Cornell University

Help Others

Student extends a hand to lift up anotherWhat to notice and how to respond

Each member of our campus community has a role to play in supporting the mental health of our campus community. Thank you for caring for the health and well-being of others. The following describes how to recognize and respond to three different levels of distress.

Levels of distress

  • Concern: Observed signs of possible distress, needs follow-up conversation to learn more
  • Urgent: Demonstrated distress with possibility of risk requiring professional intervention
  • Emergency: Immediate threat of harm to self or others

For more information view the Concern for Others resources.

Concern Level of Distress

Signs at the Concern Level of Distress:
  • Academic: Repeated absences, decline in academic performance (e.g., quality/quantity of work), frequent missed assignments or requests for extensions
  • Physical: Marked changes in physical appearance or hygiene, coming to class under the influence of alcohol or other drugs, fatigue/exhaustion, obvious cuts/burns/bruises
  • Emotional: Appearing anxious, sad, or irritable (e.g., excessive worry, crying panic attacks), pronounced self-doubt, disproportionate response to grades/evaluations
  • Social: Isolation or withdrawal, conflicts or difficulties getting along with others (e.g., group project)
  • Experience of distressing events: Significant illness/death in one’s life, trauma, bias/microaggressions, natural disasters, major life changes
How to Respond at the Concern Level of Distress:
  • Talk with the person directly
  • Refer the person to relevant resources (e.g., academic, health-related, or social support) and offer to help get them connected
  • Check back in with the student in a few days
  • Tell someone else who can help:
  • Tips for how to talk with the person directly:
    • Talk with the person privately
    • Ask open ended questions: “How are things going?” “How are you feeling?”
    • Listen attentively to the response. Don’t give up if they are slow to talk. Allow for silences.
    • Point out specific signs you’ve noticed (e.g. mood, absences, lack of attention to detail, etc.)
    • Comment in a supportive, non-judgmental manner (e.g. “It sounds like you’ve been having a hard time lately.”)
    • Ask what the person thinks might be helpful. Help them get connected to appropriate resources or support.
    • Reduce stigma around help-seeking: “Many students have found it helpful to use the Learning Strategies Center.”
    • End the conversation in a way that allows either of you to come back to the subject at another time.
 

Urgent  Level of Distress

Signs at the Urgent Level of Distress:
  • Multiple concern situation-level signs that continue to escalate and/or
    fail to resolve
  • Expressions of hopeless or desperation
  • Talk of suicide or harm to others (verbally, in writing, on social media)
  • Worsening symptoms of psychological distress (e,g., extreme social withdrawal or isolation, intense agitation, worsening depression, increased panic attacks
  • Out-of-touch with reality (e.g., signs of extreme euphoria, paranoia, hallucinations, delusions)
     
How to Respond at the Urgent Level of Distress:

A note about talk of suicide 

  • If a student shares with you that they have been thinking about suicide or feeling hopeless, reflect back what you’ve heard, (e.g., “So, you are feeling that things are hopeless…”). Let the student know you’re glad they told you, that you want to help, and that things can get better. It’s okay to tell the student that you want to enlist the assistance of a professional resource in order to help them. For example, you can call Cornell Health (607-255-5155) with the student present so you can both consult with a mental health professional.
  • Research shows that asking someone directly about suicide does not increase the likelihood that they will act on these thoughts. In fact, asking about suicidal thoughts can lower anxiety, open up communication, and reduce the risk of an impulsive act.
  • It can be unnerving to hear someone say they are having thoughts of suicide. Take a deep breath and remember that suicidal thoughts, like all thoughts, are temporary, and that addressing those thoughts with the student does not increase the risk that they will act on them. Suicidal thinking can be treated.

Emergency Level of Distress

  • Signs at the Emergency Level of Distress:
    • Immediate threat of harm to self or others
    • Urgent level of distress in which a person has become non-responsive to outreach and is unable to connect to a crisis professional.
  • How to Respond at the Emergency Level of Distress: