kicked out of college for being suicidal

[Hurricane]

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washington post article

About 2 a.m. one sleepless night, sophomore Jordan Nott checked himself into George Washington University Hospital.

He was depressed, he said, and thinking about suicide.

Within a day and a half of arriving there, he got a letter from a GWU administrator saying his "endangering behavior" violated the code of student conduct. He faced possible suspension and expulsion from school, the letter said, unless he withdrew and deferred the charges while he got treatment.

In the meantime, he was barred from campus.

[snip]

He withdrew, went home to Upstate New York, he said, missing his friends and worried that he had ruined his education. Weeks later, he waited for his father and friends to lug things down from his dorm because, he said, he had been told he could be arrested for trespassing.

If he had known, he said, he never would have gone to the hospital.

Doesn't seem like the most effective way to encourage kids to seek help. I hope he wins his lawsuit.

 

[Psyclops]

I heard about this guy on the radio, Fed UP.

 

[jeff2005]

How infuriating. Shouldn't his medical records be private? I want to see that lawyer rip that school to shreds. As malpractice hounded doctors, we pick on lawyers a lot, but when you're in a bad situation, a good lawyer is worth their weight in gold.

 

[Poety]

"Historically, administrators have not been held responsible for student suicides, said Karen-Ann Broe of United Educators, but recent -- and not yet settled -- cases have thrown that in flux.

At Ferrum College in Virginia, where a student had made explicit threats before committing suicide, a judge said before the case was settled that the college has a duty to prevent suicide if the risk is readily foreseeable. "That's a pretty radical innovation of the law," to hold people with no expertise in mental health accountable, said Gary Pavela, director of judicial programs at the University of Maryland.

Preliminary and conflicting rulings at other schools, including the Massachusetts Institute of Technology, have left administrators confused about whether they could be held liable, Broe said."


This is the reason why they don't know how to deal with kids having SI. The problem here is people getting sued over previous suicides which has now put all these colleges in a state of fear. When you're running a business, its scary to think you could get smacked with a huge lawsuit over something you have no control over.

Unfortunately, the more lawsuits we start seeing, the worse this is going to get - more people are going to be on the defensive rather than reaching their hands out to help troubled teens.

Perfect example of fear dictating behavior 🙁

ETA: The article said one of his friends committed suicide the year before after jumping out of his dorm room - there is a nasty epidemic here that really needs to be addressed. Perhaps that is one of the big issues we should be looking at as soon to be psychs.

 

[Psyclops]

I see your point P-funk, and I generally am frustrated by frivilous law suits filed against doctors. But occasionally one has merit. I think in the case of this kid he is being punished for a psychiatric problem. Not only that but it's by his university, an institution that I think we could expect (demand?) a higher level of understandding from, if not some form of aid.

 

[Poety]

I see your point P-funk, and I generally am frustrated by frivilous law suits filed against doctors. But occasionally one has merit. I think in the case of this kid he is being punished for a psychiatric problem. Not only that but it's by his university, an institution that I think we could expect (demand?) a higher level of understandding from, if not some form of aid.

Oh I agree, apparently he could have fought the charges but didn't - he decided to finish up at the U of Maryland. In the grand scheme of things, that might have been best since he was trying to get to friend when he committed suicide in the dorm room (the door was locked) I mean better for his health here ofcourse.

What I think is unfortunate is that the colleges don't know what else to do - they need some guidance and we all know how productive "laws" are at providing guidance in the mental health arena 🙄

 

[Psyclops]

You know, at my undergraduate institution the on campus conseling department was quite accessable. They had on campus psych (both types) offered to everyone who needed it, so they wouldn't have to go searching throughout the comunity, which can be a daunting task in the face of MI. Aditionally they would have crisis workers come out any time of the night. So, when I see a university doing everything they can to provide services they shouldn't be faulted if a kid (usually adult) does commit suicide. But I guess this type of availability isn't pervasive.

 

[Hurricane]

"Historically, administrators have not been held responsible for student suicides, said Karen-Ann Broe of United Educators, but recent -- and not yet settled -- cases have thrown that in flux.

At Ferrum College in Virginia, where a student had made explicit threats before committing suicide, a judge said before the case was settled that the college has a duty to prevent suicide if the risk is readily foreseeable. "That's a pretty radical innovation of the law," to hold people with no expertise in mental health accountable, said Gary Pavela, director of judicial programs at the University of Maryland.

Preliminary and conflicting rulings at other schools, including the Massachusetts Institute of Technology, have left administrators confused about whether they could be held liable, Broe said."


This is the reason why they don't know how to deal with kids having SI. The problem here is people getting sued over previous suicides which has now put all these colleges in a state of fear. When you're running a business, its scary to think you could get smacked with a huge lawsuit over something you have no control over.

Unfortunately, the more lawsuits we start seeing, the worse this is going to get - more people are going to be on the defensive rather than reaching their hands out to help troubled teens.

Perfect example of fear dictating behavior 🙁

ETA: The article said one of his friends committed suicide the year before after jumping out of his dorm room - there is a nasty epidemic here that really needs to be addressed. Perhaps that is one of the big issues we should be looking at as soon to be psychs.

I realize they're trying to cover their asses, but I don't think having a policy of kicking out suicidal students is necessarily going to prevent future lawsuits. That kid said if he had known he'd be dismissed, he'd have never gone to the hospital. I can easily imagine a scenario in which a kid commits suicide, then his parents hear from his friends that he was feeling depressed but didn't want to talk to student health for fear of getting kicked out, then they slap the school with a big fat (and well-deserved) lawsuit for creating an environment which discouraged students from seeking mental health services when they needed it most.

 

[Doctor Bagel]

I realize they're trying to cover their asses, but I don't think having a policy of kicking out suicidal students is necessarily going to prevent future lawsuits. That kid said if he had known he'd be dismissed, he'd have never gone to the hospital. I can easily imagine a scenario in which a kid commits suicide, then his parents hear from his friends that he was feeling depressed but didn't want to talk to student health for fear of getting kicked out, then they slap the school with a big fat (and well-deserved) lawsuit for creating an environment which discouraged students from seeking mental health services when they needed it most.

Exactly. This policy is basically ensuring that GWU would lose in any future law suit following a student's suicide. However, if GWU and other schools really promoted their mental health services and let students know that they should always seek help if they need it, a parent might have trouble succeeding in a law suit against them.

This issue really hits home to me because I became seriously depressed in law school, which is actually a pretty common thing to happen. However, my law school never addressed the fact that we might have serious stress and mental health problems, and they never gave us any resources for help. The university had a worthless counseling program consisting of six total sessions with an msw, and of course, our wonderful student health insurance didn't cover mental health treatment. If I had killed myself, I could see where my family could argue that my death was foreseeable and preventable if the school had been more proactive. One of my classmates did kill himself -- I didn't hear of his family suing, but I don't think it would be unjustified.

 

[pingouin]

Just to add a slightly different spin for discussion..

I had a therapy client several years ago who had an almost-fatal suicide attempt while away at college and living in the dorms. She had been diagnosed as bipolar years before, and went off of her lithium so that she could drink while at school. There was a fight with her sig other which drew the attention of most of her floor, followed by cutting her wrists very deeply after locking herself in her room. Her floormates and SO had to break down the door and administer first aid until EMS got there. She was hospitalized, and moved back home when she was stable. That's when I started seeing her.

Mom showed me correspondence from the school- she was not allowed to come back to campus, and if she was seen, they would arrest her. I spoke with an administrator at the school to get the story, as this seemed really unfair. The rationale was that her actions were so disruptive to her peers that even if she wasn't dangerous to herself anymore, it would be unhealthy for them to be around her. They based this on the fact that they had to do multiple CISD sessions for the girls on her floor, plus individual counseling sessions, plus the impact on the students' class performance and attendance... and on and on...

Do they have a valid point? In an instance where there is action on suicidal thoughts, not just the thoughts themselves, whose rights get higher priority- the individual or their peer group? If she had been allowed to return, could the school be held liable by families for re-exposing their kids to the person who traumatized them in the first place?

 

[Hurricane]

Just to add a slightly different spin for discussion..

I had a therapy client several years ago who had an almost-fatal suicide attempt while away at college and living in the dorms. She had been diagnosed as bipolar years before, and went off of her lithium so that she could drink while at school. There was a fight with her sig other which drew the attention of most of her floor, followed by cutting her wrists very deeply after locking herself in her room. Her floormates and SO had to break down the door and administer first aid until EMS got there. She was hospitalized, and moved back home when she was stable. That's when I started seeing her.

Mom showed me correspondence from the school- she was not allowed to come back to campus, and if she was seen, they would arrest her. I spoke with an administrator at the school to get the story, as this seemed really unfair. The rationale was that her actions were so disruptive to her peers that even if she wasn't dangerous to herself anymore, it would be unhealthy for them to be around her. They based this on the fact that they had to do multiple CISD sessions for the girls on her floor, plus individual counseling sessions, plus the impact on the students' class performance and attendance... and on and on...

Do they have a valid point? In an instance where there is action on suicidal thoughts, not just the thoughts themselves, whose rights get higher priority- the individual or their peer group? If she had been allowed to return, could the school be held liable by families for re-exposing their kids to the person who traumatized them in the first place?

That's trickier, because as you said, this case involves actual actions. However, lots of college students exhibit behavior that can be construed as "disruptive" to others. The question is: is it fair to treat mentally ill disruptive students differently than other disruptive students? When I'm trying to work out in my head if a reaction to someone's mental illness is fair, I try to imagine what would be the response if the person had a more "medical" illness. Say this girl was a diabetic and she was noncompliant with her insulin and went into DKA and passed out locked in her room and they had to break the door down and call EMS and whatnot. Similarly dramatic and disruptive, but I doubt the school would threaten to charge the diabetic girl with a crime for returning to campus. Yet both are chronic diseases, requiring long-term meds, with risk of future complications and relapse.

But what really skeeves me out about the GW case is that the student didn't do anything disruptive. He simply went to the doctor because he was feeling depressed. He was basically being punished for his thoughts.

 

[pingouin]

Great points, Hurricane.

Back to the article, my only other question is- what right did the administration have to know what was in this guy's medical record in order to send that letter? It may be a GWU-run hospital, but the undergrad admin wouldn't qualify as part of the treatment team to have access to it. Although possible, it seems unlikely he would have signed a consent to release info to them.. And there was no mention of any HI toward the admin that would warrant a duty to warn.

I would think the same goes for privacy at a student health center- if a student discloses in a session that s/he is having SI/HI, the police and intended victim could be notified if it was an imminent threat, and then security gets involved and I guess it's on record. But for no imminent danger- to contact the dean? Or the student's academic advisor? That sounds like a HIPAA lawsuit just waiting to happen.........

 

[f_w]

I wonder how much more there is to this story. The way it is reported it sounds quite bizarre.

ADA with all its faults probably gives him a good handle to squeeze some dough out of GW.

Offering a medical leave to a student with a health problem is one thing. Giving him the boot and threatening him with arrest for seeking medical treatment doesn't sound like a defensible action to me. Sounds like the actions of an ill informed spineless administrator who was afraid to get sued if another kid committs suicide.

What to we learn from this: Don't go to a physician who has split loyalties if you seek treatment for psychiatric conditions.

Chances are, the college made him sign a very broad consent to look into his medical record when he enrolled (just like your life insurer will be able to pull every note from your PCP for the last 10 years). The docs in the GW emergency room probably have a policy to report students presenting with psych issues to the goons in administration and it is all hipaa 'a-ok' because of the signed consent on file.

 

[Poety]

Theres a lot of issues that I'm having with this whole thing. One is that I'm torn about the whole being kicked outta school for a mental illness, then again I'm thinking about whether or not I would want my children around someone who could potentially harm themselves on a regular basis.

This reminds me of a thread we had going a while ago about the bipolar on the plane who got killed by the sherriffs. Where do you guys really think the line is - when is mental illness safe or not safe for lay persons to be around? When should someone with severe depression or bipolar or <insert unstable mental illness here> be asked to leave a professional or any embodied society for that matter.

On our license apps they're now asking if you've ever had a mental illness, etc etc. These are things they want to knwo about. There was also a schizophrenic med student in Philly that killed a classmate .

I'm honestly interested to hear anyones thoughts on these issues - its what I started thinking about after reading throught he posts.

Thoughts?

 

[f_w]

then again I'm thinking about whether or not I would want my children around someone who could potentially harm themselves on a regular basis.

Guess what, your kids will encounter psychiatric illness all their life. Kicking sick kids out of college just perpetuates the 'bubble culture' that keeps the majority of college students isolated from real life.

- when is mental illness safe or not safe for lay persons to be around? When should someone with severe depression or bipolar or <insert unstable mental illness here> be asked to leave a professional or any embodied society for that matter.

A college is not a society. It is a service provider that is in the business of selling education.

On our license apps they're now asking if you've ever had a mental illness, etc etc. These are things they want to knwo about.

They want to know about it in order to have a professional assess whether you are able to safely practice your profession. If you put a 'Yes' in that box, the medical board will ask you to meet with a shrink and instead of just wholesale signing off on 10 applications at a time, they might discuss your application in detail and depending on what the issue is, ask you to stay in some sort of monitoring program.
This is different from just booting someone out of a college that he paid for.

There was also a schizophrenic med student in Philly that killed a classmate.

And then there are hundreds of muggers in Phili that have been known to rob medstudents.

If someone is delusional, psychotic or depressed to a level that his functioning is impaired, he probably doesn't get much benefit from attending college during that period. So just from an academic standpoint it would be appropriate to give this person a leave so he can get his medical problems under control.

By setting this example, GW has certainly achieved one goal: Students will think twice before they seek professional help and rather kill themselves in the privacy of their dorm-room.

 

[Psyclops]

The plane issue, is a little bit different in my opinion P. The way I saw it was that it was tragic that the person had Bipolar that was obviously untreated or exasperated got killed, but I thought it was fantastic that the air marshals shot someone who claimed to have a bomb. Its a situation that for necessarily evokes two emotions. The School thing is a different issue entirely.

 

[Poety]

Thanks for the two responses. I'm not starting an argument here, I'm trying to see what people feel about the different issues. Since the mentally ill at times do have the potential to self harm or harm others - is there a line that needs to be drawn. Thats the essence of my question.


F_W - you're right, all of us will always be around people that are mentally ill. However, should a student be allowed to self harm and return to college - that question I think is a little more difficult than it may seem. 1. what if the person isn't being medicated, followed properly and does end up hurting themselves.

How can a college ensure follow up care, is it their responsibility? - I totally see your point about they payed for college etc - but what about the rest of the kids there too - aren't they entitled to a non-disruptive college education? (I'm plaing devils advocate, I'm not sure where I stand on this whole issue for the safety of the ill child as well as the other students)

I didn't mean to call the college a society, I was more leaning toward the medical society in that sense - are you SURE that if you check off the fact that you've had a severe mental illness the licensing board is still going to let you practice? Also, I will say this, and I mean it so no holds barred here: i would NEVER want a physician with an SPMI treating me or my family - and thats the reality of it. Working as a physician is strenuous enough, and when you start throwing severe mental illness into the mix, no I don't want them in practice - I think it can be very dangerous for patients all the way around. Especially someone with schizophrenia (as I refer to the kid in Philly who is not a mugger - he was a MED STUDENT). Now go ahead - flame away, but that is how I feel about it.

Psy yeah I guess the plane issue is different, I was just somehow trying to tie that in with this somehow I guess it doesn't work

On the last note, I think the message GW sends is inappropriate and irresponsible, but as I stated previously, the epidemic of teen suicide needs to be addressed as well as some type of resolution to how to handle these acts when they are in college - I mean, although you may say college is not a "society" it is a community - and there are plenty of community's that pick who they want to be a member and who they don't. The problem is the message saying "mental illness is bad" It needs to be more supportive, but the question is HOW. 😕

 

[Doctor Bagel]

By setting this example, GW has certainly achieved one goal: Students will think twice before they seek professional help and rather kill themselves in the privacy of their dorm-room.

Exactly. If they're fearing litigation, they're also screwing themselves because they will be sued the next time a student kills herself, and they'll lose.

I'm not saying schools should do nothing or allow destructive students to make the lives of their roomates and neighbors hell. But I think there are lots of options for schools that are infinitely superior to just dismissing all students who show signs of mental illness. Several have already been mentioned here.

 

[f_w]

Since the mentally ill at times do have the potential to self harm or harm others - is there a line that needs to be drawn.

We ALL have a potential to harm ourself or others.

1. what if the person isn't being medicated, followed properly and does end up hurting themselves.

And a college would certainly have the right to insist on making sure that a patient is in a monitored therapy setting.

are you SURE that if you check off the fact that you've had a severe mental illness the licensing board is still going to let you practice?

Nothing is sure in life. But at least you have a semblance of due process when it comes to medical licensing. I can't imagine licensing a florid schizophrenic. But someone who has to mark 'yes' because he had a brief admission for depression and is managed on outpatient meds ever since would probably be looked at in a favorable light.

no I don't want them in practice - I think it can be very dangerous for patients all the way around.

I don't want a doc with a substance abuse problem, I don't need a superhuman.

(as I refer to the kid in Philly who is not a mugger - he was a MED STUDENT).

I didn't want to imply that he was a mugger, I wanted to say that in the broad range of possibilities to get yourself killed in Philly, schizo medstudents are one of the rarer occurrences.

the epidemic of teen suicide needs to be addressed as well as some type of resolution to how to handle these acts when they are in college -

Right. But how about screening, surveillance and unimpeded access to healthcare professionals for the students who need it.
If you work at larger medical organizations, there is typically a 'provider referral hotline'. If you think that one of your co-workers is tipping over the edge, you can call the hotline and an entity outside of the hospital contacts the co-worker trying to figure out whether he needs help.
There are many things that can be done to reduce teen suicide, kicking someone out of college doesn't strike me as a great strategy to de-stigmatize affective disorders.

I mean, although you may say college is not a "society" it is a community - and there are plenty of community's that pick who they want to be a member and who they don't.

A college is a company that sells education and as such they are bound to the same laws (ADA) as other corporations.

 

[Psyclops]

P-Funk, I applaud your efforts to find the line. Because, invariable in these issues lines need to be drawn. They might ned to be felxible though. I like the motto, "Bend don't break". What if the kid had access to services and continuously refused them? Should that be chocked up as part of the illness? It often is in th case of Schizophrenia an other paranoid spectra. But if someone is depressed, an adult, continuously refuses tx, then attempts to kill themselves in a public and disruptive manner should they be welcomed back? Main point I wanted to make: Essentially I see this as where do we draw the line between personal responisbility and how mental illness interferes with that. To the extent it falls on the side of MI,then the person should be given the benefit of the doubt. To the extent i falls on the side of a lack of responsibility and concern for others etc, punitive measures should be considered.

 

[Psyclops]

We ALL have a potential to harm ourself or others.

What? I don't think that type of reasoning gets us anywhere pragmatically.

Right. But how about screening, surveillance and unimpeded access to healthcare professionals for the students who need it.
If you work at larger medical organizations, there is typically a 'provider referral hotline'. If you think that one of your co-workers is tipping over the edge, you can call the hotline and an entity outside of the hospital contacts the co-worker trying to figure out whether he needs help.

So maybe this kids roommate should be held responsible? Is that what you are saying? I'm putting words i your mouth I know, but I wanted to illustrate that things can get dangerous even when well intentioned.

A college is a company that sells education and as such they are bound to the same laws (ADA) as other corporations.

I don't know what these laws are, but colleges are very interesting istitutions to debate about, many are state institutions, (Penn State, Ohio State, UCLA) . Also in this discussion, saying tey have a duty to provide or do X because of the law seems like a relatively uninteresting avenue to pursue, this is more of a discussion of where should the law ideally be.

 

[f_w]

So maybe this kids roommate should be held responsible? Is that what you are saying? I'm putting words i your mouth I know, but I wanted to illustrate that things can get dangerous even when well intentioned.

I am not sure about what kid we are talking right now. I am talking about the kid in the WP article who was depressed, sought counseling and went to the GW ER for suicidal ideation. And instead of receiving treatment and support, he was booted out of the school. There was no indication (at least in the article) that he did anything disruptive, although given the shoddy state of journalism in this country I wouldn't exclude that this is what actually happened.

I don't know what these laws are,

Well, as a physician to be, you might be an employer one day. You might want to familiarize yourself with these laws. They essentially say that you can't discriminate against someone because they have 1 leg or happen to be depressive. (even if you won't be an employer, you might want to read up on this because in your function as physician you might be called upon to render a professional opinion on someones disability status).

 

[Psyclops]

Sorry, f_W, I didn't identify myself properly, I'm a clinical psychology PhD student who lurks around this board. So I likely won't be a physician, or at least I don't intend to be one.

But, the intention of my post was to look at the issu form a more general standpoint, find that line that Poety was talking about.

 

[bjolly]

a friend of mine had almost the same experience -went to a resident advisor her freshman year and told her she was feeling very depressed, had considered suicide but wasn't going to act on it. She did nothing disruptive at all. She ended up being put in a police car, involuntarily committed to a hospital, and kicked out of school. She had a lawyer who advised her that she was afraid to fight it because if she lost she'd have an expulsion on her record and might never be able to get into another school. The school told her that she would lose, and that if she went quietly, they would treat it as if she was never there. She went, and was able to go to another school.
🙁 It still pisses me off to think about it.

 

[Poety]

a friend of mine had almost the same experience -went to a resident advisor her freshman year and told her she was feeling very depressed, had considered suicide but wasn't going to act on it. She did nothing disruptive at all. She ended up being put in a police car, involuntarily committed to a hospital, and kicked out of school. She had a lawyer who advised her that she was afraid to fight it because if she lost she'd have an expulsion on her record and might never be able to get into another school. The school told her that she would lose, and that if she went quietly, they would treat it as if she was never there. She went, and was able to go to another school.
🙁 It still pisses me off to think about it.

Whoa, so now the issue is, how COMMON it is for students to be kicked out after attempting to seek help for a MI - that is an absolute shame. I imagine the question could now become is whether or not the treatment of suicidal teens is directly proportional to the suicide epidemic in this country? Perhaps the teens that followed through feared the repurcussions and avoided seeking help since they knew someone who did that got kicked out of school.

This problem is very complex. Although Psy and I were trying to tweeze out where exactly the line is, perhaps all the other contributing factors would really need to be considered in order to do so.

FW and Psy, I appreciate your responses.

 

[f_w]

It is remarkable how willing colleges are to keep kids who where caught turning over cars and committing arson after their team won, but the moment someone shows signs of health problems they get kicked out.

They should make that aspect part of their orientation so people know how to go about it. If you have wealthy parents, you just seek your treatment outside of the college. If you are a poor sucker, you'll just have to kill yourself without seeking help.

 

[Triathlon]

How many student deaths are caused each year by alcohol? Drinking is almost encouraged, why isn't a student kicked out for getting plastered? That has a higher risk of harm (to self an others) than depression. We fear what we don't understand. MI is not something most want to learn about, unfortunately. So until it is understood we will continue to have these situations arise.

 

[f_w]

And I believe membership in a fraternity has a fairly high odds ratio of getting killed in college.
Lots of things to outlaw, don't think psychiatric conditions are a good place to start.

 

[OldPsychDoc]

...I just read this very good discussion of the colleges' dilemma in these cases on slate.com.

 

[OldPsychDoc]

...I just read this very good discussion of the colleges' dilemma in these cases on slate.com.

 

[Psyclops]

I think that was an interesting article. MH service provders can easily be slammed because they can't speak about the incidences due to HIPPA etc. But I also thought it brought up an interesting point when it used the term "Threatened Suicide". Often times, suicied can be a very interpersonal behavior, serving to regulate (manipulate) a patient's relationships or environment.

FW and some others, I have found that undergraduate schools are not fogiving when it comes to impulsive behavior, such as rioting and more. I went to a large undergraduate state university and they came down hard on rioters (as they should) but often times in their zeal, they hurt alot of inicent bystanders. Additionally, the Univ. semed to think it had the right (duty?) to discipline students who were caught engaging in unbecoming behavior even far off campus, when they were not representing th Univ.
For example a friend of mine, who got into a bar fight, had his diploma withheld for years. If universitys plan on regulating adults behavior, as if they were in locus parentis, when it comes those kinds of events, they should be held responsible for the safety of their student body. Which it seems they are, again, I don't know where the line should fall.

 

[Poety]

...I just read this very good discussion of the colleges' dilemma in these cases on slate.com.

I like what Illinois implemented. And the rates of suicide on campus have decreased by half, which says that it must be working. You can argue that the kids may have gone home after withdrawing from school and killed themselves but the focus of the topic is that it wasn't done at college. It has in fact decreased the attrition rate.

As Psy kind of eluded to, perhaps some of this is behavioral manipulation of their environment as opposed to true suicide attempts. Unforunately, we don't know for sure how many of the successful suicides were actually cries for help that went to completion unintentionally. In that age bracket its a bit harder to decipher how many of these kids really wanted to die and how many wanted to stop "suffering". Young adults notoriously have increased difficulty adjusting to stressors so this may in fact be some type of behavioral response to these emotions.

I thought the article was interesting when it discussed how perhaps with the widespread availability of psychotropics, more mentally unstable/disabled individuals are able to accomplish more and ultimately get accepted to college in the first place. That was a very very interesting point in my eyes. Woudl these same people have made it this far without the help of psychotropics? Is this one of the causal factors in increased suicides on campus?

ETA: I'd also like to add that although we are discussing suicide as the disruptive behavior here, I don't think any of us think that etoh abuse, rx abuse, rape, etc and other negative bahaviors on campus are "ok" - seems that was thrown in this discussion a lot but is a bit of a moot point since universitys DO have strict guidelines in dealing with criminal and violent acts.

 

[Leukocyte]

For manipulation or not....anyone with major depression who mentions that he is suicidal REALY WANTS TO KILL HIMSELF. He is just AFRAID of:

1-The pain associated with dying (managable)

2-Gods wrath in the after-life. (Non-managable)

This might not make sence to you "sane" people, but depression is a VERY SERIOUS DISEASE. There is a BIG DIFFERENCE between MALINGERING and Major DEPRESSION. Any psychatrist who is worth a penny can tell the difference. Depression has very unique PHYSICAL AND EMOTIONAL signs that cannot be faked even by the best actor.

Major Deppression + Suicide Ideas = Emergency!!!

Malingering + Suicide Ideas = Needs psychotherapy

Please do not tell me that a Psychiatrist who went to 4 years of med school + 4 yeas of residency cannot tell the diffrence between Major Depression and Malingering! 🙄 It is like saying a Cardiologist who cannot tell the difference between a Myocardial Infaction and someone pretending to have a MI.

 

[Psyclops]

Ah, Leukocyte, my favorite kind of poster. You don't just speak in generalizations you speak in absolutes. And let me tell you Big L, we in the mental health field love to be told how it really is, because obviously we are all ignoramoses. You should listen to your first quote, its self righteous tone is welcome here I can assure you. Even more welcome is the dash of christian evangelicalism you throw into the mix and in our faces, it rounds out the recipe nicely.

I'm sorry that you had a bad run in with depression before, be it you or someone you held dear, I truly am. And I hope a good practitioner was involved. But those on this board are trying their best to examine a complicated subject and don't need a lecture. You happened to step in out of your black and white world into ours which tends to be seen more in shades of gray.

 

[Poety]

For manipulation or not....anyone with major depression who mentions that he is suicidal REALY WANTS TO KILL HIMSELF. He is just AFRAID of:

1-The pain associated with dying (managable)

2-Gods wrath in the after-life. (Non-managable)

This might not make sence to you "sane" people, but depression is a VERY SERIOUS DISEASE. There is a BIG DIFFERENCE between MALINGERING and Major DEPRESSION. Any psychatrist who is worth a penny can tell the difference. Depression has very unique PHYSICAL AND EMOTIONAL signs that cannot be faked even by the best actor.

Major Deppression + Suicide Ideas = Emergency!!!

Malingering + Suicide Ideas = Needs psychotherapy

Please do not tell me that a Psychiatrist who went to 4 years of med school + 4 yeas of residency cannot tell the diffrence between Major Depression and Malingering! 🙄 It is like saying a Cardiologist who cannot tell the difference between a Myocardial Infaction and someone pretending to have a MI.

Umm ok 😕

Anyway, thoughts on OPD's link?

 

[Leukocyte]

Ah, Leukocyte, my favorite kind of poster. You don't just speak in generalizations you speak in absolutes. And let me tell you Big L, we in the mental health field love to be told how it really is, because obviously we are all ignoramoses. You should listen to your first quote, its self righteous tone is welcome here I can assure you. Even more welcome is the dash of christian evangelicalism you throw into the mix and in our faces, it rounds out the recipe nicely.

I'm sorry that you had a bad run in with depression before, be it you or someone you held dear, I truly am. And I hope a good practitioner was involved. But those on this board are trying their best to examine a complicated subject and don't need a lecture. You happened to step in out of your black and white world into ours which tends to be seen more in shades of gray.

Sorry. Just ignore my post. I was too emotional. I wanted to delete it (like most of my useless posts) but Poety beat me and posted it on to her post. 😳 I appologize If you found my post offensive.

 

[Leukocyte]

Umm ok 😕

Anyway, thoughts on OPD's link?

Again, I appologize.

To all on this thread, just ignore my post. 😳

 

[Psyclops]

Sorry. Just ignore my post. I was too emotional. I wanted to delete it (like most of my useless posts) but Poety beat me and posted it on to her post. 😳 I appologize If you found my post offensive.

No worries. It sounds like you might have another perspective to share when it comes this issue. Care to?

 

[Doctor Bagel]

No worries. It sounds like you might have another perspective to share when it comes this issue. Care to?

I'm interested, too. Personally, I think those of us with personal experiences with depression should speak out on these issues. Are we the minority here? Just curious.

Going to a concrete example here, suicide can be used as a manipulative tool. Haven't you all had that friend with the loser boyfriend who threatened to kill himself if your friend broke up with him? That happened to one of my roommates, and I know of other people who've had the same experience.

The Illinois approach seems like exactly the perfect approach for a school to take. It addresses both the needs of the suicidal student and the community. I think it's certainly reasonable to consider dismissing a student with an MI who isn't compliant with treatment. I still think GW's approach is inexcusable (unless there really is more to the story, that is), especially when it seems so easy to think of proactive ways to deal with students like this without just kicking them out.

Also, as has been pointed out numerous times in this thread, GW's supposed fear of litigation doesn't give an adequate explanation for their actions because they're not rational if that's their goal -- as we can see, they're opened themselves up to more litigation, and that result was so predictable.

 

[OldPsychDoc]

....Please do not tell me that a Psychiatrist who went to 4 years of med school + 4 yeas of residency cannot tell the diffrence between Major Depression and Malingering! 🙄 It is like saying a Cardiologist who cannot tell the difference between a Myocardial Infaction and someone pretending to have a MI.

I know you've begged us to ignore it, but I want to follow up on this point.

Maybe the "theme for today" is that not everything in real life is as clear cut as it is in med school textbooks. Yes, I hope to be able to tell the difference between MDD with SI and neurovegetative sx and someone who is obviously stating suicidality in order to gain "three hots and a cot" or disability benefits. However, what of the person who is briefly suicidal in response to an interpersonal or individual stressor? Or the person who looks to be in the depths of an MDE but is actually coming down from a cocaine binge? Or the homeless guy who really is feeling depressed and suicidal on the street, but needs the structure of my unit to get his head straight safely and connect with services?

Cardiology isn't always that easy either--it wasn't so long ago that we didn't have troponins--and we might have to try to figure out on our own if the chest pain with non-specific t-wave abnormalities was morphine-seeking or something more serious. I frequently get this from patients and families--that we're somehow going to "run some tests" and figure out conclusively what's wrong with their kid, when the answers are still equivocal and our treatments in any individual case are based on our hypotheses about that person as opposed to some hard, definitive evidence of what is going on.

Medicine is about the art of making decisions with incomplete information, in a social context in which we "artists" are expected to have omniscence and omnipotence.

 

[Psyclops]

Without seeng the data, the Illinois program seems pretty good. Particularly the notion that students are required to get help/assemssment, and they go from there. As for leaving school, voluntarily or otherwise, you can surely imagine situations in which it would be best for a student to leave, and others for them to stay.

 

[Doctor Bagel]

Maybe the "theme for today" is that not everything in real life is as clear cut as it is in med school textbooks. Yes, I hope to be able to tell the difference between MDD with SI and neurovegetative sx and someone who is obviously stating suicidality in order to gain "three hots and a cot" or disability benefits. However, what of the person who is briefly suicidal in response to an interpersonal or individual stressor? Or the person who looks to be in the depths of an MDE but is actually coming down from a cocaine binge? Or the homeless guy who really is feeling depressed and suicidal on the street, but needs the structure of my unit to get his head straight safely and connect with services?

True, but part of what's been bugging me today is that just because lots of times things aren't black and white doesn't mean some situations aren't. Specifically, I think the initial story about GWU is pretty d@mn black and white. We're having a fun conversation about grey areas, but assuming everything is grey is sort of a freshman year in college learning about cultural relativism sort of thing. It's a neat idea, but it leads you to some false conclusions. In sum, some lines are clear, and some things are indefensible. GWU's actions here are wrong. That's it. End of story.

Also, as compelling as it is for people in the medical community to assume that the legal system is totally capricious, it's just not true. If you're making a good faith effort to prevent suicides and to comply with ADA, chances are you're gonna prevail in any law suit. Hey, GWU's gonna lose their law suit, and that's the right outcome.

 

[OldPsychDoc]

...
Also, as compelling as it is for people in the medical community to assume that the legal system is totally capricious, it's just not true. If you're making a good faith effort to prevent suicides and to comply with ADA, chances are you're gonna prevail in any law suit. Hey, GWU's gonna lose their law suit, and that's the right outcome.

Just to clarify--I fully agree with you (and defer to your greater legal knowledge) on the GWU issue. My comment on "gray areas" was related to Leukocyte's rather blunt assertion that as psychiatrists "we should know the difference."

 

[MBK2003]

How many student deaths are caused each year by alcohol? Drinking is almost encouraged, why isn't a student kicked out for getting plastered? That has a higher risk of harm (to self an others) than depression. We fear what we don't understand. MI is not something most want to learn about, unfortunately. So until it is understood we will continue to have these situations arise.

I have personal experience here with friends in college. It can be just as disruptive for someone to have roommate/friend with a binge alcohol problem. Working with a number of college students in my outpatient clinic - the ones with depressed roommates are less worried about their roommates as compared with the ones with roommates with florid eating disorders and alcohol dependence. They frequently report that at least the depressed roommate has some insight. Additionally, college administration seems less sensitive when student's complain about their roommates' alcohol use, but they mention the word "depression" and all ears perk up.

I have been told by people who work in college admissions that any mention of prior mental health treatment in an applicant's file is a "near automatic" rejection. Some colleges feel that they can't support the level of campus mental health services they should have to deal with the mental health and adjustment disorder issues of 10,000 students --> their solution is to try and weed out the ones they know have pre-existing mental health issues. Very frustrating to me, particularly as someone who's going into child and adolescent psychiatry where the mantra is "treat them early and effectively so they don't have problems later on."

MBK2003

 

[Psyclops]

This brings up another issue that I've done some thinking about, it often comes up on the psychology page vis-a-vis graduate school applications. There has been some talk on this forum as well. What I'm talking about is the mentioning of prior mental illness on an application. It seems taht across the board this hurts your chances of acceptance. And, as you can imagine, many have a problem with this, saying things like it adds to the stigma, etc. Especially for clin. psych. programs, they should be more understanding etc. But the way I have always seen it, is why would you want to share it. Call me old fashioned but I wouldn't see it as appropriate per se, or maybe just to intimate for someonne to tell you about any chronic illness they had early upon meeting them. And the same would go for MI. If you feel the need to mention it in applications then it is likely to cause a problem later on. I don't know what the best way to esplain this is, perhaps if MI is a large part of the way iwhich yo define your "self" then it might interfere, but if it is just another attribute it might not. i dont know if I am making my self clear, but I'm trying to explain that in some instances denying addmission for MI is different than others.

 

[Psyclops]

True, but part of what's been bugging me today is that just because lots of times things aren't black and white doesn't mean some situations aren't. Specifically, I think the initial story about GWU is pretty d@mn black and white. We're having a fun conversation about grey areas, but assuming everything is grey is sort of a freshman year in college learning about cultural relativism sort of thing. It's a neat idea, but it leads you to some false conclusions. In sum, some lines are clear, and some things are indefensible. GWU's actions here are wrong. That's it. End of story.
.

Idiographic vs. nomothetic. You make your tools in a nomothetic manner, but apply them idiographically. Or else you are in for trouble. IMO.

 

[Poety]

True, but part of what's been bugging me today is that just because lots of times things aren't black and white doesn't mean some situations aren't. Specifically, I think the initial story about GWU is pretty d@mn black and white. We're having a fun conversation about grey areas, but assuming everything is grey is sort of a freshman year in college learning about cultural relativism sort of thing. It's a neat idea, but it leads you to some false conclusions. In sum, some lines are clear, and some things are indefensible. GWU's actions here are wrong. That's it. End of story.

Also, as compelling as it is for people in the medical community to assume that the legal system is totally capricious, it's just not true. If you're making a good faith effort to prevent suicides and to comply with ADA, chances are you're gonna prevail in any law suit. Hey, GWU's gonna lose their law suit, and that's the right outcome.

It is interesting that we don't get to hear the colleges side of the story - the jury or judge or whoever will - was the outcome already determined or is it still being heard? I'm interested to know the judgement for sure!

Excellent point MBK - I agree that other d/o are just if not more disturbing to fellow classmates - I think we ALL knew someone with the eating d/o that wouldn't go for help, etc etc. I also had a friend that went off her medication because it made her gain too much weight, and she became very ill. I was lucky enough to be at a small womens college, but I wonder what would have happened at a larger university.