(Trigger warning: mental health, self-harm, and suicide discussed below)
I recently attended a really great workshop on interacting with students who are experiencing mental health issues. The workshop was run by Michigan’s Center for Research on Learning and Teaching (CRLT), which is a fantastic resource. One thing that makes it especially good is that it has the CRLT Players – a theatre program that “uses a diverse array of performance arts to spark dialogue”. Often, they act out a scenario and then pause, allowing the audience members time to reflect and discuss different aspects of the situation in small groups. It’s amazingly effective! They are really good at creating scenarios where there’s no clear “best” option, which leads to really rich discussions.
In this case, the focus of this workshop (run by Sara Armstrong) was student mental health, and the players acted out a scenario where a student approaches her professor to ask for an extension on an end-of-semester assignment. The student discloses that she’s been having a rough time and having a hard time getting her work done. I suspect I’ve spent more time than the average faculty member thinking about how to support students with mental health conditions, but I still learned a lot from the workshop. The workshop also included a great handout with principles to guide interactions with students with mental health concerns. I’ve been thinking a lot about what was covered since the workshop and there’s been a lot of interest in the past when I’ve posted about supporting students with mental health conditions, hence this post.
With that introduction, here are some suggestions for interacting with students experiencing mental health concerns:
- As an instructor, it is not your job to try to determine whether the student really has a mental health condition. Some professors refuse to accept that a student has a mental health condition, even in cases where they have clear documentation. Please remember that a lot can be going on that you are not aware of, and that even people who seem fine to you might really be struggling. If a student discloses a mental health concern to you, it is not your job to diagnose the student yourself! I wish this didn’t have to be said, but I know students who’ve had this happen. It’s okay to say that you require documentation as long as you would also require documentation for a different health concern (e.g., a concussion), though I’ll have more in the next point on the need for flexibility.
- You cannot require something of a student with a mental health condition that you do not require of students with other health conditions. One challenge I see with this is that it can take a long time (and much persistence at a time when doing so is difficult!) to get the official documentation and accommodations for a mental health condition. So, I try to err on the side of giving the conditions even if a student doesn’t have all the documentation. In that case, it means that I also need to do the same for a student with a physical health concern.
- Your primary responsibility is the student’s learning and academic concerns, but you also have a responsibility to communicate concern for a student’s well-being. You want to maintain boundaries (though exactly where that boundary is will vary between people and situations) and you want to make sure you don’t promise more than you can deliver. When I started at Georgia Tech, they really drilled in that you cannot promise that you will not disclose what the student says to you – for example, if they indicate that they have had suicidal thoughts, you need to act on that.
Speaking of which: the National College Health Risk Behavior Survey found that
10.3% of respondents reported seriously considering attempting suicide, 6.7% had made a suicide plan, and 1.5% reported they had attempted suicide one or more times in the 12 months preceding the survey.
Please reread those numbers and then think about the number of students that you interact with each semester. The odds are good that, even if you don’t know it, you have interacted with a student who has seriously considered suicide, and maybe even with one or more students who have attempted suicide in the past year. I have ~550 students in Intro Bio. If the numbers from the NCHRBS survey apply to my students, that means about 8 of them have attempted suicide in the past year. That is a sobering number.
- Ask the student about whether they have considered self-harm or suicide. It feels very personal and even transgressive, but mental health professionals say this is really important. For this reason, the workshop suggested thinking ahead of time about what you would say to ask a student about this, and then practicing saying that. You should also think about what you would do if a student says they have considered or attempted self-harm suicide. (Note that self-harm and suicide are different things: people can cut themselves, for example, without being suicidal. This article has more on self-harm vs. suicide if you’re interested.) The University of Michigan has a list of resources at tiny.cc/distresssignals (I can’t get that to link properly!), but the short version is: during regular hours, walks the student to CAPS (our counseling services). If that doesn’t work, contact the Dean of Students office to ask for a wellness check and/or contact the campus police (but note that the latter option can also sometimes escalate a situation, as was tragically the case at Georgia Tech last year). Also note that some universities have very specific policies about what to do if a student indicates they have considered self-harm or suicide – find out what the policies are at your institution.
- When considering accommodations for a student, it’s best to aim for a balance between accountability and flexibility. The first scenario the CRLT Players ran through showed the professor being absolutely rigid – her policy was that, except in cases of emergency, she wouldn’t grant extensions unless the student asked at least one week in advance. But the second scenario – where the professor said the student could have as long as they needed, even into the next semester – wasn’t ideal, either. First, having the assignment hanging over the student for months might not be great for the student’s mental health. Second, it can be important to learn that failing an assignment does not mean failure in a much bigger sense. One recommendation was to work with students to develop a plan, and to include in that plan a way of following up with that student about their academic progress.
- When discussing accommodations, normalize that many students struggle without trivializing what the student is experiencing.
- Make sure the student knows about resources that are available to them. Sometimes, if I have some concerns about a student but not enough to think I should refer them to the Dean of Students for a wellness check, I will send them an email asking them if they would like help connecting with resources at Michigan. Some colleagues of mine ask them to come by their office so they can do this in person. Michigan is a big place and it can take a while to figure out all the resources that are available. We provide a list to our Intro Bio students, but a student who is overwhelmed might not remember that list exists or might not think to seek it out. When doing this, it’s good to give multiple resources – you don’t want to overwhelm the student, but the same thing won’t work for all students, so it’s good to give them multiple options. One thing I plan to do based on the workshop I attended is to print out the list of resources from tiny.cc/distresssignals and have hard copies on hand that I can give to students.
My experience with these interactions is that a little compassion goes a long way. So, my last point is perhaps the most important:
- Be kind.
When I was in grad school, I TA’d for a large, introductory class in which a guest lecturer made a suicide joke. When I afterwards privately told the lecturer that such jokes were inappropriate, I was mocked.
What I didn’t tell him was that of the four grad student TAs, at least two of us were seriously suicidal. (And, indeed, one of the TAs would attempt suicide a few months later.)
What I didn’t tell him was that I was the TA responsible for the paperwork from the disability office regarding extensions, so I could rattle off all the documented mental illnesses in the class…and those were just the ones that had been officially diagnosed, verified by the disability office, and then disclosed to me. The actual rates were certainly much higher.
If you interact with students in any capacity, please, be kind. Please, get yourself trained in your university’s policies, your country’s laws, your society’s best practices. Please, try to ensure that everyone else who interacts with students also gets trained. It’s really hard to know what to do when a student discloses mental health concerns to you, but that doesn’t negate the damage you can do in your ignorance.
One of the many good reminders lately that, when you are in a position of power, THE WORDS YOU SAY MATTER. You might be sending off an email or making a joke without thinking it’s a big deal but it’s what those around you are going to be using to decide whether or not you’re safe. If you don’t think there are problems with mental health or the culture around you, it might just be that no one trusts you to respond appropriately.
This is a really great post, Meghan. Could be useful at work, too, for dealing w/ supervisees, colleagues and supervisors alike. Thanks
Thank you soo much for this. I have had an increasing number of encounters with students who struggle with mental health issues and it is good to have some guidelines.
I wonder does anyone know if those issues are increasing in general or is it one of those “they have always been around but we are now noticing them” things? I guess I could google and try to find out but maybe someone here knows. It seems we have an increasing number of students struggling an I wonder if that is due to the increased pressure on them.
A very thoughtful and helpful post. Thanks Meg!
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