At-Risk Mental Health for Students

Screen Reader Version

Welcome to the simulation titled At-Risk Mental Health for Students. This is a transcript of the simulation designed for screen readers.

In this simulation, you will learn to recognize signs of distress in yourself and your peers. You will help a fellow student navigate a stressful time, connect him to support, and explore self-care strategies and positive coping techniques.

Overview

MORGAN: Hi, I’m Morgan. One of life’s most challenging situations is helping yourself or a friend who’s in distress.

Now this may sound like a heavy topic, but it’s also really common.

In fact, if you think about people you’ve known, you may realize that you’ve had friends or family members you’ve been worried about in the past, maybe someone who fit one of these descriptions.

Seemed overly anxious and/or stressed
Had been sad/depressed for a long time
Told you they think about suicide
Cut or hurt their bodies on purpose
Had issues around food and eating
Used alcohol or drugs excessively

These are all signs of distress that are fairly common on college campuses; and I’m not surprised if you have known people like this in your life. That’s why this topic is so important. When our friends feel overwhelmed, sad, or anxious, we are usually the first ones to notice and the first ones they come to when they need to talk.

Today we’ll talk about:

How do you know when you or a friend needs help?
How do you talk to a friend you’re worried about?
And where can you and your friend go for help if the situation seems too big to handle on your own?

Here’s how it’ll work. First, you’ll meet some friends here at school and figure out which one is most in distress. Then you’ll learn some really useful conversation skills and try them out in a simulated conversation with the friend in distress, to see if you can get them to open up and look for help.

So, let’s get to it!

A Friend in Distress

MORGAN: We all can feel a little down, and that’s okay because everyone’s mood changes from time to time. But for some, feeling down can go on for a long time. So, it’s important to keep an eye out for anyone who seems like they might need a little help: even the people we’d least expect.

Let’s take a look at a group of friends who are all having a tough time this year: Jesse, Rama, Maya, and Travis.

Jesse knows she can make an impact. She’s involved in many on campus groups, from criminal justice reform to homeless outreach. And of course, whenever a friend is having a tough time, she wants to be there.

PIC 1: A comic book style image of Jesse hanging out with two of her friends beside her.

But Jesse isn’t always the best at knowing when to put herself first and others second. More than once she’s chosen not to eat when she had a paper due. And she slept through a couple of her early morning classes because she was supporting a friend who went through a bad breakup.

PIC 2: Jesse looking stressed while she’s working on a laptop.

Recently, Jesse showed up at the very end of her friend Rama’s birthday dinner because she got caught up making signs for a rally.

PIC 3: Jesse busy at work and painting star images on a poster sign.

She was very upset at herself and kept apologizing to Rama for days afterward, even after he said it wasn’t a big deal.

PIC 4: Jesse looking straight ahead and looking sad.

What signs of distress do you think Jesse might be showing?

Select any that might apply:

Seems overly anxious and/or stressed
Has been sad/depressed for a long time
Mentions they think about suicide
Cuts or hurts their body on purpose
Has issues around food and eating
Uses alcohol or drugs excessively

Jesse seems overly anxious about missing activities, and appears to have skipped eating some meals, prioritizing schoolwork over her own well-being. Jesse told her friend Maya she wanted to take a little more time for herself, but hasn’t changed her routine yet.

Jesse’s friend Rama has also had a challenging year. Rama is the child of Thai immigrants and the first in his family to pursue higher education.

Other than special events like his birthday, he often stays at home and works instead of going out. Rama’s father died a few months ago from a heart attack, which left his mother alone to take care of his two younger sisters.

PIC 5: Picture frame of Rama’s father next to some memorial flowers.

Right after the funeral, Rama mentioned to Jesse he wanted to do even better in school in his father’s memory.

PIC 6: Rama walking with Jesse and talking to each other.

In the months since then, Rama has rarely spent time with people outside of projects for class. Recently, Maya encouraged Rama to come to their friend’s party. Rama said he’d try, but didn’t end up going.

PIC 7: Rama with his head down on his desk, with books piled all around him. A thought bubble appears next to Rama, showing when he remembered Maya calling him on the phone.

When Maya checked in with him, Rama said he got a C minus on a recent test and felt too upset to leave the house.

PIC 8: Rama looking straight ahead and sad.

What signs of distress do you think Rama might be showing?

Select any that might apply:

Seems overly anxious and/or stressed
Has been sad/depressed for a long time
Mentions they think about suicide
Cuts or hurts their body on purpose
Has issues around food and eating
Uses alcohol or drugs excessively

Rama has isolated himself from his friends in the months since his father’s death and has been putting enormous pressure on himself to succeed academically. Maya suggested Rama might want to talk to someone, and that she’d heard about a student support group specifically for people experiencing grief. Rama was hesitant at first because his parents never really shared personal information with people outside the family. After considering, he tried going to the student support group and found it helped a little to talk with people who shared similar feelings of grief.

Maya’s experiences in school have also been a little intense lately. Maya came out as queer to her friends earlier this year and started seeing someone. After a few months they had a bad breakup and Maya took it pretty hard.

A couple of months after the breakup, Travis got a text from Maya asking for his help getting home from a party. When he got there, he found Maya high and disoriented.

PIC 9: Maya is seen laying on her couch. She’s looking sad while on her phone. A thought bubble shows Travis on the phone texting her.

Maya saw Travis a few days later and thanked him for helping her get home. She mentioned she was embarrassed she hadn’t gotten over the breakup yet.

PIC 10: Maya looks straight ahead and a bit sad.

What signs of distress do you think Maya might be showing?

Select any that might apply:

Seems overly anxious and/or stressed
Has been sad/depressed for a long time
Mentions they think about suicide
Cuts or hurts their body on purpose
Has issues around food and eating
Uses alcohol or drugs excessively

Maya has been experimenting with drugs excessively as a way to cope with her bad breakup. Travis went with Maya to the school’s LGBTQIA+ center, where she formed some new friendships. The center became a new supportive group in her life.

Travis has also had a difficult time at school. His sister raises a child alone, which is a big cost for the family. So, Travis has had to work thirty hours a week to help pay for school. He mentioned to Jesse that juggling everything has been a lot to balance, and sometimes he’s felt overwhelmed by it all.

PIC 11: Travis is seen working at a restaurant kitchen prepping a dish. A thought bubble shows his sister’s face.

Travis has little time to do anything other than attend classes, work, and babysit his sister’s child. When he does have time off, he usually goes home with one or two six packs of beer and finishes them himself.

PIC 12: A laid back Travis is seen on his chair slumped over. He’s drinking a bottle of beer while five more empty bottles can be seen in front of him. Thought bubble images of Rama, Maya, and Jesse show up around him.

A few days ago, Travis got upset about a group project and kicked a chair. When Rama, Maya, and Jesse checked in with him a few days later, he shrugged and said he didn’t want to talk about it.

PIC 13: Travis is looking straight ahead with a concerned look.

What signs of distress do you think Travis might be showing?

Select any that might apply:

Seems overly anxious and/or stressed
Has been sad/depressed for a long time
Mentions they think about suicide
Cuts or hurts their body on purpose
Has issues around food and eating
Uses alcohol or drugs excessively

Travis has been feeling discouraged about his situation and is pulling away from his friends. He’s been drinking alone and doesn’t seem to know a direction for himself.

Jesse decides it might be worth checking in with Travis one on one.

You can check in with your friends:

In person
Over text
Video or phone calls

Conversation Skills

MORGAN: Now’s the time to reach out to Travis to see what’s going on. The most challenging part of talking to a friend about something sensitive is bringing it up without making the friend defensive. Remember those conversation skills I told you about? Now’s the time to learn all about them.

You want to stick with neutral statements Avoid negative labels at all costs! They make the other person feel bad and don’t help you reach out to them in an effective way.

Imagine Anna wants to write Travis a text. What do you think about this?

Example: “Hey. What’s up? You’ve been acting weird lately.”

Maybe you can already tell this isn’t the best way to put it. If someone told you you were acting “weird,” you’d probably get defensive. You might shut down and stop listening. Let’s change that before we send it.

Example: “Hey. What’s up? You’ve been quiet lately.”

Don’t judge. And focus on specific, observable behaviors. What do you think about this one?

Example: “You’ve been drinking too much lately.”

Wow, a little judgy. There are two good reasons not to judge. First, it makes the other person feel terrible. Second, a judgment is just your opinion, so Travis could deny it. Instead of judging, focus on specific, observable behaviors, things Travis can’t deny.

Example: “You’ve been drinking more the last few months.”

Notice how adding “I feel like,” “I think,” or “It seems like” can soften a sentence a lot. When you speak from your own perspective, it lets them know how the situation looks from the outside.

Examples:

“I feel like you’ve been drinking more the last few months.” “I think you’ve been drinking more the last few months.” “It seems like you’ve been drinking more the last few months.”

Ask neutral questions and don’t give advice about sensitive topics unless you’re asked. What about this response?

Travis: “Guess so. It’s just that my parents keep nagging me. They think I can’t take care of myself anymore.”

Example: “You should tell them how that makes you feel.”

Unless they ask for your opinion, no one wants advice about something sensitive. It makes the other person feel like you don’t trust them to solve their own problems. If you think your advice is really important, try it as a question.

Example: “Have you told them how you feel about that?”

Now, you try a few. I’ll show you some possible things the friends might say to Travis, and you decide if each one is helpful or unhelpful.

“It seems like you haven’t gotten over your breakup with Tia.”

Here you’re using an I statement (“It seems like”) to make the statement softer. Travis is less likely to get upset when you put it this way.

“You slept 13 hours yesterday. What’s going on?”

This is a specific, observable behavior. It probably won’t make Travis defensive.

“Why were you rude to Mike the other day?”

Here, you’re labeling his behavior as “rude,” which he will likely deny. You’re more likely to get a real response if you soften it: “You seemed frustrated with Mike the other day. What happened?”

“You shouldn’t get so upset over a girl.”

Beware whenever you find yourself starting a sentence with “You should” or “You shouldn’t” You’re entering Advice Town, and no one wants you to go there.

“Why do you think your grades went down?”

Here, you’re asking about a specific, observable behavior: Travis’s grades going down. He can’t deny this, so it shouldn’t make him defensive.

“I think you really messed up.”

Starting with “I think” or “I feel” doesn’t help if you’re also judging your friend. It’s better to empathize than to judge: “It sounds like you’re confused about what to do.”

“Stop saying stuff like that to people.”

This is advice. Better to talk about specific, observable behaviors or use an I statement: “You told Anna to get a life. I think that upset her.”

“You were soooo sloppy drunk last night.”

Travis may not like being labelled as “sloppy drunk.” It might embarrass him and make him not want to keep talking with you. Better to talk about specific, observable behaviors and use I statements: “You seemed to drink more than usual last night.”

“How can you live like this?”

This sounds like judging. A better question would be “How do you feel, living like this?”

“I think you’re getting high more often lately.”

This is an observable behavior, softened with an “I statement.” It probably won’t upset him.

Starting the Talk

MORGAN: Travis has been posting “sad things online.” And his friends have done the right thing by reaching out to him whenever he did, to ask if he was okay or wanted to talk. So far, he hasn’t really opened up to anybody, and today Jesse is going over to his place to see him.

PIC 14: Images of Travis and Jesse appear next to Morgan.

You’ll play Jesse, and your goal is to let Travis know you’re concerned and find out how he’s doing. Conversations like this are best face to face, but any conversation is better than none. However, you have a conversation like this, it should be private. So, let’s head over to Travis’s apartment to talk.

Scenario: Talk with Travis Part I

Ineffective Example

JESSE: I haven’t seen you much lately. What’re you up to?

TRAVIS: Yeah, I haven’t really been hanging out with anyone. Just, a lot going on.

JESSE: Yeah?

TRAVIS: Oh, yeah. I’ve got a ton of assignments due, tests to study for. So much.

JESSE: Yeah, it’s a lot.

TRAVIS: And everything’s piling up. Plus, work has been super busy, and my sister has been really sick, so I have to pull extra uncle duty. And I’ve kinda had some drama with people lately, which isn’t helping at all.

JESSE: Wow, you really got yourself into a tough situation.

TRAVIS: Yeah, thanks.

COACH: You told Travis he was responsible for feeling upset. The goal is to help him open up, not to offer judgment by pointing out his mistakes. Hit UNDO and try a different option.

JESSE: We’re all really worried about you, Trav. We think you might be depressed.

TRAVIS: What? Well, I’m glad you guys have it all figured out!

COACH: You gave Travis a negative label like “depressed” and he became a little upset. Also, you said, “we’re all worried,” which probably made it sound like all his friends are talking about him behind his back. Hit UNDO and try a different option.

JESSE: I don’t think I’ve seen you in class since Professor Brown wanted to meet with you. How’d that go?

TRAVIS: Oh, y’know, fine. She was all, “Don’t text during class. Why aren’t your assignments in on time? What’s up with your attitude lately?” Whatever.

JESSE: Nothing about that group workday?

TRAVIS: Well, yeah. That came up.

JESSE: I was on the other side of the room. I just heard the end of it. What happened?

TRAVIS: Nothing happened. I just, no one in the group was stepping up to do the work and I just had this feeling it was all going to land on me. Again. Then Olivia shot me this attitude and some words were said.

JESSE: Some chairs were kicked? Just one chair! Look, I’m done playing nice with those slackers.

COACH: You asked about Travis’s meeting with your professor. This encouraged him to share more about his situation. Because your question was neutral, he was more comfortable opening up.

JESSE: Just hang in there. It’ll get better.

TRAVIS: I’ve “hung in there” long enough, thanks. Maybe school was just a bad idea.

COACH: Your advice to “hang in there” was not very specific, and Travis shut down a little. Try a different option to help get back on the right path.

JESSE: We worked on a project together and it went great. What’s going on?

TRAVIS: Yeah, well, you pulled your weight. These jokers don’t. I already feel like I’m drowning, and I have to do everything for them, too? I guess no one else is taking school seriously? Maybe, maybe I shouldn’t even be here.

COACH: Neutral questions about Travis’s experience encourage him to share more about how he’s feeling.

JESSE: Don’t give up. C’mon.

TRAVIS: Look, this isn’t a Disney movie, okay? It’s my life, and if I want to go become a marketing person or become a bartender, or whatever, I can do it. I don’t need you giving me a hard time about it. You should be supportive.

COACH: You told Travis not to give up after he expressed some frustration at his situation. Right now, Travis needs to be heard rather than given advice. Try a different option to help get back on the right path.

JESSE: Okay, wow, don’t be so sensitive! I’m just trying to help.

TRAVIS: Well, I don’t need your help!

COACH: Travis is having a difficult time, so it makes sense that he’s feeling sensitive. And, even though you are trying to help, telling Travis that in this way doesn’t make him feel better. Try a different option to help get back on the right path.

JESSE: You’re giving up too easily.

TRAVIS: You think this is easy? Jess, you don’t know anything about it. So, lay off, okay? I don’t need this from you.

COACH: You told Travis he was giving up too easily. The more sensitive the topic is, the less advice you should give. Judging from Travis’s response, he considers this a very sensitive topic. Try a different option to help get back on the right path.

JESSE: So, what will you do now?

TRAVIS: I don’t know. I’ll probably end up doing all the work. Either that, or we fail the project. Sometimes I just can’t stand people.

COACH: You asked Travis a neutral question about his next steps, and he shared his thoughts about his situation with you. Now you can build on what he said.

JESSE: How often has that been happening?

TRAVIS: Has what been happening?

JESSE: You know, feeling like you can’t stand people.

TRAVIS: I dunno, always? Lately, at least.

COACH: You asked how often Travis feels like this. This gave you some insight into the seriousness of the situation, and how long it’s been going on.

JESSE: That doesn’t sound like you.

TRAVIS: Well, hate to break it to you, but it is me. At least, the me that has to carry these slackers through school while I can barely make it myself.

COACH: “That doesn’t sound like you” is a vague observation, so Travis denied it. In general, more specific observations are a little more difficult to deny. Try a different option to help get back on the right path.

JESSE: I get that you’ve got a lot going on. And I get that some of our classmates can be super annoying. But, maybe there are better ways to handle those people?

TRAVIS: Oh, yeah?

JESSE: Yeah, you know: breathe through it. Focus on the positive. Maybe even, you know, put yourself in their shoes?

TRAVIS: (bitter laugh) Of course you’d say that, Jess. But it’s, it’s not that simple.

COACH: You told Travis there might be better ways to handle other people, which implied he might be responsible for his situation. This isn’t a neutral observation. Try a different option to help get back on the right path.

JESSE: I have this mindfulness app. I love it. It really helps calm me down when I start to feel stressed or overwhelmed. It helps me, like, be in the moment, you know? You want to try it?

TRAVIS: Jess, look, I’m so happy that you found something that works for you, and you are living your best life or whatever, but it’s not the same. Stuff is already easy for you. Everything. School. Life.

COACH: You suggested Travis try an app when he didn’t ask for advice or say anything to suggest this app might work for him. It may help to learn more about the ways Travis prefers to take care of himself. Try a different option to help get back on the right path.

JESSE: Maybe you could, you know, bring up your concerns with your group. But, like, nicely. Let them know that you’re feeling like you’re ending up with an unfair amount of work. That they need to contribute more.

TRAVIS: (sarcastic) Yeah, nothing motivates a slacker like being called out on it. They’ll love that. I’m sure they’d change everything.

COACH: Travis knows the situation better than you, so he can probably come up with the best solution on his own. Try a different option to help get back on the right path.

JESSE: When did everything start to feel so overwhelming?

TRAVIS: I dunno. I just, I gotta do something different. It’s been like a nightmare, 24/7.

JESSE: What do you mean?

TRAVIS: I’m just trying to make it through this mess. School. Life. I mean, we get ridiculous amounts of work dumped on us, and I have so much other stuff going on outside of class. Honestly, most of the time when people are talking to me, I’m like, just waiting for them to just shut up so I can go get stuff done. Man, it’s all so.

JESSE: Stressful?

TRAVIS: Super stressful! And I know that’s probably surprising for someone like you to hear. ’cause school comes so easy for brainiacs like you, and you’re like, Miss Popular or whatever, so you can’t really relate.

COACH: Neutral questions are a great way to get people to open up and speak more about their situation.

JESSE: I guess it’s hard to live up to all the expectations when you’re feeling so swamped.

TRAVIS: That’s for sure. Everyone else seems to deal just fine, but, hey, you want a slice? It’s just from last night. It’s still good.

JESSE: Um, no thanks. I haven’t had all my vaccinations. Better not chance it.

TRAVIS: Funny.

COACH: You empathized with Travis to understand his situation. You also made a specific observation, which shows Travis you’re really listening.

JESSE: School is gonna be really stressful sometimes. Sounds like you could find better ways to handle it.

TRAVIS: You gonna recommend a juice cleanse or a vision board or something? Go ahead and preach your self-help stuff, but I’m not gonna buy it, okay?

COACH: You told Travis stress was normal, and his response was not. This implied he was at fault somehow and he got a little defensive. Hit UNDO and try a different option.

JESSE: How do you deal with the stress?

TRAVIS: What do you mean?

JESSE: Like, when you’re super stressed out. What do you do to like, feel better?

TRAVIS: Uhh, I dunno. I guess mess around on the Internet? (pause) And then I see how much everyone else is loving school and I, well, I just drown my sorrows with my friend “beer.” Or whatever’s around. Maybe distract myself with some trash TV or something.

COACH: You asked Travis a neutral question, which helped him to reflect on how he handles stress, and how he might be able to feel better.

JESSE: Just saying, if you spent that time studying instead of watching TV, it might be easier to keep up with everything.

TRAVIS: Ehhh, trust me, by the time I’m stocking the mini fridge and queuing up crappy TV, I’m not really in a “get stuff done” kind of headspace.

COACH: You gave Travis unwanted advice. It might help to learn more about Travis’s choices to destress. Try a different option to help get back on a more supportive path.

JESSE: So, drinking and watching. What, now?

TRAVIS: “Dog or No Dog.”

JESSE: Wow, um, what does it do for your mood?

TRAVIS: Ehh. It’s so dumb it’s kinda fun. Kinda numbs everything. But I guess when I turn it off, I feel just as bad.

COACH: You asked a neutral question. This helped Travis realize his method of dealing with stress isn’t actually very helpful.

JESSE: Maybe getting more sleep could help. I know, for me at least, everything seems a little easier to handle if I’m rested up.

TRAVIS: Ha. My problem isn’t sleeping, it’s getting myself out of bed and motivated to do anything, so yeah. Sleep really isn’t the issue.

COACH: You suggested Travis try getting more sleep when he didn’t ask for advice or say anything to suggest getting more sleep might work for him. It may help to learn more about the ways Travis prefers to take care of himself. Try a different option to help get back on the right path.

JESSE: I don’t think you’re alone in being really stressed out.

TRAVIS: Yeah, probably. They’re just better than me.

JESSE: I dunno. Remember sim lab last week, when Claudia fell asleep and started snoring so loud the instructor had to wake her up? (laughs) (laughs) Okay, okay. Maybe I’m doing a little better than Claudia.

COACH: You used an observation from your perspective to gently remind Travis that we all struggle sometimes, without making him feel guilty.

JESSE: If you need to relax, maybe yoga would help! My cousin is all about yoga, she swears by it.

TRAVIS: Yoga? Nahh. Not, uhh, not really my thing. I don’t bend.

JESSE: Okay. Well. Then what about meditation? Not bendy. And, honestly, when I have clinical, exam prep, and work all on the same day, it really does help me stay focused.

TRAVIS: Look, Jess. I appreciate that you’re trying to help. I really do. But I don’t think all that zen stuff would help me relax. It’s just not my thing, okay?

COACH: You suggested Travis try yoga when he didn’t ask for advice or say anything to suggest yoga might work for him. It may help to learn more about the ways Travis prefers to take care of himself. Try a different option to help get back on the right path.

JESSE: It seems like most people figure out how to manage it eventually. Even the Claudias of the world. So, maybe you have a better shot than you think.

TRAVIS: Yeah, maybe.

JESSE: You don’t sound too pumped.

TRAVIS: I just.

TRAVIS: Everything in my life is such a mess. I don’t see how I could ever fix it. Sometimes I wish I could just stop. Not have to deal with any of it anymore.

COACH: Travis is saying some pretty heavy things. If you ever think a friend may be considering suicide, it’s best to just come out and ask. It won’t put the idea in their head if it’s not there already.

JESSE: Hey, don’t say things like that, about wishing you would stop that. That really, I don’t like that.

TRAVIS: Maybe you should just head out or something. I’ve got a lot of stuff to do.

COACH: When people mention suicide, even in a roundabout way, it could be their way of asking for help, you should take it seriously. Hit UNDO and try a different option.

JESSE: Are you talking about suicide?

TRAVIS: Let’s talk about something else, okay? It’s been a hard few months, that’s all. I don’t know. I guess I sound like a real loser. I’m sorry.

JESSE: Trav, c’mon. Please don’t apologize. You don’t sound like a loser. You’re just, you’re dealing with a lot right now.

TRAVIS: Yeah.

Effective Example

JESSE: I haven’t seen you much lately. What’re you up to?

TRAVIS: Yeah, I haven’t really been hanging out with anyone. Just a lot going on.

JESSE: Yeah?

TRAVIS: Oh, yeah. I’ve got a ton of assignments due, tests to study for. So much.

JESSE: Yeah, it’s a lot.

JESSE: Sounds rough.

TRAVIS: Yeah. So, what’s up with you?

COACH: There’s nothing wrong with a simple response. By reflecting what he said, you show Travis you’re listening.

JESSE: Oh, the usual, you know. Nothing much.

TRAVIS: Hmm. How’d it go with that biology guy?

JESSE: (laughs) Not good.

TRAVIS: What happened? You have to watch out for those biology types, you know.

JESSE: Ha. Um, it’s a long story. I’ll tell you some other time.

TRAVIS: Hey, something the matter? You seem, something on your mind?

COACH: You kept the conversation casual for now, which can help Travis feel more comfortable talking with you.

JESSE: I don’t think I’ve seen you in class since Professor Brown wanted to meet with you. How’d that go?

TRAVIS: Oh, y’know, fine. She was all, “Don’t text during class. Why aren’t your assignments in on time? What’s up with your attitude lately?” Whatever.

JESSE: Nothing about that group work day?

TRAVIS: Well, yeah. That came up.

JESSE: I was on the other side of the room. I just heard the end of it. What happened?

JESSE: Some chairs were kicked? Just one chair! Look, I’m done playing nice with those slackers.

COACH: You asked about Travis’s meeting with your professor. This encouraged him to share more about his situation. Because your question was neutral, he was more comfortable opening up.

JESSE: So, what will you do now?

TRAVIS: I don’t know. I’ll probably end up doing all the work. Either that, or we fail the project. Sometimes I just can’t stand people.

COACH: You asked Travis a neutral question about his next steps, and he shared his thoughts about his situation with you. Now you can build on what he said.

JESSE: We worked on a project together and it went great. What’s going on?

COACH: Neutral questions about Travis’s experience encourage him to share more about how he’s feeling.

JESSE: How often has that been happening?

TRAVIS: Has what been happening?

JESSE: You know, feeling like you can’t stand people.

TRAVIS: I dunno, always? Lately, at least.

COACH: You asked how often Travis feels like this. This gave you some insight into the seriousness of the situation, and how long it’s been going on.

JESSE: Trav. I mean it when I say I’m worried. I, I didn’t want to say anything before, ’cause I thought, maybe you were just doing your own thing or whatever, but I don’t know. We haven’t really hung out for weeks, and you seem to be drinking more. You’ve stopped going to the gym, you said you failed some of your exams last semester. And now that big ol’ blow up in class? And, honestly, you’ve been kind of on a short fuse with everyone lately. I mean, what am I supposed to think? What’s going on?

TRAVIS: (long pause, then short laugh) I don’t know. I don’t know what to say about all that.

COACH: You used specific observations to help Travis see his situation from the outside. Since these are your observations, he can’t deny them.

JESSE: Honestly, it seems like the stress is wearing you down. That’s what really worries me.

TRAVIS: I’m just bogged down right now, with school and everything.

TRAVIS: I’ve got this pressure riding on me all the time, I dunno, I, people get under my skin so easy lately. Everything does.

COACH: “It seems like the stress is wearing you down” is a neutral statement, and it’s from your own perspective, so Travis was receptive to it.

JESSE: How do you deal with the stress?

TRAVIS: What do you mean?

JESSE: Like, when you’re super stressed out. What do you do to like feel better?

TRAVIS: Uhh, I dunno. I guess mess around on the Internet? (pause) And then I see how much everyone else is loving school and I, well I just drown my sorrows with my friend “beer.” Or whatever’s around. Maybe distract myself with some trash TV or something.

COACH: You asked Travis a neutral question, which helped him to reflect on how he handles stress, and how he might be able to feel better.

JESSE: So, drinking and watching. What, now?

TRAVIS: “Dog or No Dog.”

JESSE: Wow, um, what does it do for your mood?

TRAVIS: Ehh. It’s so dumb it’s kinda fun. Kinda numbs everything. But, I guess when I turn it off, I feel just as bad.

COACH: You asked a neutral question. This helped Travis realize his method of dealing with stress isn’t actually very helpful.

JESSE: What else might help you feel better?

TRAVIS: What do you mean?

JESSE: What, you know, puts you in a good mood?

TRAVIS: I, I used to really dig biking.

JESSE: Yeah?

TRAVIS: Yeah. Like, mountain biking. I was pretty into it. Competitive. With, with myself, even. Felt great to beat my times on the trails. Gave me something to work toward.

COACH: You asked a neutral question to help Travis reflect on what methods of self-care have worked with him in the past.

JESSE: Trav, what would you tell a friend to do if they were feeling really stressed out?

TRAVIS: I dunno, that they’ve got to do something about it because it’s bad for them. That they have to, like, find ways to manage their stress every day. That it’s important for their long term health.

JESSE: Huh. Well, that sounds like great advice.

TRAVIS: Ha. Yeah, I guess. And I know I haven’t been taking care of myself as well as I should be, and, but I’m just so far past stress management being the answer.

TRAVIS: Everything in my life is such a mess. I don’t see how I could ever fix it. Sometimes I wish I could just stop. Not have to deal with any of it anymore.

JESSE: Are you talking about suicide?

TRAVIS: Let’s talk about something else, okay? It’s been a hard few months, that’s all. I don’t know. I guess I sound like a real loser. I’m sorry.

JESSE: Trav, c’mon. Please don’t apologize. You don’t sound like a loser. You’re just, you’re dealing with a lot right now.

TRAVIS: Yeah.

Getting Help

MORGAN: When you asked Travis about suicide, he brushed it off and asked to talk about something else. Travis’s situation seems to be bad and getting worse. It may be more than he can handle on his own. Fortunately, there are resources where students can find help such as access to professional counselors. These services can help them talk about challenges like stress, sadness, relationship issues, drug and alcohol abuse, and eating issues. Campus mental health services are confidential and available to students for free or at a highly reduced cost. Your campus may offer the option to access professional counselors online or over the phone. Check the resources section for your school specific options.

Challenges:

Stress
Sadness
Relationship issues
Drug and alcohol abuse
Eating issues

Mental Health Services:

Confidential
Available free / reduced cost

Your next goal is to tell Travis about these services, known at his school as a counseling center, and encourage him to make an appointment.

We’ll talk later about other options, in case you’re not comfortable having this kind of conversation in real life.

Scenario: Talk with Travis Part II

Ineffective Example

TRAVIS: I guess I sound like a real loser. I’m sorry.

JESSE: Trav, come on. Please don’t apologize. You don’t sound like a loser. You’re just, you’re dealing with a lot right now.

TRAVIS: Yeah.

JESSE: I think you should go to the counseling center.

TRAVIS: The what?

JESSE: The counseling center on campus.

TRAVIS: No. What are you talking about?

COACH: You told Travis you thought he should go to the counseling center without sharing details about what might make that a good choice. He might be more open if asked how he’d feel about talking with someone else. Hit UNDO and try a different option.

JESSE: Do you have anyone to talk to?

TRAVIS: What do you mean? I’m talking to you right now.

JESSE: But, like, anyone else? I mean, it’s a lot to deal with all on your own.

TRAVIS: I don’t know. It’s my problem.

COACH: You asked Travis if he had anyone in his life in general to talk with about his situation, and he was a little unsure of what you meant. Because Travis has been having some intense thoughts, he may need a little extra support. If you want to hear some of Travis’s thoughts on counseling, you can ask him directly.

JESSE: Have you thought about going to the counseling center?

TRAVIS: The what?

TRAVIS: The counseling center on campus.

TRAVIS: No, I’ve never heard of it.

COACH: You asked Travis about going to the counseling center on campus. When you ask Travis for his thoughts, you invite him to discuss the idea with you.

JESSE: Yeah, they have a lot of counselors you can talk to, but it’s cheap ’cause you’re a student.

TRAVIS: I don’t know. It’s not that bad. I mean, what, you think I’m crazy?

COACH: You gave Travis some information on counseling after he said he didn’t know anything about it. Many people don’t have a clear sense of the benefits of counseling. Now you can learn more about his thoughts.

JESSE: I don’t think you’re crazy, but I do think you’re depressed.

TRAVIS: I’m not depressed! I’m just really stressed out!

COACH: You labeled Travis as depressed. Travis doesn’t need to be diagnosed by his friends. Hit UNDO and try a different option.

JESSE: No. If you were crazy, I wouldn’t be sitting here. Whiskers and I’d be out the door.

TRAVIS: (laughs) Yeah, but what are you saying? I need to go into therapy? I don’t think I need that.

COACH: You kept the conversation lighthearted while emphasizing your interest in being with Travis. Depending on your relationship with the person you’re talking with, humor could help keep the conversation from being too intense.

JESSE: Well, you were just saying you’re dealing with a lot. If it was me, dealing with all that, I’d be there already.

TRAVIS: They can’t really help me with this stuff, you know. Maybe I need to see an advisor or something. Not a therapist.

COACH: You showed Travis you were paying attention to what he had said earlier and empathized with how tough things are for him. This is a subtle way to show Travis how things look from your perspective and encourages him to go without telling him what to do.

JESSE: Whatever, you know. It’s your life. I guess you can do what you want.

TRAVIS: Great, I will.

COACH: It can be difficult to talk with a friend who isn’t being receptive, but being negative will only make the situation worse. Hit UNDO and try a different option.

JESSE: Look, I’m not saying you have to see a counselor. I know you can manage things on your own. I just wonder if it might make things easier for you, so that you can get through all this stuff you’ve got to do.

TRAVIS: Yeah. Well, I’ll definitely think about it, okay? What? What is it?

JESSE: I don’t know.

TRAVIS: I said I’d think about it. What more do you want from me?

COACH: You let Travis know you think counseling might help him without pushing him to make a decision. Now, Travis is thinking more about what counseling might be like.

JESSE: Listen, all I care about is that you start feeling better, that you figure this stuff out. How you do it is up to you. The counseling center is one option. I don’t know, do you have any other ideas? Is there someone else who might be able to help?

TRAVIS: I don’t know.

COACH: You asked Travis for any other ideas he might have for support in a neutral way, which helps him think more about the possibility of seeking support. Support can come from many places such as online or in person support groups, digital therapy and self-care, and/or trusted faculty members.

JESSE: Look, I don’t want to pressure you to do something you don’t want to do. So, I don’t know, what do you think makes sense? What do you think would help?

TRAVIS: I don’t know. I think I can take care of it all on my own. I just, I’m not sure where to start.

JESSE: Yeah.

TRAVIS: If you think the counseling center might help, I guess I can try.

JESSE: Cool. Maybe we should look up their website. Where’s your laptop?

TRAVIS: Uh, now I have to find the laptop? This is already more work that I wanted to do today.

JESSE: Yeah, yeah. Hey, just so you know, I’m really glad you’re doing this. And I won’t mention it to anybody or anything. You can tell them if you want to, okay?

TRAVIS: Thanks.

Effective Example

TRAVIS: I guess I sound like a real loser. I’m sorry.

JESSE: Trav, come on. Please don’t apologize. You don’t sound like a loser. You’re just, you’re dealing with a lot right now.

TRAVIS: Yeah.

JESSE: Have you thought about going to the counseling center?

TRAVIS: The what?

TRAVIS: The counseling center on campus.

TRAVIS: No, I’ve never heard of it.

COACH: You asked Travis about going to the counseling center on campus. When you ask Travis for his thoughts, you invite him to discuss the idea with you.

JESSE: Yeah, they have a lot of counselors you can talk to, but it’s cheap ’cause you’re a student.

TRAVIS: I don’t know. It’s not that bad. I mean, what, you think I’m crazy?

COACH: You gave Travis some information on counseling after he said he didn’t know anything about it. Many people don’t have a clear sense of the benefits of counseling. Now, you can learn more about his thoughts.

JESSE: I actually know a few people who’ve used the counselor. It seems like they all got something out of it.

TRAVIS: Maybe I’ll think about it. I just have so much to do, you know? It’s kind of silly to go do something like that when you’ve got all this work piling up around you.

COACH: You shared your experiences with people who found counseling valuable. This normalizes counseling and encourages him to go without telling him what to do.

JESSE: I kinda see it like seeing a doctor. If you have the flu, you’ll probably get better on your own, but if you see a doctor, maybe he can help you get better faster or, keep it from turning into pneumonia or something. Does that make sense?

TRAVIS: Yeah.

COACH: You shared your personal perspective on the value of counseling, which is a great way to reduce the stigma around seeing a counselor.

TRAVIS: Yeah. Well, I’ll definitely think about it, okay? What? What is it?

JESSE: I don’t know.

TRAVIS: I said I’d think about it. What more do you want from me?

COACH: You let Travis know you think counseling might help him without pushing him to make a decision. Now, Travis is thinking more about what counseling might be like.

JESSE: Why are you hesitant about it?

TRAVIS: Well, I don’t know. How excited am I supposed to be about going to see a counselor? Does it sound like fun to you?

JESSE: (laugh) Well, maybe. I mean, compared to what? Sitting around here all day?

TRAVIS: (laughs) Yeah, like maybe I should go just to get out of the house.

JESSE: (laughs) Yeah, but, you know, I think they have a no shirt, no shoes, no service policy.

TRAVIS: Oh. See, that’s the problem.

COACH: You asked a neutral question to help Travis open up about his nerves surrounding therapy. By knowing how he feels, you’ll be better equipped to support him.

JESSE: Look, I don’t want to pressure you to do something you don’t want to do. So, I don’t know, what do you think makes sense? What do you think would help?

TRAVIS: I don’t know. I think I can take care of it all on my own. I just, I’m not sure where to start.

JESSE: Yeah.

TRAVIS: If you think the counseling center might help, I guess I can try.

JESSE: Cool. Maybe we should look up their website. Where’s your laptop?

TRAVIS: Uh, now I have to find the laptop? This is already more work that I wanted to do today.

JESSE: Yeah, yeah. Hey, just so you know, I’m really glad you’re doing this. And I won’t mention it to anybody or anything. You can tell them if you want to, okay?

TRAVIS: Thanks.

Taking Care of Yourself

Great job! If Travis had not agreed to seek help, there are still things you could have done, like calling the counseling center office for advice or talking to someone on campus, a faculty or staff member, an RA, or a student leader. And if you ever think a friend is in immediate danger of harming themselves or someone else, you should call 911, campus security, or a crisis hotline.

Helpful Resources:

Mental health services
Faculty or staff
RA or student leader
Call 911
Campus security
Crisis hotline

These resources are also there for you, in case you ever realize that you’d like support yourself. Check out the resources section in your menu for a list of supportive places in your school and community.

When we get really stressed, we do things like take a walk or watch our favorite TV show. And while self-soothing like this can provide healthy distractions, we also need to make self-care a habit. Where self-soothing is about destressing in the moment, self-care is about creating a routine to manage your long term stress level.

I think of it like this; imagine a glass that’s full of water.

PIC 15: An image of a glass filled with water appears.

The water is made up of stressful things like having a fight with your best friend or studying for finals.

Sometimes adding just one more drop of stress is enough to make the glass overflow.

By practicing self-care, you can increase the size of the glass, even though you might not be able to change the amount of stress you’re dealing with, you’ll be able to handle it a little easier.

Self-care isn’t one size fits all. So, today, we’re going to talk about a few different kinds of self-care: psychological, emotional, physical, spiritual, and social. These categories overlap, so as we explore each, think about which practices you do now, and which practices you’d like to add to your routine.

Self-Care:

Psychological
Emotional
Physical
Spiritual
Social

Let’s start with psychological self-care. The things we think, negative or positive, can have a big effect on our mental health. That’s why it’s important to do things that support a healthy mindset.

Select the things you currently do to invest in your psychological self, and then select a few things you’d like to start doing:

Take some time away: day trips or vacations
Take a break from screen time
Make time for self-reflection
Check in with your thoughts, beliefs, attitudes, and feelings
Engage in individual or group therapy
Write in a journal
Read something that is unrelated to academic work
Try something new
Say no to extra responsibilities sometimes

Consider the differences between what you’re currently doing to take care of yourself, and what you’d like to be doing. In Travis’s case, it seems like he might have been neglecting to invest in his psychological self. It took his friends pointing this out for him to realize what he was going through and to reach out to someone who could help. He ended up seeing a counselor, who gave him a daily journaling exercise that he found really helped him. You can try it for yourself, if you’d like!

Exercise: Before you go to bed each night, write down three things you’re grateful for. That way, when you feel down, you have a premade list of things that make you feel thankful to flip through.

As we move from thinking about psychological self-care to emotional self-care, it’s important to think about how much our thoughts can influence our emotions. Your emotions affect how you see the world, so it’s important to know how to acknowledge and manage them.

Select the ways that you are currently investing in your emotional self, then select the areas you would like to focus on:

Spend time with others whose company you enjoy
Stay in contact with important people in your life
Give yourself praise and love
Identify comforting activities, objects, people, and places, and seek them out
Acknowledge your emotions and allow yourself to feel them fully
Find things that make you laugh or bring you joy
Express your opinions in social action, letters, donations, marches, or protests

It can be tough to remember to spend time investing in our own emotional well-being. For example, think about Jesse. Jesse was always putting others before herself. Her friends reminded her how much her encouragement meant to them, and that she deserves the same.

PIC 16: Image of Jesse’s face appears.

Now, she takes moments to stop and praise herself when she does positive actions, everything from doing well on an exam to doing laundry. (joking) You know how much we all love doing that.

Taking care of your mental health is important, but let’s not forget about your physical health! It’s important to invest in your physical self for your overall health. Taking care of your body helps to support your mental wellness, too! You could do this by getting physical activity, eating well, or getting enough sleep.

Select the ways that you are currently investing in your physical self, then select the areas you would like to focus on:

Eat when you’re hungry, stop when you’re satisfied
Eat healthily
Get regular checkups
Get medical care when needed
Take time off when sick
Do various stress relief techniques such as meditation, massage, yoga,
Dance, swim, walk, run, play sports, or do some other fun physical activity
Get enough sleep and stick to a regular sleep schedule

I know I used to have issues with my body image. When I started going to the trainer at my school, she told me about the idea of form vs. function. Now, instead of eating and working out in order to improve how my body looks, or my form. I aim to improve how my body works and feels. That’s function. While I can’t say I don’t have negative thoughts now and again, this really helps me, and gives me something positive to focus on.

Now, let’s talk about spiritual self-care. Spiritual self-care is a way to connect with who you are and who you want to be deep down.

Select the ways that you are currently investing in your spiritual self, then select the areas you would like to focus on:

Make time for reflection
Spend time in nature
Find a spiritual connection or community
Be open to inspiration
Be optimistic and hopeful
Be aware of non-material aspects of life
Be open to not knowing
Identify what is meaningful to you and notice its place in your life
Meditate
Sing
Contribute to causes in which you believe
Read inspirational literature or listen to inspirational talks or music

Spiritual self-care can be really helpful for some people. Rama went to a grief support group and learned a grounding meditation technique that he found useful. When he gets overwhelmed, he takes a moment to notice how every part of his body feels. This helps keep him grounded in the now, and helps take his mind off his anxieties.

Lastly, let’s talk about your social self. Social self-care is investing in creating and maintaining your close relationships. These are the people in your life who will be there to support you when you need it.

Select the ways that you are currently investing in your social self, then select the areas you would like to focus on:

Make time to see friends
Schedule regular dates with your partner
Call, check on, or see your relatives
Stay in contact with faraway friends
Make time to reply to personal messages
Allow others to do things for you
Expand your social circle
Ask for help when you need it
Share a fear, hope, or secret with someone you trust

It’s important to think about the people in our lives who are there to help support us. When Maya feels overwhelmed, she thinks about the last person she laughed with, and the last person she cried with, and reaches out, even just to say hi.

So, there are a lot of aspects of self-care to keep in mind, but the most important thing to remember is that the best self-care routine for you is one you can maintain. No matter how small the changes you make are, they’ll still matter.

Try out a few different exercises or practices, see what you can fit into your schedule, and what makes you feel best right now. Keep in mind that this is a dynamic process, some exercises might be more helpful at different times in your life than others.

We all face distress sometimes, so making sure that we’re there for our friends and ourselves sets us all up for success.