The mental health needs on campus are increasing as well as the severity of issues our students are addressing. PACS is seeing a growing number of students with major mental illness, trauma history, substance abuse, chronic long-term relational problems and the inability to take responsibility for oneself. While we consistently see about 6% of the UNH population, the students coming for help are more often presenting in crisis, needing psychotropic medication and academic intervention in order to continue at UNH.
The University also has a number of diverse populations, racial, religious and ethnic minorities, non-traditional students, first generation college students, GLBT, and international students who may have unique challenges in adjusting to college life. Counseling can also be helpful to these students as they navigate developmental and adjustment issues on the path to fulfilling their academic goals.
While PACS is the mental health center for UNH students, all offices and departments have contact with students with mental health issues. We have a shared responsibility to respond to students with care for their personal well-being as well as concern for their academic success. The PACS staff regularly consult with faculty, staff, parents and significant others about students of concern and how to support them. We also train departments, upon request, in how to manage students with challenging needs.
The information contained in this document explains when professional counseling might be beneficial to an individual and how to make a referral to PACS. The concept of professional confidentiality and information about other types of referral and consultation services are also discussed.
- What Is The Role Of The Faculty And Staff In Assisting Students Who Have Problems?
- Is Consultation Available?
- When Might Professional Counseling Be Beneficial?
- When To Refer?
- How To Refer?
- What About Confidentiality?
- Are Referrals To Other Sources Of Assistance Possible?
- What About Emergencies That Occur During The Weekday Or After Normal Office Hours?
- Are Counseling Services Available To Faculty And Staff?
Students often experience significant changes in their lives during the course of their education. Such changes, at times, become stressful enough to pose serious threats to the academic progress which students hope to make. The stress of academic, social, family, work, and/or financial concerns are often inter-related and may result in a student turning to you for help. In fact, anyone who is perceived as knowledgeable, caring, and trustworthy may be a potential resource in times of trouble. Signs of a Student in Distress.
A faculty or staff member's willingness to lend special assistance to students undoubtedly is influenced by the personal style and philosophy of the individual. Situational factors, such as class and residential hall size, also have a substantial effect on the type of interactions which occur between the faulty/staff and students. Nonetheless, there is ample evidence that faculty and staff members are often in a position to identify students who are troubled. Timely expressions of interest and concern may be a critical factor in helping students solve problems that are interfering with academic survival and success.
PACS provides consultation services for students, staff, professionals, and faculty. These consultations often focus on a concern for an individual, behavioral problems which occur in classrooms and residence halls, or other issues that may have important psychological dimensions. The staff will attempt to respond to requests for consultation as soon as daily schedules permit. Please tell the receptionist if you think the situation is an emergency requiring immediate attention.
The reasons that individuals seek help from psychologists are as varied as people themselves. An individual's motives for seeking counseling might range from wishing to solve a particular problem to desiring to enhance his/her own personal development. In any case, the following indicators might be useful in making a decision about referring a student to PACS. To prevent possible over-interpretation of a single or an isolated behavior, it is probably advisable to look for clusters of signs which appear at approximately the same time.
1. Stated Need for Help
The desire for assistance in dealing with a problem may be stated directly or indirectly. For this reason, it is important not only to attend to the content of what a student may say but to understand the intentions and feelings underlying his or her message. Listening involves hearing the way things are being said, noticing the tone used, and observing the expressions and gestures employed. In fact, having someone listen attentively to an expression of a problematic feeling or thought is often a cathartic experience for the speaker which, in and of itself, can result in that individual feeling somewhat better.
2. Danger to Self or Others
When an individual talks about or alludes to details of how, when, or where he or she may be contemplating suicide, immediate referral is necessary. Regardless of the circumstances or context, any reference to committing suicide should be considered serious. To conclude that a student's suicidal talk is simply a bid for attention is extremely risky, and a judgment about the seriousness and possible lethality of the suicidal thought or gesture should not be made without consultation with a professional mental health worker. In the case of an actual suicide attempt, immediately call the University police and ambulance (*911), UNH Health Services (862-9355/TTY: 7-1-1 or 800-735-2964 Relay NH), and PACS (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH).
Similarly, students who make threats against others, engage in stalking behavior, and/or engage in harassing, bullying, or aggressive behavior toward others, should be identified to the University Police (911), the Vice President for Student and Academic Services (862-2053/TTY: 7-1-1 or 800-735-2964 Relay NH), and referred to PACS for an assessment (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH).
In the case of an actual suicide attempt, immediately call the University police and ambulance (*911), UNH Health Services (862-9355/TTY: 7-1-1 or 800-735-2964 Relay NH), and the PACS (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH).
3. Changes in Mood or Behavior
Actions that are inconsistent with an individual's usual behavior may be an indicator of psychological distress. Withdrawal from usual social interaction, chronic absenteeism, unwillingness to communicate, excessive crying or anger, irritability, sleep or appetite disturbance, ongoing fatigue, inability to concentrate, excessive worry, and nausea may be signs of depression or anxiety. These symptoms will often interfere with daily functioning.
4. Eating Concerns
Compulsive overeating, chronic dieting, significant weight loss or gain, purging (excessive exercising, self-induced vomiting, laxative abuse), and distorted beliefs about one's body size and shape are signs of an eating disorder, and warrant a referral to PACS.
Any traumatic experiences, i.e. physical, sexual, emotional abuse, serious auto accidents, natural disasters, etc. that a person has experienced or witnessed, often create intense fear and reliving of the trauma and a numbing or detachment along with other anxiety and depressive symptoms.
6. Changes in Personal Relationships
Personal problems often result when an individual experiences a traumatic change in a personal relationship. The death of a family member or close friend, difficulties in marriage or family relationships, divorce, changes in family responsibilities, and difficulties in other significant relationships can all result in increased stress that affects day-to-day functioning.
7. Drug and Alcohol Abuse
Indications of excessive drinking, drug abuse, or drug dependence are almost always indicative of psychological problems. In the case of a drug overdose or severe drug reaction, call the University Health Services (862-9355/TTY: 7-1-1 or 800-735-2964 Relay NH) or the University ambulance (*911).
8. Cutting/Self Injury
In recent years there has been a substantial increase in the number of students who cut/burn or injure themselves in some other way to manage intense feelings. These students are usually not trying to commit suicide but rather find self-injury relieves difficult feelings, helps to communicate their pain, or helps them to feel in control of earlier traumatic experiences that may be unconscious.
9. Learning Problems
Many students find the demands of college-level academic work to be greater than they anticipated. While it is expected that all students will go through some adjustment period in this regard, those who demonstrate a consistent discrepancy between their performance and their potential may be in need of assistance. Poor study habits, incapacitating test anxiety, undiagnosed learning disabilities or repeated absences from class are all issues which might benefit from counseling services. The Center for Academic Resources (862-3698/TTY: 7-1-1 or 800-735-2964 Relay NH) and DSS (Disability Support Services, 862-2607/TTY: 7-1-1 or 800-735-2964 Relay NH) are two offices that also deal with these issues.
10. Retention Issues
Research conducted at the University has shown that counseling services are effective in combating student attrition. Students who are considering dropping out of school, contemplating a transfer to another institution of higher education, or worrying about possible academic failure may find counseling to be a useful resource during their decision-making.
Aside from the signs or symptoms that may suggest the need for counseling, there are other guidelines which may help the faculty or staff member define the limits of his or her involvement with a particular student's problem. A referral is usually indicated in the following situations:
- A student presents a problem or requests information which is outside your range of knowledge
- You feel that personality differences which cannot be resolved between you and the student will interfere with your helping the student.
- The problem is personal, and you know the student on other than a professional basis (friend, neighbor, relative, etc.).
- A student is reluctant to discuss a problem with you for some reason.
- You do not believe your contact with the student has been effective.
When you have determined that a student might benefit from professional counseling, it is usually best to speak directly to the student in a straightforward fashion that will show your concern for his or her welfare. It is not advisable to attempt to deceive or trick the student into seeking counseling. Make it clear that this recommendation represents your best judgment based on your observations of the student's behavior. Be specific regarding the behaviors that have raised your concerns, and avoid making generalizations about the individual.
Except in emergencies, the option must be left open for the student to accept or refuse counseling. If the student is skeptical or reluctant for whatever reason, simply express your acceptance of those feelings so that your own relationship with the student is not jeopardized. Give the student an opportunity to consider other alternatives by suggesting that he or she might need some time to think it over. If the student emphatically says "no," then respect that decision, and again leave the situation open for possible reconsideration at a later time.
If the student agrees to the referral, the student may call or go to PACS to make an appointment. The student's first contact with PACS will typically be an intake interview in which the student and the intake counselor make decisions about the type of help needed. Intake appointments are usually scheduled within a week of the student's request to be seen at PACS. Students requiring immediate help because of psychological difficulties are seen the same day on an emergency basis. Finally, you should follow up with the student at a later date to show your continued interest even if he or she did not accept your attempted referral.
In emergency situations involving students who are unwilling or unable to seek help on their own, faculty or staff members may call PACS (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH), the University Health Service (862-9355/TTY: 7-1-1 or 800-735-2964 Relay NH), or the University Police and/or ambulance (*911).
What About Confidentiality?
It is important for members of the University community to understand that the interviews conducted by psychologists are confidential in nature. Information about those interviews or the content of such interviews cannot be released except upon the student's written request, in circumstances which would result in clear danger to the individual or others, reports of child or elder neglect/abuse, reports of hazing, or as may be required by other laws PACS adheres very strictly to this policy.
If a faculty or staff member is interested in a student's contact with PACS information can best be obtained directly from the student. It should be noted that students are not bound by the same promises of confidentiality that professional psychologists are obliged to keep. However, there are circumstances when it is useful for faculty or staff to speak directly to a psychologist. When this is necessary, the psychologist will get written permission from the student to share information.
Sources of assistance for students are not limited to professional counseling, but may include referral to a physician, the University of New Hampshire Health & Wellness, the Sexual Harrassment and Rape Prevention Program( SHARPP), Housing & Residential Life, the Center for Academic Resources, the University Advising Center, the parents, a hall director, or a member of the clergy, etc. For this reason, knowledge of persons, offices, and agencies that can be of service to the student is of primary importance. Students become discouraged and frustrated when they feel passed along from office to office without receiving the assistance needed. If you are unsure of the appropriate place to send a student for specific information or help, call PACS (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH) for information or consultation as to the various sources of help on campus.
PACS provides 24-hour, 7 day-a-week emergency coverage throughout the year. Students who require immediate psychological help are seen on an emergency basis by calling PACS (862-2090/TTY: 7-1-1 or 800-735-2964 Relay NH) during business hours Monday through Friday, 8:00 a.m. to 5:00 p.m. After hours, students can call Health Services (862-9355/TTY: 7-1-1 or 800-735-2964 Relay NH) and speak with someone on the phone or go to Portsmouth Hospital Emergency Room for a face-to-face evaluation.
Other emergency services include:
- Sexual Harassment and Rape Prevention Program (SHARPP): 603-862-3494/TTY: 7-1-1 or 800-735-2964 (Relay NH)
- Community Partners (Strafford County): 603-516-9300
- Center for Behavioral Health at Portsmouth Hospital: 603- 433-5135
While PACS does not provide ongoing counseling services for University employees, staff psychologists will meet with such individuals to assist in assessing a concern or problem and making an appropriate referral to another source of help. The University provides an Employee Assistance Program for all employees and their family members. Employees can call 1-800-424-1749, 24 hours a day, 365 days a year.