The suicide test
Alarmed by recent reports of student depression and fearing malpractice lawsuits, colleges are struggling with ways to treat suicidal students -- including expelling them.
By Sarah Elizabeth Richards
March 9, 2007 | On a chilly afternoon in the fall of 2005, "Jane," a 19-year-old junior at Brown University, sat on her dorm bed and decided to follow through with her plan to kill herself. In despair over a psychology paper she couldn't finish, and unable to shake her choking depression, she swallowed, two by two, the 120 pills she had stashed -- the antidepressant Lexapro, Tylenol and sleep aids. When she failed to pass out, she got nervous and asked a friend to take her to the hospital, where doctors gave her charcoal to soak up the drugs.
Somehow, the school learned what Jane had done. So when she returned to campus a week later, a Brown dean and a campus psychologist called her into a meeting with this message: "We need to talk about where you're going from here." They meant it literally -- the school would encourage her to take a leave of absence.
Overwhelmed by a rise of troubled students in the past several years, colleges are dealing with mental health issues with renewed intensity. A 2006 survey found that more than 9 percent of college students seriously contemplated suicide in the previous year. Further, college researchers estimate that more than 1,000 kill themselves each year, making it the second leading cause of death among college-age men and women (after auto accidents). Many colleges are responding by beefing up counseling centers, offering free therapy sessions and forming support groups on everything from body image to stress management. But they're bewildered about what to do with students like Jane who quietly collect pills and attempt suicide under their noses. Increasingly, they are worried about their own institutional liabilities and policies regarding troubled students.
The main reason is that in 2002, the parents of MIT student Elizabeth Shin filed a $27 million wrongful-death lawsuit against the school after their daughter set herself on fire in her dorm room two years earlier. They claimed that the school's counseling services didn't adequately respond to her depression. Last spring, MIT settled for an undisclosed sum. Similarly, a Virginia federal court recently found that Ferrum College had a legal "duty of care" to a student who hanged himself on campus after his girlfriend showed a letter in which he threatened suicide to a resident assistant and other college officials.
To try to prevent suicides, colleges are taking the usual precautionary steps: controlling access to prescription drugs at medical schools, keeping track of lethal substances like cyanide at chemistry labs, blocking rooftop access to tall buildings. In 2003, NYU installed plastic windows on open-air crosswalks in Bobst Library after two students jumped onto the marble floor below. College counseling centers are also training dorm supervisors and campus staff to recognize the warning signs of suicidal behavior.
But universities are taking more drastic -- and controversial -- measures to head off legal trouble. Many schools are drafting or enforcing rigid withdrawal policies that could boot mentally ill students off campus at the first sign of worrisome behavior. Others, such as the University of Illinois and the University of Washington, are requiring students who even talk about suicide to meet with counselors or take medical leave. (In 2004, students from NYU and Columbia accused the schools of forcing them to take leave for seeking treatment for depression.) Some colleges, fearing malpractice lawsuits, have considered eliminating counseling services altogether.
The idea that universities are somehow responsible if a student takes his or her own life may seem preposterous -- akin to suggesting they're to blame for "freshman 15" weight gain or too many tequila shooters. In fact, in the '60s and '70s, courts declared that colleges were no longer in loco parentis, or surrogate parents. Rather, 18-year-olds were to be considered full-fledged adults who were responsible for their own behavior. That's news, however, to some of the current generation of "helicopter" parents, who expect colleges to be involved in nearly every aspect of their children's well-being. "When anything goes awry on campus, parents will sue," says Sheldon Steinbach, a higher education attorney with Dow Lohnes, in Washington, D.C.
So just what is a school's legal obligation to try to prevent student suicide? That's still up for debate, say legal experts. But one thing is clear: If a student behaves in a troublesome way that threatens the student or others, the university must respond, says Steinbach. "To have knowledge about a potential danger to the community and fail to act is opening an invitation to liability," he says. But short of referring students to counseling, there's no established protocol on what that response should be. Should schools call students' parents? Should counselors alert administrators about a despondent student? What about teachers or dorm staff?
"This is something that every university mental health center is really grappling with," says Todd Sevig, director of Counseling and Psychological Services at the University of Michigan. Schools must navigate confusing privacy laws that vary by state. "Some places notify parents when a student is in trouble and some only in extreme circumstances. A whole bunch are in between," he says.
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