By Michael S. Gerber
Special to The Washington Post
Tuesday, November 6, 2007
On the wall above Alison Malmon's cluttered Dupont Circle desk is a photograph of her older brother, Brian, taken soon before he killed himself more than seven years ago. He was a 22-year-old college student and she was a college freshman.
The photo reminds her daily that mental illness should not be an embarrassment and that silence can cost lives.
As executive director of Active Minds, a group she founded in 2003 to promote dialogue about mental health on college campuses, Malmon works to share that message with all who will hear it. More than 200 people attended the Washington-based organization's fourth national conference at the Georgetown University Law Center last month.
Mental health issues have become a growing concern on college campuses, especially after a depressed student shot 32 people to death at Virginia Tech in April before killing himself.
College counselors say media attention brought by the shooting is a two-edged sword: While they welcome the dialogue it has fostered about mental health, they worry it may lead some to exaggerate the link between violence and mental illness.
Violence against others is "a real anomaly," said psychiatrist Richard Kadison, director of Harvard University's mental health service. "When people are depressed or having mental health problems, they usually turn inward and, if they do anything destructive, it's self-destructive."
A recent American College Health Association survey found that nearly half of all college students report feeling depressed at some point during their time in school. About 15 percent of college students meet the criteria for clinical depression -- depression severe or prolonged enough to warrant treatment -- the study also showed.
Many other serious mental illnesses, such as schizophrenia and bipolar disorder, first begin displaying symptoms during college years.
Campuses nationwide are seeing a rise in the number of students seeking counseling and other mental health assistance, Kadison said.
"There's been an increase in the severity of mental illness on campus," he said. "It's put a real strain on the system."
One reason, according to Kadison and other experts: Mental illness is being diagnosed in more young adults during high school, and because of earlier access to counseling and treatment, more of those students are going on to college.
Kadison also cited the economic strains of rising tuition and added pressures on international students, who have to adapt to cultural and language differences in addition to academic stress.
But while record numbers of students are seeking help, many are still keeping quiet -- embarrassed or afraid to seek counseling, Kadison said. Faculty and friends, he said, are often unsure how to recognize signs of mental illness or how to approach students who may be exhibiting those signs.
According to his sister, Brian Malmon developed symptoms of a schizoaffective disorder, hearing voices and having suicidal thoughts while a student at Columbia University in New York. He hid them from his friends and family and, after taking a leave of absence from school and returning to his family's Potomac home, he sought counseling and treatment.
But the illness won out: He bought a gun and shot himself in March 2000.
"I was thinking about him 24-7," after his death, said Malmon, 26, a graduate of Churchill High School. So she thought, "Why not make it something I did?"
What started as a small group of students at the University of Pennsylvania, Malmon's alma mater, has grown into more than 80 chapters at colleges nationwide. The chapters work with campus counseling centers to promote mental health awareness and reduce the stigma associated with depression, eating disorders and other mental health issues.
But getting students on board can be difficult.
"It's really hard to get people interested in issues like depression," said Ashley Sekhon, president of the Active Minds chapter at George Washington University, where she is a senior psychology major. "No one wants to talk about it."
Sekhon learned about Active Minds when the founder of the campus chapter spoke at a meeting she was attending. "I had some friends in high school who dealt with mental illness," she said. "Knowing what my friends had gone through and knowing what the stigma is . . . I really wanted to get involved."
The GWU chapter has worked with the school's counseling center to sponsor a depression screening and a showing of "Thin," an HBO documentary on eating disorders. Later this year the students are co-sponsoring a mental health symposium.
"It's kind of difficult to gauge how we're really affecting people," Sekhon said. "No one really wants to talk about 'I had these problems and you guys really helped me.' That's really hard."
But Malmon said students have approached her and done just that, telling her that "participating in Active Minds 'saved my life.' "
At least one small study suggests Active Minds' efforts may be helping: In research she conducted as part of her master's thesis at Colorado State University last year, Kathleen McKinney found that participating in the group's activities lessened the stigma that students associated with mental illness.
"In only an eight-week intervention time, [I was] able to show that there were some differences" in the students' attitudes, said McKinney, now an instructor at Colorado State and faculty adviser for its Active Minds chapter.
Malmon said she hopes to expand the organization to 100 chapters by the end of this school year and 300 by the spring of 2010. She said she hopes Active Minds can reduce the stigma associated with mental illness "so that other families don't have to go through what we did."
Michael S. Gerber last wrote for Health about coverage options for the uninsured. Comments:firstname.lastname@example.org.