QPR is a program that provides individuals with the skills and knowledge to recognize and respond to warning signs of suicide.

What does QPR mean?
QPR stands for Question, Persuade, and Refer — the three simple steps anyone can learn to help save a life from suicide.

Just as people trained in CPR and the Heimlich Maneuver help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. Each year thousands of Americans, like you, are saying "Yes" to saving the life of a friend, colleague, sibling, or neighbor.

Training requests for a particular group or department by contacting a QPR Committee Member. Routine QPR trainings are advertised in SLCC Today and Employee Wellness emails.

Live On is a statewide effort to prevent suicide by promoting education, providing resources, and changing our culture around suicide and mental health. Together we can get through, reach out, lift up, look ahead, and Live On.

Please join your fellow SLCC coworkers in becoming a Suicide Prevention Ambassador! Full-time & part-time employees can help us reach our goal of 1,000 employees becoming LiveOn Ambassadors by completing the LiveOn Utah Playbook program through Canvas.

Full-time employees may submit a Level 1 Employee Wellness incentive through the Employee Wellness website to receive an incentive.

This course can be done anytime, at your own pace. Total time to complete is approximately 2 hours. Access the training through this link.

Use the link below to take the free mental health "self-evaluation":

Mental Health Self-Evaluation Tool

Prevalence:  A significant and growing number of college students struggle with common mental health problems, such as depression and anxiety.  A 2016 survey of over 4,300 community college students at ten U.S. schools found that half of these students were experiencing a current mental health condition.  Our 2017 health survey of SLCC students found that within the last 12 months, 41 percent of students felt so depressed that it was difficult to function, 59 percent felt overwhelming anxiety, and 11 percent seriously considered suicide.  About 1,100 college students across the country commit suicide every year.  Unfortunately, only half of college students with mental health problems seek help.    

Social Inclusivity:  Issues of race, gender and sexual orientation tend to dominate the spotlight when we talk about the struggle for social inclusion.  It can be forgotten that people with mental health problems must also be a part of any inclusive society.  According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 25 percent of people with mental health disorders have completed some college education, and only 9.5 percent hold a bachelor’s degree.  This represents the lowest educational attainment level for any disability group.  The National Alliance for Mental Illness (NAMI) suggests that in order to foster diversity and reduce mental health stigma in the workplace, professional development trainings on diversity and inclusion should include discussions about mental illness.  

Academic Success:  There is growing awareness that for college students to succeed, academic preparedness is not enough.  They must also possess good mental and emotional health.  A 2014 joint publication by the American Council on Education, NASPA and the American Psychological Association states simply that “Mental and behavioral health problems are also learning problems.”  Students cannot learn when beset by anxiety, depression or other disruptive mental health issues.  In fact, the same report notes that social and emotional difficulties predict student dropout as well as or better than academic difficulties.  Our 2017 health survey of SLCC students found that four of the top five factors contributing to negative student academic outcomes related to mental health: stress, anxiety, sleep difficulties, and depression.   

Economic Impact:  In addition to adverse personal and academic consequences, poor college student mental health has negative financial impacts on institutions of higher education.  Research shows about 5 percent of college students drop out each year due to mental health problems.  Given recent SLCC enrollment figures and retention rates, this works out to several hundred students a year.  If we calculate the tuition and fees these students would have paid had they been able to remain in school, the loss to the school is financially significant.  Many institutions are finding that investments in mental-health related resources for students have a significant positive impact on student retention and academic success, and thus on both their school’s reputation and bottom line.

In 2012, NAMI published a national survey of college students with a mental health condition, entitled College Students Speak.  As part of this survey, students were asked what they would like faculty and staff to know about their mental health issues.  Below are the students’ recommendations.

General Education on Mental Health Conditions.  Information on the warning signs, symptoms, prevalence and treatment of mental health issues. They need to know mental health conditions are real, what they look like in students and how hard it can be for students living with mental health conditions.

How to Support Students.  Faculty and staff should know what to do if they see a student experiencing mental health issues or if a student shares information with them.  They should be proactive in connecting students to help and encouraging them to seek help. They should also know what to do during a mental health crisis.

 How to Communicate with Students.  Faculty and staff should be trained on how to express care and concern and be sympathetic, empathetic and understanding when talking about mental health issues.  Faculty and staff should hear students out and be respectful, non-judgmental and sensitive to their issues.  They should also address mental health in the classroom and let students know they are available to talk.

Mental Health Conditions are Real.  Faculty and staff should know that mental health issues are as real and as serious as other physical health issues.  They are not used as an excuse for being lazy, irresponsible or a bad student. It is not a scam or a choice.

Students can be Successful with Accommodations.  Students living with mental health conditions want the chance to succeed in college just like everyone else.  They can be successful if faculty and staff respect and enforce accommodations that students need.  Faculty and staff should understand the effects of mental health conditions on students and their academic performance.  Students living with mental health conditions can be successful but just need to complete the work in different ways.

A main purpose of this guide is to provide information and guidance on these issues.  The most important for faculty and staff to be aware of are covered in detail in the sections that follow.

Students may become distressed for a number of reasons, including academic pressures, lack of money, family problems, relationship conflicts, loss of significant others, poor health, physical or sexual abuse, and many others. Often there are indicators a student is experiencing distress long before the situation escalates into a crisis. It is therefore important to identify difficulties as early as possible. As a faculty or staff member, you may be the first to notice that a student is having difficulty. The presence of one of the following indicators alone does not necessarily mean a student is experiencing severe distress. However, the more indicators which are present, the more likely it is that a student needs help.

Academic Indicators

• Repeated absences from class or lab
• Missed assignments, exams, or appointments
• Deterioration in quality or quantity of work
• Extreme disorganization or erratic performance
• Written or artistic expression of unusual violence, morbidity, social isolation, despair, or confusion; essays that focus on suicide or death
• Continual seeking of special provisions (extensions on papers, make-up exams)
• Patterns of perfectionism, e.g. cannot accept themselves if they do not get an A
• Overblown or disproportionate response to grades or other evaluations

Emotional and Behavioral Indicators

• Direct statements indicating distress, family problems, or loss
• Angry or hostile outbursts, yelling, or aggressive comments
• More withdrawn or more animated than usual
• Expressions of hopelessness or worthlessness; crying or tearfulness
• Expressions of severe anxiety or irritability
• Excessively demanding or dependent behavior
• Lack of response to outreach from course staff
• Shakiness, tremors, fidgeting, or pacing

Physical Indicators

• Deterioration in physical appearance or personal hygiene
• Excessive fatigue, exhaustion, falling asleep in class repeatedly
• Visible changes in weight; statements about change in appetite or sleep
• Noticeable cuts, bruises or burns
• Frequent or chronic illness
• Disorganized speech, rapid or slurred speech, confusion
• Unusual ability to make eye contact
• Coming to class bleary-eyed or smelling of alcohol or marijuana

Other Factors

• Concern about a student by his / her peers or teaching assistant
• A hunch or gut-level reaction that something is wrong

Once you have identified a student in distress, there are two pathways for intervening with the student. If you have a relationship or rapport with the student, speaking directly with the student may be the best option. If you do not really know the student, you may prefer to contact the Behavioral Intervention Team for consultation about how to proceed with the student. 

Your decision about which path to choose may depend on your level of experience, the nature and severity of the problem, and your ability to give time to the situation. If you decide to have a direct conversation with the student, you will not be taking on the role of counselor. The goal is to gather information, express your care and concern, and offer resource and referral information to the student. 

Below are suggestions for making contact with and speaking to a student in distress. 

Arrange a Meeting

• Ask the student if you can schedule a private one-on-one meeting.
• Assure that you both have enough time to talk.
• Let someone else in the office or department know about the meeting.

Express Concern

• Set a positive tone: express your caring and concern.
• Point out specific signs or behaviors you’ve observed (“I’ve noticed lately that you…”)
• Ask, “How are things going for you?”

Listen

• Listen attentively to the student’s response and encourage them to talk. (“Tell me more about that…”)
• Allow the student time to tell their story; don’t give up if the student is slow to talk.
• Ask open-ended questions dealing directly with the issues. (“What problems has that situation caused you?”)

Empathize

• Restate what you have heard in a validating manner, showing an understanding of both the “facts” of the student’s situation, and the “feelings” this is causing for them.
• Avoid judging, criticizing or negatively evaluating the student.
• Give the student hope that things can get better.

Refer

• Ask the student what they think would help. (“What do you think you need to get back on track?”)
• Suggest resources and referrals (e.g. Center for Health & Counseling, Disability Resource Center) and share the potential benefits to the student. (“I know the folks in that office and they are really good at helping students work through these kinds of situations.”)
• If there are signs of a safety risk, ask if the student is considering suicide. A student considering suicide will likely be relieved that you asked. Asking a student about suicide will not put “ideas in their head.” (see Responding to Students at Risk for Suicide below)
• Avoid promises of confidentiality, particularly if the student presents a safety risk to themselves or others.
• Unless the student is suicidal or a danger to others, the ultimate decision to access resources is the student’s.

Follow Up

• Let the student know you would like to follow up with them in a day or two.

Consult

• Consult with campus resources as appropriate, and follow up with the student as agreed.

Suicide is the second leading cause of death among college students. According to our 2017 health survey of SLCC students, 11 percent reported contemplating suicide within the past twelve months, with 1.8 percent actually making a suicide attempt. Suicidal feelings or impulses can be triggered by any painful change in life circumstances which threatens a person’s sense of self-worth, connection and belonging, or hope for the future. Such events can compromise a student’s usual coping mechanisms, leaving him or her feeling that suicide is the only way out. 

Fortunately, most suicidal states are usually time limited. Once a suicidal person receives appropriate support and/or counseling, they often quickly return to their normal state of functioning. However, individuals are more at risk if they have a history of suicidality or depression, or if they have previously made a suicide attempt. Additionally, those who have a specific suicide plan are at a higher and more immediate risk of suicide. It is therefore important to be aware of some of the most commons warnings signs for suicide.

These warning signs include:

• Talking about wanting to die or to kill oneself.
• Looking for a way to kill oneself, such as searching online or buying a gun.
• Talking about feeling hopeless or having no reason to live.
• Talking about feeling trapped or in unbearable pain.
• Talking about being a burden to others.
• Losing interest in things one cares about.
• Increasing the use of alcohol or drugs.
• Acting anxious or agitated; behaving recklessly.
• Sleeping too little or too much.
• Withdrawing from others or feeling isolated.
• Showing rage or talking about seeking revenge.
• Displaying extreme mood swings.
• Visiting or calling people to say goodbye.
• Making arrangements; setting one's affairs in order.
• Giving things away, such as prized possessions.

While responding to a student in distress, faculty and staff may learn that the student poses some level of risk for suicide. It is important to then take the appropriate steps to help the student stay safe as well as get the help they need. To this end, SLCC has developed a Student Suicide Prevention Protocol to guide faculty and staff in dealing with suicidal students. 

The Protocol provides instructions for dealing with students at three different levels of suicide risk. These levels are 1) a student who is in imminent danger of suicidal behavior, 2) a student who has made a suicide threat, and 3) a student who is showing warnings signs for suicide. 

Suicidal behavior is defined as any potentially injurious behavior which is self-inflicted and by which a student intends, or gives the appearance of intending, to kill him or herself. A suicide threat is defined as any interpersonal communication, verbal or non-verbal, which can be interpreted as indicating that a student may engage in suicidal behavior in the near future, which may or may not be imminent. 

Instructions for dealing with students at these levels of suicide risk are as follows:

• If a student has just engaged in, is in the process of engaging in, or is about to engage in suicidal behavior: Call 911.

• If a student has made a suicide threat: Contact the Dean of Students/Behavioral Intervention Team (BIT) for consultation and support at (801) 957-4776. The threat will then be assessed with appropriate intervention to follow. If the situation allows, the student may be walked directly to the Center for Health & Counseling (CHC) for an emergency appointment. If it appears that suicidal behavior may be imminent: Call 911.

• If a student is showing warnings signs for suicide: Contact the Center for Health & Counseling at (801) 957-4268 for consultation and support, talk with and encourage the student to make an appointment at the CHC, or bring the student, with their permission, directly to the CHC. Also notify the Dean of Students/BIT about the situation.

Additionally, the CHC offers a more intensive one-hour “gatekeeper training” to faculty and staff on dealing with students at risk of suicide. This training, called QPR (Question, Persuade, Refer), is designed to equip non-mental health professionals with the skills to know how to identify, talk with, support and refer a potentially suicidal student to appropriate resources for help. It is listed as a Best Practice by SAMSHA’s National Registry of Evidence-based Practices and Policies. 

Students in severe emotional distress, or crisis, may need to be seen immediately for support and intervention. Such students may call, present themselves in person on their own, or be brought to the CHC accompanied by faculty or staff, without having previously scheduled an appointment.

When the student arrives, our front desk staff will alert our counselor-on-call at that time, who will usually be able to meet with the student within a few minutes. On rare occasions when all our counselors are busy, there may be a slight wait as we make arrangements for a counselor to be available to meet with the student.

There is no charge for a crisis appointment, and students in crisis do not need to complete any of our usual intake paperwork prior to being seen.

The following situations are some reasons for which a student should be referred to or brought to the CHC for a walk-in crisis appointment:

• Student is having thoughts or feelings about harming themselves or has a plan to attempt suicide.
• Student is having thoughts or feelings about harming someone else or has a plan to harm them.
• Someone the student knows is seriously harming / abusing them (or a loved one) or threatening to do so.
• Student has been physically or sexually assaulted within the last few days.
• Someone close to the student has died within the last few days.
• Student is having strange experiences such as hearing voices or seeing things that others do not hear or see.
• Student is having recurring gaps in memory about personal information or about what they have been doing lately.
• Student is unable to provide for their own food, clothing, or shelter.
• Student is having a severe reaction to a psychiatric medication.

When trying to persuade students in distress or with mental health problems to seek counseling, it may be useful to share with them some information about counseling services. Perhaps the simplest and most significant fact that can be shared is that counseling works. Years of clinical research has yielded significant evidence that those who receive counseling for their problems are better off than those with similar problems who do not receive counseling. Additionally, research on students has shown that those who receive counseling actually have higher rates of academic success and retention in school than those who do not. 

There is no particular length required for students to benefit. Some students may find they are feeling better after only one or two sessions. Others may find they need to be seen either periodically or regularly throughout a semester. Students should also know that the information they share in counseling is confidential, does not become part of their academic record, and is not accessible to faculty and staff at SLCC. 

Regardless of the nature of the mental health problem or stressors that a student is struggling with, counseling can be of benefit in a number of specific ways:

• Provide a safe place to share thoughts and feelings
• Decrease feelings of isolation and/or a lack of support
• Reduce debilitating symptoms which are interfering with normal functioning
• Receive guidance in resolving current problems and stressors
• Learn new skills to deal with current problems and stressors
• Increase self-awareness of areas in need of personal growth
• Diagnose and clarify previously unidentified mental health disorders or conditions
• Assess the possible need for medications - which can be prescribed by our CHC Health Clinic
• Provide documentation necessary to receive disability accommodations or to withdraw from classes

Center for Health & Counseling (CHC) - 801-957-4268

• Offers counseling, assessment, crisis intervention and medication management for students in distress, crisis or with a mental health problem as well as consultation to faculty and staff working to help these students.

Accessibility & Disability Services (ADS) - 801-957-4659

• Offers individual accommodations to students with documented disabilities, including those with a diagnosable mental health condition.

Behavioral Intervention Team (BIT) - 801-957-4776

• Receives reports about and provides consultation, assessment and intervention for students whose behavior is extremely unusual, troubling or concerning, disruptive to the academic environment, discomforting to others, or potentially threatening in any way to themselves or others.

Crisis Line - 801-587-3000

• Provides 24/7 phone crisis intervention, suicide prevention, emotional support and information and referrals to community members in distress or in crisis.

Crisis Text Line – Text HELLO to 741741

• Provides 24/7 crisis support, with a live trained crisis counselor, via texting to anyone in the U.S. experiencing any kind of crisis.

Warm Line – 801-587-1055

• Provides peer phone contact for Salt Lake County residents who are not in crisis but seeking support, encouragement and engagement. Peer specialists are available from 9 am to 10 pm.

SafeUT Crisis Text & Tip Line (Mobile App)

• Statewide service that provides real-time crisis intervention to youth and college students through texting and a confidential tip program. The 24/7 crisis line, manned by licensed clinicians, responds to all chats, texts and calls, providing supportive or crisis counseling, suicide prevention and referral services.

Mobile Crisis Outreach Team (MCOT) – 801-587-3000

• Provides 24/7 free, prompt, face-to-face intervention to any resident of Salt Lake County who is experiencing a psychological crisis. MCOT can be accessed in crisis situations when the Center for Health & Counseling services are not available (i.e. after hours or during the weekend).

Receiving Center - 801-587-3000

• Provides a short-term (up to 23 hours) secure setting for people in crisis including therapeutic crisis management, assessment, medication management and wellness recovery / discharge planning. It is staffed by psychiatrists, advance practice nurses, social workers, certified peer specialists, and psychiatric technicians.

9-1-1

• Call 911 if you believe a student poses an immediate threat of harm or violence to themselves or others or is in need of emergency medical attention.

In addition to the information provided in this guide, faculty and staff should seek consultation in dealing with students in distress or of concern as needed from one or more of the following:

1. The Manager of Counseling Services is available to consult with faculty and staff at 801-957-4755.
2. Help from the Behavioral Intervention Team (BIT) can be sought through submitting a report about a student of concern through the Online Reporting Form or by directly contacting the Dean of Students, Candida Mumford, at 801-957-5027 or candida.darling@slcc.edu.

Please note: Cases initially directed to the Counseling Manager may be referred to the BIT for additional support and intervention. Conversely, cases initially reported to the BIT may be referred to the Counseling Manager for subsequent follow up.

The Behavioral Intervention Team (BIT) serves as the coordinating hub for a network of campus resources focused on education, prevention and intervention in situations involving students experiencing distress, engaging in disruptive behaviors, and/or posing a threat of harm to themselves or others. BIT will offer case coordination and consultation, assess needs and at-risk behaviors, and develop intervention and support plans for students of concern. Visit their web page for additional resources, tips, and reporting forms for students or situations of concern. Visit the Behavioral Intervention Team's site.