The following signs of student distress when immediately present, or presented over a period of time, suggest that the problems with which a student is dealing with are more than “typical”, and may indicate the need for a referral.


Key Link
Referral Guide For Faculty & Staff
    • in sleep patterns (insomnia or extreme sleepiness, nightmares)
    • in appetite (overeating or loss of appetite)
    • in energy level (hyperactivity or exhaustion)
    • in mood (more irritable, more excitable, or more depressed)
    • in performance or activity (compulsive, erratic, or diminished)
    • in academic performance or behavior:
    • Poor performance and preparation
    • Excessive absences or tardiness
    • Repeated requests for special consideration, especially when this represents a change from previous functioning 
    • Unusual or changed pattern of interaction
    • Avoiding participation
    • Dominating discussions
    • Excessively anxious when called upon
    • Excessive test, or class assignment related anxiety
    • Disruptive behavior
    • Problems with roommates or family

Physical Complaints Of Unknown Origin:

    • headaches, skeletal pain, gastrointestinal disturbances, cardiovascular problems, frequent illness or accidental injury, dizziness, or extreme weakness

Atypical Appearance:

    • hyperactivity or very rapid speech
    • swollen or red eyes
    • change in personal hygiene or dress
    • excessively thin or overweight


    • from activities and social interaction
    • from emotional involvement with others
    • from academic work and classroom participation
    • from family and friends

Emotional Overreaction:

    • spells of crying
    • hypersensitivity
    • outbursts of anger inappropriate to the situation
    • violent behavior


    • reckless driving
    • excessive risk taking
    • unsafe and / or inappropriate sexual behavior
    • general impulsivity

Substance Abuse:

    • overuse or regular use of illicit drugs, alcohol, nicotine, and / or medication (without medical monitoring)
    • exudes smell of alcohol, marijuana, or nicotine from person
    • alcohol / drug use in connection with the following:
        1. driving a car
        2. engaging in unsafe or unwanted sexual behavior
        3. interfering with academic, work or social responsibilities
        4. family, friendship, or relationship conflicts
        5. displays of reckless or aggressive behaviors


    • inability to concentrate or focus
    • persistent memory lapses
    • restlessness
    • preoccupation


    • feelings of pessimism, helplessness, or hopelessness
    • feeling out of control
    • anxiety
    • self preoccupation
    • negative self evaluation
    • references to suicide

Poor Contact With Reality:

    • irrational conversation
    • obsessional ruminations or worrying
    • exaggerated suspiciousness or fear
    • apparent distortions of reality (auditory or visual hallucinations, inability to distinguish fantasy from reality), disorientation

Inappropriate Behavior:

    • behavior inappropriate to the setting or situation
    • dangerous or threatening (to self or to others) behaviors
    • bizarre or strange behaviors
    • anti-social and / or illegal acts (stealing, forcible sex)


    • panic feelings
    • physical shakiness
    • obsessive and ruminating thoughts
    • rapid heart rate
    • shortness of breath
    • persistent worrying