Physical complaints without a medical cause, such as headache, stomach pains, etc.
    • Unusual ritualistic or repetitive behavior.
    • Chronic fatigue.
    • Suicidal thoughts, plans, threats.
    • Overwhelming financial obligations.
  3. Student's Background:
    • History of emotional disturbances (e.g., depression, alcohol, drug abuse, eating disorder, anxiety, suicide attempts).
    • Traumatic family event(s) such as recent separation or divorce of parents, serious illness or death of family member, physical, emotional, or sexual abuse at home.
    • Recent loss of an important person (either by death or by separation/break-up).
    • Recent loss of esteem.
    • Previous period of poor functioning.

Guidelines for Responding

  • Share your interest and concern openly, directly and with care.
  • Set clear limits.
  • Maintain a student's privacy.
  • Do not promise confidentiality. Rather, inform a student that you will use discretion if seeking outside assistance.
  • Help a student tell his or her story. Offer the opportunity to listen to whatever is on the student's mind.
  • Demonstrate an understanding of what the student discloses.
  • Clarify vague, confusing, or disturbing student disclosures. Ask, "What do you mean by...?"
  • Inquire how the student is attempting to respond to the problem.
  • Develop response options together.
  • Consider with the student the consequences of "doing more of the same."
  • Consult with colleagues, Student Affairs staff, or others if you feel you need additional perspectives, before or after approaching the student.
  • Suggest a referral to the Counseling Center, health educator, or other community resource.
  • Follow up. Offer and be open to further contact.

Consultation and Referral


It's always a good idea to consult with colleagues, deans, counselors, or others who might be able to give you feedback and suggestions for working with a problem student.

Often a referral is not necessary; approaching the student with your concerns can make an immediate impact on his or her behavior or performance in your class.

No one has the expertise to handle everything an individual may present to them, so we all need to be familiar with the process of asking for help or referring a problem to someone who has the training, experience, and position to do the best job.

When to Refer:

  • The problems or requests made are beyond your level of competence.
  • There are personality differences which interfere with your ability to work with a student.
  • The boundaries of your role make it unwise to work with students on personal issues.
  • A student expresses a preference (directly or indirectly) to speak with someone else about their concerns.
  • After some time and effort, you feel like you are not making progress in helping this student.

How to Refer:

Consider helping the student make an appointment, perhaps by walking with the student to the office where the referral is being made or letting the student call from your office. After a referral, communicate to the student your continued concern and openness to help. Be aware of the requirements of confidentiality in the counseling process, but let the student know that you are interested in whatever information he or she wants to share. There may be times the student wishes to stop talking to you about the problem altogether. Do not expect miracles. Behaviors, attitudes, and feelings take time to change, and a student may show slow progress or, for a while, none at all. Communicate your continued concern and availability.

Making a Referral to the Counseling Center:

Office hours are 8:00-5:00 p.m., Monday - Friday. The Counseling Center generally operates on an appointment basis, although students are seen on a walk-in basis. Walk-in wait times may vary depending on staff availability. Students wanting an initial meeting are advised to call the Center (240-895-4289 or campus ext. 4289) or stop by Chance Hall (the Counseling and Health Center) to make an appointment. Emergencies are always accommodated as soon as possible. In case of an emergency after hours, Public Safety should be notified, and they will get in touch with a counselor or on-call personnel.

by Dr. Glenn Bowan, Hampden-Sydney College. Reprinted by permission.