The Aftermath of the Virginia Tech
Tragedy; Asking the Right Questions
By Harold S. Koplewicz,
M.D.
Once again we are confronted with headlines telling us that
violence has erupted in one of our schools. Pundits demand: how could this
happen again? Could this disaster have been avoided? As the dust begins to
settle one thing is clear, our current college and university mental health
services are grossly inadequate.
We need to recognize and act on the fact that growing numbers of
American children and teenagers are suffering from mental health problems and
are not being identified and receiving treatment. The pressures of growing up
in this age of unlimited and unfiltered information have emphasized
competitiveness, academic, athletic and social achievement at the expense of
promoting psychological well-being. Many students enter college unprepared to
handle the new demands for independence and self-organization in addition to
new social challenges. Many of those feeling alienated and in need of mental
health support are not getting it. Those students who do seek counseling often
face understaffed clinics, long waiting lists and insufficient health insurance
coverage.
The statistics are alarming. In a recent survey, 94 percent of
the college students reported feeling “overwhelmed” by all they had to do,
nearly one-third reported feeling “so depressed it was difficult to function”
and more than 5 percent reported they “seriously considered suicide.” College
counseling center directors are concerned about increases in several areas: the
number of entering students with already diagnosed problems, the number already
on medications, and students with severe problems. This increased demand for
services as well as the growing complexity of psychological problems has not
been accompanied by a corresponding increase in resources. The ratio of college
mental health professionals to students has fallen in the last decade, and over
24 percent of students who seek services are seen for only one session.
Colleges and universities need to respond to this mental health
epidemic they way they respond to a physical health epidemic, much as our
government is now proposing to do. In both the state and federal legislatures,
parity bills under consideration will require health insurers to provide equal
benefits for both physical and mental
illnesses. Think about how schools respond to meningitis outbreaks;
administrators take concrete action to get their students tested and
treated. In contrast, when a student attempts suicide the first
inclination of the administration is to hide it or cover it up. And if
someone actually kills himself, the traditional response has often been one of
excessive hand-wringing (“Oh, if only we had known . . . .”) accompanied by
proclamations, mass e-mails and posters about the available counselors
(“Feeling depressed? Stop by the health center!”). Only rarely is
concrete action taken—such as actually reaching out to students individually
or in groups or implementing screening to identify vulnerable students who
might need help—instead of putting the responsibility of asking for help
on the student.
However, let’s not shoot the messengers; college counseling
centers are asking for help. They are overwhelmed and overburdened and
most importantly under-funded. It is time for the administration, development
offices, and alumni to take action and provide the necessary resources.
Instead of building that shiny new sports complex, it is time to invest in the
mental health services of our schools. For example: why not endow positions
for psychiatrists? According to the National Survey of Counseling Center
Directors, in 2006 less than 1% of the Directors of surveyed centers were
M.D.s. The mental health of our college students is worth the investment.
Lastly, an event like the tragedy at Virginia Tech forces us to
ask the right questions. But the reality is we need to take action not
only because it will prevent a small number from becoming that killer, but
because of the thousands of kids who, while not turning to external violence,
are suffering, often in silence, from mental illness. Despite what we see on
the news, the real danger in life isn’t the very, very rare school shooter, but
the everyday occurrences on campuses everywhere for which kids are not getting
treatment.#
Sources: American
College Health Association, Spring 2006
National Survey of Counseling Center Directors, 2006
Dr.
Koplewicz is Founder and Director of the NYU Child Study Center and the Arnold
and Debbie Simon Professor of Child and Adolescent Psychiatry.
