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How to Help your Distressed Friend: A Pamphlet for Georgetown University Students

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Why you are so important

Friends are in an important position to identify and help students who are in crisis or distress.  This may be particularly true for students who can not or will not turn to their parents, RAs, or faculty.  Many of these students have not sought counseling and may be unaware of the services available to them.  You may be the first to notice changes or hear about early signs of distress.  Students are apt to turn to you, especially if they perceive you as available and willing to listen. Your expression of interest and concern may be a critical factor in saving your friend's academic career or even his/her life.

Possible warning signs of a Student in Distress

Academic

• Deterioration in quality of work
• Missed assignments or appointments
• Repeated absence from class or lab
• Continual seeking of unusual accommodations
• Lack of engagement in participation-oriented classes or labs
• Inappropriate disruptions

Physical

• Marked changes in behavior and/or appearance
• Excessive fatigue or sleep difficulties
• Visible increase or decrease in weight
• Exaggerated personality traits or behaviors (agitation, withdrawal, lack of apparent emotion)
• Excessive use of alcohol or other drugs
• Unprovoked anger or hostility
• Irritability, constant anxiety, or tearfulness
• Marked changes in concentration or motivation
• Overtly suicidal thoughts

Other Signs

• Isolation
• Dependency or seeking a lot of your attention
• Direct statements indicating social and academic problems, personal losses, break up, etc.
• Expressions of concern about the student by other peers
• Written notes, emails, or verbal statement that has a sense of hopelessness or finality
• Your sense, however vague, that something is seriously amiss
• Click here for general signs of depression.

Consulting with CAPS

If you decide to be more explicit about your concern with your friend, feel free to contact CAPS (202-687-6985) to discuss various options on how to handle the situation before you meet with your friend.  If you are currently with your friend and he/she seems to be in extreme crisis, you can request to call CAPS for consultation, at that moment, for your own support on how to handle the situation.  In case of emergencies after-hours, you can PAGE CAPS.  A clinician will help you:

• Assess the situation, its seriousness, and the potential for a referral
• Propose possible interventions
• Explore resources, on and off campus
• Find the best way to make a referral, if appropriate
• Clarify your own feelings about the what is going on and consider ways you can be most effective
• Discuss follow-up concerns after you have spoken with your friend

Talking with your Friend

Converse with your friend in private, and when both of you have the time and are not rushed or preoccupied.

• Be direct, specific, and non-judgmental, and especially when expressing your concern.
• Avoid judging, evaluating, shaming, criticizing, even if the he/she asks for your opinion.
• Avoid offering advice outside your area of expertise.

Listen carefully and sensitively, to the student?s thoughts and feelings in a non-threatening manner. 

• Give your friend your undivided attention.   
• Communicate understanding by repeating back the essence of what your friend  has told you.  
• Let the your friend talk; don't minimize or immediately provide reassurance. Telling your friend that things aren't that bad, or that he/she has everything to live for will likely discourage further disclosure, and may increase his/her sense of guilt and hopelessness. 
• Praise them for being open and honest with you.
• Eventually emphasize that help is available, depression and problems are treatable, and that suicidal feelings are temporary.

Ask specifically about their level of risk

• Ask if they have thought about suicide.  Use the word suicide.  This does not increase the risk, and most students are relieved to have someone to talk to about this.
  • "Do you ever feel so badly that you have thought of suicide?"
  • "Do you have a plan?"
  • "Do you know when you would do it (today, next week)?"
  • "Do you have access to what you would use?"
• Never agree to keep suicidal thoughts in confidence.
• Suicide can be a scary topic, especially for a friend, but it can be a very serious one that needs attention.
• Asking the above questions will allow you to determine if your friend is in immediate danger, and to get help if needed.  If your friend is in immediate danger, consider this an emergency.

• If you feel the person isn't in immediate danger, acknowledge the pain as legitimate and offer to work together to get help.  Make sure you follow through.

Refering the student to CAPS

Refer the student to CAPS if you feel it is appropriate.  Be sure to:

• Let them know that help is available and problems are treatable.
• Indicate that seeking help is a sign of strength and courage rather than a sign of weakness or failure, and it is also a sign of good judgment and the appropriate use of resources.
• Prepare the student for what they might expect if they follow your suggestion, stressing confidentiality and free services at CAPS (see services for more information).
• Give your friend the CAPS number (687-6985) to make an appointment.

Emergencies

Emergencies are likely if the student is exhibiting:

• Suicidal behavior, attempts, and/or explicit statements 
• Extreme anxiety resulting in panic reactions
• Severe obsessive thinking
• Inability to communicate (garbled or slurred speech, disjointed thoughts)
• Confusion, disorientation, hallucinations, or delusions
• Highly disruptive behavior (hostility, aggression, violence)

Also be aware of the potential for violence, particularly if you notice:     

• Alcohol or drug intoxication
• Homicidal threats, written or verbal, or attempted assault
• Paranoia, agitation, hostility, aggression, recent acts of violence or property damage
• Destruction of property or other criminal acts

If you believe there may be an imminent danger of harm to the student or someone else, immediately call the Department of Public Safety, DPS (202-687-4343 or 202-687-HELP) if the student is on campus, or 911 if off campus.  Call CAPS for help in assessing the situation. 

Following-up:

• Make sure you follow through. This is one instance where you must be tenacious in your follow-up.  Give your friend CAPS' contact info, participate in making the first phone call, or go along to the first appointment. If you're in a position to help, don't assume that your persistence is unwanted or intrusive. Risking your feelings to help save a life is a risk worth taking.
• Check with them later to see if the referral appointment was kept, to solidify their resolve to obtain appropriate help and to demonstrate your commitment to help them in this process.
• If they did go, ask and how it went.  
• Please keep in mind that, by law, CAPS cannot inform you that your friend has made an appointment or has been seen, or of any content of sessions, treatment plans, or progress, unless he/she signs a written CONSENT that explains the purpose and content of any disclosures.