Assisting Students in Distress

Suicide prevention training

Washington University offers two free evidence-based trainings for faculty, staff, and students.

Suicide Prevention Training

Four steps to recognizing and helping students in distress

Many college students with concerns about their emotional health are afraid to get the help they need. When students do reach out, they usually choose friends and family over RAs, staff or faculty. During your time at Washington University in St. Louis, you may need to help a friend or another student in distress. These four steps have been designed to help guide you in supporting your friend or family member.

Step 1: Recognize the warning signs
Recognizing the warning signs of a student in distress does not require special training or expertise. It does, however, require an awareness of what to look for. A friend may not come right out and tell you that something is wrong but his/her language and behaviors often do.


  • Shows up for an event for a while, but leaves early
  • Is “too busy” studying or surfing the web to hang out
  • Just doesn’t seem to connect well with others
  • Skips class frequently
  • Stays in room or bed all day
  • Avoids eye-contact

Disturbing speech/communication:

  • Uses language indicating intention to harm self or someone else
  • Expresses a hopeless or negative outlook
  • Blames self or others for his/her mood/behavior (“I’m just lazy…”)

Significant changes in mood or behavior:

  • Used to seem happy but now seems agitated, depressed, “checked-out”
  • May have been easy-going but now seems uptight, aggressive or “on edge”
  • Neglects personal hygiene or appearance
  • Increased use of alcohol or drugs
  • Significant weight gain or loss
  • Increased sleep or inability to sleep nearly every day
  • Decreased ability to concentrate

The greater the number of warning signs present, the greater the likelihood that the student needs assistance.

Step 2: Listen

Don’t be afraid to ask “What’s wrong?” or “What’s going on?” Simply asking the question won’t create a problem where there is none. Don’t underestimate the importance of listening. Without “doing” anything else, you are providing the support that could help your friend feel heard and understood (maybe for the first time). While it may be necessary or convenient to communicate electronically at times (email, text or instant messaging), if at all possible, try to listen in person where it is easier to pick up on cues from facial expressions and other nonverbal language.

Effective listening requires:

  • Attentiveness
    • Maintain eye contact.
    • Ask for clarification when you don’t understand something that has been said.
    • Lean forward with open posture to indicate interest.
  • Attention to verbal and nonverbal language
    • Pay attention to what is said and what is not said (i.e., tone of voice, posture, hand or facial gestures).
    • Notice when the nonverbal language doesn’t match the verbal language. Point out the disparity.
  • Accepting attitude
    • Try not to judge or discount what you are hearing.
    • Don’t say: “You shouldn’t feel that way” or “You’ll be fine.”
    • Do say: “This sounds like a tough situation.”
    • If you find yourself slipping into an advice-giving or “fix it” mode, you may not be listening. Take a breath and refocus on what your friend is saying.

Step 3: Express concern
It’s okay to express concern in a calm, nonjudgmental way. However, be careful not to over-react with too much emotion or panic.

  • Acknowledge the struggle
    • You can do this by simply explaining without judgment that you are concerned.
    • Do say: “I’m worried about you. It seems like you haven’t been yourself lately.”
    • Don’t say: “It seems like your life’s a mess right now.”

Step 4: Make a referral

Keep in mind that struggling with normal life events does not always require counseling. It is often the struggles in life that provide the most opportunity for growth. However, if the situation seems to be triggering a more severe reaction (things seem to be spiraling out of control for the student) or it has been going on for more than a couple of weeks, then a referral to counseling may be appropriate. Center for Counseling and Psychological Services staff members are here to provide support for your friend and for you. If you would like to consult with a staff member about how to handle your concerns, call 314-935-6695 to speak to the mental health service coordinator and schedule a consultation.

When to refer:

  • Review the warning signs to determine if any apply to the student (but always trust your own instincts even if there are no identifiable signs).
  • If you have immediate concerns about a student’s safety (i.e., you think he/she might cause harm to self or someone else), stay with your friend and call (on campus) Washington University Police Dept. at 314-935-5555 or when off campus, 911. If it is not a life-threatening situation but you are still concerned, accompany the student to Habif during regular business hours or call 314-935-6695. If it is after hours, call 314-935-6666 and press option #1.
  • If you are feeling overwhelmed by the student’s situation, consider talking with a counselor about how you can take care of yourself and get support.

How to refer:

  • Express concern again, “This sounds pretty difficult. There are more qualified experts who are available to help.”
  • The first step is a brief meeting with a MHS staff member. The purpose of the conversation is to clarify and assess needs, and explore options for next steps. The consultation can be scheduled by calling 314-935-6695 early on the day the student wishes to be seen
  • Commend your friend for taking this first step