Hypothetical Scenario: Suicidal Student. What would you do?

[Puget]

So no, don't try to be a therapist if you have a student displaying alarming behaviors. Follow your institution's policy.

To be clear, the primary reason not to try to be the student's therapist is not that it is against university policy,  that, unless you are also a therapist, you ARE NOT QUALIFIED to do therapy.

Just as you wouldn't try to do a medical procedure more complex than first aid but would instead get them to a qualified medical provider, you should never try to do more than mental health first aid while getting the to a qualified mental health provider. Mental health first aid consists of:

1. Listening empathetically to the student
2. Expressing concern and support
3. Assuring them that help is available and that you will help them get it
4. Following through on #3 immediately

[writingprof]

It's a pretty cold-hearted action to go full bureaucratic when the person is in active crisis and one knows that no one will be picking up at emergency services.

True.  However, the ability to summon that cold-heartedness is why they pay us the big bucks.

If I were thinking quickly enough, I would freeze my face and body to mimic a Zoom malfunction, sneak my finger up to the "end the call" button, and alert campus security.

[Caracal]

What does happen most places is a risk assessment and a conversation between the student and care team (and parent(s) if the student wants to include them) about what would be best for the student. Sometimes that is a medical leave, but certainly not always or even the majority of the time. Something like 1 in 10 college students will have suicidal thoughts at least once in a given year-- it doesn't mean they all need to leave campus.

Yeah, you have to assume in cases like this that the student could be in real danger and act accordingly. However, in lots of cases, the situation may not be that dire. They may not be actually suicidal, or even having suicidal thoughts. It could be anxiety. They might be having a panic attack. It doesn't necessarily mean they need to leave school for the semester.

If someone has sudden chest pain and shortness of breath, you get them to the Emergency Room, but it doesn't mean they are necessarily having a heart attack. It could be something very minor, but you want the doctors there to figure out what is happening. Same basic idea here.

[kaysixteen]

I get that a professor who is not a licensed therapist should not be offering actual therapy, but immediate counseling to prevent suicide attempts while real help is summoned is very different.   How much training, for instance, do Samaritans volunteers get?

[Bonnie]

We are required to follow a protocol almost identically to this at Big Urban College. Unfortunately, we don't seem to keep our counseling center reliably staffed (it's not viewed by some of our political appointees as an important budgetary item) so a lot of calls go to voicemail at an empty desk.

Zoom calls provide an interesting dilemma. The student is possibly off campus and may not even be in the area. I don't think I've been informed what to do in this particular scenario. Probably the same thing (call the empty counseling center office), and then call either Campus Police or 911.

For students who are not in the area, our counseling center would try to connect them to a local service provider and try to make sure they are with someone responsible in the meantime,  or in a true emergency call 911 (but in general you REALLY do not want police responding to a mental health situation).

Agreed on not wanting police involved in almost all mental health crises situations. Any time you call 911 for someone in a mental health crisis, you should ask for EMTs to be dispatched, and specifically request EMTs with specialized mental health crisis/first aid training.

[lightning]

It's a pretty cold-hearted action to go full bureaucratic when the person is in active crisis and one knows that no one will be picking up at emergency services.

Ain't that the truth, sadly.
Student Services when students need them the most, have their answering machines on.

[Aster]

The upside is, Big Urban College didn't even *have* a student counseling center until very recently.

So, maybe having something that only works sometimes is better than having nothing at all.

[Caracal]

I get that a professor who is not a licensed therapist should not be offering actual therapy, but immediate counseling to prevent suicide attempts while real help is summoned is very different.   How much training, for instance, do Samaritans volunteers get?

I wouldn't really describe that as counseling. I assume what people mean is that if a student expresses suicidal thoughts, the goal should be to make sure they see a professional as soon as possible and we shouldn't be trying to deal with the problem ourselves or guess how serious the situation is. Listening, and expressing concern and support is completely appropriate. I'm pretty sure that's what volunteer hotline groups do. I think what you want to avoid is telling the student how much they have to live for or something.

[lightning]

The upside is, Big Urban College didn't even *have* a student counseling center until very recently.

So, maybe having something that only works sometimes is better than having nothing at all.

You're very right about that.

[smallcleanrat]

Thanks, everybody, for sharing your perspective/experiences.

So, some would contact some form of help (counseling center, police, 911...) and stay online with the student until help arrived. Some would sign off and then call for help on the student's behalf.

The common element to all replies has been to notify people who can intervene that a student may be a danger to themselves. Would you consider this an ethical or professional obligation, or a freely chosen act of kindness?

So far, nobody's answer has been in the spirit of, "I would close the chat and go about my day. If the student needs help, they can pick up their own phone and call for it. This is not my responsibility."

Would your answer be at all different if 1) you did not like the student and/or 2) you yourself were especially busy and stressed?

[lightning]

Thanks, everybody, for sharing your perspective/experiences.

So, some would contact some form of help (counseling center, police, 911...) and stay online with the student until help arrived. Some would sign off and then call for help on the student's behalf.

The common element to all replies has been to notify people who can intervene that a student may be a danger to themselves. Would you consider this an ethical or professional obligation, or a freely chosen act of kindness?

So far, nobody's answer has been in the spirit of, "I would close the chat and go about my day. If the student needs help, they can pick up their own phone and call for it. This is not my responsibility."

Would your answer be at all different if 1) you did not like the student and/or 2) you yourself were especially busy and stressed?

Of course I would help the student, even if I did not like the student and I'm too busy.

A student got my attention after an evening event, after everyone had left, after I was closing up the facility. I didn't like the kid, and I had had a long day and night, almost a 14-hour workday. I just wanted to go home.

I kept him occupied (kept him talking) until real help arrived, which ultimately was a pair of paramedics. The only support I got was from the university security guards whose real job is to bust underage drinkers (the ones who called 911). University counselors? Hah! They only take appointments 9-5 during the business day. I accompanied the kid to the emergency room at our med center, in the late evening . . . . still no help from university counselors.

I should add that when I referred other students to see the mental health counselors, the students didn't want to see them (because they either didn't trust them or there was a stigma attached to seeing them). Obviously, our counselors are useless. Still better than nothing, I suppose.

[Puget]

Would you consider this an ethical or professional obligation

Yes, both.

1) you did not like the student and/or 2) you yourself were especially busy and stressed?

1)No of course not! Liking the student has absolutely nothing to do with it, just as it should have nothing to do with I grade them, etc. I'll go ahead and say that anyone who says otherwise is a terrible human being.
2) Also no. I suppose being rushed and stressed might well cause me to miss subtle signs that all is not well with a student but if they are obviously very distressed, what could be more important than making sure they get help?

[dr_codex]

Thanks, everybody, for sharing your perspective/experiences.

So, some would contact some form of help (counseling center, police, 911...) and stay online with the student until help arrived. Some would sign off and then call for help on the student's behalf.

The common element to all replies has been to notify people who can intervene that a student may be a danger to themselves. Would you consider this an ethical or professional obligation, or a freely chosen act of kindness?

So far, nobody's answer has been in the spirit of, "I would close the chat and go about my day. If the student needs help, they can pick up their own phone and call for it. This is not my responsibility."

Would your answer be at all different if 1) you did not like the student and/or 2) you yourself were especially busy and stressed?

As others have indicated, if this happened in a face-to-face situation (classroom, office, or otherwise), I'd see my obligation as consisting of staying with the student as much as possible, and coming with them to whomever could provide professional help. Anything else (classes, students, or whatever) can suck it until the crisis is resolved to the best of my ability.

On Zoom, I would do my best to do the same. Keeping the student on the line would be the most important thing, and I think (but don't know) that that's suicide hotline job #1. I'd try to determine where in space they are, and use that to find out what kinds of response would be possible.

I went to the funeral of a Freshman who shot himself in the head a month into September, when his girlfriend dumped him. Never again, if I have anything to do or say about it.

The only exceptions that I can see to this moral and professional obligation would be instances in which my participation might precipitate violence directed towards myself, the student, and/or others. That is, if I were told to back off, I would. But I'd still alert whomever I could, in any ways that I could.

It's the bare minimum that we owe to one another.

[smallcleanrat]

Ok. On the one hand, I'm relieved to hear the general consensus is to get the student some help.

On the other, I'm still left trying to understand my own experience with this scenario.

Earlier in the year, I was the student; the faculty member was the professor I TA'ed for.

I was barely holding together before the Zoom talk. After the talk, I felt completely broken.

His responses included:

1) Pointing out the advantages I have that many people never will.

2) Describing some of the issues his neurology patients deal with (he would pause the chat to take calls from patients), saying it makes his own problems seem small and insignificant. Not sure if this was a veiled message to me that I had no real problems to justify my despair. It felt that way.

3) Saying, "Well, you'll just have to." when I said I didn't think I could keep going.

4) Closed the chat as I was crying with the parting message "'Laugh, and the world laughs with you. Cry, and you cry alone.'"

That last line was devastating. I had already been having difficulty trying to build some form of support network. And it sounded as though he was telling me "Don't bother asking for help. No one will want to offer it."

Maybe the message was meant to be "Choose to laugh instead of cry." but...that's not how depression (or extreme distress over a major life event like student dr_codex mentioned) works. And since his field is neurology, I figured he was aware of that.

It didn't occur to me until much later to wonder why he did not contact student counseling or emergency services to try to help me. I don't think it would have been very time-consuming if he simply wanted to convey the message and then wash his hands of the situation. I started to doubt whether I had been right in assuming there was some kind of policy in place (or at least an understanding of best practice) to alert...*someone*...that a student was potentially in danger. I'm doubting so many things lately.

Odd thing was, I wasn't even asking him for help staying alive. I was pretty sure I had outlived my usefulness, and that death would stop my pain and free others of the burden of having to deal with me. What I had wanted from him was just a brief moment of acknowledgement, some proof that I had value as a person, not just as a student or employee. I even told him I just needed to know that I had some value as a human being (apart from any academic or professional role). He wouldn't even say that.

He had had a tendency throughout the term to treat me as if I didn't exist (sharp contrast to how he treated the other TA), and the final TA meeting of the term ended with him and the other TA saying their farewells and the Zoom call being terminated right when I was in the middle of saying something. I didn't want that to be my last real interaction with the people who knew me; I wanted the small bit of comfort from feeling like I had been a valued part of a team. I messaged him and the other TA about getting cut off and greatly wishing to just have a few minutes to say a proper goodbye. These messages were ignored.

He wasn't even the only person who acted dismissively when I was in distress and actually asking for help. So it's been very difficult not to believe that people in my life care whether or not I'm alive.

Last year, our department lost a student to suicide. A flurry of emails over the following months kept announcing mental health seminars, counseling resources, etc... There was a lot of emphasis on asking for help if you were struggling. I had thought, if anything, people would have been more alert to protocol dealing with students in crisis (at least temporarily). I don't know if other students had been treated the same way, or if the problem is just me.

My therapist has suggested I draw up a document about the difficulties I had trying to get help, not just for my own sake, but for the sake of other students who might be hurting and running into the same obstacles. I'm not even sure who would read a document like that, or if it would make any difference at all.

[Bonnie]

Ok. On the one hand, I'm relieved to hear the general consensus is to get the student some help.

On the other, I'm still left trying to understand my own experience with this scenario.

Earlier in the year, I was the student; the faculty member was the professor I TA'ed for.

I am so sorry. The professor did not handle your crisis well. At all. I hope you have continued access to your therapist and that perhaps they have helped you develop a crisis plan. You may know this already, but if you are in the US and you have those thoughts again, you can  contact the national crisis hotline through chat at https://suicidepreventionlifeline.org/chat/ or phone 800-273-8255.

You deserve to be seen and acknowledged. That not happening in that Zoom call was about the professor, not about your worth. I wish you wellness.