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“Red Folder” guide for recognizing, responding to and referring distressed students

An image shows the front of a file folder labeled RED FOLDER. It describes in large type that it is designed to help recognize, respond to and refer distressed students.The “Red Folder” guide was produced by Penn State’s Student Affairs/Counseling and Psychological Services and Commonwealth Fee Board, and updated with Hershey-specific information by the Office for Professional Mental Health at Penn State College of Medicine.

The folder is a quick-reference guide to help faculty and staff recognize, respond to and refer distressed students. You can also download this resource as a PDF from OneDrive to print it out (updated June 21, 2019).

How to Use the Guide

Recognize indicators of distress

  • Common indicators are listed below. Students may present with indicators not listed.

Respond appropriately

  • Each situation is unique. Use the tips and decision tree to determine the most appropriate response

Refer the student

  • Use the list of resources to refer the student to the most appropriate campus resource.

Jump to topic



Look for groupings, frequency, and severity of behaviors, not just isolated symptoms.

Academics Expand answer
  • Sudden decline in quality of work and grades
  • Frequently missed classes and assignments
  • Disturbing content in writing or presentations
  • Classroom disruptions
  • Consistently seeking personal rather than professional advice
  • Multiple requests for extensions/special considerations (a change from prior functioning)
  • Doesn’t respond to repeated requests for contact/meetings
Physical Expand answer
  • Marked changes in physical appearance (e.g., poor grooming/hygiene or sudden weight loss/gain)
  • Strange or bizarre behavior indicating loss of contact with reality
  • Visibly intoxicated or smelling of alcohol or marijuana
  • Rapid speech or manic behavior
  • Depressed or lethargic mood or functioning
  • Observable signs of injury (e.g., facial bruising or cuts)
Psychological Expand answer
  • Self-disclosure of personal distress (e.g., family problems, financial difficulties, assault, discrimination, legal difficulties)
  • Unusual/disproportionate emotional response to events
  • Excessive tearfulness, panic reactions
  • Verbal abuse (e.g., taunting, badgering, intimidation)
  • Expressions of concern about the student by peers
Safety risk Expand answer
  • Verbal, written, or implied references to suicide, homicide, assault or self-injurious behaviors
  • Unprovoked anger or hostility/physical violence (e.g., shoving, grabbing, assaulting, use of weapon)
  • Academic assignments dominated by themes of extreme hopelessness, helplessness, isolation, rage, despair, violence, self-injury
  • Stalking or harassing
  • Communicating threats/disturbing comments via email, correspondence, texting or phone call


Use these tips to determine the most appropriate response for a distressed student.

Mandatory reporting

In addition to referring a student to resources, any sexual or gender-based harassment or assault requires mandated reporting. For questions regarding mandated reporting, please contact the Office of Sexual Misconduct Prevention and Response at 814-867-0099.

Stay safe Expand answer

Call Penn State Police or 911 if there is an imminent danger to the student, you, or anyone else

Stay calm Expand answer

Take a few deep breaths to calm yourself. Use a calm voice when talking and asking questions.

Take your time Expand answer

If this is not an imminently dangerous situation, take time to think through what might be the most helpful step.

Seek consultation Expand answer

You are not alone. Ask those around you for help. Consult with a colleague, call another office on campus (see resources)

Use active listening Expand answer

Make eye contact, give your full attention. Restate what the student says to make sure you understand what is causing the distress and/or what they are asking for help with.

Ask direct questions Expand answer

Don’t be afraid to directly ask the student if they are having thoughts of harming themselves or others (by asking, you are not instilling the thought).

Give concrete help Expand answer

Help get them to the next step (e.g., contact the academic advisor with the student to make an appointment; help them call counseling services to schedule an appointment).


Follow the steps below to determine who to contact when you are concerned about a student who is distressed and/or disruptive. Emergency and campus resources are listed.

If the student's conduct is clearly dangerous or threatening, including self-harm or harm to others Expand answer

Call 911 or Penn State Police at 717-531-8888.

If you are not concerned for anyone's immediate safety, but the student is having significant academic and/or personal issues and could use some support Expand answer

Refer the student to campus resources as appropriate.

If the student is with you currently and shows signs of distress, but it is not clear how serious it is Expand answer

Call the Office for Professional Mental Health or the Penn State Crisis Line at 877-229-6400. Then, refer the student to appropriate campus resources.

If the student is not with you but you're concerned about what they said OR what they did (acted bizarrely, aggressive or disruptive) OR how they looked (unkempt, unwashed, or drugged/drunk) Expand answer

Report to Campus Safety and Security 717-531-8711 or the Behavioral Threat Management Team.


Emergency Resources Expand answer
  • Campus Safety and Security, 717-531-8888 or 911
  • Penn State Crisis Line, 1-877-229-6400
    • 24/7 confidential service
    • Licensed mental health counselors
  • YMCA/Rape Crisis and Domestic Violence Services, 1-800-654-1211
    • Off-campus services for victims of sexual and relationship violence and stalking
    • 1101 Market St., Harrisburg, PA 17103
Urgent Resources Expand answer
Additional Resources Expand answer