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August 16th, 2007

A Prescription for Parents

How do you know when your child at college needs help

 
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SUICIDE

Certainly, suicide is not something you want to think about as you pack your child off to college, but it is a fact of college life. The scariest statistic that I have encountered is from American College Health Association data reporting that nine percent of all college undergraduate students seriously think about suicide.

That is a frightening piece of data; it means that in a college with 10,000 students, 900 of them will report thinking seriously about suicide. The good news is that actual suicide is a rare event. The bad news is that it happens, and sometimes it is unpredictable and unstoppable. It is every parent, college, and counselor’s worst nightmare, but fortunately, there are things we can do to minimize the risk. And certainly, parents can help.

The statistics on college-age suicide make this a subject that just can’t be ignored. A significant number of college students find the pressures of college life just too great to bear; feeling helpless and hopeless they think about, attempt, or complete suicide. The facts are shocking:

  • Suicide is the second leading cause of death among 20- to 24-year-olds (after “accidents and homicides”).
  • More teenagers and young adults die from suicide than from all medical illnesses combined.
  • The suicide rate peaks among young adults (ages 20 to 24).
  • One in 12 U.S. college students makes a suicide plan.

Who is at Risk?

There are two distinct groups of students who are at risk for suicidal thoughts and attempts: Those who come into the college with pre-existing mental health problems and those who develop mental health problems during the college years.

The students who come to college with diagnosed mental illnesses, usually keep this fact a secret. Even though there are laws protecting people with any sort of disability from discrimination, the students and their families do not advertise a psychological problem in the application process and after acceptance usually keep the facts to themselves. We may suspect a problem based on the prescribed medications listed on a student’s health form or the acknowledgement of certain needs on their housing applications. But for the most part we do not know which of our incoming students have diagnosed conditions such as depression or bipolar disorder that put them at risk for suicide.

But we do know the numbers of these students is rising as the number of high school students suffering mental health problems increases. The Youth Risk Behavior Survey in 2001 polled 13,601 students nationally in grades 9 through 12. It found that in the 12 months before the survey, 28.3 percent of high school students acknowledged feeling so sad or hopeless almost every day for more than two consecutive weeks that they stopped doing some usual activities. Nineteen percent of students reported that they seriously considered attempting suicide, and 14.8 percent had made a specific plan to attempt suicide. And 8.8 percent had attempted suicide in the previous year.

Although these numbers are startling, because of improvements in early diagnosis, competent therapy, and pharmacology, students with mental illnesses and learning disabilities now succeed in high school and move on to college as never before. But when they move into the college system, they need ongoing, intensive care that not all schools are able to offer. The typical unstructured environment, erratic sleeping patterns, and academic stresses can ultimately push these students to the edge.

Then there is the group who develop mental health problems while in college. The common risk factors for attempted suicide that may begin during the college years include depression, alcohol or other drug use, and physical or sexual abuse. In fact research has shown that more than 90 percent of people who kill themselves have depression or another diagnosable mental or substance abuse disorder [NIMH 2003b]. Unfortunately, as mentioned earlier, these high-risk signals are often ignored by the students until they find themselves on the edge of hopelessness and despair.

Students’ gender can also put them in the high-risk category. Among the 20-24 age group, more than seven times as many men as women die by suicide. Women report attempting suicide during their lifetime about three times as often as men . So a daughter is far more likely to talk about suicide or attempt suicide, but a son is more likely to use a lethal means (most commonly firearms) to go through with it.

Although it’s impossible to create an fool-proof profile of at-risk students, many of them feel driven to achieve more than is humanly possible; some are perfectionists who cannot bear failure; others have a history of mental illness in the family; some simply lack adequate coping skills to get them through tough times; and others have no identifiable traits at all.

Whatever the cause, specific signs of potential suicide include:

  • Talking openly about committing suicide
  • Talking indirectly about “wanting out” or “ending it all”
  • Taking unnecessary or life-threatening risks
  • Giving away personal possessions

Ideally, troubled students receive help long before they get to this final stage. That’s why it is so important for us to pay very close attention to students like the 66.2 percent of college students who said they felt overwhelmed by all they had to do in the last year and the 46 percent who felt so depressed that it was difficult to function. These are all at-risk students.

It’s ironic that just at the time when you feel you are setting your children free is the time when children often need your support and attention more than ever. Although you cannot solve all the world’s problems for your young adult children, you can still be involved and proactive in guarding their mental health. All of our sons and daughters attend the college of the overwhelmed. It is my hope that the information in this book will get us talking about that. We all can be part of the solution if we learn to recognize the symptoms associated with being overwhelmed, take steps to insure that students have access to appropriate care (especially since most of the problems are very treatable), and do our part to reduce the sources of stress that push too many college kids to the edge.


Excerpt taken from College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It with the author’s permission.

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The Author : Dr. Richard Kadison
Dr. Richard Kadison is the Chief of Mental Health Services at Harvard University
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