Distressed Student Guide Table of Contents

Introduction 1

College Students and Mental Health 2

Contact Information 3

MSU Billings Student Consultation Team (SCT) 4

MSU Billings Conduct Review Team (CRT) 5

Signs of Distress 10

Disruptive Behavior 10

How to Help:

The Aggressive Student 11

The Bipolar Student 12

The Demanding Student 13

The Depressed Student 13

The Disruptive Student 14

The Student with Eating Problems 15

The Student Under the Influence 21

The Student who is a Survivor of a Hate Incident 22

The Student who is a Survivor of a Hazing Incident 22

The Student who is a Survivor of Relationship Violence 23

The Student who is a Survivor of Sexual Assault 24

The Student who is a Survivor of Stalking 25

How to Effectively Respond to Students with Other Concerns:

Responding to a Student with a Disability 26

The Academically Dismissed Student 27

The Undecided Student 32

The Indecisive Student 33

Introduction

Montana State University Billings is committed to creating a safe and healthy learning, working, and living

environment. One way to achieve this goal is to address the mental health needs of our students. When we

take on a sense of ownership for the holistic health of our students, it can provide us with an opportunity to

be a part of helping another person achieve his/her academic dreams.

be particularly true for students who cannot or will not turn to friends or family. Students are apt to turn to a

classmate, roommate, staff member they know or faculty member they trust, especially if they perceive them

as available and willing to listen. Our goal is to create a “Culture of Support.” Also, following regulations from

the Office of Civil Rights, a university’s response to sexual harassment is paramount. Showing interest and

concern may be a critical factor in saving a student’s academic career or even a life.

The Distressed Student Guide has been created for the purpose of providing you with information about

Student Health Services, about other campus resources, and how to most effectively assist students in

distress.

College Students and Mental Health

According to the MSU Billings 2018 American College Health Association National College Health

Assessment II (n=376)

Students rated the following top 5 academic impacts:

• Stress 34%

• Received a lower grade on an exam, or an important project

• Received a lower grade in the course

• Received an incomplete or dropped the course

• Or experienced a significant disruption in thesis, dissertation, research, or practicum work

Within the last 12 months, % of students who said the following has been traumatic or difficult to handle:

MSUB data Fall 2018 (N=26,181)

Finances 46% Academics 48%

Academics 43% Finances 31%

Sleep Difficulties 38% Sleep Difficulties 31%

Felt overwhelmed by all they had to do 86% 87%

Felt so depressed it was hard to function 45% 42%

Felt overwhelming anxiety 66% 63%

Felt overwhelming anger 44% 42%

Seriously considered suicide 13% 12%

Students, Stress, and Sleep

47% rated their overall level of stress as “more than average”

46% felt “tired, dragged out, or sleepy” at least 3 days/week

41% felt they did not get enough sleep to feel rested in the morning at least 3 of the past 7 days

Contact Information:

Student Health Services: 657-2153/City College 247-3027

Community Crisis Center: 259-8800

YWCA

University Police: 657-2147

University Housing: 657-2333

• Counseling

If students have questions regarding emotional health or just want to talk with a counselor, they can

call (406) 657-2153 to make an appointment. They should arrive a few minutes early to complete

paperwork before their first appointment.

This is not a drop-in crisis counseling center. The counselor coordinates with Student Health Service

physicians when psychotropic medications seem advisable.

If the student wishes to pursue seeing a professional in the community, Student Health Services is

would like to access Student Health Services, they may pay the fee.

**No-Show Policy**

If a student is unable to keep their Student Health Services Counseling appointment, they must call

(406) 657-2153 at least 24 hours in advance to cancel (or as soon as possible for appointments made

for later the same day) so that other students can have access to this limited student support resource.

Failure to cancel two appointments in the same semester at least 24 hours in advance will result in the

student:

• Medical

The Student Health Service is staffed by Advanced Practice professionals (Nurse Practitioners) and

Registered Nurses. Our clinicians can diagnose, treat, and write prescriptions for a variety of health

issues.

Although walk-in appointments may be available, we encourage the student to call (406) 657-2153 to

make an appointment in order for us to best serve you.

A fee is automatically assessed to students taking seven (7) or more credits. Students taking less than

7 credits may pay the Health Service fee.

Additional Resources:

Vice Chancellor for Student Access and Success

http://www.msubillings.edu/vcsa/index.htm

Phone: 406.657.2307

Disability Support Services

http://www.msubillings.edu/dss/default.htm

Student Support Services/TRIO

http://www.msubillings.edu/sss/index.htm

Phone: 406.657.2162

Career and Employment Services

http://www.msubillings.edu/careers/default.htm

Phone: 406.657.2168

Academic Support Center

http://www.msubillings.edu/asc/index.htm

Phoenix Center

http://www.msubillings.edu/studenthealth/phoenix_ce

nter/index.htm

Phone: 406.794.3829

ASMSUB Student Government

http://www.msubillings.edu/asmsub/index.htm

Phone: 406.657.2365

Emergency Resources:

Community Crisis Center

704 N 30th Street

https://www.crisiscenterbillings.org/

Phone: 406.259.8800

YWCA

https://www.ywcabillings.org/emergency-services/

Phone: 406.245.4772

MSU Billings Student Consultation Team (SCT)

Purpose:

The purpose of the Student Consultation Team (SCT) is to serve as a network of existing professionals

focused on prevention and early intervention in community situations involving members experiencing

distress or engaging in harmful or disruptive behaviors (Cornell University's statement). This also involves

proactive intervention when determined potential behavior may be disruptive to the campus community.

information is gathered, shared and investigated in a timely manner and provides support for people of

concern.

Responsibilities:

1. Receive, review and document information about community concerns regarding student, faculty, staff,

and or guest behavior.

2. Perform initial assessment of risk and refer incidents to specific offices and/or community resources as

needed.

3. Review information and determine best source of care for individuals determined in need.

4. Make recommendations to University officials regarding policies and procedures related to assessment of

and prevention measures related to disruptive behavior.

Membership:

• Dean of Student Success-Chair

• Conduct Review Team Chair—Associate Dean of Students

• Counseling Director, Student Health Services

• City College Representative

• University Police

• Consultation representatives: DSS, Athletics, ASC, Advising Center, NAAC

MSU Billings Conduct Review Team (CRT)

Purpose:

The mission of the Conduct Review Team is to allow for experiential and collaborative engagement by

university hearing officers to discuss and address alleged violations of the student conduct code. The

following student learning outcomes are a result of the CRT mission.

• Students who participate in the conduct process will be able to identify new skills & knowledge that

promote health, wellness, and reduces risky behavior.

• As a result of completing the student conduct process students will be able to consider personal

decisions on academic future.

Membership:

• Director of Housing/Residential Life – Chair

• Hall Directors

• Vice Chancellor for Student Affairs

How to Deal with Reports of Sexual Harassment, Violence and/or Assault

When a faculty or staff member receive information from a student who states either they or someone close

to them has been involved in a sexual assault (or other forms of harassment), there are required steps a

the incident to Title IX Office (Human Resources).

• If the student wishes to not provide details, go to University or Billings Police, report to Title IX

Coordinator, or report the incident to the Dean of Student Engagement office, that is their right.

However, it is mandatory you share the report to the appropriate reporting parties (listed below).

• This can be a third-party “Jane Doe” report.

• Let the student know there are services on campus to assist, such as the Student Health Services,

YWCA resources, etc. The Phoenix Center, University Police, Housing personnel, YWCA and

Student Health Services personnel will have lists of other resources available.

• If a student decides to report the assault, please encourage them to contact University Police, and

the Title IX Coordinator (Human Resources) or Dean of Student Engagement Office. Also,

A Note on Confidentiality

in counseling. For information about the student to be released to you or others, we must first get permission

from the student.

What Can You Do

If you choose to approach a student you are concerned about or if a student comes to you for help, here are

some suggestions which might make this more comfortable for you and be more helpful to the student. In

many cases of student distress, faculty and staff can provide adequate help through empathetic listening,

discussing concerns, instilling hope, being nonjudgmental, and offering options. Students are often oblivious

to the impression they make. Careful listening and courteous dialogue will often resolve problems.

• Maintain clear and consistent boundaries and expectations.

• Listen carefully and sensitively to the student’s feelings and thoughts in a non-threatening way.

• Give student your undivided attention.

• Communicate understanding by repeating what he/she has told you.

• Let the student talk. Don’t minimize or immediately provide reassurance.

• Praise for student for openness and honesty.

• Ask specifically about their level of risk regarding suicidal thinking.

• Ask if they have thoughts about suicide.

• “Do you ever feel so badly that you have thoughts of suicide?” “Do you have a plan?”

• “Do you know when you would do it?”

work together to get help. Make sure you follow through.

When and How to Refer

In some cases, students need professional help to overcome problems and to resume effective coping. The

following signs indicate that a student may need counseling.

• The student remains distressed following repeated attempts by you and others to be helpful.

• You find yourself conducting on-going counseling rather than consultation and advising.

2. Speak to the student in a direct, concerned, straightforward manner.

Since faculty and staff are in a position to observe and interact with students, they are often the first to

recognize a student in distress. Look for a pattern of these indicators:

• tearfulness or excessive emotions inappropriate to the situation

• markedly diminished performance

• alcohol or drug use

Students experiencing mild depression often respond well to additional attention over a short period of time.

Prompt intervention increases the student's chances of returning to earlier performance levels. Do not

attempt to provide in-depth counseling.

Helpful Actions:

• Let the student know you are aware he or she is feeling down and you would like to provide support

and assistance.

Unhelpful Actions:

• Minimizing the student's feelings ("Everything will be better tomorrow.")

• Bombarding the student with fix-it solutions or advice.

• Trying to solve the student’s problems.

• Ignoring signs of suicidal thoughts or warning signs

It is expected that by the time students reach college they will know how to behave in a classroom.

Unfortunately, college instructors often experience, on a daily basis, students who are chronically late, who

talk to friends during class, who eat or sleep in class, and who engage in arguments with instructors or other

Helpful Actions:

• Invite the student to speak in a private area (if you feel safe). Acknowledge the emotions, if the

student seems upset, angry, or frustrated (“Sarah, I notice you seem frustrated.”)

• Briefly state your concern, “Sarah, I am concerned that you have been late for class every day

since the beginning of semester.”

Unhelpful Actions:

• If unsure how to proceed in a particular situation, consult with your department head, the Dean of Students

There are a multitude of reasons that individuals may develop disordered eating patterns such as stress,

perfectionistic tendencies, a need for control, sports-related expectations, a need for comfort, distraction from

intense negative emotions, etc. These patterns can fall on a continuum from mild and situational to severe

and life-threatening. Disordered eating patterns include over and under eating in relation to energy and

• low energy

• hoarding food

• restricting entire food categories for non-medical or religious reasons

• refusal or reluctance to eat around others

Helpful Actions:

• Speak directly to the student about your concerns and the behavior you observe.

• Let the student know other qualities/characteristics you appreciate about him or her.

• Encourage the student to make an appointment with a professional counselor.

Self-injury is defined as any damage intentionally caused to one’s own body. This behavior is also referred to

as self-harm or self-mutilation. Like substance abuse, self-injurious behavior can be linked to no single

cause. It is observed in all cultures and socioeconomic levels and is observed in both females and males. It

does occur, however, more often among females and people who have a history of physical, emotional, or

sexual abuse. Even though there is always the possibility that a self-inflicted injury could be fatal, self-injury

is not considered to represent a suicide attempt. Self-injury usually occurs when people feel overwhelmed by

their emotions and are desperate to find relief from intense feelings, pressure, or anxiety. Self-injurious

• hair-pulling (trichotillomania)

• head-banging

• hitting (with a hammer or other objects)

• bone-breaking via a number of methods

Helpful Actions:

• Speak honestly to the student about your concerns and describe specifically what you have

observed that makes you suspect they have been engaging in self-injury.

• Encourage the student to make an appointment with Student Health Services to help her/him to

• Responding with shock, horror, or disgust to the self-injurious behavior.

• Ignoring the behavior and the possibility of serious physical damage.

• Becoming overly involved with the student beyond your level of expertise.

When someone suffers a loss, it disrupts their sense of the order of things and can sometimes lead to

feelings that life is out of control and meaningless. People may deal with the death of a parent, sibling, family

member, friend, pet, or classmate, or a divorce or other losses. These deaths may be accidental, may be

sudden, or may be the result of a long illness. An entire campus or academic department may grieve the

death of a beloved professor or classmate. Feelings are often compounded by a sense of shock and a

longing for the opportunity to "say goodbye." The loss of meaning and control adds distress to grief.

the common grief reactions. These reactions to loss may include:

Physical Reactions:

• Fatigue/Exhaustion

• Sleep disturbance

• Change in appetite

• Headaches

Cognitive Reactions:

Emotional Reactions:

• Guilt

• Feelings of helplessness

• Anger/irritability/moodiness

• Sense of hopelessness

Helpful Actions:

• Talk slowly and remain calm.

• Encourage the student to talk with someone about her/his feelings, fears, and uncertainties. Refer

the person to Student Health Services at (406) 657-2153.

Unhelpful Actions:

• Feeling pressure to “say the right thing” or break silences. Your supportive and caring presence can

be comforting.

• Forcing discussion about death and loss.

• Minimizing the loss and being suggestive that one must just move forward.

• Judging the person’s response to death, unless it seems extreme or frightening to you, in which

The Overanxious Student

Anxiety is a normal response to a perceived danger or threat to one’s wellbeing. While everyone suffers from

occasional anxiety, sometimes the level of anxiety can become overwhelming. For some students, the cause

of anxiety is clear; for others, it is difficult to pinpoint the reason for their distress. Regardless of the cause,

the student may experience the following symptoms: rapid heartbeat, chest pain or discomfort, dizziness,

sweating, trembling, or shaking. The student may also complain of having difficulty concentrating, always

• Let the student discuss her or his feelings and thoughts in an appropriate setting; this alone often

relieves a great deal of pressure.

• Provide reassurance.

• Be clear and directive.

Unhelpful Actions:

• Minimizing the perceived threat to which the student is reacting.

• Taking responsibility for the student’s emotional state.

appropriate referrals if needed

The Student who Presents as Threatening

All encounters have the potential for escalation into violence, and that escalation has predictable, and

identifiable, behaviors. There are two forms of violence:

Intended Violence - Planned, premeditated attack on a specific target. (Example: stalking a former

relationship partner with intent to harm)

657-2222, or call 911.

Give more information, reframe to the positive. Identify behaviors you are observing and the

consequences if they continue.

Can we go down the hall/step into this room, and talk about it?” Empathize, yet be firm. “I

understand this doesn’t make sense to you.” Don’t make threats or tell them you’ll have them

arrested. You can say, “If you don’t calm down, I will call the police.” Ask them to step back if in your

space. Usually they will honor that, if not, call Campus Security and Police.

The Student in Poor Contact with Reality

student’s statements, contact Student Health Services as soon as possible.

Helpful Actions:

• Respond with warmth, kindness, and firm reasoning.

• Remove extra stimulation from the environment (turn off the radio, step outside of a noisy

classroom).

• Explain your concerns and assist the student in getting help. Contact Student Health Services as

soon as possible.

• Acknowledge the student’s feelings or fears without supporting the misperception (“I understand

• Encouraging further discussion of the delusional processes or playing along with the student’s

delusion (“Oh, yes, I hear voices, too.”)

• Demanding, commanding, or ordering the student to do something to change her or his

perceptions.

• Expecting customary emotional responses.

• Acknowledge that you are having difficulty understanding the student and ask for clarification.

• Focus on the here and now.

The Suicidal Student

It is important to regard all suicidal comments as serious. Watching for some of the following behaviors will

offer clues on the student’s frame of mind. If a student exhibits any of the symptoms below, refer her or him

• comments that life isn’t worth the trouble

• recurrent thoughts or statements about suicide

Helpful Actions:

• Be confident, caring, and prepared to provide information about available student resources.

• If you have an intuition that something is wrong with the student, call Student Health Services for

consultation with professional staff.

• If you believe there is imminent danger, call Student Health Services at (406) 657-2153 to check for

counselor availability. If counselor is not available, refer to Community Crisis Center - 704 N 30th

• Being too busy to intervene.

• If it is after hours and the student is cooperative, call a friend, family member, or University Police at (406)

• If it is after hours or the student is uncooperative, call University Police at (406) 657-2222 or 911.

The Student Under the Influence

four for women, is popular and can quickly become lethal. Other adverse effects of alcohol consumption

include: hangovers, hospitalization for alcohol overdose, poor academic performance, class absences, injury,

alcohol or drug abuse sabotages student performance.

Be aware that substance abuse may result in overly aggressive behavior. In such cases, remain calm and

get help if necessary (send a student for a staff person, faculty member, department chair, or security

officer). Stay safe by retaining access to a door, knowing whom to call (University Police, (406) 657-2222, for

emergencies call 911), and keeping furniture (e.g., a desk) between you and the student. Do not threaten,

corner, or touch the student.

after a referral is made.

Unhelpful Actions:

• Conveying judgment or criticism of the student’s substance abuse.

• Making allowances for the student’s irresponsible behavior.

• Ignoring signs of intoxication in the classroom.

If the behavior continues, consult with your department head and the Dean of Students (406) 657-1696.

The Student who is a Survivor of a Hate Incident

A hate incident is an act that, while not meeting the legal definition of a crime, involves the same types of

behavior and targeting of underrepresented groups. Hate incidents are more common on college campuses

than hate crimes.

Helpful Actions:

• Talk to the student survivor in private.

• Recognize that the student is probably experiencing a range of intense feelings, including shame,

anger, fear, and denial.

• Downplaying the situation.

• Expressing personal biases.

• Getting caught up in the technicalities or legalities of the situation.

The Student who is a Survivor of a Hazing Incident

Facts about Hazing

Hazing involves persecution and harassment with difficult, meaningless, or humiliating tasks; it is used as a

rite of passage or initiation into a campus organization.

Hazing can be psychologically damaging and present serious physical risks (including death) to students. A

• Talk to the student survivor in private.

• Recognize that the student may be feeling vulnerable and experiencing a range of emotions.

• Advise the student to report the incident to the Office of the Dean of Students (406) 657-1696.

• Advise the student to report the incident to the University Police (406) 657-2222.

• Refer the student for follow-up counseling at Student Health Services (406) 657-2153, if

appropriate.

Unhelpful Actions:

• Minimizing the situation.

The Student who is a Survivor of Relationship Violence

Relationship violence is a term used to describe abuse within a relationship that is psychological, emotional,

sexual, or physical. Abusive behaviors may include: physical abuse, verbal abuse, name calling, sexual

violence, isolation, coercion, harassment, economic control, abusing trust, threats and intimidation, emotional

withholding, destruction of property, or self-destructive behavior. Most forms of relationship violence are

as: inability to concentrate, emotional trauma, Post-Traumatic Stress Disorder (PTSD), physical harm, or an

abuser preventing the student from attending class or completing course work.

Helpful Actions:

• Listen to and believe the student.

• Understand the seriousness of all forms of abuse.

• Respect the student’s right to make their own decisions.

• Help the student to identify resources such as, Student Health Services, Phoenix Center, University

Police, or the YWCA.

• Blaming the student for staying in the relationship-the dynamics of relationship violence are

complex and the survivor is NEVER at fault for the abuser’s behaviors.

• Telling the student something is wrong with her/him if she/he has not left the relationship-this

reinforces the abuser’s messages of low self-worth.

• Giving advice or pressuring for decisions -the student knows the dynamics of the abusive

relationship best and she/he will know what feels safe and what actions put her/his life in danger.

• Criticizing the abuser instead of the abuser’s behavior - this may cause defensiveness in the

student.

• Let the student know that if the abuser has threatened harm to another person, you are to report this to

The Student who is a Survivor of Sexual Assault

The Student with Math Anxiety

Facts about Math Anxiety:

Students can experience math anxiety in any class that has quantitative activities. Math anxiety can be

caused by poor math teaching; cultural expectations (e.g., only men excel in math); not being

developmentally ready for certain math concepts; having a math learning disability; and the sequential nature

Math anxiety can be successfully addressed, using both psychological and learning strategies coupled with

appropriate math placement.

Symptoms of math anxiety include:

• rapid heartbeat, sweaty palms

• feelings of inadequacy, negative self-talk

• an inability to retain information in a test situation

Helpful Actions:

• Recommend some study strategies (e.g., note cards, time management, paper-and- pencil

techniques) to help the student begin to take control of the learning process or some

accommodations, such as extended time for an assignment.

• Refer the student to the Academic Support Center (406) 657-1641.

• Refer the student to the Student Health Services (406) 657-2153 for counseling.

Unhelpful Actions:

• Minimizing the situation.

• Expecting the anxiety to just go away.

Avoidance of important work can lead to stress, depression, shame, and guilt which, in turn, can cause the

student to avoid the same tasks in the future.

While some students procrastinate because a given task is aversive, there is usually an emotional cause at

the root of serious procrastination.

Helpful Actions:

• See the student privately.

• Help the student assess time management skills and refer the student to the Academic Support

Center (406) 657-1641 for skill building.

• Help the student set specific and realistic goals. Procrastinators often cannot see the trees for the

forest!

• Be clear with deadlines, limits, and consequences.

• Identify how procrastination hurts the student and use his/her suffering as a motivator for change.

Unhelpful Actions:

• Assuming that the student is lazy or stupid.

• Communicating in ways that increase shame and, thereby, decrease motivation to change.

• Being pushy because the student could respond with resentment or rebellion.

• Conveying disappointment or irritation if the student does not make quick progress. Such messages

may lead to a standoff, which is a relationship pattern that procrastinators often have with others.

The Student with Writing Anxiety

Facts about Writing Anxiety:

Anxiety may result in assignments being late or not turned in at all. A history of incompletes may be a sign of

writing anxiety.

Often the student is emotional when discussing his/her writing.

• poor organization skills problems with grammar

• poor grades on writing assignments in the past

• a learning disability

Helpful Actions:

• Have a private appointment with the student.

• Listen carefully to the student’s explanation of the problem.

• Look for patterns and repetition of the problem behavior.

• Refer the student to a writing counselor at the Academic Support Center (406) 657-1641 for

Unhelpful Actions:

• Concluding that the student is only trying to obtain extra time for the assignment.

• Assuming the student can simply control the behavior by him/herself.

Being undecided about a major or career is a normal developmental process.

Difficulties and delays in making a career decision can lead to stress and poor academic performance.

Helpful Actions:

The Indecisive Student

Facts about Career Indecision:

Indecision refers to chronic difficulties in making decisions about a major or career, and often in other areas

of life.

Helpful Actions:

• Be supportive and understanding.

• Point out the self-defeating patterns or symptoms.

• Refer the student to the Student Health Services (406) 657-2153 for career counseling.

• Refer the student to the Student Health Services (x2153) for interest testing, career guidance,

occupational information, and internships.

Resources:

Boise State University Health and Recreation Counseling Services

http://healthservices.boisestate.edu/resources/materials/reachingOutHandout.pdf

Student in Distress and Sexual Harassment: A Guide for Faculty and Staff

MSU Billings

http://msubillings.edu/VCSA/PDF/GuideforFacStaff-StudentBehavior.pdf

National Alliance on Mental Illness web-based survey

August-November 2011 N=765

http://www.nami.org/Content/NavigationMenu/Find_Support/NAMI_on_Campus1/NAMI_Survey_on_College