Prevention On College Campuses
is the second leading cause of death among college aged students.
In his 2001 book Noonday Demon, Andrew Solomon wrote
that “Someone in a first depressive episode is particularly likely
to attempt suicide.” Many experience their first bout of depression
in college. As a result, college counseling services and administrations
are crucial to preventing suicide.
we’re talking about suicide among college students, generally
we’re talking about
mental illnesses,” says Dr. Laura Smith, Director
of Barnard College Counseling Services. Confirming Dr. Smith’s
comments are Solomon’s statistics from the National Institute
of Mental Health : 90-95 percent of suicides, especially at the
college age, are the result of mental illnesses, the most prevalent
being depression. Studies cited in Kay Redfield Jamison’s noteworthy
book on suicide Night Falls Fast (reviewed in this issue),
depressives are at approximately twenty times the suicide risk
of the general population. Those who have previously attempted
suicide are at thirty-eight times the risk: “Contrary to popular
myth, those who talk about suicide are the most likely to kill
themselves,” states Solomon’s book. Targeting these populations
can cut suicide rates.
Dr. Smith contends that peer support and student groups play an
invaluable role in raising awareness, de-stigmatizing the seeking
of help and helping others recognize depression in themselves.
There is less stigma attached to therapy than there once was,
Dr. Smith explains, but still not every one who needs help seeks
it. Some want to prove that they can handle the independence that
comes with college without help. Others, especially at highly
selective institutions, are used to succeeding on their own and
looking for help simply does not occur to them. For those adjusting
to college, or who are under academic or other forms of stress
it can be difficult to draw a line between what is an appropriate
response and what constitute symptoms of depression. In these
cases student groups can help by having students being open about
their experiences with counseling and referring students to the
services they need. Jamison writes of a young man who took his
own life, “Drew’s family, whose warmth and understanding of him
would have been, in a fairer world, more than sufficient to keep
him alive, could not compete with a relentless and ruinous disease,”
explaining that all the kindness and support shown to a suicidal
person is not necessarily enough. As Andrew Solomon points out,
“Illness of the mind is real illness…and it requires treatment.”
So what do college counseling services do once a patient is in
their hands? Both Dr. Smith and Dr. Paul Buckingham, Director
of Counseling Services at Brigham Young University (BYU) Hawaii
explain that there is no textbook response to how to handle a
severely depressed or suicidal patient. Each case must be evaluated
on an individual basis. Doctor/patient relationships remain confidential
unless the student’s safety is at risk. Students at both institutions
are encouraged to contact family members, if appropriate, and
generally they are willing. If it were necessary and appropriate,
family members could be contacted without consent of the patient.
If the situation calls for it, students can be hospitalized. Dr.
Smith observes that generally students who bring themselves in
know they are struggling, and in that sense they are better off
than those who are brought in by others. The latter tend to require
hospitalization more often.
are not equipped to be mental health centers,” says Dr. Buckingham
justifying the hospitalization of students. At BYU Hawaii suicide
is an honor code violation. Consequently, if a student is talking
about suicide and refuses treatment he or she can be forced to
leave the school in order to get treatment. In such a case acceptance
is guaranteed with reapplication provided that the student includes
a letter from a mental health professional stating that he or
she has been treated successfully. Hospitalization also has the
advantage of taking pressure off friends. Dr. Smith emphasizes
that although it is important for students to have peer support,
friends of depressed patients need to put their own well-being
Dr. Smith’s statistics show that around 23% of Barnard students
use counseling services (numbers went up after September 11th),
and Dr. Buckingham’s numbers show that at BYU Hawaii 8%-12% of
students do. Few of these cases are severe enough to require hospitalization.
Both Dr. Buckingham and Dr. Smith say that a large number of people
who come in complain of depression. The causes range from academic
stress to family problems to romantic problems, and at BYU Hawaii
where a large part of the student population is international,
adjustment difficulties. Both doctors say treatment for less severe
cases of depression vary. In some cases medication is suggested.
“We would never put a student on medication, without following
through with therapy,” says Dr. Smith. In other cases only therapy
The University of Illinois, Urbana–Champaign has a successful
suicide prevention program that follows up every suicidal gesture
or attempt with an incident report and four weeks of mandatory
assessment. Approximately 1,500 students have gone through this
program in seventeen years. None have committed suicide. Considering
the high risk that these students were at, this is a remarkable
Another program called Columbia Teen Screen, researched at Columbia
University under Director Dr. David Shaffer, has been successful
in high schools. The program has four steps: obtaining permission,
then completing a questionnaire. If the participant scores positively
on the first screening, they are more thoroughly assessed by a
computerized diagnostic interview called the Voice-DISC (Diagnostic
Interview Schedule for Children). The DISC allows for youth to
complete the interview independently and eliminates the cost of
having trained interviewers. Those who are identified by the Voice-DISC
as meeting criteria for a disorder are evaluated by a mental health
professional. The clinician may then recommend further evaluation
and/or treatment to the child and the child’s parents after discussing
the results. The advantage of this program is that it catches
young people before they attempt suicide thereby helping to predict
or prevent depression later in life. Dr. Ted Greenberg, a coordinator
of the program says, “it should be used in colleges”.
Programs like the University of Illinois’ and Columbia Teen Screen’s
only exist in a few communities. In 1997 Senate resolution #84
that declared suicide a national problem, passed unanimously.
In 1998 a similar resolution (House Resolution #212) passed unanimously
in the House of Representatives. The Surgeon General has also
made suicide one of his priorities. All these are signs that help
is on the way. Part of the senate resolution states, “the Senate
acknowledges that no single suicide prevention program or effort
will be appropriate for all populations or communities,” pointing
out how important it is for every community to take its own initiative.
Organizations such as the American Foundation for Suicide Prevention,
and the American Association of Suicidology have already been
established to provide such initiatives with the necessary resources,
and to encourage networking.#
Wallace is a student at Barnard College and an intern at Education
Update, Inc., P.O. Box 20005, New York, NY 10001.
Tel: (212) 481-5519. Fax: (212) 481-3919.Email: firstname.lastname@example.org.
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