CUIMC Office of Well-Being

CUIMC Blue Folder

Guidance and Resources for Helping Colleagues in Distress

Message to Faculty, Postdoctoral Trainees, and Staff

Supporting the well-being of our colleagues is a vital component of keeping the University a safe and productive environment. Within our community, we have the opportunity to show care and compassion for colleagues experiencing distress. Colleagues’ distress can present itself in many ways. Here we present some tools to recognize, respond, and refer colleagues appropriately when someone might need help.

CUIMC Blue Folder for Colleagues

Trust Your Instincts

While the Blue Folder is intended to provide guidance about addressing concerns, you may still have questions. If an encounter with a colleague leaves you feeling concerned, alarmed, or threatened, consult with someone. Faculty, postdoctoral trainees, and staff can consult the Resource section regarding any mental health or behavioral concerns. For any immediate safety risk, call Public Safety and notify your supervisor immediately. You can reach CUIMC Public Safety by phone at 212-305-7979 (Emergency Line).

Recognize

Indicators of Distress

For situations that may not pose an immediate safety risk but cause concern, use the following guidance to help you identify a colleague in distress. Pay particular attention to notable changes in the colleague's behavior, performance, mood, and appearance. Any one of the following indicators alone does not necessarily suggest the colleague is at risk or needs intervention. Together, however, they may indicate the colleague needs or may be asking for help.

Behavioral Concerns

  • Expressing feelings of guilt, worthlessness, or hopelessness
  • Marked changes in physical appearance (e.g., grooming or hygiene deterioration)
  • Reckless, risky, or impulsive behavior
  • Behavior seems out of context or concerning
  • Signs of paranoia or odd beliefs that are not reality-based
  • Flattened emotional expression or indifference
  • Sudden decline in quality of work, professionalism, and performance
  • Pattern of disorganization not previously observed 
  • Repeated absences
  • Multiple requests for extensions on deadlines
  • Unusual/disproportionate emotional response to events
  • Excessive tearfulness or panic reactions
  • Uncharacteristic irritability, disproportionate reactions, and behaviors such as taunting or intimidation
  • Concern from peers
  • Signs of possible abuse or self-injury (e.g., cuts, burns, bruises)

Recognize and Respond to Suicide Risk

The simplest and best advice is to take any concerns about suicide or self-harm seriously and connect the colleague to professional help. While no single formula can determine if someone is simply sad or is severely depressed or at risk for suicide, these and similar behavioral red flags may indicate a colleague needs professional assistance.

To learn more about asking about suicide, consult the Columbia Lighthouse Project.

Respond

Behavioral Concerns

There may be reluctance to initiate a conversation about a colleague’s well-being for various reasons. A common misconception is that talking about issues, like suicide or self-harm, could worsen the situation or inadvertently encourage these actions. In reality, the converse is often true. Engaging a colleague or friend in a supportive dialogue regarding such concerns can be a vital step in linking them with essential resources and demonstrating your concern for their welfare.

Be Direct With the Colleague

Identify what the concerning activity is. Doing this privately is typically recommended; however, addressing the entire team is sometimes necessary. Use your judgment. If a colleague's presentation raises concerns about substance abuse, violence, or suicide, ask directly. Do not be afraid to engage, it shows you care.

  • “Hi ____. I just wanted to check in. I’ve noticed ____ and wanted to see if you wanted to talk about it.”
  • “I’ve noticed ____  and I want you to know that I am here to support you.”

Listen to the Colleague

Actively listen, using a non- confrontational approach and a calm voice. Avoid threatening, humiliating, and intimidating responses. Allow them the opportunity to respond and ask appropriate follow-up questions.

  • “I’d like to hear more about that.”
  • “I’m sorry, that seems like a difficult situation to be in. What is that like for you?”
  • “That sounds really difficult, how is that affecting you?”

Refer the Colleague to University Resources

Remember that your role is to connect the colleague to the right resource for support. Connecting the colleague to additional resources helps prevent a situation in which you become the colleague's main source of support.

  • “Thank you for being so open with me. I want to be sure that you can access the resources you need to get through this challenging situation.”

It’s okay to say:

  • “I am not sure, but there are people at Columbia who can help.”
  • “I am not sure, let me find out.”

Follow Through With the Colleague

Ensure that the colleague gets connected to resources and follow up with the colleague to express ongoing care and concern.

  • “How have you been since we last spoke?”
  • “Was that resource helpful?”

Conduct Additional Follow-Up if You Remain Concerned

If, after addressing the behavior, you still feel concerned, continue to refer the colleague to the appropriate resources, inform their manager, and notify Faculty Affairs or Human Resources. For more information, visit our Resources section.

Activate a Wellness Check, As Needed

If you have not seen or heard from a colleague over a period of time and/ or you have immediate concern for the colleague's well-being, call Human Resources or Faculty Affairs so that a wellness check through Public Safety can be considered. The purpose of a wellness check is to ensure that a colleague of concern is safe, able to communicate and understands there is concern about their well-being.

When a Colleague Seeks Support for Distress

If a colleague reaches out and expresses they are in distress, follow the psychological first aid guidance below, provided by the New York City Department of Health and Mental Hygiene Office of Mental Health Disaster Preparedness and Response.

Promote SAFETY

  • Help people meet their basic needs for food and shelter and emergency medical attention if needed
  • Provide simple and accurate information on how to obtain assistance to meet their basic needs 
  • Stress may alter the individuals’ ability to process information. Repeat information as often as necessary

Promote CALM

  • Listen to people who wish to share their stories and emotions 
  • Remember people react differently to disasters and there is no right or wrong way to feel 
  • Be friendly and compassionate even if people are being difficult 
  • Obtain and offer accurate information about the disaster or trauma, and the relief efforts, to help victims better understand the situation

Promote CONNECTEDNESS

  • Help people to contact their friends or loved ones
  • Keep families together 
  • Keep children with parents or other close relatives 

Promote HOPE

  • Find out the types and locations of government and non-government services that are available and direct people to these services
  • If you have the correct information available tell people that help is on its way 

Promote SELF-EFFICACY

  • Give practical suggestions on how people can help themselves 
  • Help people regain their sense of control by engaging them in activities to meet their own needs

*Source: New York City Department of Health and Mental Hygiene Office of Mental Health Disaster Preparedness and Response

Tips for De-Escalation

If a colleague is agitated, threatening, or you are concerned about imminent risk, please call Public Safety. Follow these tips and guidance for de-escalation until help arrives, provided by the Crisis Prevention Institute:

1. Be Empathic and Non-Judgmental

  • Pay attention to the person—whatever they may be experiencing, it may be the most important thing in their life at the moment.

2. Respect Personal Space

  • Stand at least 1.5 - 3 feet away from a person who is escalating.
  • If you must enter someone’s personal space, explain your actions so the person feels less confused and/or frightened.

3. Use Nonthreatening, Nonverbal Communication

  • Keeping tone and body language neutral go a long way towards defusing a situation.
  • As a person escalates, they lose the ability to hear your words; they will increasingly react to your non-verbal communication (e.g., gestures, facial expressions, movements and tone of voice).

4. Keep Your Emotions in Check

  • Always remain calm, rational and professional; your actions will have a direct impact on whether or not the situation escalates.
  • Convey a sense that the situation is manageable, and that you know what steps to take. Doing so will help to keep both you and the colleague calm in the moment.

5. Focus on Feelings

  • Watch and listen carefully for the person’s real message and identify how the person is feeling.
  • Supportive words will help the person know that you understand what’s happening in the situation, and can help to elicit a positive response.

6. Set Limits

  • Give clear, simple and enforceable limits when a person’s behavior is belligerent, defensive or disruptive.
  • When a person is upset, they lose the ability to hear what you say. Be clear, speak simply and offer the positive choice first.

7. Choose Wisely What You Insist Upon

  • Offering people flexibility and options can help you avoid unnecessary conflicts or power struggles.
  • Be thoughtful in deciding which rules are negotiable, and which are not.
  • Silence is a powerful communication tool and can give people a chance to reflect on what’s happening and what steps they wish to take.
  • When a person is upset, they may not be able to think clearly. Give them a few moments to think through what you’ve said.
  • Stress increases when a person feels rushed. Allowing time can bring calm to the situation and allow for better decision making.

*Source: Crisis Prevention Institute

Identifying a Colleague in Need

Does the colleague need immediate assistance?

Scenario 1: The colleague's conduct is clearly reckless, disorderly, dangerous, or threatening and suggestive of immediate harm to self or others in the community.

  • YES … RESPOND
  • If you believe a colleague is in immediate danger of self-harm and is on campus, immediately call Public Safety and inform your supervisor:
  • If you believe a colleague is NOT in immediate danger of self-harm, refer the colleague to CopeColumbia and the Employee Assistance Program.

Scenario 2: You observe indicators of distress, but severity is unclear. The interaction has left you feeling uneasy or concerned about the colleague.

Scenario 3: I’m not concerned for the colleague’s immediate safety, but they are having significant academic and/or personal issues and need some support.

  • NO … REFER
  • Refer to the appropriate campus resource, using the detailed list provided in the next section. Consider following up with your colleague.

Refer and Consult

You are not alone. There are numerous offices here to support you. Below are resources that you should consult early if you have concern about a colleague's well-being. You can also refer colleagues to the appropriate offices.

Public Safety

Public Safety is available for faculty/staff consultation and can conduct wellness-checks. 

CopeColumbia

Refer colleagues to CopeColumbia when they exhibit or share concerns related to their personal, physical, and emotional well-being. CopeColumbia serves as a resource for all faculty and staff at CUIMC. If the concern relates to a student, refer them to their Dean of Students.

CUIMC Human Resources

CUIMC Human Resources should be notified of concerns and sought out for consultation when a matter involves an Officer of Administration or Support Staff member. If warranted, CUIMC Human Resources can assist with connecting the colleague of concern to confidential support resources, and the Office of Leave Management.

CUIMC Office of Faculty Affairs

CUIMC Faculty Affairs should be notified of concerns and sought out for consultation when a matter involves an Officer of Instruction or Research. If warranted, CUIMC Faculty Affairs can assist with connecting the colleague of concern to confidential support resources, and the Office of Leave Management.

Office for Postdoctoral Affairs and Early Career Research (OPA)

If you are concerned about a Postdoctoral Trainee or an Associate Research Scientist, you may consult OPA, which has a dedicated wellness staff member who is available to consult about situations concerning postdoctoral well-being. OPA is also able to offer assistance to postdocs on many areas regarding professional development and their appointment at Columbia. Please note that OPA is not an on-call service.

Sexual Violence Response

The Sexual Violence Response (SVR) team leads Columbia University’s prevention, advocacy, prevention, and outreach related to sexual violence and harassment. SVR is committed to transforming culture to prevent violence and advocates for anyone impacted by these forms of harm—students, staff, faculty, and campus visitors.

Sexual Violence Response Role & Services

Survivors can speak confidentially with an advocate to explore their rights and options and to connect with resources, medical support, emergency housing, safety planning, filing orders of protection, care packages, and healing initiatives. All people impacted by sexual violence have the right to be treated with respect and care, and survivors can receive support—whether they decide to report or not.

Responding to Disclosures of Sexual Violence and Sexual Harassment

  1. Provide Care and Support
    1. If responsible employee, explain confidentiality limitations
    2. Offer resources and connection to an advocate
  2. Connect to an Advocate at SVR
    1. Introduce the affiliate to the 24/7 Helpline at 212-854-4357
    2. Introduce affiliate to the on-call advocate
    3. Step out to provide the affiliate privacy
  3. Mandatory Reporting
    1. Report an Incident
    2. You can also consult with the Title IX Coordinator at 212-853-1276

SVR Contacts

  • To connect with urgent support, call the 24/7 Helpline at 212-854-4357.
  • To consult with a specialist or to schedule an appointment, contact the SVR main line at 212-854-3500.

Resources

The following offices are available for colleague referral and faculty/staff consultation. Resources marked with an asterisk are confidential. The University offers a number of confidential resources for individuals who are unsure whether to report prohibited conduct and/or who are seeking counseling or other emotional support in addition to or without making a report.

Comprehensive Psychiatric Emergency Program*

Hospital-based emergency psychiatric services provide a full psychiatric assessment, stabilization, extended observation, treatment, and referral of patients 18 and older. Our psychiatrists, social workers, and nurses are trained in emergency psychiatry and work together as a team to develop a rapid response to acute care needs.

ColumbiaDoctors Psychiatry*

ColumbiaDoctors psychiatrists and therapists provide a comprehensive array of mental health services at multiple locations across the NY metro area and are in-network with UnitedHealthcare. They offer a wide range of services including expert consultations, medication management, and many types of therapy.

CopeColumbia*

CopeColumbia peer-support services are available to all CUIMC faculty and staff. Sessions provide an opportunity for employees to talk about their experiences, ask questions, and obtain guidance and practical suggestions for coping and well-being from our psychiatry faculty. Services are confidential, virtual, and free of charge.

Employee Assistance Program (EAP)*

Supporting a colleague of concern can have a personal impact on faculty and staff wellbeing. The EAP program is available for all Columbia faculty and staff, offering confidential counseling and support at no cost for benefit eligible faculty and staff and their household members.

Title IX Coordinator

Columbia’s Title IX Coordinator takes reports alleging discrimination and harassment on the basis of categories including race, color, national origin, gender, age, and sexual orientation/identity, which includes allegations of sexual harassment and sexual violence.

UnitedHealthcare (UHC) Behavioral & Mental Health Providers*

Reach out to Advocate4me for a referral to a mental health professional who is in-network.

Additional Mental Health Resources

  • AmWell
    • 24/7 virtual visits for urgent care 
    • Virtual primary care, behavioral health and specialty care visits available. 
    • Website: patients.amwell.com 
  • Doc on Demand
    • Doctor on Demand offers 24-hour online urgent care. 
    • Book therapy or psychiatry mental health session with clinical experts 
    • Website: www.doctorondemand.com 
  • Teladoc
  • Virtual Therapy
    • Alma
      • Find a therapist who fits your needs and takes your insurance.
      • Website: www.helloalma.com
    • Talkspace
      • Online Therapy - Private and Secure.
      • Check insurance coverage or pay out of pocket.
      • Get matched with a therapist.
      • Start therapy.
      • Switch providers at any time at no additional cost. 
      • Website: www.talkspace.com  ​​​​​​

Campus

Columbia University Irving Medical Center

New York-Presbyterian/Columbia University Irving Medical Center

Lamont

Morningside & Manhattanville

Mount Sinai Morningside

Community

NYC 24-Hour Crisis Services/Mental Health Hotline

Call for immediate, confidential crisis support and intervention.

NYC Well Crisis Hotline

Confidential helpline for mental health and substance use services.

NYC HOPE – NYC Domestic Violence Hotline

Resources to help you or a loved one experiencing dating, domestic, or gender-based violence.

NYC Family Justice Center

Call for services or support, including immediate safety planning and shelter assistance.

Acknowledgments & Contributors

Acknowledgements

Thank you to our partners in the CUIMC Office of Professionalism, Office of Postdoctoral Affairs and Early Career Research, CUIMC Student Health on Haven, and Columbia University’s University Life for their support and collaboration in developing this resource for helping colleagues in distress.

Contributors

Thank you to the many colleagues across the Columbia University Irving Medical Center that were integral in developing this comprehensive & important resource guide for our community: