Growing Up, Getting Help

Listen to this 'Talk of the Nation' topic

My second year at Juilliard, a girl in my viola studio jumped out her window. It was, of course, horrifying — but it was also a shock. The usual refrain floated around the cafeteria, "She seemed so happy!" Juilliard is a pressure cooker — there's no doubt about that — but what occurs to me now, is that, at the time, I would have had very little idea of where to go for help if I had been severely depressed. And given that students don't do the kind of work at Juilliard that might indicate emotional problems, it's hard to see how an adult could have seen what was going on with that particular student (does playing your Beethoven with particular passion indicate a problem, or a solution...). Since my tenure at Juilliard a thousand years ago, the mental health system has been utterly transformed, much like other colleges reacted after the tragedy at Virginia Tech a year ago. Today we're going to focus on those changes, particularly in Cornell's approach (which was before the VA Tech events). And we're going to talk to a professor from my other alma mater — the irreplaceable Tristan Davies at Johns Hopkins Writing Seminars. He reads hundreds of pieces of creative writing — and has had to step in from time to time when a red flag appears.

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You talked about the stigma associated with mental illness. How about health insurance? Will a student that seeks mental health treatment in college have trouble getting health insurance later in life?

Sent by David | 2:28 PM | 4-17-2008

When I was in college I had a severe eating disorder. The Dean was confronted by some of my peers who then blindsided me with a choice. I was to get better or get kicked out of school. I was already in counseling (school provided) and was enrolled in an intensive outpatient treatment program that began when the semester ended. She called my mother (who was well aware of the situation) to try to scare me. My therapist was not contacted, there was no assistance in my travel home (I had to withdrawal passing all of my classes), and no one kept up with my progress after I was sent home. There were far more sensitive ways this could have been handled. I left school three days later, alone, on a bus traveling home halfway across the country. I was lucky and was able to return the following semester (not without getting a similar threat 3 months later), and did complete my degree on time.

Sent by Julia (hoolia) | 2:29 PM | 4-17-2008

I was a student who took a downturn a year ago. I was in my mid-thirties, already with another degree and past career, but multiple life events and the pressure of not making good grades caused me to spiral. I had never felt suicidal before, but began to fantasize about it. I got help, and was pleasantly surprised to be surrounded, within days, with a team of a doctor, psychologist, counselor, nutritionist and simply- constant follow-up, communication and monitoring. I was very grateful, and the medicines made a difference for me that I would have ever imagined. Frankly, I felt better able to cope and more importantly, received practical and non-judgemental support that made me feel hopeful again. It was "luck" perhaps that when I most needed help, I was in a university environment.

Sent by Theresa | 2:30 PM | 4-17-2008

I attended the University of Cincinnati during my undergraduate years. During that time, I developed a serious eating disorder. I confided in a college professor, who encouraged me to seek out the university's psychiatric counseling services. Because I was on the university's health insurance plan, my coverage was limited to the university's staff and services.

I had to meet with a psychiatrist initially before I would be called to set up an appointment to see a therapist on a regular basis. The psychiatrist was extremely rude, aggressive and put me on the defensive immediately. He told me, someone who sought help for bulimia and anorexic-like behaviors, that I still had weight to lose. I left his office and promptly lost another 20 pounds within three weeks. I never did receive a call to follow up on therapy.

I did see another therapist - a non-university therapist - several months later. She encouraged me to have a physical, as I had long ceased menstruating and had heart palpitations. I went to the university health clinic, where I informed them of my eating disorder, health issues, and therapist recommendation. They sent me for a pregnancy test, even though I assured them I could not be pregnant. No other tests were done to ensure my physical or mental wellbeing.

This was five years ago; I hope the university has improved its services since then.

Sent by Rachel Richardson | 2:31 PM | 4-17-2008

What is alarming, and seldom discussed, is the gap in coverage experienced by students once they LEAVE college. A university may be a place that provides coordinated care between therapist, psychiatrist and physician, but all of that evaporates once the student graduates. It's a big enough jar adjusting to the "outside world," particularly in this economic climate -- but to couple that with the added burden of mental illness... the mind reels. Students are forced to go off meds, because they are no longer covered by parents or university's insurance. And, increasingly, the jobs most readily available to recent graduates (food service, temp agencies, etc.) do not supply health care benefits. The effect on not just individual's mental health, but also the climate of our country and economy must surely be taken into account in dialogues such as this.

Sent by Robin McGee | 2:37 PM | 4-17-2008

I am currently a sociology major at James Madison University. I have a very depressing outlook on the world, especially knowing that I am a part of a capitalist machine that needs to exploit others to continue. What's worse is that I cannot change the system without years of working from within the political and economic systems and changing the entire consumer culture. Which isn't going to happen. Plus I'll be labeled a terrorist or a communist. I don't want to be a part of this system any longer, I don't want to be sedated with xanex or programmed to work with ritalin. I know going to get "help" will result in pills, I've been through it many times before. I'd rather be depressed and dying than drugged up and mechanical.

Sent by chris y. | 2:41 PM | 4-17-2008

Caller Kevin's experience is much like my wife's experience. I was deployed to Iraq. She was not getting my pay. went to Family Services for help was "compelled" to go to a local hospital (and denied access to her own Psychologist).

Sent by Kieth Stansfield | 2:44 PM | 4-17-2008

When I taught at the University of Massachusetts Amherst, I came to realize that college roommates are very helpful when identifying students in distress.

Roommates are often in the best situation to identify problems because they witness the mood and behavior of their fellow roommate on a daily basis.

If a college or university encourages a culture of caring, roommates can serve as a valuable link between their peers and mental health services.

Here is an example:
One of my students had a number of absences because her "roommate was having a crisis." When I asked her about her roommate, it turned out that she was another student of mine who had been absent for a number of days.

I was able to then talk to the student in crisis about getting help with the university's mental health program. The student thanked me for caring answered that she was indeed getting help from mental health services.

Sent by Sigrun | 2:49 PM | 4-17-2008

My son had extreme depression (of which we were unaware) at Columbia in New York in the winter of 2002 (following 9/11). Not only did the psychiatrist he went to see dismiss him and his concerns, but the school would not allow us to get him a medical leave. He has since told us he was suicidal at this time. If a school like Columbia let him fall through the cracks, I'm not sure how other schools can avoid the same.

To simply talk about mental health on campuses is only part of the problem. Our experience with the mental health system at this time and since, have led me to believe in a system which punishes the patient, if only in the length of time it takes to see a doctor. Since most psychiatrists do not do much counseling themselves, patients are then left to find a counselor, usually a social worker. The system is so antiquated, and cumbersome, and please don't even mention insurance coverage. My son now has a regular therapist (not an M.D.)and is doing well. But the Columbia experience taught us that the system helps to frustrate more than it can help.

Sent by jackie page | 2:52 PM | 4-17-2008

I just listened to the 1st 1/2 of today's show & was pleased with the caring attitude espoused by your guest from Johns Hopkins. I wanted to share an experience that occurred to a colleague during my first year teaching at a public high school. This teacher (for whom it was also his 1st year in education) assigned his science students to create a time-line of events in their lives (in preparation for studying geological time-lines). One student plotted his death, at 16, on his time-line. This raised a red flag with the teacher who asked several of us what we thought he should do. He was advised to speak with the student & to also pass the info. onto the student's guidance counselor. The student said everything was fine - no reason for concern. Tragically, a year later this student committed suicide - unfortunately, well-meaning adults can't always change the outcome - but I was so thankful that this teacher had not ignored this red flag. It turned out that through the guidance counselor, the student had been receiving help for his depression.

Thinking about how easy it would have been for my colleague to ignore this unusual response to his assignment - & how devastating it would have been to live with if he had - I have always followed through on any red flags, no matter how trivial they may have appeared. I have taught high school & college students for the past 23 years & have never had a student respond negatively to my concern. In every case it has benefited my relationship with the student. I don't think anyone can fault someone for showing they care.

One more point on this subject: I was astonished, after the Columbine Killings, at how many cries for help the student shooters had made to their peers, parents, teachers, & school staff before actually following through. It appeared as if everyone ignored them - rationalizing their behaviors as "typical teenage angst" or else none of anyone's business.

The callers/bloggers who report negative experiences by school personnel reflect, I think, the complexity & delicacy of the responses required to those who raise a red flag. Clearly, there are those who can competently advise & help a troubled (or not troubled) student & those who make the situation worse. However, the inconvenience experienced when a student is referred for help when it is not in fact necessary cannot possibly compare with the tragedy of ignoring a red flag by a student in need of help.

Thank you for tackling this difficult issue.

Sent by Tracey Devlin | 2:59 PM | 4-17-2008

I just finished listening to this piece and I'm sorry I wasn't quick enough to share my comments.

I studied abroad for a year and a fellow student in the same exchange program (who was already a bit odd to begin with) started showing signs of schizophrenia and auditory hallucinations, with increasingly frightening outbursts. His host family tried to help but didn't know how to deal with it and he was moved to a small apartment building with a few other students. Obviously, this did nothing to quell his growing paranoia, and his neighbors began to fear he would become violent. Since he never crossed that line, despite numerous complaints filed, nothing could be done about it without him voluntarily seeking help.

It was only after several outbursts in class that involved verbally abusing other students that his parents were called and finally he was coaxed into returning home, but even then, had he refused there was nothing that could have been done.

It later came out that he had a history of mental illness and had gone off his medication shortly before he entered the program, and we were all shocked that this hadn't been caught by the particularly stringent screening process. What startled us even more was how dismally unprepared the school and program were to deal with this sort of situation. Our resident advisers pulled double duty as counselors for minor problems, but they had no more idea of how to deal with the situation than the poor student's host family, and were not privy to his previous medical history.

After I returned, I saw the Virginia Tech coverage and was genuinely worried that something similar could have happened to us. Just like in VA, we (the other students) could see the problem coming, but were ultimately powerless to do anything until AFTER he crossed that line; we could only hope that when he did, it would be a minor incident and no one would get really hurt. That sort of reactionary thinking is no way to deal with mental illness so severe.

I realize that there are patient rights to consider and I don't want to force treatment down anyone's throat, but I believe that schools (and exchange programs) should be aware of the wide spectrum of problems that their students may face, and try to be prepared to handle this kind of situation in a way that doesn't infringe on anyone's rights, but also doesn't put anyone in harms way.

Thank you.

Sent by David B | 3:07 PM | 4-17-2008

Let's call the so-called "stigma" of mental illness by its proper name - HATE. The issue is not the "stigma" carried by people with psychiatric conditions, but the hate directed at them by the so-called "normal" population and "professionals" who ought to know better. The same kind of hate that's been directed at blacks, Jews, Asians, gays, and so on.

Sent by Paul Goldschmid | 3:30 PM | 4-17-2008