A Year After Virginia Tech Shootings, Impact Felt On Mental Health Treatment

The rampage carried out nearly a year ago by a deranged Virginia
Tech student who slipped through the mental health system has
changed how American colleges reach out to troubled students.

Administrators are pushing students harder to get help, looking
more aggressively for signs of trouble and urging faculty to speak
up when they have concerns. Counselors say the changes are sending
even more students their way, which is both welcome and a
challenge, given that many still lack the resources to handle their
growing workloads.

Behind those changes, colleges have edged away in the last year
from decades-old practices that made student privacy paramount.
Now, they are more likely to err on the side of sharing information
- with the police, for instance, and parents - if there is any
possible threat to community safety. But even some who say the
changes are appropriate worry it could discourage students from
seeking treatment.

Concerns also linger that the response to shooters like
Seung-Hui Cho at Virginia Tech and Steven Kazmierczak, who killed
five others at Northern Illinois University, has focused
excessively on boosting the capacity of campus police to respond to
rare, terrible events. Such reforms may be worthwhile, but they
don't address how to prevent such a tragedy in the first place.

It was last April 16, just after 7 a.m., that Cho killed two
students in a Virginia Tech dormitory, the start of a shooting
spree that continued in a classroom building and eventually claimed
33 lives, including his own.

Cho's behavior and writing had alarmed professors and
administrators, as well as the campus police, and he was put
through a commitment hearing where he was found to be potentially
dangerous. But when an off-campus psychiatrist sent him back to the
school for outpatient treatment, there was no follow-up to ensure
he got it.

People who work every day in the campus mental health field -
counselors, lawyers, advocates and students at colleges around the
country - put the changes they have seen since the Cho shootings
into three broad categories.
---

- IDENTIFYING TROUBLED STUDENTS. Faculty are speaking up more
about students who worry them. That's accelerating a trend of more
demand for mental health services that was already under way before
the Virginia Tech shootings.

Professors "have a really heightened level of fear and concern
from the behavior that goes on around them," said Ben Locke,
assistant director of the counseling center at Penn State
University.

David Wallace, director of counseling at the University of
Central Florida, said teachers are paying closer attention to
violent material in writing assignments - warning bells that had
worried Cho's professors.

"Now people are wondering, 'Is this something that could be
more ominous?"' he said. "'Are we talking about the Stephen Kings
of the future or about somebody who's seriously thinking about
doing something harmful?"'

Mississippi State and the University of Kentucky are among the
schools creating teams involving people such as resident advisers,
teachers, administrators and campus police to try to identify
troubled students. Others, including Virginia Tech, that already
used such "care" teams have added another layer to deal with
those identified as potentially threatening.

"People who have been really depressed and are thinking about
hurting themselves, these folks I think are coming to our attention
a little bit earlier," said Keith Anderson, staff psychologist at
Rensselaer Polytechnic Institute. "Because it's been a kind of
national awakening, we have a sense of hope people will refer folks
before something gets out of control."

The downside is officials may be hypersensitive to any
eccentricity. Says Susan Davis, an attorney who works in student
affairs at the University of Virginia: "There's no question
there's some hysteria and there's some things we don't need to
see."

That's a problem because counseling centers already had their
hands full. A survey last fall by the Association for University
and College Counseling Center Directors found colleges on average
have just one counseling staffer for every 1,941 students. Those
ratios could decline given that some colleges are adding staff -
Virginia Tech has added four, with plans for three more - but in
many states the ratios are still well above the nationally
recommended guideline of one counselor per 1,500 students.

Meanwhile, a recent MTV/Associated Press survey found 12 percent
of college students found "life was not worth living" at least
sometimes. About 10 percent have considered suicide in the last 12
months, according to the American College Health Association, and
more than 1,000 commit suicide annually.

"At Wake Forest, every year we see more people, every year the
demand increases," said Marianne Schubert, director of the
university counseling center. But, "I don't think people are being
paranoid. I think given the circumstances of what has happened (at
Virginia Tech) and the culture and society we live in, I think it's
appropriate."
---

- PRIVACY. In Virginia, a measure signed into law Wednesday by
Gov. Tim Kaine requires colleges to bring parents into the loop
when dependent students may be a danger to themselves or others.
Even before Virginia Tech, Cornell University had begun treating
students as dependents of their parents unless told otherwise - an
aggressive legal strategy that gives the school more leeway to
contact parents with concerns without students' permission.

In Washington, D.C., meanwhile, federal officials are trying to
clarify privacy guidelines so faculty won't hesitate to report
potential threats.

"Nobody's throwing privacy out the window, but we are coming
out of an era when individual rights were paramount on college
campuses," said Brett Sokolow, who advises colleges on risk
management. "What colleges are struggling with now is a better
balance of those individual rights and community protections."

The big change since the Virginia Tech shootings, legal experts
say, is colleges have shed some of their fear of violating the
federal Family Educational Rights and Privacy Act (FERPA). Many
faculty hadn't realized that the law applies only to educational
records, not observations of classroom behavior, or that it
contains numerous exceptions for potential safety threats.

In any case, colleges have concluded it's better to risk a
mistake on FERPA than miss the danger signs in a student like Cho.

"You have to choose your lawsuit," said Ada Meloy, general
counsel of the American Council on Education, the Washington
D.C.-based umbrella organization that represents colleges.

Still, while conversations with therapists almost always stay
private, some worry about the perception that confidentiality is no
longer the top priority. There's no way to measure how many
students aren't getting treatment.

"The real balancing act is, are you chilling the mental health
treatment you want these students to receive?" said UVA's Davis.
"Are they going to stop going to these centers because there's
this state law out there that says you have to call mom and dad?"

- STIGMA. As news of the Virginia Tech shootings broke, Erica
Hamilton was one of many people who worried the violence could
prompt a backlash against the mentally ill, discouraging treatment
and leading to misguided new laws.

"I was really nervous," said Hamilton, a student at the
University of North Carolina-Greensboro who works with Active
Minds, a mental health advocacy group with chapters at 127
colleges. "It shined a negative light on people who have mental
illness."

On balance, Hamilton says that hasn't happened. But the tone of
some of the debate remains a concern.

"In general, the attention to campus mental health was
desperately needed," said Alison Malmon, founder of the national
Active Minds group. But some of the debate, she added, "has turned
in a direction that does not necessary support students." All the
talk of "threat assessments" and better-trained campus SWAT
teams, she said, has distracted the public from the fact that the
mentally ill rarely commit violence - especially against others.

"I know that, for many students, it made them feel more
stigmatized," Malmon said. "It made them more likely to keep
their mental health history silent."

The media has often drifted toward coverage of campus police
training and emergency text-messaging systems. Malmon isn't saying
money spent on those areas was wasted. She just doesn't want anyone
to think it will prevent another Virginia Tech.

Sokolow, the risk consultant for colleges, estimated in the
aftermath of the Virginia Tech and NIU shootings, the schools he
works with spent $25 on police and communications for every $1 on
mental health. Only recently has he seen a shift.

At Florida's public universities, the board of governors last
month approved an $18 million request to the legislature to fund
police and emergency warning systems that a state task force called
for. The board also approved recommendations of a task force on
mental health care, which found Florida schools needed 92 more
counselors to reach the recommended ratio. But there has been no
funding request yet. The report suggested the state lift caps on
student fees.

Bill Edmonds, a spokesman for Florida's board, said it
recognizes the need for more counselors and is exploring ways to
fund them.

"Campuses come to me, they want me to help them start
behavioral intervention systems," Sokolow said. "Then they go to
the president to get the money and, oh, well, the money went into
the door locks."

Phone messaging systems and security are nice, he said, but
"there is nothing about text-messaging that is going to prevent
violence."


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