Identifying the High Identifying the High Risk StudentRisk StudentPresented by:Presented by:

Ed Derr LPC, NCCEd Derr LPC, NCC

Director of Counseling Director of Counseling

FSC 116 - 873.7457FSC 116 - 873.7457

September 24, 2008September 24, 2008

Presentation AgendaPresentation Agenda

“ “The Numbers Game”The Numbers Game” The Reality NationwideThe Reality Nationwide Suicide RiskSuicide Risk Risk for ViolenceRisk for Violence Tips for Staff and QuestionsTips for Staff and Questions

The Reality The Reality NationwideNationwide(National College Health Assessment, (National College Health Assessment, 2007)2007)

Number of students entering college with a prior Number of students entering college with a prior psychiatric history or a documented disability psychiatric history or a documented disability continues continues to increaseto increase Many chronic psychiatric disorders present for Many chronic psychiatric disorders present for the firstthe first time in late adolescence and early adulthoodtime in late adolescence and early adulthood Faculty and staff struggle with issues related to Faculty and staff struggle with issues related to “ “support” and career preparation. What is support” and career preparation. What is appropriate?appropriate? When is it too much or not enough?When is it too much or not enough?

Suicide Prevention Suicide Prevention Basics Basics (CDC Data, 2004 Suicide Fact Sheet)(CDC Data, 2004 Suicide Fact Sheet)

31,000 people died by suicide last year31,000 people died by suicide last year "Gay youth are 2 to 3 times more likely to attempt "Gay youth are 2 to 3 times more likely to attempt suicide thansuicide than other young people."  United States Department of other young people."  United States Department of Health andHealth and Human Services.Human Services. 1111thth leading cause of death ahead of homicide or leading cause of death ahead of homicide or HIV HIV Third leading cause of death ages 15-24 and Third leading cause of death ages 15-24 and second leading cause of death for those 25-34second leading cause of death for those 25-34 Males 4 times more likely to die by suicide butMales 4 times more likely to die by suicide but females attempt morefemales attempt more

Suicide Prevention Suicide Prevention Basics Basics (CDC Data, 2004 Suicide Fact Sheet)(CDC Data, 2004 Suicide Fact Sheet)

50% of those that die by suicide had50% of those that die by suicide had major depressionmajor depression Those with major depression have Those with major depression have eight eight times the suicide rate of the generaltimes the suicide rate of the general populationpopulation Abuse of alcohol and drugs furtherAbuse of alcohol and drugs further increases riskincreases risk

Warning Signs: Warning Signs: Suicide Risk Suicide Risk ( ulifeline.com)( ulifeline.com)

Prior attempts and lethality of past Prior attempts and lethality of past attemptattempt Intent and planIntent and plan Family history of suicide Family history of suicide Talking/writing about suicide/watchingTalking/writing about suicide/watching violent movies, etc.violent movies, etc. Giving away possessions Giving away possessions

Warning Signs: Warning Signs: Suicide Risk Suicide Risk ( Ulifeline.com)( Ulifeline.com)

Sudden change in behaviorSudden change in behavior Withdrawal/social isolationWithdrawal/social isolation Increased absences or tardinessIncreased absences or tardiness Change in physical appearanceChange in physical appearance No reason for living/hopelessness/lack ofNo reason for living/hopelessness/lack of purposepurpose

Warning Signs: Warning Signs: Suicide Risk Suicide Risk (ulifeline.com)(ulifeline.com)

Coming to your office, class, work Coming to your office, class, work intoxicated intoxicated

Decreased concentrationDecreased concentration Sudden change in class/work Sudden change in class/work performanceperformance Increased disorganizationIncreased disorganization Recent loss/ history of multiple lossesRecent loss/ history of multiple losses

Risk for Campus Risk for Campus Violence Violence (American Academy of Experts in (American Academy of Experts in

Traumatic Stress, 2004)Traumatic Stress, 2004)

FBI data not conclusive as number of FBI data not conclusive as number of incidentsincidents so smallso small No consistent “profile”No consistent “profile” American Academy of Experts in TraumaticAmerican Academy of Experts in Traumatic Stress- “Signs & Symptoms” of students Stress- “Signs & Symptoms” of students whowho may need intervention (brochure) may need intervention (brochure) Greater number of indicators = increased Greater number of indicators = increased riskrisk

Risk for Campus Risk for Campus Violence Violence (American Academy of Experts in (American Academy of Experts in

Traumatic Stress, 2004)Traumatic Stress, 2004)

Usually not impulsive act. RetrospectiveUsually not impulsive act. Retrospective

studies show a visible process of planningstudies show a visible process of planning Attackers have usually told someone of Attackers have usually told someone of planplan Prior history of depression or suicide Prior history of depression or suicide gesturesgestures Revenge for bullying in 2/3 casesRevenge for bullying in 2/3 cases

Early Warning Signs:Early Warning Signs:Violent Behavior Violent Behavior (American Academy of Experts in Traumatic Stress, (American Academy of Experts in Traumatic Stress, 2004)2004)

Destructive or threatening Destructive or threatening statementsstatements Past history of destructive behaviorPast history of destructive behavior Specific plans to harm self/othersSpecific plans to harm self/others Appears withdrawnAppears withdrawn May “bully” othersMay “bully” others Family stressorsFamily stressors

Early Warning Signs: Early Warning Signs: Violent Behavior Violent Behavior (American Academy of Experts in Traumatic Stress, (American Academy of Experts in Traumatic Stress, 2004)2004)

Significant change in moodSignificant change in mood Poor impulse controlPoor impulse control Experienced past trauma/abuse victimExperienced past trauma/abuse victim Substance abuseSubstance abuse Has been tormented/teased by othersHas been tormented/teased by others Seen by peers as “different”Seen by peers as “different”

Early Warning Signs: Early Warning Signs: Violent Behavior Violent Behavior (American Academy of Experts in Traumatic Stress, (American Academy of Experts in Traumatic Stress, 2004)2004)

Art/poems/writings violent themesArt/poems/writings violent themes Low frustration toleranceLow frustration tolerance Externalizes blame for problemsExternalizes blame for problems Preoccupation with Preoccupation with guns/weapons/inappropriateguns/weapons/inappropriate useuse Frequent disciplinary problemsFrequent disciplinary problems Recent loss/or history of multiple lossesRecent loss/or history of multiple losses

Early Warning Signs: Early Warning Signs: Violence Violence (American Academy of Experts in Traumatic Stress, (American Academy of Experts in Traumatic Stress, 2004)2004)

Expressed feelings of hopelessnessExpressed feelings of hopelessness Sleep and eating disturbancesSleep and eating disturbances Gang involvementGang involvement Preoccupation with televisionPreoccupation with television Poor academic performancePoor academic performance Decreased motivationDecreased motivation

Biopsychosocial Model: Biopsychosocial Model: Violence Assessment Violence Assessment (Meloy,2000)(Meloy,2000)

Individual/Psychological- Male, age 15-24, PastIndividual/Psychological- Male, age 15-24, Past

history of violence, paranoia, below averagehistory of violence, paranoia, below average

intelligence, anger/ fear/ impulse control intelligence, anger/ fear/ impulse control problemsproblems Social/Environmental- Family of origin and/or Social/Environmental- Family of origin and/or peer peer

group violence, economic instability or group violence, economic instability or poverty, poverty,

weapon history or skill, interestweapon history or skill, interest Biological- prior head trauma’s, CNS problems, Biological- prior head trauma’s, CNS problems,

mental disordermental disorder

Early Intervention Early Intervention Referrals: Why?Referrals: Why? A student is depressedA student is depressed A student is unable to control emotions and/or A student is unable to control emotions and/or behaviorbehavior A student’s weight and/or eating behavior is of A student’s weight and/or eating behavior is of concernconcern A student’s substance use is of concernA student’s substance use is of concern A student appears to be in an abusive relationshipA student appears to be in an abusive relationship A student is having difficulty grieving a lossA student is having difficulty grieving a loss Whenever you are concerned about a Whenever you are concerned about a student, student, even if you are unclear about what is going even if you are unclear about what is going on on with the student and/or what your specific with the student and/or what your specific concerns areconcerns are

How to Talk to Students How to Talk to Students About Your Concerns About Your Concerns (non-(non-emergency)emergency)

Privacy – Talk in private when you and the Privacy – Talk in private when you and the studentstudent have time and are not preoccupied.have time and are not preoccupied.

Honesty – Be frank about your concerns, Honesty – Be frank about your concerns, sharingsharing what you observe without judging.what you observe without judging.

Limits – Be clear about the limits of your Limits – Be clear about the limits of your ability toability to help. It is not your role or responsibility tohelp. It is not your role or responsibility to counsel students, but you can help them get counsel students, but you can help them get the the support they need.support they need.

How to Talk to Students How to Talk to Students About Your Concerns About Your Concerns (continued)(continued)

“ “Sounds like you are really struggling with________”Sounds like you are really struggling with________” Many people find it helpful to talk with someoneMany people find it helpful to talk with someone in confidence who is outside of the situation.”in confidence who is outside of the situation.” “ “I want to help you get the help you need and I want to help you get the help you need and deserve”deserve” “ “Give Counseling Services a try. You have nothing to Give Counseling Services a try. You have nothing to lose.”lose.” “ “Meeting with a counselor is confidential and will not Meeting with a counselor is confidential and will not gogo on your academic record.”on your academic record.” “ “These are services your tuition pays for; takeThese are services your tuition pays for; take advantage of them.”advantage of them.”

How to Talk to Students How to Talk to Students About Your Concerns About Your Concerns (continued)(continued)

Suggest that a student seek help instead of telling orSuggest that a student seek help instead of telling or ordering them to.ordering them to. Inform the student of Counseling Services and tell themInform the student of Counseling Services and tell them that students visit Counseling Services for a variety of that students visit Counseling Services for a variety of reasons.reasons. Timing – If a student is receptive to seeing a counselorTiming – If a student is receptive to seeing a counselor provide them with Counseling Services’ phone number, provide them with Counseling Services’ phone number, offer them access to your phone so they can make anoffer them access to your phone so they can make an appointment, or accompany them to Counseling Services.appointment, or accompany them to Counseling Services.

Tips for Staff: Tips for Staff: PreventionPrevention

Model and expect students to utilize good stress Model and expect students to utilize good stress management skills ( adequate sleep, eating healthy, etc.)management skills ( adequate sleep, eating healthy, etc.)

Have available in your offices info on stress and anxiety, Have available in your offices info on stress and anxiety, responsible responsible drinking, testing taking tips, relationships, etc. drinking, testing taking tips, relationships, etc. Counseling Services would be happy to helpCounseling Services would be happy to help

Phrase feedback positively whenever possible Phrase feedback positively whenever possible

Understand that some students lack basic “life skills”Understand that some students lack basic “life skills” and are playing “catch up” in many areasand are playing “catch up” in many areas

Tips for Staff: Tips for Staff: PreventionPrevention Refer students to time management and studyRefer students to time management and study skillsskills Check in with students regularly and create Check in with students regularly and create a climate where it is safe for students to come a climate where it is safe for students to come toto you if they are getting “overwhelmed”you if they are getting “overwhelmed” Encourage use of prof office hours and help Encourage use of prof office hours and help sessionssessions Consult with a counselor as needed for Consult with a counselor as needed for feedback-feedback- we are here to support you and the student!we are here to support you and the student!

Tips for Staff: Tips for Staff: PreventionPrevention Create opportunities for “connections” on campus Create opportunities for “connections” on campus and work to engage the withdrawn or socially isolatedand work to engage the withdrawn or socially isolated studentstudent

Encourage student involvement events and campus Encourage student involvement events and campus clubsclubs

Encourage students with disabilities to self-identify Encourage students with disabilities to self-identify andand utilize accommodationsutilize accommodations

Tips for Staff: Tips for Staff: Possible EmergenciesPossible Emergencies Make referrals to Counseling ServicesMake referrals to Counseling Services

( now have 2FT! Paige Buschling)( now have 2FT! Paige Buschling) If this has not been successful-ask counselor to If this has not been successful-ask counselor to “ “outreach” student before or after classoutreach” student before or after class For URGENT after hours concerns, dial Security For URGENT after hours concerns, dial Security at at

873.7911 or phone Ed Derr at home – 873.7911 or phone Ed Derr at home – 877.0992877.0992 Call Security at 7911 or 911 if you are ever Call Security at 7911 or 911 if you are ever feeling feeling

unsafe or unsure of how to respondunsafe or unsure of how to respond Refer behavioral concerns to Dean of Students Refer behavioral concerns to Dean of Students

Thank you. Any questions?Thank you. Any questions?