A mental health crisis occurs when an individual’s behaviors put them at risk of harming themselves or others. The individual may experience limits to their day-to-day level of functioning.
With 75% of lifetime mental health issues becoming present by age 24, there are hundreds of thousands of students experiencing anxiety, depression, suicidality, and/or psychosis, among other mental health concerns. Being able to recognize and identify a student in crisis is vital for protecting the health and well-being of the individual, their families, and the community at large.
As a campus leader responsible for the health and well-being of students, it’s important to be able to identify a student at risk and understand signs and symptoms, who faces increased risk, and how to support a student who may be undergoing a mental health crisis or emergency.
What Does a Mental Health Crisis Look Like?
A mental health crisis can occur at any time, anywhere, which is why it’s important for faculty, staff, administrators, students, and other community members to be able to recognize those at risk.
Common signs and symptoms of a mental health crisis include:
- Inability to complete daily tasks (i.e., bathing, dressing, attending class)
- Contemplation of death, suicidal ideation, or a suicide attempt
- Social withdrawal, isolation, or avoidant behaviors
- Engaging in impulsive, aggressive, and/or reckless acts and behaviors
- Changes to eating and sleeping patterns
- Rapid change to mood and inability to regulate mood responses
From 2013 to 2021, rates of anxiety and depression among students have increased 110% and 135% respectively, with the highest rates among racial and ethnic minority students.
Who is Most at Risk for a Mental Health Crisis?
Mental health crises are inevitable and can occur with depressive episodes, trauma experiences, eating disorders, substance use, self-injury, suicidal thoughts, among other situations. Nearly 73% of all college students experience some sort of mental health crisis during their college careers. While they can occur on any campus, by anyone, some students may be more likely to experience a crisis.
Studies have found that students identifying in the following groups are at a higher risk of a mental health crisis:
- Racial or ethnic minority students – Factors contributing to mental health problems among college students of color include experiences of microaggressions, discrimination, imposter syndrome, and negative campus climate.
- Members of the LGBTQ+ community – LGBTQ+ students have an increased propensity to stress related to having a marginalized social identity, which can impact their mental health. The risk is even higher for transgender and nonbinary students who may not be able to find or access identify-affirming care.
- First generation college students (FGCS) – FGCS may experience stress from lack of academic support, absence of support from family and friends, and difficulty with cultural transitions.
- International students – As a minority on a college campus, international students have needs that may be overlooked by their campus or university. International students often have a hard time navigating the medical system and are less motivated to seek psychological services and may lack access to resources due to financial, language, and cultural barriers.
- Student-athletes – These students are pressured to perform inside and outside of the classroom. They may also face stigma around mental health and help-seeking behaviors, have trouble finding care that meets their needs, and are unable to access counseling services during traditional hours due to their challenging schedules.
Students with a mental health diagnosis also have an increased risk of experiencing a mental health crisis, as they may have a hard time managing day-to-day stressors in conjunction with their mental health problems.
Students, in general, are dealing with a lot. In addition to experiencing normal college stressors, students are also navigating and adjusting to technology and social media, relationship difficulties, economic stress, eco-anxiety, and an unknown future. They are making major life decisions on what they will do with the rest of their lives – and yet, the brain does not fully mature until the age of 26, long after many students have graduated. For this reason, many young adults are acting based on feelings, impulse, and pleasure-seeking desires.
What Should You Do in a Crisis Situation?
If you recognize someone in crisis, remain calm. Speak in an even-toned voice. Do not overreact. You want to offer options of care to the individual. Ask if there’s a family member or friend you can reach out to; ask if they are working with a mental health professional; ask if they have a safety plan. If the individual cannot name anyone, call campus Counseling and Psychological Services (CAPS) and/or a crisis line. This could be the 988 Suicide and Crisis Lifeline or 911. You can also offer to walk the student to the counseling center. When all else fails, be patient.
How Do You Know If It’s a Crisis or Emergency?
A mental health crisis is different from a mental health emergency, but the former can lead to the latter. In an emergency, an individual is experiencing an acute disturbance of behavior, such as:
- A life-threatening event of delirium
- Dysregulated physiological response
- Aggressive behaviors
- Life-threatening situation or event that places them or someone else at an immediate risk of harm
To protect the safety of the student and the campus community, every campus should establish mental health crisis and emergency protocols. If you’re working with external mental health providers, including telehealth providers or local community providers, make sure they’re informed of campus-specific procedures so virtual crisis and emergency situations can be properly and safely de-escalated.
With mental health concerns continuing to rise across college campuses, colleges and universities need to act now, if they haven’t already, to establish crisis prevention strategies and protocols.
When working with partners, know that Mantra Health shares medical decision-making, screens for, assesses, and identifies students at risk, and implements virtual crisis response plans that support on-campus protocols and procedures.
We want colleges and universities to trust in our ability to aid in the deescalation of mental health crises and emergencies, which is why we work so closely with our partners to ensure that all students are protected in our care. To learn more about emergency response best practices and how we approach them, download this guide.
- Miriam Egan, MEd, MA, LPC, LCADC, NCC, Mantra Health Provider