Student - Campus Health - University of Arizona

When aStudentNeedsHeLpCommon Problems & Resources

When a Student Needs Help :: Common Problems & ResourcesforewardThe Campus Health Service has developed this handbook for you:teacher, advisor, athletic trainer, or mentor who shares bothpassion and responsibility for educating college students atforewardThe University of Arizona. Our goal is to help you identify problems andresources so that you can improve both the learning climate in yourclassroom and your relationships with students.The information in this handbook was developed in response to questionsfrequently asked of Campus Health staff. It will help you better assessdifficulties that may surface in your classroom which influence a student’sability to learn and your ability to teach. The handbook will help you knowwhat to look for, where to get information and how to approach a studentor colleague in need.Harry McDermott. M.D., M.P.H.Executive Director, Campus Health and Wellness1

When a Student Needs Help :: Common Problems & Resourceswhen a studentneeds helpcommon problems & resources2

When a Student Needs Help :: Common Problems & Resourcestable of contentsIntroduction................................................................................................ 5Campus Support Services .......................................................................... 9Alcohol & Other Drugs.............................................................................. 15Sexual Assault & Relationship Violence .................................................. 23table of contentsSexually Transmitted Diseases (STDs) .................................................... 27Sexual Orientation.................................................................................... 33Pregnancy ................................................................................................ 35Eating & Body Image .............................................................................. 39Sleep Deprivation .................................................................................... 45Stress ...................................................................................................... 49Depression .............................................................................................. 53Suicide .................................................................................................... 57Additional Referral Sources...................................................................... 61Web Resources ........................................................................................ 65Copyright 2006 :: The University of Arizona Campus Health ServiceEditor: Abbey AllenGraphic Design: Andrew J. Maghielse3

When a Student Needs Help :: Common Problems & Resourcesintroduction4

When a Student Needs Help :: Common Problems & Resourcesintroductionintroduction5

When a Student Needs Help :: Common Problems & ResourcesintroductionOur campus environmentis a place for study,discovery, challengeand growth. Althoughmost students succeed in ourcommunity, sometimes they haveproblems. Difficulties with school,friends, family, work or financescan disrupt student life.Using strategies learned fromparents, teachers, and peers,students try to cope with thesedisruptions – sometimeseffectively, sometimes not.If students are unable to solvetheir problems they may becomeanxious and depressed andmay abuse alcohol and drugs.We have identified many ofthe warning signs and symptomsto help you respond toyour students.You are in a unique position toguide, support and intervenebecause students look up to youas a source of knowledge, a rolemodel, even a trusted friend. Toa student in need, you may bethe path to a successful future.Before addressing the problemsstudents face, however, weneed to separate myth fromreality by correcting themisperceptions many of us shareabout today’s students.Myth: Most college studentsdrink heavily.Reality: 67% of UA studentsreport having 4 or fewer drinkswhen they go out or none atall. 94% of UA students believeone should not drink to anintoxicating level that interfereswith academic work and otherresponsibilities.Myth: Most college studentshave frequent sexual encountersand/or multiple sexual partners.Reality: 80% of UA studentseither did not have sex or onlyhad one sexual partner during thelast school year. 96% of UAstudents do one or more of thefollowing to reduce the risk ofSTDs and unintended pregnancy:limit the number of sexualpartners, use condoms, use birthcontrol other than condoms andabstain from sex.Myth: College students arenot concerned with their healthand safety.Reality: Half of UA studentsexercise 4 or more hours eachweek. An additional 30% exercise6

When a Student Needs Help :: Common Problems & Resources2-3 hours per week. 74% ofUA students do not use tobacco.88% of UA students use adesignated driver and 85% ofUA students refuse to ride witha driver who has been drinking.In your interactions with studentsCampus Health encourages you tobe approachable and helpful.With students in distress don’tunderestimate the power of yourattention. Please use thishandbook to identify signs,symptoms and resources.Here are some specificsuggestions for creating ahealthy learning climate in yourclassroom and starting a moreaccurate public conversationabout substance use onour campus.• Challenge the misperceptionsabout alcohol and other druguse. Don’t let a statement like,“Everyone was wasted lastnight,” pass for “That’s justthe way it is here.”• If you drink alcohol, model ahealthy, socially acceptablerelationship with alcohol.• If you are inviting studentsto meet you outside theclassroom choose neutralvenues. Meeting in barscan send students a mixedmessage that is difficultfor some to interpret.introduction7

When a Student Needs Help :: Common Problems & Resourcesintroduction8• Hold students accountablefor classroom performance.Rotate tests and assignmentsfrequently so that studentsmust be responsible duringevery class session.• Find ways to incorporateaccurate health informationinto your curriculum andcommunity service into yourcourse objectives. Encouragestudents to participate in avariety of extended learningopportunities.• If you suspect alcohol orother drugs are affecting astudent’s behavior or classroomperformance, talk to thestudent. Students who drinkheavily are at greater risk notonly for academic failure butfor sexual assault, sexuallytransmitted disease,pregnancy, accident and injury.If you are approached by astudent in need of help or if youwant to begin a conversationthat can direct a student to thehelp he or she needs here aresome specific suggestions:- Pick a quiet time and placeto listen.- Listen with your full attentionand simply reflect back whatyou hear the student sayingto you. This will help thestudent relate to you andreduce resistance.- Many times problems aretransient and most studentsare resilient. The bestsolutions are ones studentsdiscover for themselves withyour support.- If the problem is recurringor appears to be or feels moreserious, roll with resistance.Often students are not readyto make a change right thismoment and will need morehelp/time to move to a stageof readiness where changecan occur.- Always feel free to makea referral to Campus Healthor any of the agencies inthis guide if a studenthealth concern has youfeeling confused, stuck,fearful or over your head.The Campus Health Servicestaff thanks you for supportingthe students in our universitycommunity.

When a Student Needs Help :: Common Problems & Resourcescampus supportservicescampus support services9

When a Student Needs Help :: Common Problems & Resourcescampus support servicesCampus Health ServiceMedical ServicesAppointments: 621-6490After Hours On Call Provider: 570-7898The Campus Health Service islocated at Highland Commonson the northwest corner ofHighland and 6th Street.Medical services include:• Primary care• Acute care• Diagnostic services• Pharmacy• Immunizations• HIV antibody counselingand testing• Physical therapy services• Gynecological services• Special clinics (sportsmedicine, dermatology,orthopedics and surgery)A list of Tucson medical facilitiesis available at the CampusHealth Service for students whomay need health care after hours,holidays or weekends.Campus Health ServiceEligibility and Payment Options:Student Insurance/ CampusCare621-6486All regularly enrolled UA studentsare eligible to receive servicesthrough the Campus HealthService. Fees are charged for labwork, x-rays, certain supplies andprocedures, medicines and someprofessional services. Althoughstudents are not required to carryinsurance to use Campus Health,every student is stronglyencouraged to maintain adequatehealth insurance to coverunexpected medical expenses.Domestic students may choosefrom one of three financialoptions regarding care at theCampus Health Service.1. Fee-for Service:This option is automatic for mostcurrently enrolled UA students.Aside from designated office visitco-payments at the CampusHealth Service charges may beincurred for pharmacy, laboratorytests, x-rays, medical proceduresand supplies. These fees aregenerally less expensive thanthose charged in the community.2. CampusCare:This is a prepaid health careoption limited to services providedwithin the Campus HealthService. It serves as an idealsupplement for students coveredby private health insurance,10

When a Student Needs Help :: Common Problems & Resourceswhere one may have limitedbenefits or no coverage forcharges incurred at the healthcenter. This option also serveswell for students who cannotafford health insurance.After a designated office visitco-payment, all laboratory tests,x-rays, medical procedures andsupplies are covered providing thediagnostic work-up is initiated atthe Campus Health Service.3. Student Health Insurance:The University of Arizona offersone major medical healthinsurance policy designedspecifically for eligible UAstudents and their dependents.Post Doctoral Fellows, visitingscholars and visiting professorsare also eligible. This Point-of-Service (POS) policy offers innetworkas well as out-of-networkbenefits. All three State of Arizonauniversity health centers serve asprimary care providers for theenrolled students.International students arerequired to carry the StudentHealth Insurance policy. Thischarge is automatically addedto their bursar’s account afterthey register for classes.The Student Health AdvisoryCommittee (621-4671) is thestudent voice for health careand an official service of ASUA.campus support services11

When a Student Needs Help :: Common Problems & Resourcescampus support servicesCampus Health ServiceCounseling and PsychologicalServices (CAPS)621-3334Counseling and PsychologicalServices (CAPS) is located on thethird floor of the Campus HealthService building on the northwestcorner of Highland and 6th Street.CAPS offers psychologicalcounseling to students to helpthem cope with personal and familyproblems and successfully achievetheir educational goals. Otherservices offered by CAPS include:• Counseling and brief therapy• Couples counseling• Psychiatric medication• Biofeedback training• Substance abuse counseling• Eating disorders counselingCAPS staff is available to consultwith faculty and staff aboutstudents who are exhibiting signsof distress or experiencingdifficulties. CAPS staff alsoresponds to campus-widepsychological needs in the wakeof crises or traumatic events.Campus Health ServiceHealth Promotion andPreventive Services (HPPS)621-6483Health Promotion and PreventiveServices (HPPS) is located on thethird floor of the Campus HealthService building on the northwestcorner of Highland and 6th Street.Health Promotion and PreventiveServices offers a variety ofservices that include:• Prevention strategies andactivities to decrease:- Alcohol, tobacco, and otherdrug use- Sexually transmitted diseases- Sexual assault- Eating disorders• Confidential individualcounseling and support• Dissemination of printinformation on healthand wellness topics andcommunity resources• Assistance for studentswith health relatedacademic projectsSpecialty areas:• Acquaintance rape• Alcohol, tobaccoand other drugs• Contraception• Eating issues and body image• Fitness• Nutrition• Relationship violence• Safer sex and sexual health12

When a Student Needs Help :: Common Problems & Resources• Sexuality• Skin cancer• WellnessCampus Health ServiceOASIS Program for Sexual Assaultand Relationship Violence626-2051The Oasis Program is locatedon the third floor of the CampusHealth Service building, roomD301. The Oasis Programprovides information, referraland support for students, facultyand staff affected by issuesof interpersonal violence. Inaddition, Oasis works withcampus and community partnersto coordinate campus responseand prevention services.UA Life & Work Connections621-2493UA Life & Work Connections isdedicated to increasing resiliency,workplace effectiveness andproductivity in employees andthe organization. This is doneby identifying, designing andproviding specialized servicesthat address the evolving work/life needs of individuals in orderto enhance their contribution tothe University of Arizona and thecommunity. Services include:• Employee assistance/counseling• Worksite wellness• Childcare and family resources• Elder care and life cycle resources• Work/life supportcampus support services13

When a Student Needs Help :: Common Problems & Resourcesalcohol & other drugs14

When a Student Needs Help :: Common Problems & Resourcesalcohol &other drugsalcohol & other drugs15

When a Student Needs Help :: Common Problems & Resourcesalcohol & other drugsDefining the ProblemThe consequences of alcoholabuse pose significant healthissues for many college students.According to national statisticsfrom the National Institute onAlcohol Abuse and Alcoholism,these include alcohol-relatedassault, sexual abuse, injury,police involvement includingimpaired driving and propertydamage, academic problems,and for 6% alcohol dependence.Our UA data tells us (Health andWellness Survey 2000-2005) thatalcohol consumption at the UAcan be described as a bell curve.On one end of the curve, 25%to 35% of UA students exhibitproblem use of alcohol. Theseare the students at highest riskof alcohol-related health and lifeissues. At the other end of thecurve, about 25% of UA studentsdon’t drink at all. Another 40% to50% drink in moderation but onoccasion may drink too much andput themselves at risk.The Task Force of the NationalAdvisory Council on Alcohol Abuseand Alcoholism (A Call To Action:Changing the Culture of Drinking atU.S. Colleges, 2002) recommendsthat colleges and universitiesutilize a 3-in-1 strategy:1) Help student drinkers who areat risk and alcohol dependent.2) Work with the community.3) Employ prevention approachesfor the nondependent studentpopulation as a whole.On our campus, the CampusHealth Service provides servicesin all three areas. For thosestudents who are at risk oralcohol dependent, a briefintervention model is in placethat has been proven effectivespecifically with college students.Community strategies includeenhanced campus policies andenforcement, as well as city,county and state-wide initiativesto reduce access and availabilityof alcohol to underage drinkers.For students who are light tomoderate drinkers and theirpeers, we use a social normsapproach. We correctmisperceptions that increasestudent drinking.National data has consistentlyshown that although alcoholabuse occurs on our campusand nationwide, most collegestudents drink moderatelyand some do not drink at all.A majority of students use a16

When a Student Needs Help :: Common Problems & Resourcesvariety of protective behaviorsthat help keep them safe andreduce risks. Good decisionsstart with accurate information.By reducing misperceptions(through posters in campusbuildings and ads in the ArizonaDaily Wildcat) our data showsthat students can and do makebetter decisions aboutalcohol use.How You Can HelpPreventing alcohol abusecan have a direct impacton individual students, theclassroom environment andin your success as an educator.A student who is injured, hasa hangover or misses classas a result of drinking is lesslikely to succeed in your class.From a student perspective,faculty serve as significant rolemodels that can have a definingeffect on a student’s experienceat the UA.Here are ten ways that youcan have a real impact throughyour on-going interaction withstudents (adapted from theHigher Education Center’s“Making the Link: Facultyand Prevention”):• Deflate the myth.Misperception influencesbehavior. Give students thefacts about alcohol use at UA.With this information studentscan make better decisions.• Employ your syllabus.Set expectations for studentbehavior and academicperformance.• Listen for language.Listen for remarks that promotealcohol abuse as well as onesthat challenge the moderatedrinking norms.• Seize teachable moments.When alcohol issues comeup in class or in the news,address them in a direct butneutral manner.• Create accountability.Learning follows action.Students can gain muchfrom understanding that theirchoices have consequences.• Get them to show up.Create attendancerequirements that signalthat class is a priority.• Bring it up during advising.Use this as an opportunity toask students about alcohol iftheir academic performanceis suffering.17alcohol & other drugs

When a Student Needs Help :: Common Problems & Resourcesalcohol & other drugs• Make a connection.Having a faculty mentoris often one of the mostsignificant relationshipsthat a student will haveduring college.• Take a moment in class.Raise awareness based oncampus events or even better,incorporate alcohol issuesinto coursework.• Make a referral.Many students are reluctant toask for help directly but maycheck the many resources inthis book that are available forstudents who need help.Students often wonder howstatistics are obtained thatappear in the Campus Healthposters and ads. Below aresome questions that studentscommonly ask along withappropriate responses.Common Concerns andBackground InformationConcern: “How can thesestatistics be true – I see and hearabout people getting wasted atparties all the time?”Information: The truth is thosethings seem common becausethey attract our attention. If moststudents happen to be studyingfor a test or working at their jobover the weekend we’re not likelyto notice.• In 2005 the majority of UAstudents reported the following:- 67% have four or fewer drinksper occasion or don’t drink- 61% have three or less drinksper week- 75% have not usedmarijuana or other drugs inthe past yearConcern: “I noticed that you onlysurveyed about 2,000 studentsbut there are over 35,000 at theUA. How can this be accurate?”Information: Campus Healthstaff survey a statisticallyrandom sample of classes sothe data represents an accuratepicture of student behaviors atthe UA. To put this in perspective,think of the latest national pollyou’ve heard or read about.These polls try to reflect the280,000,000 people who livein the U.S. but typically samplebetween 1,000 and 1,500 people.It turns out that while you canspend more time and money18

When a Student Needs Help :: Common Problems & Resourcessurveying more people theresults don’t provide greateraccuracy. It is important to obtaina random sample that gives agood cross section.From this you can see that2,000 randomly selectedrespondents is a large numberand more than adequate forgetting accurate statistics thatreflect the UA overall.Concern: “How are studentssurveyed?”Information: The basis ofCampus Health facts is theHealth and Wellness Survey,which is administered to arandom sample of undergraduateclasses at the UA every springsemester. Because classes arerandomly selected from the entirespring schedule of classes, thesurvey can reach across all typesof classes of different sizes atdifferent times.Concern: “I’m worried that myboyfriend has a problem withalcohol. What should I do?”Information: Contact HealthPromotion and PreventiveServices (HPPS) at 621-5700for information and assessment.Signs of problem drinking include:alcohol & other drugs19

When a Student Needs Help :: Common Problems & Resourcesalcohol & other drugs• frequent intoxication• use of alcohol to “feel better”• preoccupation with drinking• increased tolerance toalcohol use• comments from others abouta person’s drinking• alcohol-related accidents,injuries and encounters withpolice or others in authority• blackoutsTalk about it. Few people decideto change as a result of oneconversation. Research indicatesthat people move through fivestages of change (adaptedfrom the work of Prochaskaand Di Clemente):• Precontemplation – nointention to change, noawareness of a problem• Contemplation – aware of theproblem but no commitment totake action• Preparation – haveunsuccessfully taken action inthe past year but intend to takeaction in the next month• Action – modify behavior,experiences or environment toovercome problems• Maintenance – work to preventrelapse. For addictive behaviorthis extends from six monthsto an indeterminate periodpast the initial action.Alcohol and OtherDrugs ContinuumReasons to Abstain• Religion or personal values• Caloric content (alcohol)• Taste• Pregnancy• Allergies• Interactions with medications• Friends don’t use the substance• Designated driver• Interference withacademic, athleticand sexual performance• Physical, emotional,behavioral effects• Previous negative experiences• Family history ofsubstance abuse• In recovery from addictionSocial Use*• Maintains a safer Blood AlcoholConcentration (BAC) of

When a Student Needs Help :: Common Problems & ResourcesRegular Use• Frequently becomesintoxicated/high• Attracts attention when usingthe substance• Becomes accident prone• Becomes more tolerantof the substance (needsincreasing amounts toachieve desired effects)• Uses the substance asa medicine in an attemptto cope with situationsor change feelings.Addictive Use• Experiences frequentblackouts (alcohol)• Feels afraid to stop• Experiences constantpreoccupation withthe substance• Loses control with thesubstance (can’t predict howmany drinks or doses they willhave after the first one)• Unsuccessfully attemptsto stop or control useof substance• Becomes dependent on thesubstance (continues useeven though it’s causingproblems in their life)• Continues to use the substancein order to feel “normal” orease withdrawal.When in Doubt, Refer to:Health Promotion andPreventive Services (HPPS),Campus Health Service:621-5700Information, Assessmentand Referral21alcohol & other drugs

22sexual assault & relationship violenceWhen a Student Needs Help :: Common Problems & Resources

When a Student Needs Help :: Common Problems & Resourcessexual assault &relationship violencesexual assault & relationship violence23

When a Student Needs Help :: Common Problems & Resourcessexual assault & relationship violenceDefining the ProblemIdentifying or “naming” sexualassault and relationship violenceis often difficult and confusing.These experiences, which rangein severity include violations ofphysical, sexual or emotionalboundaries and often involvepeople who are acquainted orfamiliar with each other. Victimsof abuse often blame themselvesand believe others will too. Theymay be reluctant to shareinformation because of fear,shame and embarrassment.Well meaning friends, parentsand teachers may not recognizethe seriousness of disclosuresand attempt to explain abuseand/or assault as indicationsof a “bad” relationship or anegative sexual experience.The following continuum mayhelp identify different typesof violations:Sexual Assault & Relationship ContinuumEMOTIONAL name calling yelling/screaming interrogation SUICIDEverbal intimidation threats of violence humiliation tacticsaccusations violence towards pets isolatingPHYSICAL pushing kicking driving recklessly HOMICIDEpunching throwing objects chokingslapping property damage use of weaponsSEXUAL unwanted touching stalking behaviors hurtful sex RAPEsexual insults sexual coercion sexual injuriesharassment forced behaviors forced sexThe following define incidents ofabuse and violence that areillegal in the State of Arizona:Sexual assault occurs when anindividual intentionally orknowingly engages in sexualintercourse or oral sexual contactwith anyone who does notconsent. Sexual contact includesfondling or manipulating thegenitals, anus or female breast.Sexual assault may be committedby a person known to the victim(e.g. acquaintance rape) orunknown to the victim.Civil liability related to sexualharassment may include:• Unwelcome sexual advances• Requests for sexual favors24

When a Student Needs Help :: Common Problems & Resources• Verbal or physical conduct ofa sexual nature including theestablishment of a hostile workor school environment.Relationship violence may belegally described as “domesticviolence” when the individualsare of the opposite sex and:• Reside or have resided in thesame household• Have a child in common• Are related by blood or marriage(spouse, former spouse,parent, child, brother, sister,grandparent or grandchild).Relationship violence maybe treated by the legal systemas a simple assault or disorderlyconduct when the individualsinvolved:• Are or have been dating• Have never lived together and• Do not have a child together, or• Are gay or lesbian.Common Concerns andBackground InformationConcern: “I should never havetrusted the person that hurt me.It’s my fault for using such badjudgment and I’m sure thiswouldn’t have happened to me ifI hadn’t been so stupid.”Information: People who havebeen assaulted tend to assumeresponsibility that is not theirsfor the assault and blamethemselves as a way ofreclaiming control that hasbeen lost. They need to bereminded of their strengthsand to understand that theirfeelings and reactions are“normal” responses to anunusual and often traumaticexperience. Victims of abuseand assault need to know theyare not alone and that resourcesare available to assist them.Concern: “A friend of mine toldme she was raped last night andis afraid to ask for help becauseshe doesn’t want it to be reportedto the police. I’m really scaredand don’t know what to do.”Information: Victims of sexualassault have resources forconfidential support and referral.Advocates for victims of sexualassault can help the victim andsignificant others by reviewingcounseling, legal and medicaloptions. Confidential resourceson campus are the OASISProgram and CAPS (Counselingand Psychological Services).Other on-campus resourcesinclude the Dean of Students,25sexual assault & relationship violence

When a Student Needs Help :: Common Problems & Resourcessexual assault & relationship violenceResidence Life, UAPD andCampus Health medical staff.Although these resourcesprovide valuable help they arenot considered confidential.Concern: “My ex-boyfriend isout of control. He’s calling meon the phone day and night,making all kinds of accusationsand threats and has started towait for me outside my classes.I have told him to leave me aloneand get on with his life but it’sonly getting worse.”Information: Harassmentand stalking can be confrontedin various ways including acourt order or injunction whichprohibits contact betweenindividuals. In addition a trainedadvocate can help assess thesituation and assist in developinga comprehensive safety plan.Concern: “I’m a grad assistant.What am I supposed to do whena student touches me in a waythat is uncomfortable or tellsme that they would like to seeme socially?”Information: Graduate assistantsabide by a professional code ofethics that defines the limitationsof social and/or intimaterelationships with students.Nevertheless, becauseestablishing and maintainingappropriate boundaries can becomplicated, graduate assistantsshould not hesitate to speak totheir supervisor or program chairabout their concerns.When in Doubt, Refer to:OASIS Program, Campus HealthService: 626-2051Confidential assistance to exploreoptions, receive information andinitiate counseling for UAstudents, faculty and staff.Referrals available upon request.The Center Against SexualAssault: 327-727324-hour counseling and referrals.Police: 911Emergency response. Referralsmade to UA police if assault hastaken place on campus.Brewster Center for Victims ofFamily Violence: 622-634724-hour crisis line, safe shelterservices, counseling andadvocacy program.Victim Witness AdvocateProgram (Pima CountyAttorney’s Office): 740-552524-hour crisis intervention forvictims and witnesses of crime.26

When a Student Needs Help :: Common Problems & Resourcessexually transmitteddiseases (STDs)including HIV/AIDSsexually transmitted diseases (STDs)27

When a Student Needs Help :: Common Problems & Resourcessexually transmitted diseases (STDs)Defining the ProblemThe term STDs, or sexuallytransmitted diseases, is a broadterm that refers to as many as20 different diseases. All of themare transmitted by sexual contact,usually through the exchange ofbodily fluids such as semen,vaginal fluid and blood. The mostcommon STDs are chlamydia,crabs, genital warts, genitalherpes, gonorrhea, hepatitis B,molluscum contagiosum, HIV,syphilis and trichomoniasis.Anyone who has sexual contactwith an infected person cancontract an STD. According to thefederal government’s Centers forDisease Control and Prevention,more than 19 million Americanmen and women get an STDeach year. More than half ofall Americans will have anSTD at some time in their lives.Approximately 45-60 millionAmericans have herpes (1 in 4adults) yet most are unawarebecause symptoms can be mildand mistaken for other conditions.Although the incidence remainsvery low, many misconceptionsand myths still surround thesubject of HIV/AIDS. The Centersfor Disease Control andPrevention’s 2004 statisticsestimate that more than 42million people worldwide areinfected with HIV. In the UnitedStates, between one and twomillion people are believed tohave HIV. Students living withHIV/AIDS attend the University ofArizona. Confidential HIV testingis available at the CampusHealth Service. Anonymous HIVtesting is available through thePima County Health Department.Many medical and communityresources are available to anystudent needing service.Signs and SymptomsSexually Transmitted Diseases(STDs)The most obvious signs arebumps, open sores, blisters,warts or cauliflower-like growthsin the genital area. Some ofthese might be very painfulwhile others cause only milditching or no discomfort at all.For men, burning duringurination, scrotal swelling or achange in the color, amount orconsistency of penile dischargeare some specific signs. Forwomen, abdominal pain andmenstrual disruptions are alsoexamples of symptoms of an STD.Regular pelvic exams and STD28

When a Student Needs Help :: Common Problems & Resourcessexually transmitted diseases (STDs)Defining the ProblemThe term STDs, or sexuallytransmitted diseases, is a broadterm that refers to as many as20 different diseases. All of themare transmitted by sexual contact,usually through the exchange ofbodily fluids such as semen,vaginal fluid and blood. The mostcommon STDs are chlamydia,crabs, genital warts, genitalherpes, gonorrhea, hepatitis B,molluscum contagiosum, HIV,syphilis and trichomoniasis.Anyone who has sexual contactwith an infected person cancontract an STD. According to thefederal government’s Centers forDisease Control and Prevention,more than 19 million Americanmen and women get an STDeach year. More than half ofall Americans will have anSTD at some time in their lives.Approximately 45-60 millionAmericans have herpes (1 in 4adults) yet most are unawarebecause symptoms can be mildand mistaken for other conditions.Although the incidence remainsvery low, many misconceptionsand myths still surround thesubject of HIV/AIDS. The Centersfor Disease Control andPrevention’s 2004 statisticsestimate that more than 42million people worldwide areinfected with HIV. In the UnitedStates, between one and twomillion people are believed tohave HIV. Students living withHIV/AIDS attend the University ofArizona. Confidential HIV testingis available at the CampusHealth Service. Anonymous HIVtesting is available through thePima County Health Department.Many medical and communityresources are available to anystudent needing service.Signs and SymptomsSexually Transmitted Diseases(STDs)The most obvious signs arebumps, open sores, blisters,warts or cauliflower-like growthsin the genital area. Some ofthese might be very painfulwhile others cause only milditching or no discomfort at all.For men, burning duringurination, scrotal swelling or achange in the color, amount orconsistency of penile dischargeare some specific signs. Forwomen, abdominal pain andmenstrual disruptions are alsoexamples of symptoms of an STD.Regular pelvic exams and STD28

When a Student Needs Help :: Common Problems & Resourcessexually transmitted diseases (STDs)• Choosing lower risk sexualactivities than intercourse(such as kissing, touching,manual stimulation, massage).• Avoiding sexual contact whenunder the influence of alcohol orother drugs (which can impairsexual decision-making).Concern: “If I use a latex condomevery time I have sex, am Iguaranteed not to get an STD?”Information: Condoms donot offer 100% protectionagainst STDs or pregnancybut they greatly reduce the risksassociated with unprotected sex.For a condom to be effective, itmust be put on properly prior toany skin-to-skin contact.Concern: “I don’t use condoms.I can tell if a person has an STDor not just by looking.”Information: While some STDshave obvious signs many healthylooking people carry diseasesand show no signs or symptoms.For example, a person who looksperfectly healthy can transmitchlamydia, gonorrhea, HIV andherpes. You cannot always tell bylooking at someone if they havean STD or not.Concern: “Is there one test aperson can get for all STDs?”Information: No, each diseasehas a specific test. Because eachSTD has a different cause (virus,bacteria, fungi, protozoa) andaffects the body in specific ways,it is best to be evaluated by amedical professional who canhelp decide which tests to order.Many STDs can be detected bya simple examination.Concern: “A woman can goto a gynecologist if she hassymptoms but what kind ofdoctor would a man go to?”Information: Women and menmay both seek medical carefrom their primary care provider,usually a general practitioneror internal medicine doctor.Concern: “What’s the differencebetween anonymous andconfidential testing and whichone should I get?”Information: HIV testing can bedone in two ways: 1) Anonymoustesting which does not requirea person’s name and 2)Confidential testing which isoffered at the UA Campus Health30

When a Student Needs Help :: Common Problems & ResourcesService and at most hospitalsand doctors offices. Medicalfacilities will only release medicalrecords when the patient requestsand signs a release form. InArizona, positive HIV results arereported to the Department ofHealth Services for demographicsurveillance and epidemiologicalpurposes only.When in Doubt, Refer to:Health Promotion andPreventive Services (HPPS),Campus Health Service:621-4967Confidential consultation for UAstudents. Literature, condoms andreferrals available upon request.Students can email questions tosextalk@email.arizona.edu.Medical Services,Campus Health Service:621-9202Diagnostic testing and treatmentfor all STDs. Confidential HIVtesting available. Offers slidingscale fees.Pima County Health DepartmentSTDs, HIV/AIDS Testing:624-8271, 791-7676Diagnostic testing and treatmentavailable for all STDs. AnonymousHIV testing available. Offerssliding scale fees.Planned Parenthood: 884-5562Diagnostic testing and treatmentfor all STDs. Confidential HIVtesting available. Testing andtreatment fees vary. Southsideclinic offers sliding scale fees.sexually transmitted diseases (STDs)31

When a Student Needs Help :: Common Problems & Resourcessexual orientation32

When a Student Needs Help :: Common Problems & Resourcessexualorientationsexual orientation33

When a Student Needs Help :: Common Problems & Resourcessexual orientationDefining the ProblemSexual orientation is nota problem in and of itself.But, when a student finds itdistressing, a variety of differentphysical and mental healthproblems may result. Sexualitymay be clearly defined for someyoung adults and somewhatconfusing for others. If astudent who is demonstratingsome confusion about sexualorientation approaches you, itis very important to listen andbe sensitive and non-judgmental.Encourage the student to explorehis or her feelings.Common Concerns andBackground InformationConcern: “I think I may beattracted to another man.Does this mean I’m gay?”Information: College-agedstudents may be exploring orexperimenting with their sexuality.Having romantic or erotic thoughtsabout a person of the same sexdoes not necessarily mean one ishomosexual. According to Kinsey’scontinuum, many of us fit into the“gray areas”.Concern: “I think my roommatemay be a lesbian. What if shetries to hit on me?”Information: It’s a myth thatpeople who define themselvesas lesbian/gay/bisexual are morefocused on sex than anyone else.Students need to explore theirdiscomfort or fear.When in Doubt, Refer to:Health Promotion andPreventive Services (HPPS),Campus Health Service:621-6483Individual counseling andeducation on sexuality issues.Counseling and PsychologicalServices (CAPS), CampusHealth Service: 621-3334Individual counseling andself-help library.Wingspan: 624-1779Lesbian, Gay, Bisexual,Transgendered Resource Center.Pride Alliance: 621-7585ASUA Lesbian, Gay, Bisexual,Transgendered, QuestioningResource Center.Delta Lambda Phi: 626-4855(Brian Shimamoto, Advisor)National Social Fraternity for Gay,Bisexual and Progressive Men.34

When a Student Needs Help :: Common Problems & Resourcespregnancypregnancy35

When a Student Needs Help :: Common Problems & ResourcespregnancyDefining the ProblemAlthough most people regardbirth as a joyous event,pregnancy is more problematic.Regardless of whether apregnancy is planned orunplanned, wanted or not,both men and women mayexperience a wide range ofemotions – anxiety, fear,embarrassment, entrapment,guilt, sadness or doubt.Signs and Symptoms• Absence of menstrual period• Breast tenderness• Nausea• Vomiting• Change in appetite• FatigueCommon Concerns andBackground InformationConcern: “My boyfriend and Iwere having sex last night andthe condom broke. Is thereanything I can do now?”Information: The CampusHealth Service’s Women’sClinic can prescribe emergencycontraception better known as the“morning after pill”. Taken within120 hours of unprotectedintercourse (due to rape, methodfailure or lack of contraception),this high dose of oral hormonesis 75-89% effective in preventingpregnancy. The pharmacy atCampus Health Service willfill emergency contraceptionprescriptions. If EC is neededafter hours, call the CampusHealth Urgent Care number tospeak with a provider on call.Concern: “I think I may bepregnant. What should I do?”Information: Students can bedirected to one of the followingfor testing and guidance :Women’s Health Clinic atCampus Health, PlannedParenthood, a county healthclinic, a private physician or awomen’s clinic for testing andguidance. Early diagnosis isvaluable and encouraged. If thestudent is pregnant and decidesto bring the pregnancy to fullterm, she should begin prenatalcare immediately.Concern: “I’m pregnant andin my first trimester. I feelnauseated all the time and I’mhaving trouble staying awake inclass because I’m so tired.”36

When a Student Needs Help :: Common Problems & ResourcesInformation: Pregnant womentire easily especially in the firstand third trimesters. Instructorsmay need to be flexible with apregnant student and makespecial arrangements toaccommodate her needs.When in Doubt, Refer to:Women’s Health Clinic, CampusHealth Service: 621-6512Diagnostic services and limitedcounseling. Referrals for prenatalcare, abortion and adoptionavailable upon request.After-Hours Urgent Care:570-7898Emergency Contraception.Planned Parenthood: 884-5562Diagnostic services andcounseling. Referrals for prenatalcare, abortion and adoption areavailable upon request. Abortionservices are available at thedowntown center. The southwestcenter offers sliding scale fees.Safe Baby: 872-SAFELocal hospitals and agencies areavailable to receive, take care of,and find a newborn baby a home.www.tucsonsafebaby.com37pregnancy

When a Student Needs Help :: Common Problems & Resourceseating & body image38

When a Student Needs Help :: Common Problems & Resourceseating &body imageeating & body image39

When a Student Needs Help :: Common Problems & Resourceseating & body imageDefining the ProblemOur society sends conflictingmessages about food, body imageand self-esteem. Students maybecome preoccupied or obsessedwith what they eat and with theirbody shape or size. They may feelguilty or ashamed and as a resultmay manage their weight inharmful ways. An estimated2-5% of college students have aneating disorder and 90% of theseare women. Even more studentshave problems although not atan eating disorder level. Thesestudents also need help.Eating Issues and BodyImage ContinuumFood Is Not An Issue• I am not concerned about whatothers think regarding whatand how much I eat.• When I am upset or depressed Ieat whatever I am hungry forwithout any guilt or shame.• Food is an important part of mylife but only occupies a smallpart of my time.• I trust my body to tell me whatand how much to eat.Body Ownership• Body image is not an issuefor me.• My body is beautiful to me.• My feelings about my body arenot influenced by society’sconcept of ideal body shape.• I know that the significantothers in my life will alwaysfind me attractive.• I trust my body to find theweight it needs to be at so Ican move and feel confidentof my physical body.Concerned Well• I pay attention to what Ieat in order to maintain ahealthy body.• I may weigh more than whatI like but I enjoy eating andbalance my pleasure witheating for a healthy body.• I am moderate and flexiblein goals for eating well.• I try to follow Dietary Guidelinesfor healthy eating.Body Acceptance• I base my body image equallyon social norms and my ownself-concept.• I pay attention to my body andmy appearance because it is40

When a Student Needs Help :: Common Problems & Resourcesimportant to me but it onlyoccupies a small amount ofmy day.• I nourish my body so it has thestrength and energy to achievemy physical goals.• I am able to assert myselfand maintain a healthy bodywithout losing my self-esteem.Food Preoccupied/ Obsessed• I think about food a lot.• I feel I don’t eat well most ofthe time.• It’s hard for me to enjoy eatingwith others.• I feel ashamed when I eat morethan others or more than I feelI should be eating.• I am afraid of getting fat.• I wish I could change howmuch I want to eat and whatI am hungry for.Body Preoccupied/ Obsessed• I spend significant timeviewing my body in the mirror.• I spend significant timecomparing my body to others.• I have days when I feel fat.• I am preoccupied with my body.• I accept society’s ideal bodyshape and size as the bestbody shape and size.• I’d be more attractive if I wasthinner, more muscular, etc.eating & body image41

When a Student Needs Help :: Common Problems & Resourceseating & body imageDisruptive Eating Patterns• I have tried diet pills,laxatives, vomiting or extratime exercising in order tolose or maintain my weight.• I have fasted or avoided eatingfor long periods.• I feel strong when I can restricthow much I eat.• Eating more than I wanted tomakes me feel out of control.Distorted Body Image• I spend a significant amountof time exercising and dietingto change my body.• My body shape and size keepsme from dating or findingsomeone who will treat methe way I want to be treated.• I have considered changing orhave changed my body shapeand size through surgicalmeans so I can accept myself.• I wish I could change the wayI look in the mirror.Eating Disordered• I regularly stuff myself andthen exercise, vomit, use dietpills or laxatives to get rid ofthe food or calories.• My friends/family tell me I amtoo thin.• I am terrified of getting fat.• When I let myself eat, I havea hard time controlling theamount of food I eat.• I am afraid to eat in frontof others.Body Hate/Disassociation• I often feel separated anddistant from my body as ifit belongs to someone else.• I hate my body and I oftenisolate myself from others.• I don’t see anything positiveor even neutral about my bodyshape and size.• I don’t believe others whenthey say I look OK.• I hate the way I look inthe mirror.Signs and SymptomsThe following signs indicate whena student’s beliefs and behaviorsabout food, weight and/or bodyare interfering with his/her collegeexperience and quality of life:• Changing their weight, foodconsumption or exercise forunexplained reasons.• Controlling food, weight orexercise in an uncompromisingmanner.42

When a Student Needs Help :: Common Problems & Resources• Judging their own body, weightand/or eating behaviors in anegative or demeaning way.• Using amphetamines orstimulants to lose weight.• Obsessing about food, weightor exercise.• Feeling shame and guilt abouttheir eating behavior and body.• Believing that their experiencesin life are dramatically affectedby their body weight and theirability to control food intake.• Fearing that they will gainfat, rigidly controlling exerciseor food intake to preventgaining fat.• Purging in any form, (i.e.,vomiting, diuretics, laxatives,additional exercising,restricting food).• Exercising excessively withoutnutritional support.• Restricting food to the point ofweighing less than 15% oftheir ideal body weight.• Repeatedly eating excessiveamounts of food and thenpurging to lose it.Signs Requiring Medical Attention• Excessive weight loss• Dry skin covered with downy fuzz• Digestive difficulties• Wasted muscles• Swollen glands in neckbeneath jaw• Broken blood vessels in eyesor face• Stomach and abdominaldiscomfort• Nausea, stomach cramps,ulcers, colitis• Loss of menstrual period formore than three months*• Infertility• Dry, thin hair• Dehydration• Brittle splitting nails• Loss of tooth enamel• Fainting• Rapid or irregular heart beat• Blurred vision*If the student has not hada menstrual period in morethan three months, she needsmedical attention to preventbone damage.Common Concerns andBackground InformationConcern: “I think my friend mighthave an eating disorder. I’venoticed over the course of theeating & body image43

When a Student Needs Help :: Common Problems & Resourceseating & body imagesemester she’s lost a lot ofweight and seems to have troubleconcentrating. I’ve tried to talk toher about it, but she doesn’tthink there’s a problem.Information: Students shoulddiscuss their concerns about afriend with a professional whocan offer advice and direction.People with eating disorders maydeny they have a problem or theymay become angry, hostile ordefensive. Caring friends mustbe persistent and patient. It maytake much time and energy to geta person to acknowledge thatshe/he needs help. Although it’sunlikely a student can stop afriend from overeating, purging orrestricting, they can encourage afriend to seek personal assistanceor call for help in an emergency.Concern: “How do I keep myweight down? I’ve been countingfat grams and exercising but it’snot working.”Information: Many students areconfused these days about eatingand exercising in a healthymanner. They feel that if they areextremely careful about what theyeat and how they exercise theywill be taking care of themselvesand should feel good.Unfortunately, some students maybegin to focus too closely on theirfood and body, creating a cycle ofpreoccupation and obsession withfat, weight and exercise. There isa wide range of healthy bodyweights and sizes. For manystudents, feeling healthy ratherthan looking good is anappropriate goal.When in Doubt Refer to:Nutrition Services, CampusHealth Service: 621-9202Provides individual consultationsthat are available for a widespectrum of nutritional concerns.Counseling and PsychologicalServices (CAPS), CampusHealth Service: 621-3334Assessment, individualcounseling, psychiatric consultsand eating issues support groups.44

When a Student Needs Help :: Common Problems & Resourcessleepdeprivationsleep deprivation45

When a Student Needs Help :: Common Problems & Resourcessleep deprivationDefining the ProblemStudies indicate that most collegestudents suffer from some formof sleep disturbance, at leastoccasionally. Possibly caused byunique circumstances involved incoming to college (e.g., freedomfrom parental supervision, livingarrangements with a largenumber of peers), studies showthat college students have poorersleep quality than averageworking adults.Poor sleep quality is correlatedwith increased physical healthcomplaints, increased levels ofsleepiness and increased feelingsof tension, irritability, anxiety,depression, anger, fatigue andconfusion. Reported excessdaytime sleepiness amongstudents is also correlated withmore frequent use of marijuanaand alcohol.Sleep deprivation impactsstudents’ performance on complexcognitive tasks resulting insignificantly worse performancelevels than their well-restedpeers. Consequences of sleep lossamong college students includepoor academic performance,higher incidents of automobileaccidents, increased levels ofminor medical illness such ascold and flu and increased ratesof depression and anxiety. Sleepdeprivation also influencesstudents to select tasks thatare less demanding and lesschallenging than those selectedby their well-rested peers. Withregard to academics, it mayreduce their educational goalsand achievements both insideand outside of the classroom.Signs and Symptoms• Falling asleep during classor lab• Difficulty concentrating, payingattention and solving problems• Lack of productivity andmeeting deadlines• Irritability and relationshipproblems• Depression and/or anxiety• Susceptibility to accidentsand injury• Susceptibility to illnessCommon Concerns andBackground InformationConcern: “I seem to be tired allthe time. I can’t stay awake in myclasses and my schoolwork and46

When a Student Needs Help :: Common Problems & Resourcessocial life are suffering. Whatcan I do?”Information: Young people in theirlate teens and early 20’s may needas many as nine or ten hours ofsleep to feel completely rested andalert during the day. Increasingthe quantity and quality of sleepwill often resolve symptomscaused by sleep deprivation.To improve quality of sleep,students could try the following:• Keep a consistent bedtime andwake time schedule as muchas possible, even on weekends.• Don’t use caffeine, alcohol ornicotine close to bedtime.• Avoid eating right before goingto bed and restrict sugar intakeat night.• Make the sleep environmentdark, quiet, comfortableand cool.• Exercise regularly and completethe workout at least 3 hoursbefore bedtime.• Use relaxing activities (e.g.,reading for leisure, listeningto soothing music) to transitioninto sleep.• Find coping mechanisms tomanage stress (e.g., timemanagement practices,progressive muscular relaxation).When in Doubt, Refer to:General Medicine Clinic,Campus Health Service:621-9202Non-emergent medicalconditions are evaluated andtreated. Referrals are madewhen necessary. Visits are byscheduled appointment.Counseling and PsychologicalServices (CAPS), CampusHealth Service: 621-3334Offers psychological counselingto students to help them copewith personal and familyproblems and successfullyachieve their educational goals.sleep deprivation47

When a Student Needs Help :: Common Problems & Resourcesstress48

When a Student Needs Help :: Common Problems & Resourcesstressstress49

When a Student Needs Help :: Common Problems & ResourcesstressDefining the ProblemStress can be defined as thestate of arousal that results fromall life changes, positive andnegative. Although some stresscan be viewed as positive, whenpeople say they “feel stressed”,this is usually a sign that theyare feeling overwhelmed andtheir existing coping mechanismsare being overlooked and notfunctioning effectively. Everyonehas unique stressors and copingmechanisms. What may feelhighly stressful to one personmay not affect another at all.Excessive or poorly managedstress can adversely affect astudent’s health and contributeto illness.Possible Signs andSymptomsPhysical• Muscle tension• Breathing difficulties• Chest tightness• Excessive sweating• Trembling/shaking• Increased blood pressure• Headache• Sleep disturbances• Dermatitis• Restlessness• Appetite changes• Stomach ulcersEmotional Symptoms& Behaviors• Feeling overwhelmed• General anxiety• General irritability• Depression• Alcohol abuse• Drug abuse• Ruminating thoughts• Difficulty concentratingCommon Concerns andBackground InformationConcern: “I have so much todo in so little time. How can Ido all my work and still reducemy stress?”Information: Students can bettermanage their lives and reducestress by:• Setting priorities• Prioritizing tasks• Making lists• Scheduling and organizingactivities• Reducing responsibilities• Delegating duties• Compromising50

When a Student Needs Help :: Common Problems & Resources• Evaluating and possiblychanging standards• Getting supportConcern: “Are there any stressreduction techniques I can use?”Information: Students can usemany stress reduction techniquesto achieve relaxation and maintainphysical health. The key is to getfamiliar with and practice themregularly, not just in momentswhen they feel overwhelmed.Relaxation• Meditation• Biofeedback• Hypnosis• Yoga• Massage• Tai Chi• Stretching and deep breathingPhysical Health• Exercise regularly• Eat a nutritious diet• Get enough sleep• Use caffeine and alcoholmoderately or not at all• Avoid non-prescribed drugsWhen in Doubt, Refer to:Counseling and PsychologicalServices (CAPS), CampusHealth Service: 621-3334Individual counseling, psychiatricconsultation, meditationworkshops, biofeedback services,yoga classes, support groups.stress51

When a Student Needs Help :: Common Problems & Resourcesdepression52

When a Student Needs Help :: Common Problems & Resourcesdepressiondepression53

When a Student Needs Help :: Common Problems & ResourcesdepressionDefining the ProblemClinical depression is more thanthe blues or the “blahs”. It ismore than normal everyday upsand downs. When someone is“down” for more than a couple ofweeks, he or she may be clinicallydepressed. Clinical depression isa serious health problem thataffects the total person. Inaddition to affecting emotionsit can influence behavior,physical health and appearance,academic performance and theability to handle everydaydecisions and pressures.Signs and SymptomsEmotional Symptoms• Sadness• Hopelessness• Worthlessness• Shame• Helplessness• Anxiety• Inability to experience pleasure• Mood swings• Despair• Indifference• Guilt• Self-reproach• Pessimism• Lowered self-esteemPhysical Symptoms• Change in eating patterns• Sleep disturbances• Fatigue and lethargy• Agitation and jumpiness• Low energyCognitive Symptoms• Diminished ability to think orconcentrate• Decreased sexual activity• Loss of interest in work andusual activities• Thoughts of death or suicide• Avoidance of friends or family• Indecisiveness• Distractibility• Impaired concentration• RuminationCommon Concerns andBackground InformationConcern: “Why do peopleget depressed?”Information: A common reasonfor depression is a sense of loss.This sense of loss may stem from:• Death of a friend or a loved one• Divorce or family separation• Breakup of a romance orfriendship• Failure to meet standards orexpectations of self or others54

When a Student Needs Help :: Common Problems & Resources• Inability to cope with life stressors• Insufficient support from familyand friends• Loss of hope about futurepossibilities.The interaction of a painful event,over taxed coping skills, negativethinking and self-devaluationmay combine to create a feelingof helplessness and hopelessness.Concern: “I have a friend who isdepressed. How can I help?”Information: Depressed peopleoften need to talk about theirdistress. They need someone whowill listen without judging oroffering advice. Sometimes theyneed a friend but at other timesthey need to talk to someone withprofessional expertise.Concern: “I have a friend whowas depressed last year butseems okay now. How do peoplestay balanced?”Information: In general, peoplestay balanced by:• Maintaining their physicalhealth through good nutrition,exercise and rest.• Keeping up friendships or creatingnew ones if they are alone• Pursuing meaningful interestsor hobbies• Being patient with themselves• Having a good sense of humor• Seeking medical or psychologicalintervention when called for• Seeking support when needed• Continuing treatment asprescribed.Concern: “Depression runsin my family. Am I likely toget depressed?”Information: There is evidenceof a genetic/biological componentto depression. Depression oftenseems to run in families. Certainpersonality characteristics mayalso predispose a person todepression such as havingunrealistic standards orexpectations, consistentlyneeding to be in control andchronic low self-esteem.When in Doubt, Refer to:Counseling and PsychologicalServices (CAPS), CampusHealth Service: 621-3334Assessment, individual counseling,psychiatric consultations, andsupport groups. Referrals for othercommunity resources availableupon request.depression55

When a Student Needs Help :: Common Problems & Resourcessuicide56

When a Student Needs Help :: Common Problems & Resourcessuicidesuicide57

When a Student Needs Help :: Common Problems & ResourcessuicideDefining the ProblemPeople contemplate suicide formany reasons. Some of the mostcommon ones include:• To escape a situation thatis perceived as intolerableor hopeless• To gain attention or cry outfor help• To be punished for a real orimagined crime• To join a deceased loved one• Lack of effective coping skill• Chronic depression• Loss of hope about the futureSigns and SymptomsSuicidal people may give differenttypes of clues as to their intentions:1. Situation CluesA situation itself may lead tosuicidal thoughts and feelings.For example, an athlete whosurvives a serious automobileaccident, but has a legamputated, may see noreason to go on living.2. Depressive SymptomsThe most frequent signs ofdepression are:Emotional Symptoms• Sadness• Despair• Hopelessness• Indifference• Worthlessness• Guilt• Shame• Self-reproach• Helplessness• Pessimism• Anxiety• Lowered self-esteemBehavioral Symptoms• Change in eating patterns• Sleep disturbances• Fatigue and lethargy• Agitation or jumpiness• Talking about suicide orrelated topicsCognitive Symptoms• Impaired concentration• Decreased interest insexual activity• Loss of interest in work orusual activities• Thoughts of death or suicide• Distractibility• IndecisivenessPossible Verbal Clues• “I’m going to kill myself.”58

When a Student Needs Help :: Common Problems & Resources• “I’d be better off dead.”• “My family would be better offwithout me.”• “The only way out for me isto die.”• “If (such and such) happens(or doesn’t happen), I’llkill myself.”Possible Behavioral Clues• Previous suicide attempts• Giving away valuedpossessions• Buying a gun• Composing a suicide note orsudden “will”• Putting personal affairs andbusiness affairs in order inabsence of terminal illness• Planning his or her own funeral• Continued difficulty adjustingto the loss of one or moreloved ones• Suddenly resigning fromorganizations or clubsAll suicidal talk should be takenseriously regardless of the actualintent that might exist.Common Concerns andBackground InformationConcern: “My boyfriend has beenvery depressed lately and saidsuicide59

When a Student Needs Help :: Common Problems & Resourcessuicidethings like ‘It’s just not worth itanymore.’ What can I do?”Information: Once someonehas made a connection with youand you think they may besuicidal ask the person directlyin a concerned manner, “Haveyour problems been getting youdown so much lately that you’vebeen thinking about harmingyourself?” If the person hasspoken about committingsuicide, advise him or her toseek professional evaluationimmediately. If possible,accompany the person toCounseling and PsychologicalServices (CAPS) as a sign ofsupport. You will not provoke anon-suicidal person to considersuicide by asking about suicidalthoughts or intent. Asking asuicidal person directly mayprovide them with relief and theopportunity to seek help.Concern: “What if he won’t gofor counseling?”Information:If the person is hesitant to see acounselor, call CAPS (621-3334)and ask a counselor what to donext. If you believe the person isin imminent danger of harminghim or herself, call 9-1-1.Concern: “Is there anything elseI can do?”Information:Help the person to assess andmobilize his or her own resources.A suicidal person often feelsisolated and alone. Try to locatefriends and relatives who will besupportive. Emphasize that thishelp is in addition to, not insteadof, your own concern.When in Doubt, Refer to:Counseling and PsychologicalServices (CAPS): 621-3334Assessment, individualcounseling, psychiatric consults,and supportive groups. Referralsfor other community resourcesavailable upon request.SAMHC: 622-6000Southern Arizona Mental HealthCenter, 24-hour crisis help line.Police: 911If the person is in immediatedanger, call the police.60

When a Student Needs Help :: Common Problems & Resourcesadditionalreferral sourcesadditional referral sources61

When a Student Needs Help :: Common Problems & Resourcesadditional referral sourcesCultural CentersAfrican American Student Affairs ..............................................621-3419http://dmps.arizona.edu/aasa/Asian Pacific American Student Center ......................................621-3481http://apasc.web.arizona.edu/Hispano/Chicano Student Center................................................621-5627http://chsa.web.arizona.edu/International Student Center ......................................................621-4627http://internationalstudents.arizona.edu/Native American Cultural Resource Center ................................621-3835http://nasa.web.arizona.edu/Disabilities: Physical Disabilities, Hidden Disability,Traumatic Brain Injury, Visually Impaired, Hearing Impairedand Learning DisabilitiesDisability Resource Center..........................................................621-3268http://drc.arizona.edu/Strategic Alternative Learning Techniques (SALT) ......................621-1242http://www.salt.arizona.edu/Campus Service CentersCommuter Student Affairs..........................................................621-8046http://www.union.arizona.edu/csil/csa/index.phpTransfer Students ......................................................................621-3237http://advising.arizona.edu/students/transfer.htmlChild Care, Elder CareUA Life Work Connections........................................................626-9683http://lifework.arizona.eduLesbian, Gay, Bisexual, Transgendered, QuestioningPride Alliance ..........................................................................621-7585http://web.asua.arizona.edu/~pride/62

When a Student Needs Help :: Common Problems & ResourcesReligious CentersBaptist Student Union ................................................................624-4236http://clubs.asua.arizona.edu/~bsu/Campus Christian Center ..........................................................623-7575Hillel Foundation ........................................................................624-6561http://www.uahillel.org/Islamic Center of Tucson ............................................................624-3233http://ictucson.com/index.htmlLatter Day Saints Institute of Religion........................................623-4204http://www.lds.org/institutes/St. Thomas More Catholic Newman Center ................................327-6662http://newman.web.arizona.edu/General ResourcesHelp-on-Call ..............................................................................323-9373Professional counseling over the phone forpersonal, family, or substance abuse problems.Information and Referral ............................................................881-1794Information on community resources and agencies.http://www.airs.org/Southern Arizona Mental Health Clinic ......................................622-6000Crisis counseling and referral to community resources.http://www.samhc.com/index.htmadditional referral sourcesContacts for University PolicyAlcohol, Tobacco and Other DrugsDean of Students ....................................................................621-7057Acquaintance RapeDean of Students ....................................................................621-7057HIV/AIDSHarry McDermott, M.D.UA HIV/AIDS Committee Chairperson ......................................621-444663

When a Student Needs Help :: Common Problems & Resourcesweb resources64

When a Student Needs Help :: Common Problems & Resourcesweb resourcesweb resources65

When a Student Needs Help :: Common Problems & Resourcesweb resourcesAlcohol and Other DrugsLocal ResourcesUA Campus Health Service:www.health.arizona.eduNational ResourcesU.S. Department of Education’sHigher Education Center forAlcohol and Other Drug Abuseand Violence Prevention:www.edc.org/hec/Behavioral Health(Depression, Suicide, Stress)Local ResourcesUA Campus Health Service,Counseling and PsychologicalServices (CAPS):www.health.arizona.eduSouthern Arizona MentalHealth Clinic (SAMHC):www.samhc.comNational Alliance for the MentallyIll in Southern Arizona (NAMISA):www.namisa.orgNational ResourcesNational Alliance for theMentally Ill (NAMI):www.nami.orgAmerican PsychologicalAssociation Help Center:www.apahelpcenter.orgEating Issuesand Body ImageLocal ResourcesUA Campus Health Service,Nutrition Consults,Counseling and PsychologicalServices (CAPS):www.health.arizona.eduNational ResourcesNational Association of AnorexiaNervosa & Associated Disorders:www.ANAD.orgEating Disorder Referraland Information:www.edreferral.comEducational Resources andInformation on Eating Disorders:www.bulimia.comEating Disorder Information:www.something-fishy.orgSexual Assault andRelationship ViolenceLocal ResourcesUA Campus Health Service:www.health.arizona.eduThe Brewster Center DomesticViolence Services:www.thebrewstercenter.org66

When a Student Needs Help :: Common Problems & ResourcesTucson Centers forWomen and Children:www.tucsoncenters.comArizona Sexual Assault Network:www.azsexualassault.comNational ResourcesThe Rape, Abuse, & IncestNational Network (RAINN):www.rainn.orgNational Sexual ViolenceResource Network:www.nsvrn.orgSexual HealthLocal ResourcesUA Campus Health Service:www.health.arizona.eduSafe Baby(Safe Place for Newborns):www.tucsonsafebaby.orgAdoption:www.adopt.orgPlanned Parenthoodof Southern Arizona:www.ppsaz.orgSouthern Arizona AIDSFoundation:www.saaf.orgWingspan(Lesbian, Gay, Bisexual,Transgender Resource Center):www.wingspan.orgNational ResourcesGo Ask Alice(Q & A internet service thataddresses sexuality andhealth related issues):www.goaskalice.columbia.eduAmerican Social HealthAssociation:www.ashastd.orgIt’s Your Sex Life(Provides reliable, objectivesexual health informationfor young adults):www.itsyoursexlife.comSleepLocal ResourcesCampus Health Service:www.health.arizona.eduNational ResourcesNational Sleep Foundation:www.sleepfoundation.org67web resources

When a Student Needs Help :: Common Problems & ResourcesThis publication was made possible bygrant number TI17172 from the SubstanceAbuse and Mental Health ServicesAdministration (SAMSHA), Center forSubstance Abuse Treatment (CSAT).The contents are solely the responsibilityof the authors and do not necessarilyrepresent the official views of SAMHSA.A special thanks to everyone whocontributed to the writing of this manual:Marian Binder, Ph.D.Carolyn Collins, M.S., C.H.E.S.Peggy Glider, Ph.D.Lee Ann Hamilton, M.A., C.H.E.S.Koreen Johannessen, M.S.W.Harry McDermott, M.D., M.P.H.Melissa McGee, Ph.D., M.P.H.Laura Orlich, M.S., M.C.David Salafsky, M.P.H.Tina Tarin, M.Ed.Gale Welter, M.S.R.D.68

Our vision...Through our commitment to highstandards and collaboration, we will helpto create a safe and healthy communityfor students and others we serve.Our mission...To promote health, wellness and safety.www.health.arizona.edu