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Student suicides

Started by pedanticromantic, July 22, 2019, 06:12:51 AM

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pedanticromantic

My school is seeing an enormous increase in student mental health problems, including a few ending in suicide.

As faculty, I feel I'm not equipped (no training and no energy--have my own problems) to deal with so many students needing pastoral care outside the classroom. I refer them to student health/counselling, but I know counselling has long wait times (they triage them for immediate need, of course, but still can't cope).

I know I've dumbed my courses way down since I started teaching (same school) but they still seem to be struggling. They all expect 90+% for basically no effort at all. I feel like I'm just handing out grades for very little work and moving them along.

I'm not in a program where I get to know students over several semesters--I usually only see them once and that's it.

I'm looking for practical suggestions for how to help students cope without draining my own time and energy.

Caracal

Well it seems like you might be conflating things that shouldn't really be conflated. I doubt that students are having mental health problems because of stress from classwork. If anything, it is the reverse. Students who are struggling in other ways, may struggle to get their work done. I doubt it all stems from entitlement or anything like that. Nothing you do with your classroom teaching is going to make a difference for student mental health.

I think you can provide a sympathetic ear for students without trying to be a therapist. Sometimes just talking to a sympathetic older person can help, even if all you are doing is validating that the student is having a hard time. Its also important to be as helpful as you can be with deadlines and work when a student is struggling. Beyond that, you have a limited role in these students' lives. Listen, be nice, refer them to other help as necessary.

miss jane marple

Quote from: Caracal on July 22, 2019, 07:22:37 AM
Nothing you do with your classroom teaching is going to make a difference for student mental health.

My thought, as well. There are many systemic/societal forces at work that have much to do with the problem, from widespread recreational substance abuse to low admission criteria (have a pulse and a loan). The lack of sufficient financial resources of the college/university to provide adequate mental health services just exacerbates an existing problem.

I disagree with the sympathetic ear thing, though. If even 10% of 200 students needed two hours per month of your time, that's 40 hours. And it would reinforce the professor-as-therapist misconception. I can tell you it's very hard to detach a needy student with psychosocial issues once they have decided to latch on.

If it will make you feel better to make your course work easier, do that, until your chair or accreditation agency squawks. Without knowing more details, it will be hard for folks on here to give specific suggestions that are relevant. Perhaps the Jedi Mind Tricks or Humane Course Policies threads on the Old Fora could be helpful.
By and large, language is a tool for concealing the truth. - George Carlin

hungry_ghost

#3
ETA: miss jane marple's post appeared while I was typing this, so I feel compelled to add: this is not directed at miss jane marple, whose posts I always enjoy and often agree with. I do things differently, but I don't think she's wrong. Students need a lot of different kinds of teachers in their professors.

OP, I agree with Caracal that you may be conflating different issues. Mental health can affect academic performance and poor life habits can lead to both poor grades and poor mental health, and bad grades can also make students anxious, down, or worse.

Does your school have a page for faculty on students who need help? Many schools do. Ours is particularly helpful since they divide it into academic problems (writing center, other tutoring programs, advising for students with overall academic challenges), mental health,  financial/food security issues, etc.
I encourage you to contact the appropriate administrator/ office (or your chair and ask to be connected to this office) to ask for specific guidelines for different sorts of situations, and to ask that these guidelines be shared with other faculty college/university-wide. I hope your school has useful resources. 

I agree with this times a million:
Quote from: Caracal on July 22, 2019, 07:22:37 AM
I think you can provide a sympathetic ear for students without trying to be a therapist. Sometimes just talking to a sympathetic older person can help, even if all you are doing is validating that the student is having a hard time.
I am so tired of people saying "this is not your job, you are not a therapist." Mentorship IS my job, and that entails some amount of listening and encouraging, including when one of my students hits a bump, including when personal life spills over into academics (or the reverse). I am here now because a university professor took time to listen to me when I had a whole knot of personal and academic problems as an undergrad, and then he gave me some brief, sympathetic, kind but somewhat stern advice on how to untie the knot. I still draw on some of his words even today.
 
So yes, I sometimes have had students sobbing in my office because their childhood cat got put down, or because boyfriend dumped them, or telling me about a variety of bad roommate/landlord problems. I listen, sometimes give advice if I feel competent (obvious things, like "contact the renters union on campus") but often all they need is someone to listen attentively for a bit, then bring us back to the topic at hand (academics).  OP, this is not directed at you, sounds like you're already doing your fair share of this or you wouldn't feel so drained.
And mentoring does not mean listening to personal problems for hours (there miss jane marple and I agree!) and the moment you feel over your head, send them to the counseling center.

ETA: YIKES I just re-read your subject line. If your school has had multiple suicides, this means you (and all faculty) are probably experiencing an entirely different stress level, and it also means your school probably has or is developing an office devoted helping students. I hope they have a good set of resources.

Puget

I'll give my perspective as someone who does research in this area, though I'm not a clinician myself.

You are not alone in this-- depression, anxiety and suicidality are at their peak in the college age range (what we call emerging adulthood), and there is evidence that they are increasing (though it is hard to disentangle actual increases from increased reporting due to decreased stigma, at least some of the increase appears to be real).
For more info see: https://www.acha.org/ACHA/Resources/Topics/MentalHealth.aspx

Long waiting lists are unfortunately common at college counseling centers, as demand has been increasing 5x greater than enrollment in the US, driven by some combination of increased prevalence, decreased stigma, and changes in the college population (many students who wouldn't have made it to college before due to mental health problems are now able to attend, which is a good thing but increases demand).

Many college counseling centers are trying to adjust and cope by triaging care so the students at high risk are seen immediately and others may have to wait, or be encouraged to try group or online treatment modalities. Be assured though that if you call or walk a student over who has expressed any suicidal thoughts/behaviors, they WILL get immediate attention.

Does your campus counseling center offer workshops for faculty on how to appropriately help students in distress without becoming their therapist? If not you might consider reaching out to them to see if they would.

Because we deal with this in our research all the time, I wrote up a whole guide for talking to students in distress (which I'll share in a new post since it is long), which is what I try to follow in conversations in office hours as well. This is definitely something you should engage with only to the extent you feel equipped to do so emotionally and knowledge-wise. That can be as little as expressing care, telling them you are going to connect them with the right people to help, and then calling or walking them to the counseling center.
"Never get separated from your lunch. Never get separated from your friends. Never climb up anything you can't climb down."
–Best Colorado Peak Hikes

Puget

As promised here's the guide I wrote, lightly edited to be non-campus specific. As warned it is long. Use at your own discretion and risk-- not a substitute for professional guidance or your own campus protocols!

Talking with a student in distress

Every conversation is going to be different and you need to take your cues from the student, but this may help give you an idea of how a conversation can be productively structured. Use your own words that are appropriate to you, the student and the situation: these are just some examples to help get you started.

Remember, you don't need to do this perfectly (there really is no perfectly)— just having an empathetic conversation were the student feels cared can make a huge difference!

1. Let them tell as much or as little of their story as they want to. You don't need to probe for content.
"I'm concerned and wanted to check in about what's been going on for you lately" can be a good way to start the conversation if they don't initially volunteer anything— this allows them to either talk about emotions or events to the extent they feel comfortable. You may also follow that up with what you've observed, said in a non-judgmental way,
"I've noticed that you [seem upset, don't seem like you've been taking care of yourself, haven't been coming to class, etc.]"

2. Paraphrase what they are telling you— this can include both emotional and content paraphrases, e.g.,
"It sounds like you've been feeling. . ."
"It sounds like your class work is really overwhelming right now"

3. Let them respond. Express empathy and paraphrase some more— the goal is to help them feel heard and validated.

4. Ask about suicidal thoughts—
"Sometimes when people are feeling/experiencing [use their words for what they are feeling/experiencing] they have thoughts about wanting to die or killing themselves. Have you had any thoughts like that?"
This is hard and takes practice, but there is strong evidence that asking directly and openly decreases risk- just telling someone decreases risk that they will act. You will not "put ideas into their head" or otherwise harm them by asking.

5. If yes but doesn't elaborate—and only if you feel prepared to do so in a calm and nonjudgmental manner, try to get a rough assessment of risk:
"What kind of thoughts have you had?" / "What have you thought about?"
"Have you thought about a plan?" "How close would you say you've gotten to acting on that plan?"
The goal is to get rough idea of risk so you can communicate that when you make your referral. You don't have to probe too much, just get an idea of risk. 

6. Express care and support—
"I'm so glad you told me, that's a really important, brave step and now we can work together to make sure you're connected to the resources to help keep you safe and get to a place where things don't feel so [hopeless, overwhelming, however they've described it]."

Emphasis that there is a whole team on campus ready to support them, they are not alone. Avoid minimizing but normalize and reinforce hope— many students go through something similar and have gotten help and gone on to thrive. 

7. Ask if they have told anyone else or are currently getting any care (e.g., going to the counseling center).

8. Let them know what is going to happen now and make the referral. If they have concerns about you making the referral, you can address their potential fears that they will automatically have to leave campus (can't promise that this will never happen, but it is rare*). *Find out what the protocol is on your campus-- in the US it's not actually legal to force students out just for reporting mental health problems, as these are disabilities, but some campuses have a bad record on this.

If the have expressed or you suspect they may be suicidal, or you have heard/observed other things that really concern you (trust your gut):

•   Tell (don't ask) them that you are going to call now and make a referral.
•   Make sure you are clearly communicating to the person who answers the phone that you are making an urgent referral for a suicidal student who is currently with you. If the student has expressed having a plan tell them that right away.
•   The therapist will likely ask to speak directly to the student on the phone. Stay with the student during this conversation—the therapist will likely need to speak with you again afterward.
•   If possible, keep the student with you until there is a plan in place for their care.
•   If the plan is for the student to go to the counseling center right away, offer to walk over with them ("How about we walk over there together? is more likely to get a yes than if you make it sound like a real choice). 

If things seems less urgent:  
•   Suggest it might help to talk to a therapist.
•   Ask if they would like your help in doing that, and if so offer to sit with them while they call or call yourself and put them on the phone.
•   Give them info on urgent care walk-in hours (if your counseling center has these), and if it is during those hours offer to walk them over. 

In either case, consider submitting a care team report (if this exists on your campus), as this will mobilize additional resources for them. 
"Never get separated from your lunch. Never get separated from your friends. Never climb up anything you can't climb down."
–Best Colorado Peak Hikes

monarda

I haven't read this book yet, but I know one of the authors (Tony Rostain). It's directed at parents, but there may be something inside that could help.



revert79

I don't have any tips (also feel drained/burned out by students who have increasingly intense mentoring needs).  But I just wanted to say I'm so sorry this is happening at your institution, and please take care of yourself, too...it must be so stressful and upsetting. 

mamselle

Chime to the empathy, consideration, and thanks for those like the posters on this thread who care.

Thanks, especially to Puget for the well-thought-out, condensed decision tree posted above.

The willingness of people to make such important resources available to others continues to astound me on this forum as in its previous iterations.

M.
Forsake the foolish, and live; and go in the way of understanding.

Reprove not a scorner, lest they hate thee: rebuke the wise, and they will love thee.

Give instruction to the wise, and they will be yet wiser: teach the just, and they will increase in learning.

pedanticromantic

Thanks for the tips so far.
The students at my school tend to be very rich, very high achievers, and a large proportion of international students. They have a complete meltdown over grades: they have no coping skills whatsoever to deal with anything they deem failure (less than a 90%). It's usually faculty who bear the brunt of the blame over this, because it's "our fault".
I'm not conflating their grades with their mental health issues, but it is one of the few things I have control over that doesn't take my own energy.

I wonder what other kinds of practical things I can do in my classroom with regards to;

1. helping them to manage/understand that a lower grade isn't failure, and to work harder, not lose it when they don't get a perfect grade
2. helping them to manage their study skills/time better.



fourhats

Quote1. helping them to manage/understand that a lower grade isn't failure, and to work harder, not lose it when they don't get a perfect grade

Some colleges have instituted centers, classes and workshops in failure studies. The problem is pervasive, especially among students who have never learned to try new things without aiming for perfection. If you Google the phrase "failure studies" you'll come up with programs at Harvard and Columbia and Smith, and newspaper articles in The Atlantic and NYT. It's worth going to the websites for these programs and taking advantage of some of the tips they give.

RatGuy

Quote from: pedanticromantic on July 23, 2019, 04:52:06 AM
1. helping them to manage/understand that a lower grade isn't failure, and to work harder, not lose it when they don't get a perfect grade

Whenever I teach freshmen, I try to assign Lamott's "Shitty First Drafts." I try to place it within the context of "process," though the terms "struggle" or "grit" used by the failure studies folks may be applicable too. It also helps that I'm in Football Country, so I can quote Nick Saban's use of "process" as well. I like to think that it cuts down on the sticker-shock of not getting an A on that first assignment. (I also pair this with LarryC's Jedi Mind Trick about assigning a low-stakes, meticulously graded assignment during the second week).

mythbuster

It must be a matter of perspective, but I have a vivid memory of my first few graded assignments in college. I got them back and was thrilled that I could handle the work, and wasn't failing.  I would never have just assumed that I would be an A student in college. And I say this having excelled at one of the top private  high schools in the country. I guess I had an innate sense of the hubris of just assuming that I would be top of the heap at my new school.
   Then again, my jaw went slack when a fellow incoming grad student in my cohort asked during the welcome party if it would be hard work. She lasted all of a week.

Caracal

Quote from: mythbuster on July 23, 2019, 01:31:58 PM
It must be a matter of perspective, but I have a vivid memory of my first few graded assignments in college. I got them back and was thrilled that I could handle the work, and wasn't failing.  I would never have just assumed that I would be an A student in college. And I say this having excelled at one of the top private  high schools in the country. I guess I had an innate sense of the hubris of just assuming that I would be top of the heap at my new school.
   Then again, my jaw went slack when a fellow incoming grad student in my cohort asked during the welcome party if it would be hard work. She lasted all of a week.

Well grad school tends to have a culture of bragging about pain and hard work which is often not great. It is hard work, but I'm not sure it is necessary to work as hard or as much as many people do. You have a lot of people bragging/moaning about how they work 100 hour weeks. Often, these people could probably be a lot more efficient and work a lot less.

Some undergrad programs have a similar culture. I've seen it at selective liberal arts schools. Everyone talks about how hard everything is, everybody feels burned out all the time, and there's a lot of competitiveness about being at the library on Saturday night.