This document provides information and guidance for recognizing and responding to students in distress or at risk of suicide. It outlines key learning objectives of recognizing warning signs and risk factors for depression and suicide, how to intervene by asking someone about their feelings and listening without judgment, and how to make an effective referral to campus and community resources. The document reviews facts about depression and suicide among college students, provides details on specific warning signs and additional risk factors. It offers guidance on how to approach a student to ask if they are considering suicide, how to talk about suicide, and tips for persuading a student to seek help. Contact information is provided for several campus and community mental health resources.

1. RECOGNIZING AND
RESPONDING
TO
STUDENTS IN DISTRESS
2010 Resource Center Staff
Suicide Prevention Gatekeeper Training

4. “I was much further out than you thought…
and not waving but drowning”

5. LEARNING OBJECTIVES
 RECOGNIZE:
 Facts about depression and suicide
 Risk factors and warning signs for suicide
 INTERVENE:
 Asking someone about depression or suicide
 Listening carefully and compassionately
 REFER:
 Knowing campus and community resources
 Making an effective referral

6. DEPRESSION AND SUICIDE
 More people die annually in the United States by
suicide than homicide--1.7 times more! (CDC
website)
 Suicide is the second leading cause of death for
college students (American Association of
Suicidology, 2003)
 Major Depressive Disorder is the leading cause of
disability in the U.S. for ages 15-44 (The World
Health Organization, 2004).

7. THE TRUTH ABOUT SUICIDE

8. RECOGNIZE
 Risk factors and warning signs – What are they?
 The need, i.e. your opportunity

9. RECOGNIZE – WARNING SIGNS
 Mood Changes
 Despair
 Isolation
 Displaying unusual anger (outbursts) or sadness/tearfulness
 Exaggerated mood swings
 Behavior Changes
 Skipping classes
 Unexplained poor academic performance
 Sudden changes in eating, sleeping habits
 Neglect of personal appearance
 Loss of interest in activities that once gave pleasure/meaning
 Acting out of character/personality change.
 Engaging in self-destructive or dangerous risk taking behavior
 Frequent arguments/fighting
 Increasing and/or abusive alcohol/drug use
 Suicide Specific
 Giving away valued possessions
 Statements about death/dying or suicidal threats
 Expression of hopelessness, helplessness or extreme loneliness

10. RECOGNIZE –
ADDITIONAL RISK FACTORS
 Alcohol and substance abuse
 Recent sexual abuse or assault
 Recent physical abuse
 Prior attempt(s)/Family History of suicide
 Significant loss
 Poor test performance
 Relationship break-up
 Parental separation / divorce
 Death of loved one
 Physical illness
 Rejection by peers or family
 Actual or threatened humiliating experience

11. RECOGNIZE - ALCOHOL AND SUICIDE
 > 50% youth suicides involve alcohol or drugs
 Alcohol acts as a depressant
 Alcohol contributes to impulsive and/or reckless
behavior
 Alcohol and some drugs impair problem solving &
perspective taking
 Alcohol abuse may delay healthy coping skills

12. INTERVENE
 Ask
 Listen
 Don‟t judge
 Don‟t solve
 Not confidential
 Be compassionate

13. INTERVENE - BEFOREHAND
1. Ideally, let a staff member know of your concern
and your intent to approach the student you are
worried about.
2. Work out a plan for back-up help if you think you
might need it.
3. Invite student to meet with you in private. Ensure
that you have adequate time and energy for this
conversation.

14. INTERVENE
1. Remain CALM, CARING, and CONFIDENT.
2. Share your concerns and ask open-ended
questions such as “How are you feeling?” or
“What’s been going on lately?” Find the words that
work for you.
3. Listen without trying to change the person‟s
feelings.
4. Express empathy for how he/she is feeling and
show you care for the person‟s welfare.
5. If you think there‟s any possibility or risk, you must
ask about suicide- directly or indirectly.

15. INTERVENE- ASKING ABOUT SUICIDE
 DIRECT IS BEST: Ask directly with a tone of care,
“Are you thinking about killing yourself?” or, “Are
you thinking about suicide?”
 OTHER WAYS (More indirect)
 “Are you feeling so bad that you‟ve thought about
hurting yourself?”
 “I‟ve noticed that you‟ve been pretty down lately.
Have you thought about suicide?”
 “What did you mean when you said I might not see
you again?”
 “Sometimes people…”

16. INTERVENE – TALKING ABOUT SUICIDE
1. If “yes”, you can ask “What are these thoughts?”
2. Wait and listen. Express care for the person‟s
welfare. You can say, “Feeling suicidal is often
temporary. Unbearable pain can be survived.
Help is available. You are not alone.”
3. If “yes”, you will be immediately involving others.
4. If “no”, Turn the conversation towards seeking
professional help. See persuasion toolkit.

17. REFER
 Normalize – feelings and help-seeking.
 Know the resources
 „warm handoff‟ is best
 Consult
 Take care of yourself.

18. REFER – PERSUASION TOOLKIT
 Normalize help seeking
 Normalize among his/her peers
 Self-disclosure
 Utilize your relationship & concern
 “This problem is bigger than you and me. Let‟s go talk to
someone who can help you sort this out.”
 “You say that you‟d like to stop feeling so bad. I really
believe that a counselor can help you with this.”
 Offer to call SHWC or accompany them
 “the warm handoff”

19. REFER – IF RISK IS SERIOUS
1.Tell the person of your responsibility to inform your
Coordinator and offer additional helping resources. Don‟t
promise confidentiality or secrecy.
2. Get help immediately. Inform your Coordinator or other
staff and wait until the Coordinator is involved. Call the
Student Health and Wellness Center.
3. Be aware of whether other students are observing or
involved and reach out to them if necessary when more
help arrives.

20. STUDENT ROLE PLAYS
In Dyads – 10 minutes
Discussion to follow

21. RESOURCES

22. RESOURCES
Laurie Nielsen
Victor Chang
Not pictured:
Diane Stamper
Asha Goldstein

23. RESOURCES
•Student Health and Wellness Center – 552-6137
•Dean of Students – 552-6223
•Women’s Resource Center – 552-6216
•Queer Resource Center – 552-8328
•Residential Life – 552-6377
•Campus Security – 552-6911
•Ashland Police Dept – 911
•Ashland Community Hospital – 541-201-4000
•Rogue Valley Medical Center – 541-789-7000
•Jackson County HELPLINE 24 / 7 – 541-779-HELP
•Jackson County Mental Health Crisis 24/7 – 541-774-8201
•National Suicide Hotline – 1-800-SUICIDE
•National Suicide Prevention Lifeline - 1-800-273-TALK

24. TO RECAP
 RECOGNIZE – educate yourself about
suicide; see the needs and risks in your
environment
 INTERVENE – be present and empathetic;
ask about suicide and listen
 REFER – get them help; consult with others.
 TAKE CARE OF YOURSELF - acknowledge
difficult feelings that might arise; use the
supports and resources available.

25. Victor Chang
Mental Health Services Coordinator
Student Health & Wellness Center
541-552-6813
changv@sou.edu