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Helping Troubled Students
Wednesday, May 17, at 2 p.m., U.S. Eastern time
Recent lawsuits arising from student suicides have many college administrators approaching the issue as a legal risk to manage. What are the legal risks, they wonder, of notifying parents -- or of not notifying them -- when their child seems at risk? Is it safer to suspend students who have mental-health problems? Those are the wrong questions, says the author of a new book about student suicide.
Helping depressed students cope is part of a college's educational mission, he says, and colleges have been too slow to notify parents, to hospitalize students, and to offer therapy.
Is he right that colleges have a responsibility to help depressed students? How should administrators and faculty members react to a student who may be suicidal? Who should notify parents and under what conditions? In what cases should students be removed from a campus? What should be expected of faculty members and fellow students?
» 'Giving Them the Help They Need' (5/19/2006)
Gary Pavela is director of judicial programs at the University of Maryland at College Park and a national expert on student suicide. His book Questions and Answers on College Student Suicide: A Law and Policy Perspective (College Administration Publications) will be published in June.
Eric Hoover (Moderator):
The Chronicle would like to welcome Gary Pavela, director of judicial programs at the University of Maryland at College Park and author of a new book, Questions and Answers on College Student Suicide: A Law and Policy Perspective. And welcome to all participants. We will now take questions for Mr. Pavela.
Question from Patrick Mattimore, Saint Ignatius College Preparatory School:
As you point out in your response to an interview question, suicides among college students are half what they are in the general population for that age group. Further, suicides in the 15-24-year-old age group are lower than for any older 10-year demographic (25-34, 35-44, etc.). Isn't this a case of our publicizing a molehill and thereby creating the illusion of a mountain?
Gary Pavela:
Thank you. It's a pretty big molehill. Suicide is one of the leading causes of death for college students. It's only reasonable for college administrators to focus on the environment where we work. Naturally, we need to be informed by data from other settings and to contribute to the general knowledge of suicide prevention
Question from Morgan, R2:
I teach English Lit. Should we be careful with dissertation reading lists for undergrads who have attempted suicide? Last year I was advised to talk one such student out of planning to spending a year writing about Plath and Sexton. Or should we let them?
Gary Pavela:
I'd confer with mental health professionals on your campus. Generally, I don't think we or the authors we assign give students the "idea" of suicide. It's more likely that exploring the topic encourages them to talk with us. We, in turn, can encourage them to seek professional help.
Question from Gretchen Baldwin, Winthrop University:
You encourage peer involvement in reporting suicidal friends. Once this occurs, to what extent do you go to recruit that suicidal student if they aren't willing to seek help from your services? Of particular concern is the student who is not in "immenent danger" (thus prohibiting a safety check by campus police).
Gary Pavela:
If there is a suicide threat or gesture an assessment can be required. I commend the University of Illinois approach in this regard. On the whole, I'd err on the side of requiring the assessment.
Question from Erik Malmberg, U. of Texas at Austin:
I was very interested in the renewed dialogue on this issue. While I am intrigued by the suggestion that administrators and faculty need to be involved as responsible educators in identifying and helping depressed college students, it seems we are really only speaking to the traditional college student (18-24 range). Couldn't these same suggestions for action and early intervention apply to graduate and non-traditional students in dealing with mental health issues? I know this is might be a tall-order for any tenure track faculty member or administrator to consider but the stresses for non-traditional and graduate students are very real. The less we talk about the issue in terms of legal liability, perhaps we can consider the struggle of these groups as well.
Gary Pavela:
Absolutely, I would not limit our focus to undergraduates. And the I think the role of faculty mentors is crucial. We can't be therapists, but we can guide and support our students, including helping them understand that seeking professional help is a sign of strength, not weakness.
Question from Eric Hoover:
Gary, would you please tell us a little more about how mandatory-leave policies may be problematic for colleges? What has your research into that issue revealed?
Gary Pavela:
Many institutions don't have such policies. We focus on behavior (not predictions of future behavior), including behavior that might be prohibited in our student conduct policies. I commend the Illinois approach again. Illinois starts with the premise that students at risk of suicide should remain in school and obtain the help they need. We need creative thinking about keeping students enrolled, not new ways to dismiss them.
Question from Gordon Dutrisac, DigiPen Institute of Technology, 4 year proprietary school:
How do liabilities and responsibilities differ for students who live off-campus versus those in on-campus housing? Our four-year college does not have dorms but attracts students from around the world so I wonder if colleges like mine need to prepare differently from traditional colleges?
Gary Pavela:
We generally owe additional duties to students who reside in our residence halls. We're like landlords in that regard. But that doesn't mean we become liable for student suicide. Landlords aren't generally responsible for suicide by tenants and neither are we. What we must pay special attention to is the student who is clearly at high suicide risk. A student who makes obvious threats, for example. Prompt intervention is necessary--for health, educational and ethical reasons, not liability reasons.
Question from Judith Lilleston, College of Westchester:
Is there a difference in the suicide risk/rate for commuter students versus resident students?
Gary Pavela:
I have no data on that important topic.
Question from Dickens Mathieu, Tufts University:
How much coordination do you suggest there be between the clinical and non-clinical administration when issues arise regarding an at risk student?
Gary Pavela:
Lots. I recommend a team approach from multiple disciplines. Mental health professionals can't reveal confidential information gained in the context of therapy with the student (except in an immediate emergeny), but they can provide critical general guidance--for example, about the role of lovesickness and suicide (as demonstrated by recent research shared with me by Morton Silverman).
Question from Karen Johnson, St. Mary's University San Antonio TX:
What kind of professional development should we be providing faculty to help them as they work with students?
Gary Pavela:
I recommend a general, brief discussion or article in the faculty newsletter once a year or so. Professors don't need long checklists of things to do, but they should be encouraged to listen to students; to inform students about services available;and to seek help for students when necessary. Also, professors need to know that they should not promise "confidential" discussions on these matters. If a student threatens suicide a faculty member can't keep the threat a secret. A proper referral must be made.
Question from Katie DeVisser, University of Denver:
We had a student complete suicide last fall. A memorial/celebration of life event is being held in 2 weeks. I understand that giving significant media attention to suicide can promote other students thinking about suicide to try/complete suicide themselves. Do you think such an event on campus may encourage this?
Gary Pavela:
This is a subject of lively debate. I recommend having a respectful service. There are media guidelines available in this regard, in my book and elsewhere.
Question from Pinkey A. Stewart, private institution:
I have studied suicide for over 10 years and feel that administrators, faculty and staff need training in order to recognize signs of depression and other indicators that students are in crisis. It can be very hard to determine whether a student is suicidal (even the professionals still have not mastered that one), but there are signs to help one know when someone is in a depressive state. In addition, colleges and universities do not necessarily have staff that are trained to work with these issues and often refer students to outside agencies. As we know students do not always follow through on referrals, but they will seek help on campus in many cases.
My question is, how can institutions be encouraged or even held accountable for providing professional psychological services to these students?
Gary Pavela:
Part of the answer is the demonstrated need. More depressed students are seeking help. Providing adequate services in this regard is a reasonable retention measure.
Question from Burt Romotsky, UC Santa Barbara:
What is your opinion for parental notification especially when roommates/peers are monitoring an at-risk student?
Gary Pavela:
I would not have roomates/peers monitoring. They can be friends, but not monitors. If they are really committed to the friendship they will want the student to obtain necessary help. That may require informing parents. Informing parents, of course, should be an administrative responsibility.
Question from Maureen, univ. employee & parent of college student:
My son experienced what medical professionals are considering a brief reactive psychosis while in his college dormitory. The medical director at the college has told us that the college can put him on either temporary or permanent medical leave (we were told this was for his protection). By their policy, permanent means they he would have to withdraw for at least two semesters, provide proof of ongoing treatment, hold a full time job and perhaps take community college courses, then apply for re-enrollment through a special committee. Does my son have any rights in this regard?
Gary Pavela:
Yes. He should ask for the institution's ADA/504 grievance policy and speak with the responsible official administering that policy. The U.S. Department of Education Office of Civil Rights is another resource.
Question from Janet Richardson, Worcester Polytechnic Institute:
Gary, can you talk a little more about contacting the parents of a student who is making suicidal gestures, particularly when the student indicates that they are the source of the emotional problem that they are coping with.
Gary Pavela:
Good point. I advise notifying parents as the "default" or standard procedure. But there will be occasions (like the one you identify) where notification should be withheld. Perhaps we should ask the student to identify *some* emergency contact. Also, as I think you agree, I would be wary of assuming that parents who may irritate us are somehow dysfunctional. On the whole, parents know their children far better than we do.
Question from TX State University SHC:
What legal liability does a university incur if it is aware that a student is suicidal and it doesn't have the resources to monitor the student 24 hours a day?
Gary Pavela:
I think you're held to a "reasonableness" standard--assuming you have any duty at all. The law will not expect you to provide all things to all people. What you must not do, of course, is make promises you can't keep. If you have limited resources in this regard, I'd say so. This point highlights the fact that students and parents will be looking at what mental health services we provide. Inadequate services will limit potential enrollment. Perhaps spending a bit more would be cost-effective in the long run.
Question from Stephen Ostendorff, Webb Institute, NY:
Do you see federal regulations stating that colleges need to set policies for the handling of suicide on campus, like we have seen for drinking and reporting campus crimes, coming down the road?
Gary Pavela:
No. I hope not. There may be pressure to notify parents more often, but I think we've already come to that conclusion ourselves.
Question from Raymond Goldstone, UCLA:
First, you have my thanks and compliments for speaking and publishing on the topic of student suicide and the need for institutions of higher education "to think about alot more than liability." Please expand upon your view that administrators might use the discipline system as a useful threat to gain leverage with students manifesting signs of suicide.
Gary Pavela:
Ray, you've been a good thinker on this and so many other topics. I've learned much from the Illinois approach. A threat of violence to self is a threat of violence. We can prohibit threats of violence. There's nothing inherently wrong with holding people with depression or most other mental disorders to some reasonable standard of behavior. Indeed, it may even be helpful. But the aim of discipline in this context is to keep students enrolled (i.e. induce them to seek help on campus), not suspend or expel them.
Question from Dickens Mathieu, Tufts University:
What about the parents? It seems that many parents would prefer to shift the burden of dealing with their childrens' emotional issues to the institution. How does a school avoid becoming in loco parentis in such situations?
Gary Pavela:
I know such parents exist, but I've seen comparatively few who can be painted with such a stark brush. Life and parenting is more complicated. Naturally, we can expect students and parents to pay for the services they receive, either directly or by insurance. And we can always be candid about the limited services we provide. If the student's "emotional issues" result in misbehavior, we can employ progressive discipline--leading eventually in suspension or expulsion if necessary. If the "emotional issues" lead to academic failure, we dismiss the student on academic grounds, as our policies provide. We have many ways of properly and lawfully declining to accept burdens that don't fit our mission.
Question from Carmen Mendoza, The Chronicle of Higher Education:
I know that the American Foundation for Suicide Prevention developed a program to screen and identify students at risk for suicide. They started with Emory University in 2002. Do you know if they have developed this program anywhere else and how sucessful has the program been?
Gary Pavela:
I know that programs of this nature are generally well regarded and seem to be expanding. The Jed Foundation is another source.
Question from Eric Hoover:
Gary, you've talked to me before about the importance of first responders. Would you mind sharing some thoughts on that topic that may be relevant to administrators and/or resident assistants?
Gary Pavela:
First responders like RAs need to know first and foremost that their primary responsibilty is to seek immediate professional help for a student whenever they encounter any suicide threat or attempt. Err on the side of overreacting in this regard.We also have to pay attention to first responders themselves after they encounter a suicide or attempted suicide. They need support and de-briefing. I have a special section of my book devoted to RA training.
Question from Mike Jungers, Missouri State University:
Gary, a problem that we encounter is that psychiatrists are not readily available and a university counseling center often will not see students who are required to be assessed. The local mental health facility may not be in tune with impact of the student they see on the roommate(s), suitemates, friends, classmates, etc., and declare the student no longer at immediate risk of harm to self. Although I agree with all of your key points, all too often I encounter students who want to forget ASAP what they threatened to do or will minimize their misery so that I will leave them alone. Getting a meaningful assessment in a timely fashion is easier said than done and so is getting a student to accept psychological services. Your comments, please?
Gary Pavela:
I think the unwillingness to participate in any kind of mandated assessment is flat wrong. Mental health professionals make such assessments in other settings, as long as the person being assessed is properly informed of the purpose of the session. I know of no ethical rules either from the American Psychological Association or the American Psychiatric Association precluding referral for assessment, with proper notice to the person being assessed.
Question from Anonymous, small private liberal arts college:
Our administration favors mandatory withdrawal of students suspected of suicidal ideation, regardless of their resources outside of the institution. What is the college's liability if such a student is forced to leave, then completes suicide? Would treating professionals at the college be individually guilty of abandonment whether or not the student commits suicide?
Gary Pavela:
Well, enrollment at your institution is going to be in a steep decline if that policy is strictly enforced. It's more of an ethical and educational issue than a legal question. Is it our job to educate only perfect people with sunny dispositions? I keep thinking about Churchill's "Black Dog" of depression and Lincoln's melancholy. Should people who struggle with such demons be denied an education? I discuss in the book the issue of "negligent referral," which we can't explore in this format. You do raise a legitimate issue.
Question from Eric Hoover:
That's just about all the time we have. Is there anything you would like to add to today's discussion, Gary?
Gary Pavela:
I appreciate the great questions. The theme, I hope, is that we find creative ways to keep students in school--with the help and accountability they need--not creative ways to dismiss them.
Eric Hoover (Moderator):
Thank you for sharing your thoughts with us today, Gary. We appreciate your time. That wraps up our chat. And thanks to everyone else for sending along questions.