Recognizing Students in Distress: When to Refer

A guide for faculty and staff 

Academic Performance Signals

  • Marked decline in academic performance 
  • Excessive anxiety regarding performance 
  • Repeated request for special provisions (extensions and make-up exams) 
  • Withdrawal/fatigue/sleepiness in class due to drug or alcohol use/misuse 
  • Excessive absences from class 
  • Bizarre and unusual thought, action, or writing 

Behavioral and Interpersonal Signals

  • Angry or hostile outbursts or aggressive comments 
  • Hyperactivity or very rapid speech 
  • Excessively demanding behavior 
  • Smell of alcohol 
  • Frequent conflict with others 
  • Concerns and complaints from classmates 

Emotional Signals

  • Crying or tearfulness 
  • Increased anxiety/ difficulty concentrating 
  • Depressed mood 
  • Marijuana or signs of other drug abuse 
  • Feelings of hopelessness or worthlessness 
  • Expression of suicide or harm to self or others 

Physical Signals

  • Marked changes in physical appearance or personal hygiene 
  • Dramatic weight loss or weight gain 
  • Noticeable cuts, bruises, or burns 
  • Disorganized speech, rapid or slurred speech, and/or confusion 
  • Signs of intoxication (i.e. decreased pupils) from drugs and alcohol use/misuse 

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