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Amanda.
Last year, one of my favorite students lost her mind.I had the ideal student: not brilliant, not a straight-A student, but very interested, someone who would ask the questions everybody else was wondering. A young woman like Amanda makes teaching easy; she illuminated for me what is unclear to the hoi polloi.
Therefore, I was a very saddened when, one Monday, her roommate (also a student) told me that Amanda was completely dropping out of school "to become an artist." I was surprised to hear this because Amanda was a Business major, and had not, to my knowledge, ever exhibited any tendencies toward making or appreciating art.
Imagine my surprise, then, when I came to my office the next day to find ten copies of a very long letter underneath my door, with the words "please translate me into anything" written on the back:
It went on and on. That happened on a Tuesday. On Wednesday, I saw Amanda outside the Student Union singing a dirge-like song - wearing clown shoes and a pageant crown. On Thursday she was doing the same thing, only dressed in her pajamas. On Friday, I received an email from Student Services informing me that she had been placed in state care.
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Monday, July 20, 2009
On Amanda and Student Fragility. Olive from Ohio Offers Perspective.
I was very touched by your recent article about Amanda, the student who dropped out of school and delivered 10 copies of her rambling letter to the professor who wrote the piece.
As a mental health professional at a small liberal arts college, I've heard Amanda's story far too many times.
I applaud your posting of the piece, and I hope you didn't do it merely to make fun of yet another "crazy" student, because this story should be a bit of a wake-up call to all professors. This sort of thing is far more common than the typical professor understands.
The term I use for Amanda's episode - because it truly could be very temporary and/or caused by a mis-prescription or mis-use of a substance - is primary psychosis. At my 3000 student college, I see a dozen Amandas a semester. There is a bit of a running joke among my colleagues in the teaching fraternity that I must do nothing all day but watch soap operas and do my Sudoku puzzles. But Amanda and other young people just like her are on every campus, and the fragility of these students is not something to make light of.
I've seen scores of students over the years who go through this sort of "break" with reality. The stresses of being away from home, living on one's own, dealing with the academic and social pressures of a typical college life can bring this on, but as I noted earlier, the use or abuse of substances can often bring about these alarming breaks. The worst I ever saw involved a freshman who simply had a new prescription for a long-standing and normally useful anti-anxiety medicine.
I try to tell my friends on the faculty that they need to be aware of their students and to watch for changes in behavior. Those of us on a college campus are not just there for a paycheck. We're there - in part - as custodians of the students who come to us. By being aware that Amanda is not simply a freakish tale, we may get ahead of the next Amanda. She may be in your class this coming semester; what will you do to help?
I feel sorry for Amanda and students like her, really I do. However, I'm just a Ph.D. in physics. I'm not qualified to diagnose or treat any ailment, and since the abandonment of in loco parentis, any attempt by me to so so would likely be seen as an intrusion, except in the most dire duress, such as improvising a tourniquet if a student is about to bleed to death. If a student asks me for help, I of course refer the student to the campus health center; once, during an exam, a student became unconscious so I called an ambulance, but that may be the extent of what I can or should do.
ReplyDeleteP.S. Seeing as how you note that conditions like Amanda's can be brought about by changes in medications, I'd like to remind you to guard against iatrogenesis. This is one reason I refrain from touching my students except during the very most serious circumstances: having a Ph.D. does not grant license to practice medicine, and I don't want to mess up my students worse.
DeleteFrod, you're not "just a Ph.D."
DeleteYou're a person.
An interesting person.
DeleteThanks, Bubba, but it still doesn't qualify me to practice medicine, or psychiatry.
DeleteA number of years ago, while I was still teaching, there were rumours that the senior administration considered making it mandatory that all instructors have first aid training. Immediately, there were objections, largely because of the legal implications. As far as I know, that's as far as it went.
Delete"Pardon me. I've lost my mind. Could you help me find it?"
ReplyDelete"Oh, yes, of course. Let's look under the cushions on the couch. I find a lot of things there... or in the refrigerator!"
One problem is that (barring the glaring evidence above) it can be hard to differentiate a student having a "reportable episode" from one merely being your average lackadaisical student. It is not uncommon for a number of students to simply stop showing up throughout the semester; some drop formally, others don't. Sometimes I find out later the student withdrew from the U in mid-semester (not just from my class), I imagine in some cases due to mental health issues.
ReplyDeleteSo how about the converse: if a student in one of my classes withdraws from the U (for whatever reason), it shouldn't be too much to ask to have some office on campus send me a note to that effect. But it never happens. I imagine reporting to me that a student in one of my classes had a "mental health episode" is barred by the rules, although it could be useful info if the student is still coming to class.
I think this can allow us to lower our guard and be helpful without feeling like we're allowing the snowflakes to win. One never knows when a student is trying to get away with something -- and when they are seriously struggling with mental illness.
ReplyDeleteI've had students who claimed phony afflictions in order to be allowed more time to write exams in the student help centre. In one case, after the main group had finished writing, I encountered him coming in my direction. He admitted that he could fib about his situation for only so long.
DeleteIt takes nothing really if one is concerned about a student to hand him a note with the phone number (or e-mail address, etc.) of counselling services. If the student is with one in one's office, then it also takes very little time to ask if you can call counselling for him and then put him on the phone. I agree there are a lot of fakers out there, but as someone who has had mental health problems, I would want someone to do something like that for me if I needed it.
ReplyDeleteYeah, I think I am with Doctor BPD. You do not want to BECOME the therapist, but sometimes ... sometimes you're the witness. One of my students who was acting really bizarre and annoying in class ended up hospitalized, and I wish I'd just said hey, maybe get some help?
ReplyDeletePersonally I'd refrain from approaching the student in a case like this, as part of a general policy of not initiating personal interactions with students (though if they take the initiative, I'll respond.)
DeleteIf someone started acting in bizarre/annoying ways in class, I'd ask him/her to come to my office and talk. If that conversation indicated a problem (or if the student didn't show up, or vanished) I'd contact Student Health Services. But bringing up mental health with the student him/herself is dangerous: especially if I'm wrong, it gives the student a potential argument to use against me if it comes to a course-related academic procedure.
Well, I'd be careful about that. As the instructor of the class in your classroom or in your office, like it or not, you're an authority figure. Suggesting a student get some help can easily be interpreted as an order, and it's based on what really is a medical diagnosis that you have made.
ReplyDeleteBut then, if a student in my classroom were in imminent danger of bleeding to death, I'd do more than call an ambulance, consequences be hanged. I just hope I wouldn't do anything to make it worse, and I'd be expecting trouble, afterward.
Frod, you really wouldn't call a student crisis line or the college counseling service for a student in mental distress? Are you just being provocative? I can't believe this.
DeleteLK
If the student was disrupting class and out of control, maybe. If a student is quietly going through a personal hell, how exactly am I supposed to know, and what exactly am I supposed to do about it? I certainly wouldn't tell a student to see a psychiatrist for dropping out of business school to become an artist: in fact, I'd probably say, "Yeah!"
DeleteOh yes, it would be wonderful always to be compassionate and helpful and protective of our students, but since the abandonment of in loco parentis, the rules no longer allow it. One of the main functions of in loco parentis was to protect us.
DeleteSomething that no one has yet pointed out is that, even in these enlightened times (and I'm being ironic here, Leslie), mental illness still carries stigma. This is one reason I've so rarely tried to seek help myself, but what I do and how I do it works reasonably well, and that's a separate issue anyway.
ReplyDeleteIf I had a student who was clearly showing symptoms of mental distress, I wouldn't suggest the student "get help." Notice that stress carries little stigma, no doubt partly because it's so common. I'd therefore suggest to the student, and then only in clear circumstances or after a clear incident, that "I think you may be under excessive stress," and refer the student to the campus health center. Let's just hope this student doesn't get referred to the "MENTAL HEALTH CENTER," as the big sign in big bold letters proclaimed, at the campus health center I had as an undergraduate.
Well, I can't call mental health services for a student sitting in my office, because my office phone disappeared due to budget cuts a few years ago (mostly, I don't miss it, but yes, there are times it would be useful. On the other hand, even our most healthy, cheerful students hate talking on the phone). But I have said things like "you might want to talk to someone about that," or even, several times, "I'm no expert, but that sounds like depression" when a student has said something that indicates a lack of will to live ("sometimes I think I'd be better off dead" or "I'm just not sure living is worthwhile anymore" are pretty clear red flags for depression -- enough so that I think any reasonable layperson can identify them as at least potentially such). The most common reply has been "I know; I should probably go back on my meds" or "I know; my meds don't seem to be working anymore." We're no longer in loco parentis, but I do think we have some duty to model reasonable adult behavior (even to students of our own age or older), and it's common knowledge among informed laypeople that mental illnesses can distort thinking, and that many such illnesses can be alleviated, if not cured, by mental health professionals.
ReplyDeleteI seem to have a bit more trouble figuring out what to say to students who strike me as over-anxious, perhaps because that line doesn't seem so clear. I'm less likely to bring up the issue with them, though I will try to be calming, and point out that the work of the class is broken down into manageable steps, and that if they just follow those steps, things are very likely to work out well. If a student expressed concern about hir general state of anxiety, I'd certainly suggest consulting a professional for an evaluation of whether it was beyond normal levels.
I'm not sure I'd suggest getting help to a student who seems to have lost touch with reality, precisely because the condition is likely to interfere with their ability to see the need for help (of course, that's true of depression, too, but are more gradations there, and the student who is coming to my office to talk about hir difficulty with work is likely to be still semi-functional). In the one case where a student in my office showed signs of what turned out to be mania (it was either that or a drug-induced high), I used the "student of concern" form right after he left, rather than say anything to him directly, and he was hospitalized within 24 hours (whether due to my own efforts or some other event, I don't know). I would, of course, do the same for a student who seemed actively suicidal (and in one case, when I was working at a residential college, did get in touch with Student Services to report a depressed student off his meds who had expressed verging-on-suicidal thoughts to me. I later got a thank-you from his parents passed back to me through the same channels.)
I honestly don't think I'm overstepping my bounds, or opening myself up to liability. I can't diagnose, but I am a nearly 50-year-old human being who has developed some sense, through experience of myself and others, of where the boundaries of normal behavior lie, and I'm willing to provide feedback to students when it seems to me that their thinking and/or actions are far enough outside that norm to suggest that they might be heading down the "danger to self" path (possible danger to others I'm likely to report, and leave, to the professionals).
I remember Amanda, our Syd Barrett.....
ReplyDeleteThe worst that could happen with insane students is that some theater professor "collects" a number of them and sees their illness as a chance to make a "truly realistic" staging of "The Persecution and Assassination of Jean-Paul Marat as Performed by the Inmates of the Asylum of Charenton Under the Direction of the Marquis de Sade."