Early Warning Signs
of
Alcohol, Other Drug Use
and/or Violence
Change in:
Ø Academic Performance
Ø Attendance
Ø Family relationships
Ø Friends or social group
Ø Normal or usual behavior
Ø Participation in extracurricular
activities
Ø Physical Appearance
Access to or possession of firearms
Affiliation with gangs
Any alcohol or drug-related clothing,
jewelry, or art
Help is only a phone call away!
Montgomery County Community
Crisis Center ........................ 240-777-4000
Montgomery County
Hotline ................................. 301-738-Call
MCPS Safe Schools
Hotline ................................. 301-517-5995
Alcoholics Anonymous .......202-966-9115
AA Spanish Hotline .............301-587-6191
AL-Anon & Alateen ............202-635-2023
Narcotics Anonymous ..... 1-800-543-4670
Cocaine Anonymous .......... 202-726-1717
Association with drug users
Drug Tip Line .......................301-773-3784
Depressed
Bethesda Youth Services ....301-593-1160
Expressed feelings of rejection
Bethesda Police District....... 301-652-9200
Fights
Maryland Youth Crises
Hotline……………...........1-800-422-0009
Involvement with the law
Intimidating and bullying behaviors
Pick-on or persecuted
Violent and aggressive behaviors
Withdrawal from peers
Student
Assistance
Program
Youth America Hotline ....1-877-968-8454
Suicide Prevention
Lifeline…………………..1-800-273-8255
Serious threats of violence
Uncontrolled anger
Walter Johnson
High School
Committed to helping "at-risk" students
obtain services.
Montgomery County
Public Schools
What is Student Assistance?
The Student Assistance Program is a school
based substance use and violence
intervention program. Student Assistance is
focused on prevention through intervention
and is not aimed at collecting evidence for
criminal prosecution.
What is the Goal of Student Assistance?
Most substance usage and/or violent
behavior takes place off school grounds out
of the jurisdiction of school officials, yet
many other effects of this are reflected in
students' performance in school. The goal of
Student Assistance Program is to identify
adolescents whose behavior, attendance, or
grades indicate that they may have problems
related to alcohol and/or other drug use or
violence. Through the different steps that
comprise the Student Assistance Program
process, these at-risk adolescents are referred
for a professional assessment and directed to
appropriate services.
How does the Student Assistant
Program Work?
CONFIDENTIALLY
Any individual (school staff member, parent,
community member, or student) can tell the
Student Assistance Program team about
his/her concern for a student. Students may
refer themselves. A "Concern Form" can
be submitted into one of the concern boxes
located in the health room, media center,
counseling office, and student commons or
to a counselor or administrator. The
Student Assistant Program team leader
collects the concerns and a data collection
process begins. Information is studied to
determine any possible indicators, such as a
drop in grades, increase in absences, frequent
visits to the nurse or behavior problems. If
there are insufficient indicators of a problem,
the matter is dropped and all information is
destroyed. If, however, the data collected
indicates the need for further assessment, the
information is then shared with the student's
parent(s) or guardian who are then
encouraged to participate in the intervention
process. Only the data collected is shared
with the parent(s) or guardian.
Any information concerning who made the
original referral is strictly confidential. A
referral may be submitted without revealing
the name of the concerned person. The
Student Assistance Program team may be
comprised of administrators, teachers,
counselors, security personnel, instructional
assistants, building service workers, office
personnel, cafeteria workers, the school
psychologist, school nurse, attendance
secretary, pupil personnel worker, and other
staff who may be in contact with students.
For more information
If you would like further information about
the Student Assistance Program, you may
contact your school counselor or
administrator.
Student Assistance Program
Confidential Concern Form
I am concerned about:
____________________________________
Student Name
Grade
Reason for Concern (Check all that apply):
o Drop in academic performance
o Increased absence from school
o Destructive behavior against
others or self
o Negative attitudes
o Signs of possible alcohol and
other drug use
o Change of friends
o Depression, anxiety, frequent
mood swings
o Suicide (Report immediately!)
o
Other concerns/comments:
____________________________________ ____________________________________ ____________________________________ ____________________________________
____________________________________
____________________________________
__________________________________
Optional Signature
Date
After completing this form, place it in an envelope
marked “Confidential” and place it in the designated
box in the counseling office, health room, or media
center.
Updated 7/2015