Dr. Decipher: Delving Deeper into College Suicide

By Dr. John Janousek, M.D. Monday, March 15, 2010

There was a lot of interest in last week’s blog about college suicide.  Each death affects many, including family, friends, and acquaintances.  Parents are forever deeply scarred.

Each year around 1100 students take their own life despite increased awareness of the risk by colleges and mental health professionals. One Virginia college even had a suicide after it opened a special campus suicide prevention center.

It can be difficult to tell if a student is contemplating suicide.  Depression is always present, but it may be hidden, or of fairly new onset.  Other mental illnesses such as bipolar disorder or psychosis can coexist.

The actress Glenn Close, whose sister has bipolar illness, has started a non-profit organization Bringchange2mind.org to de-stigmatize mental illness. It also was founded to provide access to information about treatment and support.

Parents may not know the details of their child’s mental illness and medications. Federal HIPAA privacy laws prevent disclosure of medical information to anyone, even parents, without the patient’s consent, as students are legally classified as adults.

College is a unique and artificial environment.  It is a mix of classroom lectures and tests, communal living, parties, and young adults from all backgrounds coming together without firm structure, discipline, or routine (unlike the military). Competition can be intense. Independence and self-reliance must be learned and practiced, but it is easy for a student to become overwhelmed, depressed and to feel lost.

Writing about college suicide brought to mind a lot of questions:

1. Do colleges orient and educate incoming freshman about depression, suicide, and mental health resources available to them?
2. How much responsibility should schools bear for student’s mental health? Aren't they primarily educational as opposed to social institutions?
3. Should mental illness, especially depression, be treated more aggressively in high school prior to entering the stressful college environment?
4. Should parents be able to more easily obtain information about their child’s medical treatments and condition while they are in college?
5. Is there more we can do or is a certain percentage of depression and suicide inevitable?
6. Are there any psychological screening tools, either written testing or by interview, that can be used to identify individuals who are at risk?
7. Should accommodations be made in schools for student's with mental illness, and if so what are they?
8. Are there any local support groups available?

Let’s pull back the shroud surrounding this complex problem. We should bring this issue out in the open and have frank discussions to better prevent and treat mental illness in this vulnerable population.