Recognizing and Responding to Signs of Distress in Peers

Listening, supporting, and encouraging your friends can really make a difference in their life. Sometimes you might hesitate to bring up a concern because you are afraid you will upset your friend, hurt your friendship, or not be helpful, but most of the time your friend will be grateful to know that someone cared enough to reach out and take a risk.


If you see these signs you should be thinking about reaching out or letting someone know:

  • Not going to class
  • Sleeping too much or too little
  • Fatigue or excess energy
  • Not showering, looking disheveled
  • Impaired speech or disjointed, confused thoughts
  • Aggressive or threatening behavior
  • Extreme mood changes or inappropriate display of emotions
  • Frequent crying
  • Dramatic weight loss or gain and/or preoccupation with food, weight, or body image
  • Losing touch with reality such as hearing or seeing things that are not there, beliefs they have extraordinary powers; concerns they are being watched
  • Alcohol-related consequences such as blacking out, vomiting
  • Cuts or burns on their body

Responding to Peers in Distress

  • Reach out to a friend about whom you are concerned; PLEASE do not ignore strange, disturbing or inappropriate behavior. If you feel like you cannot have the conversation, notify your RA, consult with the Counseling Center and/or complete the One Pard Universal Form.
  • It will be easier to have a positive impact if you address your concerns as soon as you notice them rather than waiting until the behavior becomes more serious.
  • Be discrete; choose a private space to talk.
  • Be specific about your concerns. “I noticed that you’ve been in your room a lot lately and you haven’t been going to our class; or I noticed that you look like you’ve been crying a lot lately, and you don’t seem like yourself.”
  • Be clear about what you can and cannot keep private. You can’t promise confidentiality if someone has told you that they are going to hurt themselves or someone else.
  • Be optimistic about the potential for them to make positive changes while encouraging them to think about the obstacles they will likely face. Being realistic about the challenges of making a change makes it much more likely to happen.

Making a Referral to the Counseling Center: Suggestions for What You Can Say:

  • “Have you ever thought about talking to a counselor about this issue? It’s free, and they have to keep things confidential; they meet with hundreds of students every year. About 40% of students in each graduating class have gone to the counseling center.”
  • “Maybe you could go just once to check it out and see if it’s for you before deciding it’s not going to be helpful?”
  • “Can you think of any benefits to talking to someone who can help you come up with some solutions vs. sticking with the same strategies you’ve been using?”
  • “I’d be willing to call the Counseling Center with you or we could go together. If you are ready to go today I know they have drop-in consultation from 10-11:30am & 1-3:30pm.”

Asking about Suicide

Asking a friend whether they are thinking about suicide can feel uncomfortable and even frightening. You cannot increase someone’s risk of hurting themselves just by bringing up the topic. Research shows that acknowledging and talking about suicide might actually reduce suicidal thoughts. Many students feel very relieved when someone realizes they are hurting so much that they are having thoughts about not wanting to be alive. Even though someone might be thinking about suicide, it doesn’t mean they have a clear plan. The opportunity to have a conversation with a caring person can significantly reduce the risk that a student will actually harm themselves.

Signs a student might be considering suicide include:

  • Expressions of hopelessness about the future, or being able to change or improve
  • Expressions of being a burden to friends, family, the college
  • Difficulty connecting with others
  • Physical signs that they have cut or injured themselves
  • Giving away possessions
  • Talking about “if/when I’m gone….”
  • Detaching from responsibilities and routine

Events associated with increased risk include:

  • Death of a family member or close friend
  • Sudden breakup in a relationship
  • Problems with family members, friends, or roommates
  • Experiencing or causing an accident
  • Getting arrested or doing something about which one is deeply ashamed
  • Diagnosis of a serious illness
  • Academic setbacks

Responding to Concerns about Suicide

If you have ANY concern that a student might be considering suicide, you should ask them directly about your concerns. Here are some ways you can ask:
-Do things ever get so bad that you have thoughts of wanting to die?
-Have you had any thoughts of suicide?
-Are you thinking about taking your own life?

  • Express your concern and let them know that their safety is your priority.
  • If they indicate they are currently thinking seriously about hurting themselves, do not let them leave your room.
  • During regular business hours, call the Counseling Center at 610.330.5005 and inform the office coordinator a student needs to be seen immediately. Accompany the student to the Counseling Center on the 2nd floor of the Bailey Health Center if possible.
  • When the Center is closed, call 610.330.5005 to speak with an after-hours crisis counselor.*Calls are routed based upon risk, so it is important to disclose any safety concerns when the call is answered.
  • Always call Public Safety 610.330.4444 for assistance if a student is communicating via text or email that they are in imminent danger of harming themselves.
  • For less urgent concerns, please complete the One Pard Universal Form to alert the Student Support and Intervention Team.

Additional Crisis Support Services

Local Hospital:

Emergency Room at Lehigh Valley Hospital-Muhlenberg (610) 402-8000
2545 Schoenersville Road, BethlehemPA 18017

Peer-to-Peer Support

Togetherall is a peer-to-peer mental health community that empowers students to anonymously seek and provide support. This online resource is moderated by mental health professionals and offers a safe space for students connect with others experiencing similar feelings 24/7, 365 days a year. Togetherall also offers journaling, goal-setting and self-assessment tools, in addition to a wide range of self-guided courses to help support student mental health and well-being.

Setting Healthy Boundaries

Setting boundaries in relationships can help decrease feelings of burnout and prevent us from neglecting our own needs. Boundaries are a way of communicating our limits of time, attention, and emotions to others clearly and compassionately. It’s important to reflect on what your own boundaries may be when helping someone else.

Questions to consider:

  • How are you approaching this person? Are you a friend, a mentor, a person who is in a position of power or authority? This can change how you approach the situation and what you express.
  • What are things you want to discuss? What are things that may be ‘off limits’ or off topic for the situation?
  • Do you have the energy you need to help the other person? What resources may you need for both you and them?
  • How will you know that you’ve communicated your concerns, and what do you want to make sure you say?
  • Do you find yourself often caring for others more than you care for yourself? If this sounds familiar, you may want to think about what you’re going to do for yourself after you talk to the person you’re concerned about.

Approaches to consider:

  • Start by reminding yourself why you’re setting a boundary. Think about what you’re hoping to accomplish and how it will benefit you and your relationship in the future.
  • Be as clear in your communication as possible. Remember that there is a difference between being assertive and being aggressive; you can be firm and respectful when telling others “no” or defining your boundaries.
  • Focus on identifying what your boundaries are rather than things that would cross them. For example: “I will text you at the end of the day” rather than “I can’t text you during class.”
  • Don’t be afraid to repeat yourself and continue to uphold your boundaries. Some people may struggle to accept a new boundary, but that doesn’t mean that you should give it up.
  • Understand that this may feel uncomfortable, which is okay and to be expected, especially if this is a new experience. Think of it like building any new skill set; it will feel hard or awkward before becoming more natural and smooth.

Practicing Self-Care

In addition to setting and maintaining boundaries in your relationships, it is vital to care for yourself when caring for others.

  • Allow yourself to connect with others as needed; you may find it helpful to process your concerns and feelings with a trusted family member or friend.
  • Togetherall also may provide a useful space to reflect on your experience and engage in focused self-care.
  • There are many dimensions to wellness; consider identifying a particular area on which you want to focus. Learn more about how to cultivate healthy behaviors to support your well-being.
  • Remember that it is not your role to be a counselor, and you do not have to navigate your concerns on your own. You can always reach out to the Counseling Center for support.

Mental Health Training

Kognito is an interactive role-play simulation for students that builds awareness, knowledge, and skills about mental health and suicide prevention, and prepares users to lead real-life conversations with fellow students in distress and connect them with support. In addition, the resource helps students to build their own self-care skills in a variety of domains. Click on the picture below to be directed to the online training.

Kognito - student