From the issue dated December 5, 2003
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More Help for Troubled StudentsNew services try to strengthen campus mental-health programs and prevent suicides
New York After two students fell to their deaths from the 10th floor of New York University's Bobst Library this semester, the administration stationed security guards and began installing tall plastic panels on the building's balconies. Then, just as those barriers were going up, a student fell from a sixth-story window of a nearby apartment. The third apparent suicide in less than six weeks stunned the university, which had not seen a student suicide since 1996. On the campus, grief mixed with a sense of futility. Could the university prevent suicides any more than it could nail every window shut? And how does a university know if it has enough safeguards for troubled students? Those questions are reverberating throughout academe amid concerns about increased demands on mental-health services from a growing number of students with documented illnesses. A recent study at Kansas State University found that between 1989 and 2001, the number of students with documented depression doubled, and the proportion of students taking psychiatric medications rose to 25 percent, from 10 percent. The number of suicidal students tripled. Those numbers trouble colleges for many reasons, among them the potential of being held liable for a student's death. Last summer Ferrum College admitted "shared responsibility" for a student's suicide in a financial settlement, the first such acknowledgment by a college. In a lawsuit that is still pending, the family of a Massachusetts Institute of Technology student has accused the institution of negligence in the death of their daughter, who killed herself after more than a year of treatment by campus counselors. As colleges scramble to shore up their prevention programs, a handful of new national organizations and commercial services, looking to bolster mental-health efforts on campuses, are attracting attention. Among those that campus officials are talking about:
"We're going to see more alternative ways of addressing the issue," says Kevin Kruger, associate executive director of the National Association of Student Personnel Administrators. "Outsourcing is not a dirty word, particularly when you look at the budget crisis we have. Counseling centers are going to have to plug into national resources -- not to replace campus services, but to supplement them." Parents on a Mission A few blocks from NYU, in an airy SoHo loft, Phillip and Donna Satow are trying to turn their loss into a lesson for colleges. Five years ago, the couple's youngest son, Jed, a sophomore at the University of Arizona, hanged himself in his family's vacation home. He was 20. Phillip Satow was scheduled to retire just three days later. But he and his wife began a second career together, establishing the Jed Foundation to help colleges identify and treat students who have depression or other emotional disorders before they become suicidal. Nationally, an estimated 1,000 college students -- out of a total of 15 million -- take their own lives each year. In one recent survey, nearly one in 10 students said they had seriously contemplated suicide, although other studies show that college students are half as likely as nonstudents of the same age to commit suicide. The Satows run their organization out of their home, in which three large photographs of their late son hang on one wall. Jed loved cars and ice hockey, and he wore his father's old number (21) on his own sports jerseys. The foundation has only one paid full-time employee, Ron Gibori, who was Jed's friend and fraternity brother at Arizona. Money has come from philanthropic foundations and corporations, including pharmaceutical companies. Following Jed's death, Mr. Gibori and the Satows asked students at Arizona what might help those who were depressed, or who were worried that a friend was suffering. The response: Build an online resource that students could use in the privacy of their dormitory rooms. So in the fall of 2002, the foundation unveiled Ulifeline.org, a free, anonymous Web site that links students to their college counseling centers and a library of mental-health information. More than 180 colleges and universities have subscribed to the site, which the foundation customizes for each institution at no charge. Students typically learn about the site during orientation, or through e-mail messages and on-campus posters. At Arizona, the site had 300,000 page views in its first week. Mr. Gibori says the Internet is an effective tool for educating students about mental illnesses, particularly since the subject tends to receive less attention at colleges than do other student problems, such as binge drinking. "I was able to walk on my college campus and be educated about how to have safe sex, but not once did someone tell me what the signs of depression were," says Mr. Gibori. "It wasn't that the university lacked resources, but that students were unaware of counseling services available." The site does not provide full-fledged counseling, but features a 24-hour screening program, developed at Duke University, that evaluates students for suicide risk and several other disorders, and provides a nondefinitive diagnosis and recommendations. "I certainly don't think it's the answer to major mental-health issues on college campuses, but it helps students to look out for their neighbors," Mr. Satow says. "It's designed to work in conjunction with existing services." Jim Probert, a psychologist in the counseling center at the University of Florida, says sites that direct students to seek help on their campuses are preferable to those that offer one-stop diagnoses. "I'd prefer face-to-face contact, or that students call a counselor -- it's more likely to be engaging," Mr. Probert says. "But realistically, if there are people out there who need help, the Internet can give students a way of testing the waters." Mr. Probert says many of the students he counsels had first read about mental-health issues online. In addition to promoting Ulifeline.org, the Satows plan to develop a "road map" for campus suicide interventions. The group is working with Columbia, Cornell, Harvard, and Yale Universities and MIT on an unprecedented study to determine which types of suicide-prevention programs are most effective, and which programs bring the most at-risk students into their doors. The latter is crucial, they say, since students with the highest suicide risk often have not been in counseling. The Jed Foundation has also begun to create a national college-suicide registry that would contain data on the number of attempted and actual suicides of students. The Satows say a large set of accurate data, including demographic information, would help colleges assess the severity of the problem and to develop their prevention strategies. Ultimately, the Satows hope to persuade more colleges to develop more-holistic prevention plans, in which athletics departments, residence-life staffs, fraternities and sororities, and professors, among others, coordinate their efforts. "We need to bring them all together, working in unison," Mr. Satow says, "There's a silo effect at most universities -- the thinking that mental health is just a counseling issue, not a university issue." Package Deals for Counseling Bill Keefe recalls how Gregory J. Hall, an associate professor of psychology at Bentley College, helped him through four years of higher education, giving him counseling and guidance that helped him overcome "adjustment issues." Figuring that many students do not find such mentors in college, Mr. Keefe and Mr. Hall created a Web site where students could find information about mental-health and other sensitive issues. The two-year-old site, Campusblues.com, like the Jed Foundation's, links to university mental-health services and a digital library of information, about eating disorders, relationships, even acne. About 350 colleges have set up partnerships with the Massachusetts-based company, providing reciprocal links that direct students to their respective college's counseling center. Richard Boyum, a counselor at the University of Wisconsin at Eau Claire, uses the site to give "homework assignments" for students he counsels, asking them to find information online that they will discuss at their next session. Web-based services, he says, are ideal for college students, with their odd schedules and Internet savvy. "It's often late at night when someone is depressed, when one student's arguing with another student over whether they've got a drinking problem," he says. There is little data with which to measure the effectiveness of Web sites as a suicide-prevention tool, however. Paul A. Grayson, director of counseling services at NYU and co-author of Beating the College Blues (Facts on File, 1999), hopes the impact is positive, but says "the jury's still out." "It's hard to see what effect they will have on lives of everyday students," he says. In a separate venture, Mr. Keefe plans to introduce a new product he believes will alter the dynamics of college mental-health services. Soon, ReconnectingU Inc., Campusblues.com's parent company, will offer a "student-assistance program" that Mr. Keefe says would shift the responsibility of student mental-health treatment from colleges to students and their parents, while increasing the available counseling services. "We're not trying to compete with counseling centers," he says, "but to support existing resources." According to the plan, participating colleges would charge students an enrollment fee of $69.95. A student would receive a wallet-size card with a toll-free phone number where he or she could reach trained counselors 24 hours a day, seven days a week. The plan would also cover six face-to-face sessions, with either on- or off-campus counselors. Participating colleges would get 10 percent of the students' subscription fees, money that could support existing counseling centers, Mr. Keefe says. Colleges would also receive compensation from the company for on-campus counseling visits. Mr. Keefe hopes that 15 colleges and universities will sign on by next fall. "There was a time when requiring health insurance for students was considered innovative," Mr. Keefe says. "We think the time has come to create a similar model to support student mental health." Mr. Boyum, who calls the plan "evolutionary and revolutionary," predicts it will appeal to many colleges looking to "fill the gap" amid staffing shortages and cutbacks. Another selling point will be liability reduction: Mr. Keefe says his company, as a third-party provider, would indemnify each college in its contract. Several college health officials and risk-management experts speculate that such a model, while no panacea, could benefit colleges. Yet they agreed that the soundness of the a plan would depend on the wording of the contract and the adequacy of the company's insurance. Jim Mitchell, director of the Student Health Service at Montana State University, is skeptical of the idea, however. "It would be a tough sell," Mr. Mitchell says. "It seems like an expensive way for a college to get additional resources." Student-Led Effort In March 2000, Alison Malmon was a freshman at the University of Pennsylvania when her brother, Brian, then a student at Columbia, committed suicide. Ms. Malmon says her brother -- an a cappella singer and sports editor of the student newspaper -- had suffered from schizophrenia, but managed to keep his illness quiet. On her campus, she found another kind of silence troubling: Her fellow students never talked about mental illness. She attempted to change that by starting Open Minds, a student organization at Penn, in 2001. A founding premise was that students can help recognize mental illness in their peers. "The group's message is for all students, not just those who might be dealing with an issue," Ms. Malmon says. "It's meant to destigmatize mental illness so that those who suffer feel more comfortable talking about it." Ms. Malmon wrote a mission statement and received a $10,000 grant from the university to sponsor guest speakers and panel discussions. The group also holds an annual two-mile race in which runners wear T-shirts with facts about mental illnesses. Last year about 200 students participated. Members of the group, many of whom are students who have been diagnosed as having emotional disorders, hold social events and distribute flyers (one describing famous people with mental illnesses) and brochures with information about mental-health services on campus. Those efforts have helped humanize the mental-health issues, university administrators and faculty members say. "They've really started a dialogue," says Ilene C. Rosenstein, director of counseling and psychological services at Penn. "It makes my job easier because they explain things to students, giving them an educational context about what they're experiencing and an understanding of resources that can help them." After graduating last spring, Ms. Malmon moved to Washington and established a national headquarters for the group, which she renamed Active Minds on Campus. Students at Georgetown University have started their own chapter, and students at DePaul and Duke Universities, among others, are developing chapters as well. Private donations have supported the organization so far, allowing Ms. Malmon to work full time on the project. She hopes to add five more campus chapters by the end of the spring semester. "Counseling centers are overburdened, and our goal is to serve as their outreach," Ms. Malmon says. "Students are more likely to listen to other students." 'Striking a Balance' There's been a lot of listening on NYU's campus this fall. Counselors have visited dorms of the students who died. Resident assistants have held meetings to remind students of the university's mental-health services. Clergy have offered help. The university's counseling center, which links to Campusblues.com and Ulifeline.org, among other sites, also plans to hire three more staff members. Although the timing of the recent deaths was devastating, the university has cautioned against lumping the three incidents together. "Each one," says John Beckman, a university spokesman, "is going to prove to have its own motivations and circumstances." Meanwhile, university officials have tried to return a sense of normality to the campus, says Mr. Grayson, the director of the counseling center. "We're striking a balance," Mr. Grayson says. "As an administration, we want to let students know we're concerned, but we're not in any sense romanticizing or glorifying [the deaths]. We don't want to say to students that we think everyone is fragile. The campus is resilient and healthy." Some students have complained about the barriers on the library's balconies, contending that they are an overreaction. Yet other students have argued that the university erred by not installing them after the first death, in September. But nobody disagrees with what Marc Wais, NYU's vice president for student affairs and services, wrote in an e-mail message to the university this fall. "Death," he wrote, "always seems so out of place on a college campus." http://chronicle.com Section: Students Volume 50, Issue 15, Page A25 | |||||||||||||||
Copyright © 2003 by The Chronicle of Higher Education