Lost On the Campus

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AP

Sinedu (left) and Ho—were they both victims of negligence?

Thoughts of suicide haunted Anita Rutnam long before she arrived at Syracuse University. The Winchester, Mass., teenager had a history of mental illness and had even attempted to kill herself. During her junior year of college, she tried again. On a February morning in 1998, just days after a campus counselor recommended she be hospitalized for her suicidal tendencies, Rutnam threw herself off the eighth floor of a Syracuse dormitory and fell 90 ft. to the patio below.

Miraculously, she survived the plunge. But three years later, Rutnam still feels the effects of that day. She walks with a limp, has not been able to finish college — and is suing her former school for malpractice and negligence. Her suit, which is awaiting trial, asserts that, given the campus counselor's advice, school officials should have done more to prevent her suicide attempt.

This incident and others have thrown a spotlight on an issue that is causing growing concern in dorm rooms and student centers. Are colleges providing adequate care for students who may be struggling with a range of mental illnesses? In the Syracuse case, a spokesman for the school contends, "The university tried repeatedly to help Anita, and we felt that they acted appropriately." But lawyers are busy there and elsewhere.

After accidents, suicide is the second biggest killer of kids in college. And while the number of students who kill themselves on campus is no higher than that of 18-to-24-year-olds in the general population, a series of sensational incidents has raised the question of whether troubled students are getting proper attention.

Last year alone, six Columbia University undergraduates or recent students died in incidents linked to clear or presumed mental disturbances. Among them was Kathleen Roskot, a sophomore stabbed to death by her boyfriend, a Columbia dropout, who later killed himself by jumping in front of a subway car. At the Massachusetts Institute of Technology, four students have committed suicide in the past three years. And Harvard University is still dealing with the fallout from a grisly 1995 murder- suicide in which a female student, who was feeling rejected by her roommate, stabbed her to death and then hanged herself.

So what are the schools' responsibilities to at-risk students, particularly those who may be genetically predisposed to mental illness? College can be a breeding ground for psychiatric problems. Poor eating habits, irregular sleeping patterns and experimentation with drugs and alcohol — especially combined with the academic stress of college life — may all play roles in triggering mental problems. Additionally, many of the major psychiatric illnesses, including depression, bipolar disorder and schizophrenia, often do not manifest themselves until the late teens or early 20s.

Two decades ago, kids with severe forms of those illnesses may have been too sick to go to college. But with the advent of antidepressants and mood stabilizers like Prozac and Zoloft, many of these students can thrive on campus. College counselors say the number of students requesting mental-health services has climbed considerably in the past decade.

"The very effectiveness of modern treatment means that a lot of people who never would have made it into college are stable enough to go to universities," says Kay Redfield Jamison, a psychiatry professor at Johns Hopkins. "(Colleges) are dealing with a lot of kids who are very sick."

Campus counseling centers are, as a result, more overburdened than ever before. Designed primarily for short-term care, many of the centers, understaffed to begin with, are then hobbled with more patients than they can accommodate in already-slim time slots. "You have maybe 10 to 15 minutes per student, and it's very frustrating," says Nancy Schulte, a social worker at Virginia's George Mason University. "You barely have time to ask basic questions." Many students are referred off campus for treatment, and the college's counselors may lack the time — or the right — to check on them.

That was apparently the case with Daniel Shuster, a Brown University freshman who became depressed after his roommate died in a car accident. When Shuster sought help on campus, a Brown therapist gave him the names of four off-campus counseling providers, and Shuster chose a psychologist whose specialty was eating disorders. Two years later, Shuster fatally shot himself in the bathtub in his apartment. His mother, Susan Klein, sued Brown in 1993 for making a negligent referral. Last summer a Rhode Island Superior Court jury cleared Brown of any wrongdoing, saying its actions were not the direct cause of death. Klein is appealing that decision.

Some students blame not only inadequate counseling but also unsupportive campus environments for undergraduate mental-health problems. At Columbia, students complain about days-long waits for counseling appointments. One sophomore, who saw a fellow student, Andrea Melendez, fall eight stories to her death last month, was unable to do homework afterward. Yet he was denied an extension for a major paper due the next day. "I was told I'd had two weeks to work on it," he told Time. In a recent editorial, the Columbia Daily Spectator demanded greater sensitivity for students' needs. "Students receive psychological support from a system that seems visible only after the death of a classmate," it said. "We need to look at whether there is enough counseling available before the tragedy to deal with the normal rigors of a Columbia day."

Some schools are taking these concerns to heart. In 1999, Harvard commissioned a broad study of its counseling services, which resulted in a larger budget, shorter waiting times for appointments and an information campaign aimed at helping faculty members spot troubled pupils. Dartmouth College, where the number of students admitting to psychiatric problems rose tenfold in the past three years, recently held a symposium on psychiatric health. And Columbia University officials, while declining to comment on any specific incidents, citing privacy laws, say counseling services and residence-life programs intended to support undergraduates have been substantially upgraded in the past five years.

Legal experts say it's still unclear whether colleges can be held liable for failing to help students like Anita Rutnam. A key issue is whether school administrations are expected to act in loco parentis. Unlike a parent-child relationship, "there is no special relationship between university officials and a student that imposes duty (to protect students)," contends Jerry Meek, a Dallas-based malpractice lawyer. Without proving that such a duty to students exists, it will be difficult for any plaintiff to claim successfully that it was breached.

But for Susan Klein, Brown's responsibility to her son was unequivocal. "When you send your kid off to college, you say, ‘You're on your own,'" says Klein, an education professor at Indiana University. "But when a student cries out, there should be a set of mechanisms whereby the right people learn about it." Others point out that parents must play a role too — by checking out a college's psychological services in advance and by not putting too much pressure on kids. Says Ed Hu, college counselor at Harvard-Westlake, a Los Angeles prep school: "They're just pushing their kids, causing the stress, not aware of the toll."

In the end, students must realize they need help and seek it out. "There are so many services that are here for us," says Celine Goetz, a Columbia sophomore, "but you have to come to them." Yet even in the age of Prozac, schools are discovering that some students need to be met more than halfway.

WHAT STUDENTS SHOULD DO
By Eugenie Allen

Coping with mental illness can be an especially tough assignment for a college student. But it can be done. Here are some survival tips from people who have been in the same situation:

Get professional help.
If you fear that you are a danger to yourself or others, head for the nearest emergency room. Otherwise, visit your college counseling center. Ideally, the staff should be able to screen for mental illness, prescribe medication and offer short-term treatment — or refer you to someone who can. But if your college's center falls short, look elsewhere. Keep in mind that for hospitalization or skillful long-term treatment, you'll probably need to go off campus anyway.

Confide in people.
Forget about the stigma. A few people need to know what you're going through so they can help. For example, a recent college graduate with bipolar disorder got extensions on papers and exams through her academic dean. She also counted on close friends to check up on her when she missed a class or failed to answer her phone.

Stick to a schedule.
After learning the hard way that all-nighters and Prozac are not a good combination, an Ivy Leaguer who suffers from major depression reports that he always feels better when he exercises regularly, eats right and gets enough rest.

Get good info.
NAMI.org, the website of the National Alliance for the Mentally Ill, is one of several good online resources. But beware of mental-health chat rooms, which can be long on sympathy and short on facts.

Stay away from alcohol and all drugs,
legal or illegal, especially if you're taking medication for your illness, and consult your doctor before using even the mildest cold remedy.

Consider taking time off.
True, you may have to forfeit some portion of your tuition and fees, but the short-term financial loss may be worth the long-term health gains. Talk it over with your parents, your doctor and your academic adviser.