Warning Signs to Watch For

Emotional Indicators

• Persistent expressions of hopelessness or worthlessness
• Verbal hints about self-harm or suicide (e.g., “I can’t go on.”)

Behavioral Changes

• Sudden, dramatic mood swings or withdrawal from friends and activities
• Giving away prized possessions or saying goodbye unexpectedly
• Noticeable decline in academic performance or motivation

Physical Symptoms

• Significant changes in sleeping patterns (insomnia or oversleeping)
• Marked changes in appetite or unexplained weight loss/gain
• Frequent complaints of unexplained aches, pains, or fatigue

Additional Red Flags

• Increased use of alcohol or other substances to cope
• Engagement in self-harm behaviors (cutting, burning, etc.)
• Preoccupation with themes of death, dying, or suicide in writing or art

If you observe one or more of these warning signs, take action:

1. Use safe, compassionate language—see the Safe Messaging Guide.
2. Follow our step-by-step Referral Flowchart to connect the student with mental health support.

Early recognition and a caring response can save lives.

Safe Messaging Guide

Why Safe Messaging Matters

Using clear, compassionate language helps build trust, ensures the student feels heard, and encourages them to seek support.

Do’s

• Use Direct Language When Asking About Risk
  “I’ve noticed you seem really down. Are you thinking about hurting yourself?”
• Validate Feelings
  “It sounds like you’ve been under a lot of pressure. That must feel overwhelming.”
• Express Care and Support
  “I care about you and want to help.”
• Encourage Professional Help
  “Let’s connect with our school counselor together so you don’t have to face this alone.”

Don’ts

• Don’t Promise Secrecy
  Never say, “Your secret is safe with me”—you’re required to share safety concerns.
• Don’t Minimize or Dismiss
  Avoid phrases like, “You’ll snap out of it” or “Others have it worse.”
• Don’t Use Stigmatizing Language
  Avoid “committed suicide” or calling someone “crazy.”
• Don’t Ask Leading Questions
  Avoid, “You’re not going to do anything, right?” which can shut down honest answers.

Example Phrases

Effective: “I’m concerned about you. You’ve seemed really withdrawn lately. Are you thinking about taking your life?”
Ineffective: “You’ll be okay, right? Lots of kids feel stressed.”

Next Steps

1. Follow the Referral Flowchart to connect the student with mental health support.
2. Review key warning signs in the Warning Signs Poster.
3. Practice these messages during the Scenario Activity using Scenario Cards.

Remember: Your words can open a path to help.

Referral Process Flowchart

Use this step-by-step guide to move from initial concern to follow-up, ensuring every at-risk student receives timely, compassionate support.

1. Notice Warning Signs
   • Refer to the Warning Signs Poster for emotional, behavioral, and physical indicators.
   • Decide that a private check-in is needed.
2. Initiate a Private Conversation
   • Find a quiet, safe space away from peers.
   • Explain your concern: “I’ve noticed you seem [specific observation]. Are you okay?”
3. Use Safe Messaging
   • Follow the Safe Messaging Guide:
     • Ask directly about self-harm or suicidal thoughts.
     • Validate feelings and express care.
     • Avoid promises of secrecy or judgmental language.
4. Assess Immediate Risk
   • If the student indicates imminent danger (e.g., plans, means, intent), treat as an emergency:
     1. Stay with the student.
     2. Contact 911 or your school’s crisis response team immediately.
5. Notify Designated Mental Health Staff
   • Regardless of immediate danger level, inform your school counselor, psychologist, or social worker right away.
   • Use your school’s established referral form or electronic system.
6. Complete Referral Documentation
   • Fill out required paperwork with factual observations (e.g., dates, student quotes).
   • Submit documentation to the designated office or digital portal.
7. Coordinate Next Steps
   • Work with mental health staff to develop a safety plan.
   • Inform relevant colleagues (e.g., grade-level team) in a confidential manner.
8. Follow Up with the Student
   • Check in within 24–48 hours to see how they’re doing.
   • Reinforce support: “I’m here for you and want to see you succeed.”
9. Reflect & Debrief
   • After the process, debrief with your mental health team:
     • What went well?
     • What could be improved?
   • Share insights during staff meetings to keep protocols fresh.

Early, coordinated action can save lives. Use this flowchart alongside the Warning Signs Poster, Safe Messaging Guide, and Scenario Cards to practice and reinforce your skills.

Scenario Cards

Use these scenario cards in small groups to practice identifying warning signs, applying safe messaging, and following the referral process.

Card 1: Jordan’s Withdrawal

Scenario:
Jordan, a 10th grader, used to be active in class discussions and group projects. Over the last two weeks, Jordan has become quiet, stopped participating in group work, and often looks downcast. Yesterday, Jordan told a friend, “I just don’t see the point in coming to school anymore.”

Discussion Prompts:

1. Which warning signs are present?
   
   
   
2. How would you approach Jordan using safe messaging (“I’m concerned...”, validating feelings, etc.)?
   
   
   
   
   
   
3. What steps in the Referral Flowchart would you follow next?
   
   
   

Card 2: Sam’s Self-Harm

Scenario:
Sam, a 9th grader, has been wearing long sleeves even on hot days. You notice thin scars on Sam’s forearms and overhear Sam say in the hallway, “Cutting is the only thing that helps me feel something.”

Discussion Prompts:

1. Which warning signs are present?
   
   
   
2. How would you speak with Sam to address self-harm thoughts safely?
   
   
   
   
   
   
3. Which referral steps would you take immediately (including assessing immediate risk)?
   
   
   

Card 3: Taylor’s Hopelessness

Scenario:
Taylor, an 11th grader, has turned in excellent work until recently. Today, Taylor handed in an assignment with writing about feeling like “a burden” and “everyone would be better off without me.”

Discussion Prompts:

1. Which warning signs do you see in Taylor’s behavior and writing?
   
   
   
2. How do you start a private conversation using safe, supportive language?
   
   
   
   
   
   
3. Outline the referral steps from conversation to documentation.
   
   
   

Card 4: Alex’s Goodbye Gifts

Scenario:
Alex, a middle school student, has been unusually generous—giving away a favorite video game and drawing a goodbye card for a classmate. Alex told a friend, “I want you to have this since I won’t need it anymore.”

Discussion Prompts:

1. What warning signs are evident here?
   
   
   
2. How would you use safe messaging to ask about Alex’s intentions?
   
   
   
   
   
   
3. Which steps from the Referral Flowchart will you initiate?