Mr. J, a 23-year-old male student, was noticed to be staying alone, missing classes, speaking irrelevantly, and neglecting his self-care. He was diagnosed with schizophrenia and started treatment. Mr. S, a 26-year-old male, started feeling homesick and depressed in his engineering program. He lost confidence, failed classes, and discontinued his studies. After 14 months of treatment, he started working as a teacher and plans to complete his degree. The document discusses recognizing signs of emotional and behavioral problems in college students, responding appropriately, maintaining boundaries, and making referrals to help and support services.

1. Emotional & Behavioral Problem in
College Students
Dr. Lokesh Kumar Singh, MBBS, DPM, MD
Assistant Professor
Department of Psychiatry
AIIMS, Raipur

2. Mr J, 23 yr old male, shy in nature, good at
studies………..
Was noticed to remain alone, miss classes, talks
irrelevant, self care deteriorated, smile to self &
not allows others to enter his room
Was taken for treatment, diagnosed as
Schizophrenia. Currently on treatment, resumed
his studies.

3. Mr. S, 26 years old unmarried male, joined B.E,
started feeling homesick, feeling sad, used to go
home every week, wait for Saturday. Could not
make friends, had language problems, Lost
confidence, could not concentrate, started failing
in the tests. Started failing in few subjects, every
time he planned but postponed studies, Felt
anxious during exams, could not build good
relationships with lecturers.
Discontinued B.E., working in their own provision
shop.
Started on treatment for 14 months………………….
Today (24/03/2015) reported that he joined school
as teacher &planning to finish his studies.

4. Goals
 Faculty & staff roles in identifying and responding
to student behavior of concern.
 Develop strategies for and comfort with
responding.
 Know resources and mechanisms for
consultation, reporting, and referral.

5. Establishing a community of caring: why?
 Student distress is real and on the rise—and it
impacts academic performance and persistence in
college.
 While more students are seeking help, many still do
not due to stigma or other reasons.
 Often those with the most serious needs don’t seek
help without encouragement.
 Faculty & staff are the front lines with esteemed
status among students – in prevention parlance, you
are “gatekeepers”..

6. Causes of Stress in College
Students
 Changing to a new environment
 Change in eating and sleeping habits
 Not enough money/excess money
 Unrealistic expectations/Parental expectations
 A break-up with a boy or girlfriend/unplanned
pregnancy..

7. Other issues….
 Career indecision/Lack of good job
opportunities
 Alcohol/drug problems, peer pressure
 Serious mental illness
 Restriction of physical activity/ sports
 Internet/ mobile addiction
 Virtual social interactions..

8. When does stress become distress?
 Criteria is deterioration in daily functioning
 Impairment in one of several areas, including:
 Social
 Occupational
 Academic
 Emotional

9. Signs of Distress
 Change in mood (depressed or irritable)
 Excessive absences
 Withdrawal/fatigue/sleeping in class
 Avoidance of or change in participation
 Excessive anxiety regarding performance
 Unusual or inappropriate expressions in writing,
drawing, or other coursework
 Deterioration in hygiene and self-care..

10. Responding to the distressed student
 Observe – Take note of verbal & non-verbal
behavior that suggest signs of distress
 Trust your gut – It is better to error on the side of
safety and concern by doing something
 Reach out – Ask to talk in private and share your
observations in a direct and nonjudgmental
manner..

11. Responding to the distressed student
 Listen – Encourage the student talk and listen to
both thoughts and feelings
 Offer support– Your care, interest and listening
may prove pivotal in the student seeking help
 Give hope – Let them know things can get better
and you will help, identify options for assistance..

12. Responding to the distressed student
 Maintain boundaries – Be clear and consistent
about expectations and honest about the limits to
your ability to help
 Follow-up – Arrange a time to check back with
the student. This communicates continued care
and interest
 Refer …

13. Boundaries: Consider referral when . . .
 The student expresses openness to
receiving help
 There is immediate danger to student or
someone else
 The problem or request is beyond your
expertise or job role
 Your objectivity is compromised, perhaps
d/to a personal relationship..

14. Boundaries: Consider referral when . . .
 The student is reluctant to talk to you about
the problem
 You are feeling overwhelmed, pressed for
time, or otherwise at a high level of stress..

15. Referrals
 Counseling agency/counselor
 Psychotherapists
 Psychiatrists
 Seek help from NGOs
 Online counseling services

16. Suicide is the 2nd leading cause of death in college students (after
accidents); accounts for more deaths than all illnesses combined.

17. Signs of Distress – Suicide Risk
 Threatening to hurt or kill oneself; talking or writing
about death, dying, or suicide
 Suicide planning behavior/access to lethal means
 Overwhelming hopelessness & helplessness;
feeling trapped – like there is no way out
 Past attempts or other self-injurious behavior
 Reckless or risky behavior/ mood changes
 Withdrawing from friends, family, society
 Giving away possessions..

18. Prevention strategies
 Regular refresher courses/ exam preparation
 Life skill modification training
 Mentorship/ student self help group
 Yoga/ meditation
 Games & extra curricular activity
 Good nutrition..

19. singhlokesh123@gmail.com
Thank You