Colleges that don't flunk mental health?

College Search & Selection
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<p>In light of this rather disturbing article on "How Colleges Flunk Mental Health" <a href="http://mag.newsweek.com/2014/02/07/colleges-flunk-mental-health.html"&gt;http://mag.newsweek.com/2014/02/07/colleges-flunk-mental-health.html&lt;/a&gt;&lt;/p>

<p>I thought it might be useful to have a discussion of colleges that <em>don't</em> flunk mental health -- colleges that don't punish students for being in crisis, and are able to provide appropriate help and support, or point students in the right direction if they can't. </p>

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<p>I just want to comment on this: as someone who has worked in student affairs and has been involved with this kind of thing directly, this is not “punishment.” (FWIW, I don’t work in student services anymore, so it’s not like I’m defending my employer.)</p>

<p>I’m not saying that some universities can’t do better on mental health issues - most could. I’m also not saying that many universities are just as or more concerned with their public image as they are with their students’ mental health. And a lot of the university tales in this article (UCSB and Sarah Lawrence’s stood out, as well as the sexual assault example - I didn’t read the whole thing from beginning to end, though) were handled absolutely abysmally and show serious flaws in the system.</p>

<p>But I do take issue with the idea that some of the steps some universities take are “punishment.” In many cases, they are for the protection of the student involved.</p>

<p>In my old position, I was on crisis call for the university. If a student was suicidal or severely depressed during the evening hours when the university mental health center was closed, I was automatically called. I sat down and had a conversation with the student (sometimes for hours, but I didn’t mind - it was my job and I liked helping students). If the student seemed like they were in imminent danger - had explicit suicidal thoughts, had a plan, or had already attempted to commit suicide - I was required to call Public Safety and escort the student to the emergency room; they didn’t have a choice. But in my experience, it wasn’t because we didn’t want a poor public image; it was because we didn’t want our students to die! Public Safety was well-trained and very friendly and helpful to the students involved. In fact, I often got emails from the students (or their friends, who were usually the ones who called me) in the next few days thanking me for my help.</p>

<p>This student says that his experience overdosing on antidepressants just made him sleepy, but not all students are so fortunate. Besides, that student is in acute mental health crisis. If that doesn’t work, what’s to say he won’t try something more extreme? Suicidal students are severely depressed and they need help. If a kid fell down the stairs and hit his head, or got hit by a car, wouldn’t you want the university to send him to the hospital’s emergency room?</p>

<p>I have also had experiences where we have prohibited students from returning to campus. It’s usually pending a mental health screening and a determination that the student is healthy enough to return and continue classes. Sometimes, the mental health professional involved (not always someone affiliated with the university) makes the determination that the student needs to take a medical leave for a semester. Again, universities do not want students to die. Mononucleosis or a broken leg are not comparable situations. Clinical depression is literally a life-threatening illness that can often be exacerbated by stressful college experiences. The kid in the example given is a student who tried to kill himself and then return to class just three days later. If a student had a stroke or a heart attack or a sickle-cell episode…would they be trying to return to class 3 days later? Likely, no.</p>

<p>Antidepressants also take a long time to work and need to be monitored over time. It’s great that he was feeling better just a week later, but that isn’t common - and antidepressants can have ups and downs. This student may have felt better a week later and then another week could go by and he could feel horrible.</p>

<p>Involuntary commission (or a 72-hour hold) is NOT PUNISHMENT. You can only get put on a 72-hour hold if you are an immediate danger to yourself and/or others - e.g., you tried to kill yourself, tried to hurt someone else, or threatened to do either or both.</p>

<p>College counseling centers are also not equipped to provide routine care for students who are severely mentally ill, just like they’re not equipped to provide routine chemotherapy or physical therapy. But it’s not that mentally ill students aren’t allowed to attend college - many do, including at the schools named in the article. However, students need time to 1) re-stabilize and 2) put a plan in place to care for their health, like a regular therapist nearby their campus and/or medication necessary to remain stabilized.</p>

<p>NOW, I will say that the way the UCSB hall director handled the student who cut herself was ABYSMAL and he should be fired. I have also NEVER EVER heard my university asking a therapist to waive confidentiality to provide “weekly updates” to administrators - in all of my experiences, we take confidentiality VERY seriously. We can’t even tell RAs if they have a student with a mental disorder on their hall, and I’ve been in a couple of situations in which students had to take medical leave from their floor and the RA couldn’t know why. I, as a hall director, didn’t even know which students are mentally ill on my halls and usually when a student goes on medical leave I didn’t know why they’re leaving, either. Universities should not try to violate students’ medical confidentiality - the only people who need to know are the ones directly involved in the students’ care.</p>

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<p>How does the school handle it if the issue can affect how the RA handles his/her job, meaning that the affected student’s behavior can cause the RA to become involved, and the RA’s actions could affect the safety of the affected student and other students?</p>

<p>Also, the article says that “30 percent of college students reported feeling ‘so depressed that it was difficult to function’ at some time over the past year.” Have mental health issues become much more common in recent years? Or have they always been around at such high rates (and probably also among people not in college), but just reported or self-reported more now than before?</p>

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<p>Word is more MI is showing up on campus (not just better reported). No source to cite. Sorry. </p>

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<p>“Word is” without any source cited? I would like to know whose word it is.</p>

<p>We are asking a lot of our universities if they’re supposed to function as mental health care facilities as well as institutions of higher learning. I feel it’s reasonable to provide diagnostic help, referrals for pharmacological and other therapeutic help, and on-campus therapy for students in need. But I don’t see how it’s discriminating against suicidal students or students in crisis to require them to take a leave. If the school can’t guarantee that student’s safety through 24/7 treatment or monitoring, isn’t that more responsible? </p>

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<p>I think it’s more the people that are dealing with the issue at the university,than any university, in particular. I know many parents so disappointed at how some issues were handled, and, yes, they could have been better handled even with HIPAA restrictions in force. It’s not the strong point of college. Your kid is an adult and though there are some amentities and half way house like protections, it’s not like a boarding school where the kids are underage. </p>

<p>My one son’s college, a small LAC, had a number of professors that took interest in their students’ welfare. My son’s roommate chose to live in a apt alone off campus sophomore year, and went into a depressive funk. When he missed class, the prof actually tracked him down,and got him help. To this day, he and my son credit that rescue for him getting back on track so quickly. </p>

<p>But then my other son went to a large state uni, not at all known for personal attention, and he got it in abundance. Without the direct intervention and attention of his dept chair, he would not have graduated in 4 years, likely not at all. I give the man every accolade, for going above and beyond. Actually the support services there are in place, and look good to me, but without someone goose stepping a kid to take advantage of them, they tend to go unused. </p>

<p>So the striking difference is made more by someone capable, showing enough interest and taking enough trouble to get the student and the services offered together. Like the uncashed check to be deposited sitting next to a bounced check notice, the services there, and the student not using them is what often causes unfortunate outcomes.</p>

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<p>@juillet I see ‘involuntary commission’ as prison without due process. I think only the highest level of proof would justify that and that in every single case a trial on the process should be necessary to prove the unusual level of proof of danger TO OTHERS. No one went to the university for them to have control of their freedom of movement and at very minimum if parents are willing to take the kid back there should be no possibility of a university having this power.</p>

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<p>@julliet I don’t even necessarily object to involuntary commission. But in many of these cases it sounded like the students were barred from returning to campus even after they were “cleared” by mental health experts as not being a danger to themselves or others. But I agree with @collegevetting also that this should be a last resort, and if parents are willing to take responsibility for the student instead, it should be avoided.</p>

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<p>I want to thank the OP for bringing this article to my attention. As a professor I’ve seen a lot of students who’ve complained of mental illness and helped some of them to recover by walking them over to the counseling center. It takes very little time and usually is a pleasure to have helped someone in this way. I’ve never once had a student tell me that the university where I worked ever treated him or her in anything like the dehumanizing ways some of the students in this article have reported. I am not questioning the accuracy of the student’s experiences but rather the suggestion that these policies are found on every campus. I think rather that there are people in positions of authority on some campuses whose judgement cannot be trusted to do what is right for the mentally ill student or the campus. </p>

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<p>OK, here’s one source:
“Increase in Severity of Mental Illness Among Clinical College Students: A 12-Year Comparison” -
John C. Guthman, PhD, and Laura Iocin, PhD, Hofstra University; Despina D. Konstas, PhD, Hellenic American University, Athens, Greece - 2010</p>

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<p>RAs are trained to handle situations based on the behaviors and actions that actually happen, not based on perceptions that arise based upon the student’s mental health status. For example, a student with suicidal ideation is treated the same regardless of whether we know she has a history of depression or not, at least on the RA’s end - the RA always calls up to his/her supervisor (my level), who would then call up to MY supervisor, and the student is escorted to the hospital. The mental health guidelines about how to deal with a suicidal person don’t change based on that person’s diagnosis or mental health history.</p>

<p>If a student feels uneasy around their roommate because of vaguely threatening or strange behavior, we help that student get a room change (our policy is no student should feel uncomfortable or threatened in their own room). I can’t think of a single situation in which it was necessary for the RA to actually know what the student’s diagnosis was; they handle the behavior at the point of crisis.</p>

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<p>I personally don’t know - I think they were just more undiagnosed in the past, but with increased awareness of both mental health in general and the impact it has on student performance particularly, more students are getting diagnosed. The rise of drugs available to deal with them also makes them more likely to be diagnosed.</p>

<p>As a side note, when I was working for student affairs I got lots of calls from professors and advisers late at night who were concerned about their students. I was always really touched. Sometimes we would get emails, too. The adviser would’ve either just met with the student or gotten an email from the student that really concerned them, and they’d find our number on the website or from someone else and call.</p>

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<p>It’s not. Not legally, anyway. And it happens off-campus, too: college students are not the only ones susceptible to this. People who are not in college can be placed under 72-hour-holds, as well. I think the idea of this as “prison” comes from people’s absolutely dismal ideas of what mental health care is like. It’s not like these people are being locked in a padded room and fed through a slot in a door. They’re in hospitals, under the care of psychiatrists and mental health nurses who are trying to get them to a place in which they don’t feel like killing themselves or hurting others. If you wait to go to some kind of “trial” it may be too late; the student may have already killed themselves.</p>

<p>I have no children, but I do have other family members. I’d rather them be held involuntarily in the hospital for 3 days than dead.</p>

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<p>`@julliet and families who wouldn’t take the kids back would have input. And actually, at least in some states it is in fact a breach of due process under law, but it depends on the duration. Personally, I think it is in all cases, under the Constitution. Since we are talking about due process, the question is whether a student who ISN’T a danger to themselves or others should be involuntarily committed by whim of a bureaucrat without actual evidence or showing of any proof or any ability to challenge the need for it and put up a defense. </p>

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<p>collegevetting, there’s too much huffing and puffing here. no bureaucrat is going to commit anyone against their will. only physicians can do that in the states I’ve lived in. I have some experience trying to commit a loved one to a hospital, and it is no easy thing even when I’m holding the power of attorney and the person has a history of illness and hospitalization. The docs want to see with their own eyes evidence of the behavior that the family is reporting before they’ll involuntarily commit someone, and often times that evidence just isn’t there when you get the person to the docs. the physicians I’ve dealt with have a healthy respect for the rights of the mentally ill and a strong desire not to be sued for committing them and certainly seem disinclined to accept anyone’s authority but their own.</p>

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<p>* `@julliet and families who wouldn’t take the kids back would have input. And actually, at least in some states it is in fact a breach of due process under law, but it depends on the duration.*</p>

<p>I am speaking specifically about a 72-hour hold, the legal mechanism that most states have for involuntary psychiatric hold. It’s called something different in different places and it’s sometimes longer, but rarely shorter.</p>

<p>The question is whether a student who ISN’T a danger to themselves or others should be involuntarily committed by whim of a bureaucrat without actual evidence or showing of any proof or any ability to challenge the need for it and put up a defense.</p>

<p>No, it’s not.</p>

<p>First of all, we’re not talking about involuntary commitment. That’s different from emergency hospitalization for psychiatric reasons, or the “72 hour hold.” A 72-hour hold is more akin to being taken to the hospital because you got hit by a car than prison. If you got hit by a car and you couldn’t move your spine without never being able to walk again, the hospital would keep you there too. The difference is that you are able to clearly recognize the danger, while many people in mental crisis are not.</p>

<p>Involuntary commitment is a completely different animal, and MUCH MUCH harder to get. Involuntary commitment is when a person is committed to a psychiatric ward or hospital for a longer period of time to get more than emergency care. There’s an in-patient version (where you have to live in the hospital) and an out-patient version (you can live at home but you have to come to treatment for specified period of time on specified days). A 72-hour hold is just to stabilize you and get you past the point of danger. Involuntary commitment is more for ongoing care.</p>

<p>Second of all, this part - “without actual evidence or showing of any proof” - is completely inaccurate. In all of the cases in the article the student escorted to the hospital had done something that provided evidence that they were at least a danger to themselves. Swallowing an entire bottle of pills is a pretty clear indication that you’re trying to kill yourself. These students WERE a danger to themselves, even though they thought they weren’t.</p>

<p>Furthermore, most depressed people just want to be left alone because they have disordered thoughts. They think they are worthless; they don’t think they are worth saving; they thing they bring problems to everyone around them; they often think that their pain is unsolvable and that they themselves are unlovable and unable to recover. OF COURSE they don’t want to go the hospital. You cannot force a 72-hour hold or get someone committed without evidence/proof that they are in danger.</p>

<p>Thirdly, we’re not talking about the government putting you in McLean. However you may feel about this, private organizations do have the right to determine who attends their institutions. So a private university is well within their legal rights to insist that a student see a psychiatrist before returning to the school (although not to demand private medical records). Whether that’s morally right is a different story.</p>

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<p>yes, it was a 72 hour hold with which I’ve had experience. Even that physicians have been very reluctant to issue, in my experience.</p>