Getting a friend through tough time can be challenging. Whether they have an existing mental health condition or are experiencing stressful circumstances in that moment, friends often turn to one another for support. While this list is by no means exhaustive, the following may be indications that your friend needs help.

Signs and Symptoms of Distress

  • Difficulty sleeping for more than a few nights
  • Sadness or crying more often than usual
  • Loss of interest in pleasurable activities
  • Being irritable most days or having unexpected outbursts of anger
  • Lack of motivation
  • Excessive worry or being unable to think about anything but the problem
  • Restlessness; hyperactivity; pressured speech
  • Excessive alcohol or drug use
  • Decline in academic performance; drop in class attendance
  • Social withdrawal
  • Changes in eating patterns
  • Self-injury (cutting; scratching; burning)
  • Unusual or exaggerated response to events (e.g., overly suspicious; overly agitated; easily startled)

There are also other signs that should be taken very seriously because they could be Suicide Danger Signs:

  • Severe depression or hopelessness
  • Making verbal or written threats (including text, on-line, or e-mail) of harm to self or others
  • Giving away prized possessions and saying goodbye
  • Exhibiting self-injurious or self-destructive behaviors
  • Having a past history of suicide threats or attempts

How to Help

Take the person aside and talk to them in private. Try to give the other person your undivided attention. Just a few minutes of listening can really help them to make a decision about what to do.

Listen carefully and with sensitivity. Listen without necessarily agreeing with them. For example, you could say something like: "It sounds like on the one hand, you very much want to please your family but on the other hand, you aren't sure that what they want for you is what you really want to do."

Be honest and direct, but avoid labeling your friend. Share what you have observed and why it concerns you without using psychological terms. For example, you might say: "I've noticed that you've been missing class a lot lately and you aren't answering your phone or text messages like you used to. I'm worried about you. What can I do to help?"

Make a referral. Direct the person to Counseling Services. Encourage them to call and make an appointment right then and there (503)370-6471. Or, you could offer to accompany your friend to the appointment. Sometimes, having a trusted friend in the room for that first appointment can be very helpful.  Remember that we have Walk In appointments every day where no advance appointment is needed. 

Follow up. Let the person know that you'll be checking back with him or her later to see how things turned out.

Responding in a caring way to a person in distress can help prevent the distressed person's situation from escalating into a crisis.


If a person’s coping mechanisms are no longer working, emotional or behavioral crisis can result. The nature of crisis is highly subjective and personal, and severity can range from mild to life-threatening. Regardless of its nature, a crisis should always be taken seriously. When a person is in a state of emotional crisis, you might see or hear the following:

  • Extreme agitation or panic
  • References to or threats of suicide, or other types of self-harm
  • Threats of assault, both verbal and physical
  • Highly disruptive behavior: physical or verbal hostility; violence; destruction of property
  • Inability to communicate (for example, slurred or garbled speech; disjointed thoughts)
  • Disorientation, confusion, loss of contact with conventional reality

What You Should Do with a Friend in Crisis

If someone you know is exhibiting some of the above behaviors-particularly if there is imminent danger that the person might harm either him/herself or someone else - you should immediately call for assistance.

For on campus student emergencies, call Salem Campus Safety at (503)370-6911 or Portland Campus Safety at (503)621-2061. They are available 24/7 and can access other on campus resources that may be able to help. If it’s not an emergency, you can also call Counseling Services between 8 am – 5 pm. 

For off campus student emergencies, call 911. If there is no threat of immediate danger or if you are unsure how to respond to the situation, call Counseling Services at (503)370-6471 (during normal business hours), or WUTalk serviced by ProtoCall at (503)375-5353 (a 24/7 service).  By calling WUTalk, you will be connected to ProtoCall, a call center staffed by Masters and Ph.D. level counselors familiar with Willamette’s resources.  Calls are free and confidential, and you can request a next business day follow-up inquiry from Bishop.   Bishop Wellness Center is securely notified of your call, but like all records in Bishop, this is not a part of your academic record. 

You should not approach someone who is highly agitated or violent or decide by yourself what is in the person's best interests. For your safety - as well as that of others and the person in distress - those decisions should be left to trained professionals.

How to Make a Referral to Counseling Services

  • If your friend is a Willamette University or PNCA student, suggest that they make an appointment. They can do this by calling (503)370-6471, or by coming to the front desk in Bishop Wellness Center.
  • If you are concerned about a friend, but are unsure about the appropriateness of a referral, feel free to consult with one of our counselors. We will make every effort to assure your confidentiality, but please note that counselors are legally compelled to act if imminent risk is present.
  • If your friend is not a Willamette student, please feel free to talk with one of our counselors for an off campus referral.
Willamette University

Counseling Services

Baxter Hall
900 State Street
Salem Oregon 97301 U.S.A.
503-370-6471 voice

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