How Do I Know If My Student Is Dangerous?

A psychiatric nurse explains when to refer a student for help.

By Ellen Gecker

Although the Virginia Tech murders last spring probably made you consider your own vulnerability as a professor to campus violence, most of the time you are not in any danger, even if there are mentally ill students in your classroom. The stress of the college years can exacerbate the symptoms of mental illness, however. Because you may work directly with students for extended periods during such a stressful period in their lives, it is important to recognize signs of potential violence in troubled students and to be aware of the resources your campus offers for students who need help.

Warning Signs

Perhaps you have had a gut feeling about a student—something just didn’t seem right. Maybe it was the way a student looked at you—too long or glaring or angry. Maybe it was a nasty, sarcastic, or overly loud tone of voice. Or was it a couched threat you heard from a student, so subtle that you can’t claim you were actually threatened?

All of these behaviors are cues that there is something wrong. A student who acts in such ways might have barely suppressed anger, which in some cases can lead to violence. There may also be a sign of some degree of mental illness, which sometimes accompanies anger. It is important to emphasize, however, that most mentally ill people are not violent.

Your cues might even be more obvious. Perhaps the student walks in and out of the room and purposely slams the door, kicks the wall or desk, or curses loudly or yells racial slurs. Or perhaps, like the professor at Virginia Tech who was alarmed by the writings of the student who later murdered thirty-two people, you are concerned about the violence of a student’s written work. Sometimes people who have a propensity for anger or are mentally ill fantasize about violent scenes. Quite possibly these students don’t realize that readers will find their writings disturbing or abnormal—or they might write about violence to intimidate someone who they know is going to read their writing.

One fairly strong indication of mental illness is hearing voices. A student who walks down the hall alone talking or mumbling at length or sits in your class and mutters constantly may have a serious problem. (First, of course, make sure the student is not on a cell phone.) A person who is hearing voices may sometimes listen to them without talking—evidence of this includes laughing or smiling without cause or repeatedly looking at an open space as if someone were in that spot (it might even be up in the air). Hallucinations can be visual or tactile as well, but their most common form is auditory. Auditory hallucinations are generally a sign of mental illness, but they can also be caused by drugs or withdrawal from them.

The next sign of mental illness is delusional thinking. A student who is delusional will have created a fantasy and believe it to be real. For example, a student could believe that you said something that you never said. It might be that he believes you invited him to your home for dinner or that you promised him an A. Or he may think that he is president of the college and can do what he wants, including getting you fired. Often, these delusions are paranoid, with a strong fear component. A paranoid student, for example, might believe that everyone in the class is talking about or laughing at her.

There are more signs that may be present with mental illness, but remember that one or two signs alone do not necessarily mean a student is mentally ill. You have to look at the whole picture.

Other signs include

• a flat affect;
• unusual emotional reactions;
• inability to concentrate;
• poor memory;
• impatience or poor impulse control;
• childlike behavior;
• lack of interest in doing anything enjoyable or lack of hobbies;
• use of alcohol and illegal drugs as a method of self-medicating;
• heavy cigarette smoking;
• poor hygiene;
• difficulty conversing, with minimal or inappropriate responses to questions;
• social isolation;
• difficulty sleeping or sleeping too much;
• poor appetite.

Such signs may indicate that a student needs help.

What You Can Do

Okay, let’s say you see some signs that concern you and you want to engage a student to determine if he needs help. Probably the best thing you can do is ask the student some questions in a calm and caring but almost nonchalant manner, something like, “You seemed upset in class,” or “You seem preoccupied. How are you feeling?” If the student is comfortable speaking with you, he may let you know if he is having problems.

If the student is hearing voices, he may tell you something like, “It’s God telling me that I’m not praying enough,” or “They tell me that I’m bad,” or “I can’t figure out what they’re saying. ”There is no cause for you to panic, but you do need to get the student help right away. This student may have stopped his antipsychotic medications and his symptoms may get worse with each day that goes by. You should call the campus counseling center and make an appointment for him or walk him over to it. If the student indicates a desire to harm himself, you should send him by police or ambulance to an emergency room or psychiatric crisis center. He should not be left alone; while waiting for help to arrive, have another person stay with him as well. If the student gives any indication that he intends to harm others, get everyone away from him and call 911. Obviously, you and everyone around the student are at high risk in such a situation. What if the student tells you something that seems clearly delusional to you? You won’t be able to talk him out of it, so don’t try. Just say something like, “Oh, okay.” Then get him some help immediately.

Most mentally ill people are not dangerous or violent. Colleges and universities usually provide faculty members with lists of the resources available for students who are troubled. Don’t be shy about using those lists. Disturbed, isolated students can easily fall through the cracks, especially at large institutions; you may be the person who has the most regular contact with such an isolated student. Offering to help students get the assistance they need is never inappropriate. Showing students that you have noticed that they are having a hard time can be just the impetus they need to acknowledge their own difficulties and seek help.

The tragedy at Virginia Tech can help faculty members be a bit more alert—not just for students who might be violent, but also for any students whose behavior reveals that they aren’t able to cope with college or the world on their own.

This article does not constitute medical advice. If you are concerned about the mental health of a student, consult with qualified health professionals on your campus.

Ellen Gecker has worked in the health centers of both Virginia Polytechnic Institute and State University and Philadelphia University. She has also been employed as a clinical specialist in psychiatry at a state psychiatric hospital and a private psychiatric unit. Currently she is an instructor of psychiatric nursing in Phoenix, Arizona.

Comments

Please excuse me. I am a Bipolar lady who mumbles quite a bit and I do not hear voices. I have to think aloud to guide myself to the next task because I have a slight learning disability. You people might want to delineate between a person who "talks to voices" and a person who "talks to themselves for reasons of personal clarity" when having a list of things to do, completing a task or studying for a test.

For example, if you hear "Order of Operations..parenthesis, exponent..etcetera, then the mentally ill student might be trying to recite data to himself or herself for a test. Or, if you hear a person say: okay, go buy books, then pay tuition, then later, go wash my car.....Could this person be reciting a list? Or even "Boy what a rough day!" this is thinking to the self, processing cognitive information OUT LOUD.

Now if a person answers his or herself or says something that sounds dangerous THIS IS WHEN YOU WORRY.

Sometimes, I think that people want reasons to persecute people with mental illness; a person like the Virginia Tech shooter does not represent the the norm for my
population.

Lastly, may I say that I have a Code of Consumer Ethics for myself that stipulates that if I feel that someone has brought a serious injustice against me, I go to the COURTS OF LAW to straighten it out and I have a policy personally of non-violence.

Catherine H.

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