When to Refer a Student

The college years can be an important and stressful period of personal and psychological growth for students. On occasion students may experience difficulty coping, and the people around them (students, faculty and staff) may be the first to become aware of personal difficulties affecting a student.

If you are reading this, chances are you’re concerned about someone in your life. You may feel afraid, angry and/or helpless. These feelings are natural, but know that you’re doing the right thing by looking for ways to help. Sometimes it is difficult to know what will be helpful. This Web page is designed to give you some ideas about what to do.

Warning Signs

Consider referring a student to the Center for Counseling and Student Wellness if you notice any of these warning signs:

  • You find yourself doing more personal counseling than academic advising with a student

  • A student seems excessively tired, anxious, depressed, irritable, angry, or sad

  • You notice marked changes in a student’s appearance or habits (e.g., deterioration in grooming, hygiene, weight loss, interpersonal withdrawal, acceleration in activity or speech, or change in academic performance

  • A student seems hopeless or helpless

  • A student’s use of alcohol or other substances interferes with her/his relationships or work

  • A student's thoughts or actions appear bizarre or unusual

How To Refer

If you notice any of these warning signs, inform the student of your concern in a straight-forward, matter-of-fact manner. Be specific regarding the behavior patterns you have observed. At this point, suggest that he/she consider personal counseling and refer the student to the CCSW. Encourage the student to come to the CCSW during our walk-in hours (3:30 – 4:30 p.m., Monday - Friday), or to call for an appointment. Except in emergencies, the student should be allowed the option of declining a referral for counseling.


An emergency can occur anytime and may require immediate action. The CCSW provides 24-hour emergency crisis assessment and intervention throughout the academic year. The following are examples of emergency situations:

  • Suicidal gesture, stated intention or attempt to commit suicide
  • Behavior posing an imminent threat to the student or others.
  • Demonstrated inability to care for oneself.

Any reference to suicide should be taken very seriously, and a referral to the CCSW is strongly advised. If the reference includes any mention of details of a suicide plan, immediate response is critical.

How to Respond to an Emergency

  • If possible, offer a quiet place for the individual to talk.
  • Listen to the person, while maintaining a straightforward, considerate, and helpful attitude.
  • Do not leave the individual alone, unless you feel concerned for your own safety.
  • Secure help as soon as possible.

Who to Call During an Emergency

When faced with a mental health emergency, please contact the Center for Counseling and Student Wellness "Counselor-on-call." During business hours call the center directly (781-3388); after business hours call the Department of Campus Safety (781-3333) and ask the dispatcher to page the Counselor-on-call. If you are concerned about imminent danger to the student or others, ask the dispatcher to send a security officer right away. Be prepared to provide as much information as possible, including:

  • Your name and department, and the name of the student in question
  • Description of the situation and necessary assistance
  • Exact location and description of the person in need of help


As required by law and professional codes of ethics, all communication between a counselor and a client is confidential. Once a student becomes a CCSW client, we cannot discuss his/her situation, or even acknowledge the fact that counseling is being provided, without the consent of the student. However, the Center’s staff typically requests students’ permission to acknowledge referrals; if you do not hear from us, it is likely that permission has been denied.

The limits of confidentiality notwithstanding, the staff at the center can always listen to your concerns. Don’t hesitate to contact us to discuss your concerns and explore possible courses of action.



In most instances the problems people experience are not emergency situations. Everyone feels stress at times. However, stress may be of concern if you observe the any of the following:

  • Drop in academic performance
  • Excessive alcohol or drug use
  • Depressed or lethargic mood
  • Hyperactivity and/or rapid speech
  • Social withdrawal
  • Changes in eating patterns
  • Self-injury (i.e., cutting, scratching)
  • Unusual or exaggerated emotional response to events

If you choose to approach the person you are concerned about or if that person seeks you out, here are some suggestions:

  • Talk in private when both of you have time and are not preoccupied. Give your undivided attention. It is possible that just a few minutes of listening may be enough to help her/him feel comfortable about what to do next.
  • Be direct and non-judgmental. In a supportive and gentle but straightforward way, share what you have observed and what your concerns are. For example, say something like: "I've noticed you've been avoiding your friends lately and have been oversleeping and missing class. I’m really concerned and would like to talk about this.”
  • Listen sensitively. Listen to thoughts and feelings in a sensitive way. Communicate understanding by paraphrasing what you’ve been told. Try to include both the content and feelings. For example, "It sounds like you miss your family and are really feeling alone." Remember to let the student talk and be prepared for the possibility of strong feelings/reactions from the person (i.e. denial, anger, confusion).
  • Refer. Toward the end of the discussion, point out that help is available and seeking help is a sign of strength. If the person in an HWS student, you can refer them to the counseling center.
  • Follow up. Check with your friend later to find out how he or she is doing. Provide support or encouragement as appropriate.


A crisis is a situation in which a person’s usual coping style is no longer working. As emotions intensify, coping becomes less effective until the person may become disoriented, non-functional or attempt harm. If your friend is in a serious mental health crisis, you might see or hear the following:

  • Suicidal statements or suicide attempts
  • Homicidal threats, written or verbal or attempted homicide or assault
  • Destruction of property or other criminal acts
  • Extreme panic reactions
  • Inability to communicate (e.g., garbled or slurred speech, disjointed thoughts)
  • Loss of contact with reality (e.g., seeing or hearing things that aren't there, expressing beliefs or actions at odds with reality)
  • Highly disruptive behavior (e.g., hostility, aggression, violence)
    If you believe there may be an imminent danger of harm to her/himself or someone else, as evidenced by several of these crisis symptoms, immediately call Security at ext. 3333.

If you need help in assessing the situation, call the Counseling Center at ext. 3388 between the hours of 9 a.m. and 5 p.m. You may also consider walking the student to the Counseling Center during these hours since this is often an excellent way of showing support. After 5 p.m., you can contact Campus Security (ext. 3333) and ask the dispatcher to page the counselor-on-call.


Hearing about someone else’s struggles can be difficult and can leave you feeling emotionally drained. Your well-being is just as important as your friend’s. The following may be helpful for you as you deal with your friend:

Recognize the limits of your own power/responsibility. You do not have the power to:

  • Make your friend change
  • Control how your friend will respond to you

You do have the power to:

  • Be genuine and supportive
  • Be concerned about your friend
  • Determine how to express your caring and concern
  • Be honest with yourself about the amount of time and effort you can expend in helping your friend
  • Get support yourself
  • Be aware of your own needs and find ways of meeting them, e.g., seeking people who can give you emotional support
  • Maintain healthy boundaries

Remember, you don’t need to do it alone. Use the staff at the Dean’s Office, the Chaplain’s office or the Center for Counseling and Student Wellness when you need information about how to handle a situation. And realize the importance of taking care of your own needs.


Preparing Students to Lead Lives of Consequence.