Worried Colleges Step Up Efforts Over Suicide
December 3, 2004
By KAREN W. ARENSON
Nicole Thompson had been at Columbia University for only a
few weeks when she went out drinking with a group of
friends downtown last year and became separated from them.
She had skipped her medication for bipolar disorder. Now it
was 3 a.m. and, crying and in a panic, she called friends;
she told them, she said, that she "just wished the traffic
would take me out."
Although she made it back to campus safely, her friends had
already notified Columbia that they were worried about her.
For Columbia officials, it was the first clue that Ms.
Thompson faced any kind of mental health problems.
"I wasn't on Columbia's radar at all," said Ms. Thompson,
who is back on campus now after being forced to take a
Increasingly, college officials and mental health experts
have come to realize that many of the most vulnerable
students - the ones prone to self-injury and suicide - are
like Ms. Thompson: they never go near the counseling
centers or reveal anything about their experience before
college. As a result, colleges are stepping up efforts to
find them and to get them into treatment, sometimes forcing
them to leave temporarily.
The goal is to help students like Ms. Thompson. But
colleges have more at stake. Suicide - the second-biggest
cause of death among college students - can be costly,
injuring reputations and prompting litigation. The suicide
of a student at the Massachusetts Institute of Technology,
Elizabeth Shin, in 2000, and strings of suicides at New
York University, George Washington University and the
University of Illinois, have drawn wide attention. There
has also been a rise in lawsuits involving student
Ann H. Franke, a vice president of United Educators, a
company that insures 1,200 universities, colleges and
schools, said suicide prevention had risen in priority as
claims had risen; her company, Ms. Franke said, now has a
"handful" of claims, up from none six years ago.
"They can be very severe claims financially," Ms. Franke
said, "not to mention the emotional and reputational impact
they can have on a school."
In a closely watched case, the family of Elizabeth Shin has
sued M.I.T. for $27 million.
One study of suicides on college campuses, based on a dozen
universities in the 1980's, found a rate of about 7.5 per
100,000 students, which is about half the rate for young
adults not in college and represents about 1,100 suicides a
year for the entire college population.
Although there have
not been comparable studies since then, most mental health
experts say they believe the rate has remained at about
To address the problem, Emory University and the University
of North Carolina are inviting students to fill out
anonymous mental health questionnaires. Duke University is
asking faculty members to be alert to changes in behavior -
noticing, for example, when a student suddenly becomes
sullen or quiet, or stays away from class. Columbia, New
York University and Cornell now place counselors in
residence halls. The University of Illinois and the
University of Puget Sound in Tacoma, Wash., are requiring
any student who threatens or attempts suicide to attend
But the best way to reach these students remains unclear,
and students do not always welcome the intervention. Some
experts fear that forcing students to enter treatment or to
take a medical leave can dissuade others from asking for
help and discourage their friends from sounding the alarm,
even though students who take such leaves generally come
back and graduate.
The recent forced withdrawal of a freshman at N.Y.U. was
front-page news in the student newspaper, Washington Square
News. The student, Sue Schaller, told the paper that
although she had been briefly hospitalized for depression
and suicidal thoughts, she felt much better when she
returned to campus and wanted to stay in school, but that
the university would not let her.
An editorial in the newspaper called for the university to
"do everything it can, including requiring therapy and
regular check-ins, to ensure that troubled students who
wish to remain on campus can stay and that they pose as
little risk as possible," adding, "Pushing those students
out of the university community is not the answer."
In retrospect, Ms. Thompson, the Columbia student, said she
had mixed feelings about how the university treated her.
She said she still felt wounded by the process - she called
it a "charade" - that ejected her from school.
Even with things going smoothly, Ms. Thompson, whose dark
hair is tinted purple and who speaks with energy and humor,
said her mind sometimes wandered to what she missed last
year, while she was on leave, and to the possibility of
running into new trouble.
"I am so scared about screwing up," she said, "and of being
sent home again." [RG: The other side of grade inflation.]
Columbia officials declined to comment on Ms. Thompson's
case. They said that the university did not keep statistics
on how many students were forced to go home, but that there
were few of them.
For years, colleges and universities have been grappling
with a growing flood of students with histories of mental
illness. Most have expanded the number of counselors and
the hours they are available.
But now they are going further. Some are turning to the
Internet as a way to bring troubled students in for help.
The American Foundation for Suicide Prevention has
developed an anonymous online mental health questionnaire
and a program to steer troubled students to counseling,
which is being tested at Emory and the University of North
Carolina. Those involved say the initial results seem
At Emory, which started using the program in 2002, only 8
percent of the students who received the survey filled it
out, but 85 percent of those students were deemed at
moderate or high risk of suicide or other severe problems
based on their responses to the questionnaire. They are
encouraged to speak to a counselor on or off campus, or to
consult anonymously with a counselor online.
"The yield is relatively small," said Ann Haas, research
director for the suicide-prevention foundation. "However,
we are absolutely convinced that those kids would not have
gotten into treatment. We think we are reaching the right
Many campuses, including Duke and M.I.T., are asking
faculty and staff members and students to tell a dean or
the counseling office if they see students who show signs
of depression or potential suicide.
At Duke, when faculty members or parents relay concerns
about students to Larry Moneta, the vice president for
student affairs, he and members of the residence hall staff
check up on the students, sometimes surreptitiously.
"Many times I've called the residence hall staff and asked
if they can dispatch a paraprofessional to inadvertently
drop by a student's room as if it were a casual encounter,"
Dr. Moneta said. "I do that all the time."
After Ms. Shin's suicide, M.I.T. began running training
sessions for faculty members, departmental administrators,
athletic coaches, dormitory personnel, fraternities and
sororities to help them spot people showing signs of
problems - one of several steps recommended by a mental
health task force created after the suicide.
Cornell is making a special effort to reach out to Asian
and Asian-American students. Of 16 students there who have
committed suicide since 1996, 9 were of Asian descent. The
university created a task force to explore those students'
experience at Cornell and how to help them when they have
problems, since they do not use Cornell's counseling
services at the same rate as their classmates, said Susan
H. Murphy, the university's vice president for student and
academic services. Often when they do seek help, "they are
in real crisis," Ms. Murphy said.
Colleges are also leaning more heavily on students who show
suicidal tendencies to enter counseling. Several are
examining or adopting a program developed by the University
of Illinois at Urbana-Champaign, requiring any student who
threatens or attempts suicide to attend at least four
Paul Joffe, the program's director, said the results had
been good: all but one of nearly 2,000 students in the
program over 20 years remained at the university during the
counseling sessions, and none committed suicide. And
although the university has had suicides among students not
in the program - including six in the last academic year -
it says its suicide rate is about half of what it was
before the program started.
While some college officials question whether students
should be forced into counseling, others favor the
heavy-handed approach. The University of Puget Sound, one
of the campuses that recently began using the Illinois
approach, bluntly describes the program as "a public
statement that suicide is unacceptable here."
"We don't know what it is about that model that is so
effective," said Donn Marshall, director of counseling,
health and wellness services at Puget Sound. "Is it that
somebody stands up and says suicide is unacceptable? Or is
it that somebody says, 'I care'? Or is it something about
what happens in the four sessions with a psychologist?"
When Ms. Thompson arrived at Columbia last year from
Nashville, she had been struggling with bipolar disorder
and problems with drinking and drugs, and she had a
cabinetful of medications. She had planned to contact the
counseling service to find someone to talk to, but three
weeks into the school year, she had not gotten around to
it. She said she had arrived confident she could succeed.
"There was a big to-do before I went to school to ask my
doctors if I was ready," she said. "They all said yes."
What most put her off about the way Columbia handled her
case, she said, was the quick interview with a university
psychologist that she thought was intended to figure out
what she needed to do to stay at school, but that she later
learned was to decide whether she should be allowed to
She said she had been totally candid in talking to him,
because "I've talked to a lot of psychologists, and
realized that if you tried to butter them up, you don't get
the help you need."
But she said she did not believe the university had been
equally candid. "He worked for the school, not the
patient," she said. "If they don't tell you that, you lose
trust. The kids they are dealing with are smart enough to
understand the dynamic after the fact."
Margo D. Amgott, assistant vice president for health
services at Columbia, said the university tried to make
sure students understood that the interview was for the
university's evaluation purposes and even required that
they sign a document saying they understood.
Ms. Thompson said that while she did indeed signed papers,
she had had no choice, and thought that the decision to
stay or leave would still be up to her and her family. But
when she and her father talked about lining up support for
her in New York, they learned that it was not their call,
and she was given four days to move out of her room.
Being sent home to Nashville just three weeks into her
freshman year made her feel worse rather than better, she
said, and she ended up in a psychiatric hospital.
She said that now that she was back at Columbia, she was
doing well. She is majoring in anthropology and has a
late-night radio program, "Zombies vs. Ballerinas," that
features groups like Mogwai.
And while she is in regular touch with a college adviser
assigned to her, she has not sought psychological help,
either at Columbia or outside.
"Last year's treatment was so expensive that it has driven
my father into debt," Ms. Thompson said. "It makes me feel