When Colleges Go On Suicide Watch

By Julie Rawe, Kathleen Kingsbury

Anne Giedinghagen wanted desperately to stay in school. Having struggled with depression and anorexia since the sixth grade, the rail-thin Cornell junior was meeting regularly with a therapist at the university's counseling center in Ithaca, N.Y. But late last fall, when she told her therapist about her increasingly strong urge to kill herself, Giedinghagen received an ultimatum from the school she loved so much: she had to get better or she would have to leave. So she did what any crafty 20-year-old would do. She tried to carve out a third option--feigning improvement by, as she put it, acting "as normal as I could." When she agreed to spend her winter break at a psychiatric hospital, the university stopped threatening to kick her out. But afterward, says Giedinghagen, "I felt like I had to hide how I was doing from my doctor, my counselor, my nutritionist, so that I could stay."

Giedinghagen is one of thousands of troubled college students who each year are forced to make such stark choices. With two recent court rulings holding that college administrators may be held partly responsible for student suicides--which total some 1,100 a year nationwide, making suicide the second leading cause of death among college students, after motor-vehicle accidents--many universities have hastily adopted mandatory-leave policies in an effort to reduce the risk of self-inflicted, on-campus deaths. But a tragic result, say psychiatrists and student advocates, is that emotionally distressed students may be less willing to come forward and get the professional help they need.

Another unintended consequence: hypervigilant colleges are getting sued by students who allege they are being discriminated against for being mentally unstable. The U.S. Department of Education last year warned at least a handful of schools that receive federal aid that the Americans with Disabilities Act protects people with mental problems. Several students who were suspended after threatening to commit suicide are in the process of suing their schools; others have been offered settlements before their cases reached the courts. In a sign of just how flummoxed the world of higher education has become over the issue of suicide, United Educators, which insures more than 1,100 colleges and secondary schools, issued a bulletin last month noting that when dealing with emotionally distressed students, schools are left "with the quandary of being sued no matter what they do."

That is particularly alarming since the number of students diagnosed as mentally fragile appears to be rising. The 2005 National Survey of Counseling Directors, conducted by the University of Pittsburgh, found that 95% of directors reported an increase in the number of freshmen who arrive on campus already taking psychiatric medicines. "A lot of students who may not have gone to college five years ago are able to attend today because their illness has been recognized earlier and they are on medication," says Joanna Locke, a program officer at the Jed Foundation, a New York City--based college suicide-prevention and outreach program.

The pressure to inoculate schools from legal liability has sometimes led them to come across as shockingly insensitive. In a case study of apparent hamhandedness, Jordan Nott had spent less than 48 hours in the psychiatric ward he checked himself into, in October 2004, when he received a terse letter from George Washington University informing the sophomore that he had been suspended for being a danger to himself and others. "It was a huge slap in the face," says Nott, 20. "They don't hand out this letter that says, 'We want you to get help.' What it says is, 'You've been suspended; you've been barred from campus.'" The letter went on to explain that if he returned to campus, he would be arrested. Rather than contest the suspension, he switched schools and is now suing for compensatory damages. A spokeswoman for G.W.U. says that because Nott's suspension fell within the school's disciplinary system, the wording of that letter may have seemed impersonal. However, she stresses, "the goal here was to protect a life."

But how, exactly, does yanking a kid out of college count as protection? "A lot of suicidal people don't just kill themselves," says Peter Lake, a higher-education law professor at Stetson University in Deland, Fla. "They also can hurt others, even if it's unintentionally." Schools steadfastly reserve the right not to let one person's disturbing behavior disrupt anyone else's educational experience. And they argue that their mandatory-leave policy can force emotionally distressed students to get the best possible help. Gary Pavela, a judicial-policy expert at the University of Maryland and author of a book on student suicide, says the approach is designed for "getting rid of troubled kids, getting them into the hands of others, as soon as possible."

Litigious parents are also to blame for the tough line. After Elizabeth Shin died in 2000 in a dorm-room fire at M.I.T. within hours of threatening to kill herself, the sophomore's parents filed a $27 million lawsuit against her psychiatrists, as well as her house master and a dean of student life, for failing to take adequate precautions. (They had scheduled an appointment to see her the following day.) When a judge last year refused to throw out the suit, alarm bells went off in administrative offices across the country. "To hold a university liable for simply trying to help a student is extraordinary," says Nelson Roth, Cornell's deputy university counsel, explaining why the school joined six others in supporting M.I.T. in the case. Shin's death was a tragedy, Roth says, "but not every tragedy warrants a lawsuit."

Although the Shins settled last month for an undisclosed amount--and publicly admitted that their daughter's death appeared to be accidental--the case has had a chilling effect on student-services professionals and has led to more frequent use of emergency-leave policies. But after several students complained about getting summarily booted, the Department of Education's Office for Civil Rights started informing schools that a person should be considered a direct threat only when there is "a high probability of substantial harm and not just a slightly increased, speculative or remote risk." In other words, there needs to be a detailed evaluation and at least some opportunity for students to make a case for why they should be allowed to stay.

Many schools are trying to emulate the University of Illinois, which requires students who express suicidal thoughts to see a counselor for four sessions if they want to remain in school. More than 1,800 students have gone through the program since it was launched in the early '80s, and none have committed suicide. Only one participant was forced to leave.

While Illinois rarely advocates taking time off from school, Cornell pushes a hundred or so of its students each year to take a voluntary medical leave that allows them not only to get help but also to de-stress. In Giedinghagen's case, it didn't take long for her to realize her fake-it-till-you-make-it strategy wasn't working. By April, she says, "the stress was so bad that I knew if I stayed at Cornell one more week, I would kill myself." After lengthy discussions with her therapists, the double major in German and neurobiology agreed to head home last month to Kansas City, Mo., with plans to enter a psychiatric hospital. Five weeks later, she's disappointed that Cornell hasn't made any follow-up calls to see how she's doing. But Cornell's deputy counsel Roth has an explanation: "Once the student is gone or goes home, the individual becomes the responsibility of parents. Our obligation ends."