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“Mad” or Bad? Helping Faculty To
Recognize & Manage
Student Mental Health Issues
Peggy Mitchell Norwood, Ph.D.
Professor of Psychology
Community College of Aurora
[email protected]
Which scenario
really happened?
A 22 year old female student never spoke in class, pantomimed,
and had her boyfriend “interpret” for her.
B. A 25 year old male student accused his female professor of
constantly staring at him and aggressively bumped up against her
as he left the classroom.
C. A 17 year old female student burst into tears and ran out of the
classroom when it was her turn to make her oral presentation to
the class.
D. A 16 year old concurrent enrollment high school student tipped
his chair backwards, intentionally fell to the floor, and remained
there until the whole class noticed.
A.
Behavior Problem vs.
Mental Health Issue
• Some classroom behavior problems might
be related to mental health issues
• You might use different classroom
management strategies and recommend
different resources if you believe a student
has a mental health issue
“Sometimes I feel like I am invisible, a silhouette which cannot
be touched or touched in return and at times that seems
maddening to me…I can catch hints enough to know I do
not really belong…You don’t have to be afraid of me or
anything crazy like that, and I am not mentally ill. Just
alone.”
- email from a student
Mental Disorder
A pattern of persistent, maladaptive
behavior or psychological experience that
causes significant distress or impairment
Continuum of Behavior
Any one behavior is not sufficient to
diagnose a mental disorder
Why is
This Topic
Important?
NIMH Statistics: Any disorder
among adults, retrieved from
http://www.nimh.nih.gov/statistics
/1ANYDIS_ADULT.shtml
NIMH Statistics: Any disorder
among adults, retrieved from
http://www.nimh.nih.gov/statistics
/1ANYDIS_ADULT.shtml
More Statistical Information
National Institute of Mental Health (2012) Statistics, retrieved
from http://www.nimh.nih.gov/statistics/index.shtml on
March 28, 2012.
Discharge Plan:
“Why don’t you
take a class or two
at the local community
college?”
Freedigitalphotos.net
“When I was a child my parents often criticized
me, calling me ‘stupid’ so often that I believed
them. I now know that my parents were just
being cruel, that it wasn’t true, but I still have my
doubts, deep down…. When I get depressed
and feel I have no one to talk to, I can get
suicidal. It’s pretty scary. So I guess you’re one
of the people I’ve adopted to talk to.”
- email from a student
“MAD”
BAD
• Disruptive
• Schizophrenia & Other
• Inappropriate
• Attention-seeking
•
• Irritating
•
• Immature
•
• Rude
•
Psychotic Disorders
Bipolar Disorder
Major Depressive Disorder
Personality Disorders
Anxiety Disorders
Defining Abnormal Behavior - 4 Ds
• Distress
• Disability
• Deviant
• Dangerous
Are students allowed
to be
“just plain strange”?
Mental Health and Campus Life
“…national surveys show that nearly half of the students who visit
counseling centers are coping with serious mental illness, more than
double the rate a decade ago. More students take psychiatric
medication, and there are more emergencies requiring immediate
action.”
Gabriel, Trip (2010, December 19). Serious mental health needs seen
growing at college campuses. The New York Times. Retrieved from
http://www.nytimes.com/2010/12/20/health/20campus.html?pagewanted
=all on March 28, 2012.
American Psychological Association (2012). The state of mental health on
college campuses: A growing crisis. Retrieved from
http://www.apa.org/about/gr/education/news/2011/collegecampuses.aspx on March 28, 2012.
Brief Overview of Disorders
DSM IV TR Behavenet.com
http://behavenet.com/apa-diagnostic-classification-dsm-iv-tr
Screenshot
http://www.amazon.com/gp/product/08
90420254/ref=pd_lpo_k2_dp_sr_1/183
28797662404540?pf_rd_m=ATVPDKI
KX0DER&pf_rd_s=lpo-top-stripe1&pf_rd_r=0JN3VEX4GCSKRVE8MA
J8&pf_rd_t=201&pf_rd_p=486539851
&pf_rd_i=0890420262
Schizophrenia
• Severe disorder characterized by disturbance
in thought, behavior and emotions
• Marked impairment in social or occupational
(or school) functioning
Freedigitalphotos.net
“I was scared because I was having weird
thoughts, that cameras were watching me
in the school.”
-email from a student
Symptoms of Schizophrenia
• Delusions - false, fixed beliefs
• Hallucinations - false sensory experiences
• Disturbance in thought (evidenced by odd
or bizarre speech or writing)
• Disorganized behavior and movements
• Diminished range of emotional expression
• Loss of interest or pleasure
Examples
Hallucinations:
http://www.youtube.com/watch?v=s33Y5nI5Wbc
Disorganized speech:
http://www.youtube.com/watch?v=avbfd_OkLoU&feat
ure=results_main&playnext=1&list=PLDE8B2510DB23
030E
Other Psychotic Disorders
Screenshot
http://www.nextmovie.com/
blog/youngest-oscarnominees-winners-of-alltime/
• Delusional Disorder -
Erotomanic Type
(eg.,John Hinckley)
• Brief Psychotic Disorder
(eg., “Snapped”)
Screenshot
http://en.wikipedia.org/wiki/John_Hinckl
ey,_Jr.
It’s a myth that
mentally ill people
are more violent
Screenshot http://www.imdb.com/title/tt0081505/
I worked in an Elite-Pioneering Research, Development and Design Environment. The Dogma was
“Zero-Anomalies”. I was a Defense Contractor. But, “Was” and in respect to my other positions:
Contractual and Confidentiality Agreements are always binding. (Recalling your Academe being
Virginia based, Bethesda and Langley will hopefully shed some light. Virginia is a Beautiful State. It
reminded me of Illinois.)
“Dr. Norwood, I have no problems sharing my Portfolio with only you. It will give insight into many
items.
Dr. Norwood, I will stop with the Meticulous Boredom. But, I do recognize how [student’s name]
seems to be “Odd or Something?”. I still require Mandible, (TM-Disorder), repair. When I speak, care
must be taken not to dislodge my jaw.
I dislike mentioning this but yes I am watched and investigated by the Respondents: If for any reason
someone/? makes any inquiries about me; please follow this legality. [student’s name], is on Social
Security Disability Insurance. I qualify under the protection of the Department of Justice. This
entitlement is provided through the ‘Americans With Disabilities Act’ and the United Stated
Department of Human Health Services, Mandate; ‘Hospitalization Insurance Portability Accountability
Act’. Without the written permission/waiver of such individual, [student’s name], information cannot be
“shared or Transmitted by any Media-Type.”
Doctor, I do hope your classes will be available again. I wish to re-enroll. I will still follow the syllabus
on my own. And, please no worries…I have excellent personal Attorneys.
- email from a student
Bipolar Disorder
Disturbance in mood typically characterized by
periods of mania and depression
Freedigitalphotos.net
Symptoms of Mania
• Elevated, euphoric, or
irritable mood
• Inflated self esteem or
grandiosity
• Decreased need for
sleep
• Pressured speech
• Flight of ideas
• Distractibility
• Self-destructive,
pleasurable activities
http://youtu.be/h5aSa4tmVNM?t=57s
“I’m not bipolar, I’m bi-winning!”
- Charlie Sheen
Appearance (“Manic Makeup”)
Screenshot https://illreviewanything.wordpress.com/2011/06/10/baby-wipes/
Symptoms of Depression
• Depressed, sad mood
• Loss of pleasure or interest
Freedigitalphotos.net
• Feelings of worthlessness
• Diminished ability to think or concentrate
• Indecisiveness
• Recurrent thoughts of death, suicide attempts
Example of Bipolar Disorder
http://www.youtube.com/watch?v=f-znjojBojc&feature=related
http://www.youtube.com/watch?v=ahfwEgpIAWg&feature=related
“I was really depressed. My therapist wanted
me to be hospitalized, but I didn’t want to
go. My extreme and bewildering reaction I was suicidal and having wild mood swings
- ruined my spring break.”
- note from a student
Suicidal Ideation
• Never be afraid to inquire directly
• “Are you having thoughts of killing or
harming yourself?”
• Assess the seriousness of the thoughts
using “SLAP”
• Specificity
• Lethality
• Availability
• Proximity
Have you ever encountered a suicidal
student? How did you handle the situation?
Suicide Intervention
• Call 911 or Mobile Crisis Unit
• Share Suicide Hotline numbers
• 1-800-SUICIDE
• 1-800-273-TALK
Personality Disorders
Rigid, pervasive, enduring, selfdefeating personality patterns
that cause significant distress or
impairment
• Narcissistic Personality Disorder
• Histrionic Personality Disorder
• Borderline Personality Disorder
• Antisocial Personality Disorder
Screenshot
http://ateenagersguideto.blogspot.com/20
11/11/what-is-personality-disorder.html
Narcissistic Personality Disorder
• Arrogant
• Monopolizes
discussions
• Self-centered
• Lacks empathy
• Puts others down
• Requires excessive
admiration
• Sense of entitlement
Screenshot
http://www.motherrr.com/help/topics/
narcissism
Histrionic Personality Disorder
• Excessively
emotional
• Dramatic attentionseeking
• Sexually provocative
behavior or
appearance
• “Drama King” or
“Drama Queen”
Freedigitalphotos.net
Borderline Personality Disorder
• Unstable moods,
relationships, and selfimage
• Intense anger
• All or nothing thinking
• Eg., Glenn Close in “Fatal
Attraction”
Screenshot
http://www.ew.com/ew/gallery/0,,20256
078_20572167,00.html#20572167
“I was so enraged and hurt by him that
I cut my arm; this was a compromise
and brought relief. Until I saw myself
bleeding, terrible thoughts were going
through my mind. Making the
superficial cuts was better than hurting
someone or killing myself.”
- note from a student
Antisocial Personality Disorder
• Violates rules, laws,
others’ rights
• Irresponsible or Impulsive
• Deceitful
• Lack of remorse
• Aggressive
• Charming yet manipulative
• Eg. Ted Bundy
Screenshot
http://www.clarkprosecutor.org/html/death/U
S/bundy106.htm
Anxiety Disorders
Excessive, irrational dread,
worry, or nervousness that is out
of proportion to the situation or
persists longer than reasonable
Social Phobia
• Fear of social or performance situations in
which the person is exposed to possible
scrutiny by others
• Fears acting in a way (or showing anxiety
symptoms) that will be humiliating or
embarrassing
Panic Attack
• Palpitations, sweating,
trembling, chest pain,
dizziness
• Fear of going crazy
• Feeling detached from
oneself
Screenshot
http://www.sheknows.com/parenting/arti
cles/810080/could-it-be-a-panic-attack
Have you ever encountered a student who showed
signs of a mental disorder?
Schizophrenia | Bipolar Disorder | Depression |
Suicide | Personality Disorders | Anxiety
Disorders
How does believing a student has a mental
disorder (vs. a behavior problem)
change your response?
How did you handle the situation?
Stay in Your Lane
Be clear in advance
how you plan to
handle these types of
situations
Freedigitalphotos.net
Managing
Disruptive Behaviors
• Make expectations about classroom behavior (for
everyone) clear on day one (eg. Syllabus)
• Acknowledge and deal with inappropriate, bizarre,
or disruptive behavior sooner rather than later
• Differentiate between bad behavior and mental
health issues
• Refer students who self-disclose a mental disorder
to Accessibility Services before granting special
accommodations.
Tips for Managing
Disruptive Behaviors
• Speak with students privately and respectfully
• Read student’s body language and voice for
escalating anger or impulsivity:
 Glaring
 Clenching fists or teeth
 Invading your (or other students’) personal space
or “bumping” you
 Yelling
 Pacing (“psychomotor agitation”)
Making a Referral
• Make referrals and/or reports to appropriate
college or community resources
• Call Security or 911 if you feel threatened or if
a student may be suicidal…better safe than
sorry!
Freedigitalphotos.net
Making a Referral
• Acknowledge a change in behavior or inappropriate
behavior
• State your concern directly and what you intend to do
about it
• Provide student with resource information or walk
them to appropriate campus office if practical
• Offer to let them call from your office depending on
urgency/need
Top 5 Helpful “Soundbites”
1. “I’m concerned about the outburst you had in class
2.
3.
4.
5.
yesterday and want to refer you to speak to someone.”
“You wrote in your essay that you are depressed and
feeling suicidal. I am concerned and I’d like for you to
get some help.”
“I don’t feel comfortable letting you leave here today
without getting some help.”
“Would you be willing to call or walk over to the
Counseling Office right now and make an
appointment?”
“Your behavior is disruptive and scary to your
classmates. I need to refer you to the Student
Disciplinary Committee.”
Possible Resources
and Referral Sources
• 911
• Campus Security
• Campus Counseling Office (if available)
• Accessibility (Disability) Services
• Community Mental Health Center
• Suicide Hotline
• Community Crisis Intervention Line or Mobile Crisis
Unit
• Others?
“This is a personal message not really pertaining to
school. I realize this is not part of your job
description, but I appreciate the fact that you did
notice my mood Thursday in class…”
- email from a student
Resources
National Depression Screening Day Online Screening Tool
http://www.mentalhealthscreening.org/programs/colleges/ndsd
.aspx
Online Screening for Social Anxiety
http://www.adaa.org/living-with-anxiety/ask-andlearn/screenings/screening-social-anxiety-disorder
First person narratives of students with mental disorders
http://www.nami.org/Template.cfm?Section=NAMI_on_Campus
&template=/ContentManagement/ContentDisplay.cfm&Conten
tID=12236
Resources
Virtual hallucinations – simulation on Second Life of what it is
like to experience hallucinations and delusions:
http://www.youtube.com/watch?v=s33Y5nI5Wbc
Example of disorganized speech that is common in
Schizophrenia:
http://www.youtube.com/watch?v=avbfd_OkLoU&feature=resul
ts_main&playnext=1&list=PLDE8B2510DB23030E
Case example of someone with Bipolar Disorder:
http://www.youtube.com/watch?v=f-znjojBojc&feature=related
http://www.youtube.com/watch?v=ahfwEgpIAWg&feature=relat
ed
Questions or Comments?
Peggy Mitchell Norwood, Ph.D.
Community College of Aurora
[email protected]
720-212-4028