After Virginia Tech; A Tragedy Showed the Risk of Underestimating Mental-Health Problems. Now Schools Are Intervening Sooner

Article excerpt

Byline: Daniel McGinn (With Joan Raymond and Samantha Henig)

He displayed all the signs of a young man headed for trouble. Professors raised alarms over his violent writings. Roommates worried about his isolation and lack of friends. Around campus, his creepy attempts to befriend female classmates led authorities to hospitalize him for a psychiatric evaluation. But despite all the warning signs, administrators at Virginia Tech weren't able to find a way to help--or stop--Seung-Hui Cho before his murderous rampage left 33 dead, including himself.

The Virginia Tech tragedy in April added a violent new data point to an ongoing debate over whether colleges are doing enough to help mentally ill students. By all accounts, schools are dealing with more students with emotional problems than ever. In a 2004 study, 8.3 percent of Penn State undergraduates reported having taken psychiatric medication (including drugs like Ritalin) before they came to college, 22 percent had received counseling and 1.6 percent had been hospitalized over psychiatric issues. National surveys also suggest that college students suffer high rates of depression. According to a 2005 survey by the American College Health Association, four out of 10 college students said that at times they felt "so depressed it's difficult to function." Ten percent said they'd "seriously considered suicide"--which remains the third leading cause of death among college-age Americans (behind car accidents and homicides), according to the American Association of Suicidology.

Health-care professionals cite various causes for the distress. Some observers blame added pressure on today's adolescents--including the anxiety that can accompany college admissions. Others say college students are now less resilient, since today's "helicopter parents" have often been more involved in their teenage lives than was typical a generation ago. But the biggest factor, most experts believe, is that thanks to better diagnosis, treatment and medications, children with mental illnesses are more able to attend college. For parents of children who've already experienced emotional problems--and even for those who haven't--getting a handle on how schools deal with these issues is becoming another part of the college search.

Parents are right to be concerned, since some university mental-health centers are facing strains. In the past decade, many colleges have beefed up their counseling centers, but it can still be hard to keep up with student needs. In 2001, the counseling office at the University of Virginia had 24 one-hour psychiatrist appointments available each week; earlier this year it had 80. Still, like the staffers at most campus counseling offices, those at Virginia must typically limit their therapy to eight or nine sessions. "We focus on brief treatment and stabilization," says psychologist Russ Federman, UVA's head of counseling. "Once a student's initial needs are met, we refer them into private [counseling]."

At the majority of colleges, the most serious cases--particularly those requiring hospitalization--are usually referred off campus. The number of students who require those interventions is growing. Last year, the typical college hospitalized eight students for psychiatric reasons, up from five in 2001, according to an annual mental-health survey conducted by University of Pittsburgh education professor Robert Gallagher. But even when they're treating more students, counselors can have a difficult time actually preventing suicides. Out of 154 suicides reported by the colleges in Gallagher's survey, 82 percent of the victims had no contact with the school's counseling staff beforehand.

That so many troubled students never walk into the clinic is a key reason colleges are spending more time focusing on getting faculty and fellow students to identify disturbed students--and to understand how to work together to get help. Cho's case shows how important this is: while individual Virginia Tech faculty, roommates and administrators recognized aspects of his troubling behavior, no one had enough information to connect the dots and understand the extent of his problems. …