Case Narrative: Understanding Emma's Struggle

Emma, a 20-year-old college student, has been feeling increasingly overwhelmed with her academic workload and personal life. Recently, her friends noticed that she has been isolating herself more, missing classes, and avoiding social activities she used to enjoy. Emma has also been posting concerning messages on social media about feeling hopeless and trapped.

One evening, Emma’s roommate, Lily, finds her sitting alone in her room with a distraught expression. Emma admits that she has been feeling extremely low and has thought about self-harm. Lily is unsure about how to handle the situation and is worried about Emma’s safety.

Lily decides to talk to Emma about her feelings and suggests seeking help. Emma is reluctant and expresses that she feels like no one understands her. Lily wants to ensure that she supports Emma effectively and finds the best way to help her.

Which of the following behaviors is a warning sign that Emma might be at risk for self-harm?

• Increased involvement in social activities

• Frequent visits to the campus gym

• Isolation from friends and avoidance of previously enjoyed activities

• Improved academic performance

If Emma has admitted to thinking about self-harm, what should Lily do?

• Call emergency services immediately

• Talk to Emma about her feelings

• Ignore her admission

• Encourage her to focus on her studies

What is the most appropriate way for Lily to respond when Emma expresses that she feels no one understands her?

• Tell Emma that she is just being dramatic

• Listen empathetically and validate Emma's feelings

• Change the subject to avoid discussing her emotions

• Tell Emma to focus on the positives in her life

Lily suggests that Emma seek help from a mental health professional. Emma is reluctant. What should Lily do to encourage Emma to seek help?

• Pressure Emma to go to therapy immediately

• Offer to help Emma find a counselor and possibly accompany her to the first appointment

• Ignore her reluctance and hope she changes her mind on her own

• Dismiss Emma's reluctance as unimportant

Which of the following actions would best support Emma during this time?

• Encouraging her to avoid discussing her feelings to prevent further distress

• Providing a supportive environment and regularly checking in with her

• Suggesting she focus solely on her academic work to distract herself

• Asking her to keep her emotions private

Friends like Lily should attempt to solve Emma's problems on their own without involving professionals.

• True

• False

What should be included in a safety plan for someone like Emma who is at risk of self-harm?

• Coping strategies, emergency contacts, and identifying triggers

• Strategies to avoid talking about emotions

• Plans to manage academic stress without external support

• List of social events to distract her

Emma expresses that she feels uncomfortable discussing her feelings with a counselor. How can Lily address this concern?

• Ignore Emma's discomfort and insist she see a counselor

• Reassure Emma that it is normal to feel uncomfortable and that counselors are trained to help people in her situation

• Suggest she should try to manage her feelings on her own first

• Encourage Emma to avoid counseling and try self-help strategies alone

If Emma is in immediate danger of self-harm, what is Lily's best course of action?

• Try to distract Emma with other activities

• Call emergency services and ensure Emma is safe until help arrives

• Leave Emma alone to process her feelings

• Ask Emma to wait and see if her feelings change