A cluster of sudden deaths over a few months last winter and spring, including two suicides, prompted a George Washington University commission to ask some tough questions in an internal report that has already changed life on campus.
The university doubled the student health service psychiatry hours to 20 a week. It launched a peer education program, in which students can earn credits for talking about warning signs. It pushed harder to promote counseling, with ads and online links, and encouraged faculty and staff to watch for signs of trouble.
Donna and Phillip Satow started an anti-suicide foundation in memory of their son, Jed, who was a college student.
(Tina Fineberg -- AP)
The commission also asked the university for more funding for the counseling center, and the university is seeking money from private sources for other projects. The university does not provide long-term psychiatric care on campus, and some have complained that there are not enough counseling staff members for the 20,000 or so students.
Then in September, another student killed herself.
"Suicide has hit GW pretty hard in the last year or two," said student Lisa Cahan. "People are really coming up and talking about it more and more."
At many campuses, there is a growing urgency to find ways large and small to prevent suicide -- to help students long before they skid into psychiatric hospitalization or worse. That means more emphasis in dorms and classrooms on watching for warning signs, and everything from hiring more counselors to bringing dogs onto campus during exam week, as the College of William and Mary has done, for stressed-out students to pat.
There's a wave of interest now, said James Welsh, assistant vice president of student health services at Georgetown University, who has been talking with staff about improving training for faculty. A Georgetown student committed suicide last spring, and a student died the previous winter; before that, years had gone by without a suicide there.
Suicides are rare on campus -- in the past five years, GW had just one other suicide -- and college students are far less likely to kill themselves than other people their age. But a cluster of deaths at New York University recently reminded administrators across the country that suicide is still the second-most-common cause of death for college students. Suicides have led to lawsuits against schools by angry parents, pushed questions about privacy and responsibility to the forefront, and underscored just how overwhelming academic life can be.
Increasing numbers of students are seeking counseling, with increasingly serious problems, at colleges across the country.
There are lots of reasons for that, said Michael Mond, director of the Johns Hopkins University Counseling Center, including students who wouldn't have been able to handle college years ago who have gotten medication and treatment in high school. Now there's less stigma attached to getting counseling, more efforts by colleges to promote services and, he said, higher stress.
And more money could become available to help. Sen. Gordon Smith (R-Ore.) sponsored legislation, signed into law last fall, which he said will provide $11.5 million this year for youth suicide prevention.
"We just watched our son really deteriorate physically and emotionally," Smith said. "It's a very helpless and hopeless feeling that a parent has when you see a child suffer that way." Garrett Lee Smith killed himself in fall 2003 at a college in Utah.
"Many of my colleagues [in Congress] came forward for the first time to talk about suicide in their own families," Smith said. "We touched a raw nerve."
And more research is underway. The parents of a 20-year-old college student who killed himself formed a national nonprofit group, the Jed Foundation, in 2000. Jed has helped fund studies on prevention at universities and gotten an anonymous online screening form onto hundreds of college Web sites.
Across the region, schools have been emphasizing prevention in different ways. Johns Hopkins tracks students who have indicated suicidal risk on a questionnaire -- last year, 39 of about 7,000 students were considered at serious risk -- and a group meets every week to talk about the students they're most worried about.
Catholic University prefers to treat the most serious cases on campus, seeing the potential for coordination among housing, faculty and counseling as a powerful safety net.
At the University of Maryland, efforts include a crisis hotline with students trained to take the calls so that getting help is less intimidating.
Sociologist Donna Holland Barnes at Howard University said she is working on a grant proposal to screen students entering historically black colleges. Her son Marc Jamal Barnes died in 1990 while away at college in Massachusetts. He told his roommate that he was going to kill himself, she said, and by the time the other student came back with help, her son was gone. He drove his car into a river.
"Most of these kids don't want to end their lives," said David Jobes of Catholic University, a clinical psychologist and past president of the American Association of Suicidology. They're feeling overwhelmed, he said, but by and large they're smart, motivated young people who do very well with treatment. "The vast majority of kids can be helped."
But experts don't agree yet on exactly how to provide that help. An Air Force program had become a national model -- a study found it had reduced the risk of suicide by a third over six years -- but last year the rate climbed back up with more deaths.
"It's exasperating," said Jobes, who is a consultant to the Air Force program. "We're trying to see what's going on with that. It's not uncommon in the field of prevention: You develop a gold-standard program, it works really well . . . then you start to see the thing you're trying to prevent creep back up."
Jobes said he hopes that 10 years from now, counselors will have solid data on the most effective means of suicide prevention for college students.
Meanwhile, at GW, things are changing.
Cahan, a senior, started a student group in 2003 that has offered yoga or a movie along with information about counseling. Students will be more aware of the help that's out there, Cahan said.
"They've made it less intimidating," said Jessie Wood, a senior who helps run GW-SPAN, a chapter of the Suicide Prevention Action Network USA, with Cahan.
And online resources will help, Cahan said, because many students steer clear of the counseling center out of concern over confidentiality and what their friends, parents or future employers might think.
Cahan said one of the most important things she and others in her group do is just watch for problems -- if someone's not sleeping or is freaking out about classes.
"We all have our own friends, and we look out for them," she said.