Deborah did approach both Mrs. Pacuska and myself regarding issues she is having in both classroom and clinical.  Deborah states that she has been struggling in clinical and her grades in theory have been dropping.  She does state that she has multiple personal problems presently and feels that because of that she has been \"in a daze\" recently.  She states that this is affecting her school performance.  I did speak to Deborah at length regarding the importance of dealing with her personal issues.  She did at this meeting have somewhat slow speech and appear to possibly be under the influence, however she was coherent and appropriate.  I did address this directly but she states that she just has \"not been sleeping well\".  She states that she is currently under care of her private physician and has longstanding use of anti-anxiety and antidepressant meds under her provider\'s supervision.  I did direct her to contact her provider but she voices concerns regarding her lack of insurance.  I did provide her with contact numbers for free health clinics as well as counseling centers.  I did direct her to have a health assessment either by her current provider or one of the facilites I provided.  She also agreed that counseling may be helpful and she will call to arrange.  She states that she would like to continue in the program at this time but if she continues to struggle she will consider applying to repeat level 2.  She also agreed to contact me next week to keep abreast of her status.