This past winter, three Penn students took their own lives. In some ways these tragedies had little in common; they were two young women and a young man, two of them undergraduates and one a grad student, and they killed themselves at sites both away from campus and on it. They followed an off-campus suicide from the previous summer. One of the suicides attracted national media attention, making an already challenging and emotionally charged situation even more so, especially for those working at Penn’s Counseling and Psychological Services (CAPS) and other support services.
The subject of mental health on any college campus is a complex one, and the University responded in multiple ways. On February 4, President Amy Gutmann, Provost Vincent Price, and Executive Vice President Craig Carnaroli W’85 sent emails to all students, faculty, and staff, emphasizing an “unwavering” message that students are not alone and that “extensive support services” (whose names, website addresses, and phone numbers were included) are available to those in need: “Tell a friend, talk to an adviser, reach out to a trusted staff member, faculty member, or your family. Support is all around you.”
That same day, the third student killed himself on campus, and two days later the administration sent out a more urgently worded message that began: “Nothing is of more paramount concern at Penn than the health, safety, and well-being of our students.” While “all evidence indicates that the recent student deaths are unrelated to each other, and certainly unrelated to the work done at CAPS,” they added, “we know that the needs of the community are placing greater than ever demand on our valuable student support teams.”
That increased demand had led to complaints by some students about long wait times for appointments, many of which appeared in The Daily Pennsylvanian. The administration responded by announcing that funding had been approved for three additional full-time positions at CAPS. (Over the past eight years, the administration noted, “total clinical staff has increased from under 25 to more than 37” full-time employees, including psychologists and psychiatrists.)
Later in February, Gutmann and Price announced that they had formed a new Task Force on Student Psychological Health and Welfare, to be chaired by Anthony Rostain, professor of psychiatry and pediatrics and director of education for the Department of Psychiatry, and Rebecca Bushnell, the SAS Board of Overseers Professor of English and former dean of SAS. In addition to Joann Mitchell, Penn’s vice president for institutional affairs, who is serving as the task force’s vice chair, the group includes seven other members of the University community.
“Like peer campuses across the country, Penn has seen an increasing need for psychological support services and programs, and we have worked assiduously to ensure the well-being of our students,” noted Gutmann in a statement published in the Almanac, the University’s journal of record, adding: “Now is the time to review our work and to ensure that we have in place the best practices in outreach, education, intervention, and treatment.”
The task force will call on “faculty experts, student leaders, and administrators,” Gutmann and Price said, and will “examine trends at Penn and elsewhere; review peer practices; and identify optimal means of promoting student welfare and psychological health.” The task force hopes to finish its work by the end of the calendar year and to issue its findings early in 2015. (Rostain declined to comment until then, noting that it was “important to preserve the integrity of our work.”)
Students and some faculty members quickly criticized the task force for not including students, though it will meet regularly with students. “Rather than funnel through a single student voice—a tremendous responsibility—I’m assuming the task force will want to hear from a variety of student voices,” Joann Mitchell told the DP.
“I think it’s critical that students are a key component of every analysis and planning that the administration does around mental health,” says Alison Malmon C’03, founder of Active Minds, a national nonprofit organization dedicated to raising awareness of mental-health issues on college campuses [“Alumni Profiles, Mar|Apr 2009]. (The Penn chapter, one of more than 400 around the country, is up and running again after a period of quiescence.)
In her view, creating a “supportive environment that talks about all issues openly” basically boils down to transparency and a rapid, caring response.
“In many ways, transparency is just acknowledging that [a suicide] has happened on campus, that it affects so many people, and that ‘we are working as hard as we can, as quickly as we can, to respond, or to learn more and to involve everybody that we can.’
“What students want to see is just a response,” Malmon adds. “I recognize, being on the other side and running an organization myself, that many times you have to stay quiet to get your ducks in a row and figure out what your formal response is going to be. But the problem is that with every moment there’s no response, there’s more and more disappointment from the other side.”
Three years ago, the American College Health Association-National College Health Assessment, a nationwide survey of college students, found that some 30 percent of college students reported feeling “so depressed that it was difficult to function” at some point in the past year. While suicide is very rare (approximately one out of every 10,000 students), it is still the second leading cause of death on college campuses. And Penn has nearly 25,000 students.
“These are issues that touch every community, and every counseling center director will tell you that if they haven’t had a suicide on campus, then they’re lucky,” notes Malmon.
“College mental health as a field has really changed, and changed very rapidly, in the last decade,” says Meeta Kumar, associate director and psychologist at CAPS. In its early years, “this was more of a college counseling center, and we saw more of the homesickness and the occasional guidance kind of issues—as well as more serious concerns here and there,” she recalls. “Now we are providing a full array of comprehensive sets of treatment, and practicing community psychology in a big way.
“More and more students are coming with a prior history of being in treatment and on medications,” she adds, pointing out that CAPS offers “the full array of psychological services in a direct-service department, which ranges from almost 24 hours [a day] functioning as a crisis-response center, to providing individual psychotherapy” as well as “medication assessment and management.”
From her position as director of outreach prevention services, Kumar notes that CAPS has been “increasingly trying to incorporate prevention in our thinking,” and has been “experimenting with and implementing large-scale prevention models targeting freshmen, building peer-to-peer support—a lot of collaborative, community-based” work. In an effort to increase visibility and help reduce the stigma of mental-health issues, she adds, CAPS has been developing a lot of student-led programs, ranging from Penn’s intensive “I CARE” gatekeeper training, a comprehensive freshman initiative (in collaboration with Student Health Services, the Weingarten Learning Resources Center, and other campus agencies), stress-reduction workshops, and the Pennsive blog, started by Penn’s Active Minds chapter and CAPS student advisory board, which aims to “promote emotional support in the community.”
It’s not exactly news that college can be a stressful time—or that any suicide is excruciating for all involved.
“First and foremost is just the pain, the grief that I have felt with every new story of a student who has taken his or her life,” says Malmon, whose brother Brian (then on leave from Columbia University) took his own life while she was a freshman at Penn.
Outside news coverage of the suicides tended boil down to Ivy League Kids Who Have It All and Still Kill Themselves. It wasn’t helpful.
While most Penn students are indeed privileged, “that doesn’t mean that mental-health issues and suicide can’t touch us,” says Malmon. “When you have everything going for you, it doesn’t mean that you may not have depression, or thoughts of worthlessness and hopelessness. And so many external stories that I see really just present that sensational story, and it continues to make those on campus who are struggling feel like there’s something wrong with them. If the outside world thinks that you should have everything together, and you have all this privilege, and there’s nothing for you to be upset about, it’s really hard to understand for yourself that it’s OK to not feel right, and it’s OK to feel depressed, and it’s OK to feel anxious—it’s not your fault, but you should go get help for it.”
Asked if she has a message for students, parents, and alumni, Kumar responds: “I think there is a great, great team here at Penn that is coordinated, extremely collaborative, very much behind the scenes, but working 24/7 to provide the best care, in keeping with the best practices out there in the field, incorporating everything that we know.
“Is there room to do more and do better? Of course, there always is, but we take that extremely seriously, and I feel proud to be part of this team that we have here at Penn, that’s so dedicated, and works tirelessly, day in and day out.” —S.H.