Thursday, April 19, 2007

The College Mental Health Crisis

Tears streamed down my face as I watched the news last night and saw clips of the students and professors who had been killed. To think about so many people unnecessarily losing their lives because of the actions of someone who was delusional, sick, unhappy, angry, isolated, and violent is incomprehensible to me.

How does this happen? I wondered. Earlier in the day, I had read an article in the Los Angeles Times, A Puzzling Start to a Deadly Day, in which I learned that Seung-hui Cho had been a silent bully for quite a while before he exploded like a time bomb. He'd frightened other students in his classes by refusing to make eye contact with them or talk to them. In an English class, he took their photographs with his cell phone, and everyone was so uncomfortable with his behavior that they stopped coming to class. His professor talked to the department chair and she tutored him privately so that the other students could resume their studies. At the end of the semester, she gave him an "A," not because he deserved it but because she was afraid of him. She recommended that he get counseling but he didn't.

Last night on MSNBC Countdown with Keith Olbermann, I learned that Cho lived in a suite with four other students and they never talked. A roommate from last year said Cho preferred to communicate by instant messaging--even with the kids who lived with him. In December of 2005, he had been evaluated as incompetent by a judge who had said Cho was dangerous to himself and to others.

From everything I've seen and read, Cho was totally alone in a community of 25,000 students. How does this happen? When should college administrators have intervened? When should they have determined that his behavior wasn't acceptable? When should they have demanded he receive help in order to remain on campus?

How do parents who are from a culture so very different from ours, recognize that their child is in dire straights? How do they seek help for an illness that is so stigmatic and "shameful" in a culture where "shame" is a "dirty" word?

In their 2005 book, College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It, authors Richard Kadison (he's chief of mental health services at Harvard) and Theresa Foy DiGeronimo discuss their concerns about the serious mental health problems on campuses throughout the country. They note statistics showing that one in ten students say they have seriously considered suicide. They outline the stressors that students face, the self-destructive behavior they engage in, and they recommend ways for dealing with these problems.

In the February 28, 2007 issue of The Cornell Daily Sun, college president David J. Skorton has written an article, "Facing Mental Health Issues: Looking Out for Each Other." In it, he expresses his concern for the "level of stress and for the mental health issues that affect our campus." He talks about student suicides and notes that "the rate of referral and self-referral for mental health services at Cornell has risen briskly...increasing 128 percent in the last eleven years."

This is true across the country. In a 2006 piece on Fox News entitled "Colleges Struggle, Innovate to Meet Mental Health Needs of Students," Dr. Trisha Suppes, director of the Bipolar Disorder Research Program at the University of Texas Southwestern Medical Center in Dallas, is quoted as saying "We know that psychiatric distress among college students is very high. It's in the past five years that an effort for greater awareness has been made."

"According to the 2005 National Survey of Counseling Center Directors--which represents the responses of 366 college counseling centers across the country--90.3 percent of directors reported a rise in the number of students with severe psychological problems, and 95 percent reported an increase in the number of students coming to counseling who already are on psychiatric medication. Directors overall reported that more than 43 percent of their student clients have severe psychological problems."

Statistics from Active Minds, a mental health student advocacy program on some college campuses, are staggering. "Young adults aged 18-24 have the highest prevalence of diagnosable forms of mental illness in the whole population at 27%. Half of all adults with depression report onset before age 20. 75 % of people with schizophrenia develop the disease between the ages of 15-25."

While one can only hope and pray that there will be no more Seung-hui Cho's, there is clearly a mental health crisis on college campuses, which needs to be addressed. Like everyone else, I probably have more questions than answers. But I do believe that as long as "mental illness" is stigmatized, students will not get the help they need.

If we continue to view every problem as "pathological," rather than understanding that in some cases, students just need help in adjusting to college, or they need to learn stress management techniques, or they need psychoeducation, or they need to learn coping skills, we will miss out on opportunities to help them in a non-threatening environment.

In other cases, students have more serious problems. They may need to remain on medication or have medication prescribed for them. They might require regular counseling sessions and participation in support groups. It might be best for them to take time off from college in order to regroup and recover.

In all cases, mental health must come out of the closet. Just as we teach our children how to take care of their physical needs, we need to teach them how to take care of their emotional needs. In a perfect world, we would address mind-body issues together rather than separating them. Until that happens, we must teach our children that it's important to seek help--whether for a physical or psychological problem. And we must teach them to help others in need as well.

As the parent of a 17-year-old son who will be going away to college in the fall, I cannot begin to imagine the pain and sadness that the parents of the slain Virginia Tech students are feeling. And I am certainly not excusing Cho's behavior in any way. I believe he's totally responsible for his actions.

But I do agree with David J. Skorton, the president of Cornell University, who wrote the following words last February, "All of us must acknowledge our interdependence and share responsibility for our own and others' health and well-being...When we are aware of someone who is in distress, we demonstrate compassion when we extend ourselves to that person, rather than ignoring the need."


marja said...

You did a lot of thorough research to prepare this post and I thank you for that.

I agree with you that we need to be open and discuss mental illness without stigma in the same way we discuss other illnesses. We need to do away with the shame people feel about being diagnosed with such illnesses. Only then will they feel less fear about getting the help they need.

Well done, Susan. And once again, thank you for the work you did on this.

luckymud said...

Good work, but woah - I'm not sure the following quote fits in with the rest of your research:

"How do parents who are from a culture so very different from ours, recognize that their child is in dire straights? How do they seek help for an illness that is so stigmatic and "shameful" in a culture where "shame" is a "dirty" word?"

None of the studies you reference indicate the presence or involvement of parents, particularly parents whose culture is "so different" from "ours". In fact, don't the studies imply that parents of American origin are just as likely to have problems recognizing the problems of their college-aged children? I don't believe it has anything to do with the parents being from a "different" culture. As the studies show, "shame" is a dirty word in the North American culture as well.

Bipolar Writer said...
This comment has been removed by the author.
Bipolar Writer said...

Dear LuckyMud,
Interesting question. I'm not sure that I'm wrong but you do bring up a good point. Having researched mental health grants for different populations in Los Angeles (for a client), I believe I am right that it's a problem within the Asian community.

The National Institutes of Mental Health is certainly concerned about the disparity in mental health services for underrepresented groups. See following link.

According to a unit of a chapter by Dr. Stanley Sue at the University of California at Davis, it's a problem. "For many Asian Americans, cultural attitudes and beliefs must be considered in the analysis of service utilization. Particularly important is the concept of "shame" or "face." "Haji" among the Japanese, "Hiya" among the Pilipinos, "Mentz" among the Chinese, and "Chaemyun" among the Koreans are terms that reveal concerns over the process of shame or the loss of face (Sue, 1994)."

And I'm including another link as well. It's on the Effects of Psychoeducation for Korean Americans with Mental Illness.

I'm sure there are more recent studies but I don't have the time to look them up.

However, I do agree that seeking help for mental health treatment isn't easy for anyone.

P.S. I'm having difficulty giving you the proper links but maybe this time it will work.

BamaGal said...

Thank you for such a wonderful post....all the time spent in the research--- MH consumers/survivors must speak out to educate others

and thank you for all the great links in the post and in the comment section

Jo said...

Very impressive post. I'm worried about the same thing, and in particular how mental illness is being portrayed in the media, lumping me as a person with mental illness in with him in some way. I hope college students who need help won't hesitate to ask for it despite the way mental illness is being portrayed.