[0:02]In the previous modules, we provided information about college student mental health, reviewed risk factors and warning signs of suicide, and offered some strategies for how to talk to students who may benefit from mental health services or supports. We also reviewed some key resources for students in crisis. In this section, we will review a few examples to demonstrate how to work with someone experiencing these challenging, complex issues. It is not possible to provide a specific script for members of the campus community to follow because every situation is different. However, we expect that providing a few examples will help you feel more comfortable navigating these types of conversations. One example is between a professor and a student. The next example is between two college students who are friends. And the last example is demonstrating a peer using a crisis hotline. In all scenarios, the concerned community member uses the same strategy of expressing concern, asking about suicide, and making an appropriate referral. Let's jump into our first example. Michelle is a 20-year-old undergraduate student who has exhibited a downward trend throughout the semester. That is, you have observed that Michelle has gone from being an active participant in classroom discussion to coming to class late and falling asleep in class, asking for extensions on assignments, and appearing completely disengaged in a group project. After noticing these changes, you decide to briefly check in with Michelle after class to better understand what is going on. You invite her to your office for office hours to initiate the conversation. You ask, Hi, Michelle. I noticed you've been coming late to class recently, which isn't like you. I am curious, how have you been doing lately? It's been a tough week. Actually, the semester has been hard for me in general. I'm falling behind in all my classes. I'm sorry to hear that. Yeah, I have noticed that you seem tired in class and haven't been participating as much as usual. Yeah. Tell me about falling behind. I just don't have the energy for all of my schoolwork. I have been having a hard time concentrating, and it feels impossible to catch up on everything. I'm embarrassed about being so far behind and it has been a vicious cycle of trying to catch up in one class and then falling behind in another class. I don't know what happened to my motivation. I hope you know it isn't anything personal about your class. It sounds like this semester is overwhelming, and you have been feeling really down about it. Yeah, I am. I can see my grades slipping. It's been like I'm losing everything I've worked so hard for. I'm worried about you. It seems like it could be helpful to talk to someone about everything you are going through. Yeah? Maybe it would be helpful. I'm not sure. Well, have you ever thought about making an appointment with someone in the counseling center? I haven't considered it. It's not that I wouldn't, I just don't know if it's for me. That's a totally common feeling to feel uncertain about making an appointment at the counseling center, especially if you've never been there before. I've personally heard from other students that they've found the counseling center to be quite helpful. Yeah. My mom tells me I just need to push through to graduation. But I feel so much pressure on me. I wish I didn't have to deal with all of this anymore. Can I ask? Have you been thinking about hurting yourself or killing yourself? To be honest, my best friend from home killed themselves two months ago, and since then I just haven't been able to stop thinking about it... I just want to make the pain go away. I'm so sorry for what you've been going through. If it's okay with you, we could call or walk over to the counseling center together and let them know what's going on. I'm concerned from your safety and think it's important that you see them today. Okay, I guess that would be all right. The conversation between Michelle and her professor was relatively brief and supportive, and it served to assist Michelle in accessing a resource that might benefit her as she experiences psychological distress after the recent suicide of a friend, and has been experiencing thoughts of suicide herself. As this conversation demonstrated, checking in with a student does not have to lead to an extremely long conversation, and it does not require being a mental health professional. Making time to help a student experiencing serious challenges can make a difference for them in understanding that support can be easily accessed and reduce their distress. When approaching these conversations with students, consider stating what behaviors you have observed, voicing your concern, directly asking about thoughts of suicide, and providing support to access relevant resources if they may want or need it.
[5:29]Some background on our next example. Alex is a 21-year-old undergraduate student that you have known since you were both freshmen. You've noticed that this semester, Alex has been turning down invitations to hang out after class and go to the gym and has been talking a lot about feeling tired all the time. After Alex does not show up for your class together two weeks in a row, you decide to reach out to them via text. Hey! I noticed you weren't in class today or last week. It's been a minute since I've seen you. How are you doing? I'm doing okay. I guess. Yeah?
[6:06]Quinn and I broke up and it has been wrecking me. We had planned to move in together after graduation and now it's just over. Oo...that totally sucks. I'm really sorry, dude. Yeah, it's been bad. My sleep's messed up & I feel useless. Idk if you have ever felt like this before but everything feels like and effort. So that's why I haven't been to class. Dude. You sound like you might be kind of depressed. Maybe? Idk. I feel weird even talking about it with u. I don't want you to have to handle my baggage. It's all good. I'm your friend and I want to help you. It sounds like ur going through a pretty rough time right now. Yeah. But it's all good. I can just off myself & then none of this will matter... LOL I can't tell if ur kidding. For real- Are u thinking about killing yourself? I've had thoughts about things being easier if I didn't have to deal with all this right now but I would never actually kill myself. I promise. I could never do that. U sure? I'm sure. I know I'll get over the whole Quinn thing & I have so many reasons to live. I get what you're saying. What do you think about talking to someone @ the counseling center or something? I have some friends who have gone for a couple sessions & they found it pretty helpful. I think I would like that actually. Cool! You mind letting me know if you end up going? Sure. Will do. Thx. Dinner tomorrow? Sounds good. This conversation between Alex and their friend demonstrated that you don't have to be face-to-face with someone to offer them support, resources, and a reminder that they're not alone. If you are unsure about what to do in a situation where you are concerned about someone's safety, you are encouraged to consult with your school's counseling center so they can help clarify a student's level of risk and what resources may be beneficial for their well-being and safety. Engaging with a person you're concerned about and offering resources may not go as smoothly as it does in these first two scenarios. For example, it may be the case that someone shares they are struggling or having thoughts about suicide, but that they're not interested or comfortable in seeking formal support. It might also be the case that you have an unsettling feeling about someone's safety and you're unsure of what to do. These are challenging situations to navigate. In the next roleplay, we're going to demonstrate how to navigate a challenging situation by using resources that can help you if you're feeling uncertain. Remember, the National Crisis Hotline, which you can reach by dialing 988, or similar hotlines, aim to support individuals in crisis, in addition to individuals who are worried about someone who might be in crisis. In this scenario, we will pause at a few points to identify a few things that are likely to occur when calling a crisis hotline, like 988. Knowing this information in advance can help you feel prepared to use a hotline resource in the future. Okay. Let's turn to this next scenario. Ash and Isaac have been lab partners since the beginning of the semester. Initially, Isaac was an eager participant in the experiments and fun to be around. But now, two months into the semester, Isaac frequently misses lab time, and when he does show up, is often disengaged and quiet. Ash recently talked with Isaac about noticing the change in his behavior, but Isaac ended the conversation quickly and wasn't interested in any resources. Now Ash is feeling worried and is unsure how to move forward with Isaac. So Ash reaches out to a crisis hotline for advice. Thank you for calling the crisis line. My name is Harper. How can I help you? Hi Harper. My name is Ash. I'm not entirely sure how to do this call. It's okay to be candid with a crisis line, and it can be helpful to provide your name to make it feel like a more trusting conversation. Thanks for calling Ash. There's no one right way to call. I'm just glad you did. What prompted you to reach out today? I'm calling about my lab partner, Isaac. I'm really worried about him. Sometimes when people call worried about another person, they're also having a tough time. Have you had any thoughts of wanting to kill yourself in the past few days? A suicide hotline will ask you about your thoughts of suicide, even if you're calling about someone else. Just answer honestly. No, I'm just not sure what to do about Isaac. Okay, I promise, we will talk about Isaac. But I just want to make sure you're safe. Have you had any thoughts of suicide today? Sometimes there is a set series of questions that a crisis line must ask any caller, like this one. Again, just answer honestly, and then they will talk with you about your concerns. No, and I'm good. I appreciate you answering my questions. Talking about suicide can be really hard, and I'm grateful you were willing to call. So, Isaac sounds like the reason you're calling. What's going on that makes you worried about him? Ash reports the change of behavior they have noticed, along with the context that Isaac recently experienced a breakup. Thank you for sharing all of that with me. It sounds like you really have been paying attention to Isaac's changes. In those changes that you have noticed, has he said or done anything that makes you nervous he might try to kill himself? I mean, I haven't asked him directly, because we're never alone together. But he makes some really dark jokes sometimes. Yeah, it can feel really scary to be concerned about a peer. Do you know if he's attempted suicide in the past? I don't know him that well, and I'm not really sure what to do because he didn't want resources either. Sometimes people get worried about saying or doing the wrong thing. It is normal to feel confused or unsure how to move forward sometimes when people decline our offers for resources. At this point, the crisis counselor may ask Ash more detailed questions about the changes in behavior they have witnessed, Isaac's relationship with alcohol and other substances, and assess whether Ash is concerned about Isaac's immediate safety. It can be really hard to answer these questions because you can't read his mind. I really appreciate you thinking about it with me. The crisis counselor may ask further questions about protective factors, such as events Isaac may be looking forward to, social connections Isaac seems linked to, or religion/beliefs that may inhibit suicide as an option. It's okay to not know the answers to these questions. The focus of this conversation is brainstorming together. Talking about suicidal thoughts can sometimes make us nervous or scared, and we talk around the topic instead. When you talk with Isaac next, it's important to be direct, and then listen to him. Giving a person the ability to be frank and honest about how they are feeling, and actively listening can be one of the most important things we do to provide care. Also, given the sensitive nature of this conversation, if possible, it would be ideal for it to be in private or where others are unable to hear you. I'm feeling really stressed about talking with Isaac. Yeah, it's normal to feel anxious. But Ash, you're doing a really great job. Clearly, you care about Isaac. Sometimes it can be stressful, but please know that the crisis line is here to support you as well. If you ever feel overwhelmed or stressed, we are on your team and are here to talk to you about you. Thanks. How would you feel about talking through how that conversation with Isaac might go? The crisis counselor may help Ash think through how they're going to approach the conversation with Isaac. The crisis counselor may even offer to three-way call Isaac with Ash. I'm not sure how I feel about adding Isaac to this call. I don't want to surprise him out of the blue. That's totally fine, and you have a good sense of him. But if the need arises, you can always call the hotline together in the future. We've talked through some next steps. How confident are you feeling about supporting Isaac? I'm feeling better. I'm going to ask him directly next time I'm concerned and listen to how he responds. If needed, we might call you guys back together. That sounds good. And remember, you can call us back 24/7 if you need more support. I'm really glad you called. Me too. Thanks.
[14:44]In this module, you saw multiple examples of how members of the campus community may talk to someone who they feel may be at risk for suicide. You learned to share what patterns you've observed, ask open-ended questions to explore the person's experiences, reflect and summarize what the student is saying, express concern, offer a resource, and normalize using resources when support is needed. This concludes module five.
