Walking the Edge

NYU confronts its suicide problem with counseling and a questionable questionnaire

He cites the case of a woman attending a private school in Illinois. After confessing suicidal thoughts to a school counselor, she was thrown out of campus housing "for fear she would become disruptive," Rickgarn says. "It is very unethical to say to someone seeking help, 'Go away.' "

Determining the success of any suicide prevention program is difficult.

While few schools have thoroughly studied the problem on their own campuses, Dr. Paul Joffe, chair of the Suicide Prevention Team at the University of Illinois, leads the only one in the country that offers empirical data. He says the policy, called mandated assessment, decreased the number of student suicides at the University of Illinois by 58 percent over an 18-year period. The program runs on the theory that suicidal college students can be easy to spot. "I was struck by the number of students known to be suicidal that went on to commit suicide, that were given no treatment," Joffe says.

illustration: Rachel Salomon

Following a suicide attempt or threat, the university assigns four mandatory counseling sessions. If a student fails to complete the four sessions, the school considers a variety of punishments, including expulsion. "Leaving school is always a possibility," Joffe says. The university has withdrawn only one student, a person who complied with the program but remained suicidal.

Since the advent of the program in 1984, some 2,000 students have gone through the mandated sessions, none of whom—to the best of the program's knowledge—went on to commit suicide.

In some respects, the spate of suicides at NYU mirrors what's happening nationwide. According to the Centers for Disease Control, suicide rates among young people nearly tripled between 1952 and 1995. In 1998, suicide killed more young adults than AIDS, heart disease, cancer, birth defects, pneumonia, stroke, lung disease, and influenza combined. Suicide today is the second leading cause of death among college-age students.

A 2002 survey of counseling directors at 283 colleges, reported the Chronicle of Higher Education, revealed that 95 percent were seeing more students on psychiatric medication than in previous years. The counseling directors also noted an increase in the number of students attending university with severe mental health concerns.

One of the most common psychiatric problems among young adults is depression. Standard treatment for it has become a point of debate. Currently Prozac is the only antidepressant approved by the FDA for use in young adults, though doctors often prescribe other popular drugs like Paxil and Zoloft.

Last week, an FDA advisory committee called for stronger warning labels on antidepressant medication, saying that previously hushed data revealed an increase in suicidal tendencies for children and teenagers who regularly take the drugs. The committee took into consideration emotional testimony from families who had lost a child on antidepressants to suicide. The panel also considered convincing data found in an independent study conducted by Columbia University. Out of 100 young patients treated with antidepressants, two or three will likely display evidence of suicidal thoughts or actions that otherwise would not have appeared, Columbia found.

Dr. Morton Silverman, senior adviser to the suicide prevention resource center in Newton, Massachusetts, has served as a consultant for NYU over the last year. Silverman is strongly in favor of "black box" warning labels for antidepressants. He agrees that the number of college-age students using them has increased. "They have now been approved for eating disorders, panic disorders, depression, and obsessive-compulsive disorder," he said.

That's no secret to officials on Washington Square. "Irrespective of events of the past year, NYU has seen what every other college and university has seen—a demand for more mental health services," university spokesperson John Beckman says. "Students who are coming into college these days have more emotional problems than in the past."

While toxicology reports have not been made public for the NYU students who committed suicide, two of the six reportedly had a history of taking antidepressants—which may or may not prove anything. "We still don't know that there is a link to suicide," said Kay Redfield Jamison, author of Night Falls Fast: Understanding Suicide. "There is a link to suicidal thinking, but there is a big leap from suicidal thinking to killing yourself."

Six Suicides at NYU

September 12, 2003: John D. Skolnik, 20, jumped from the 10th floor of Bobst Library.

October 10, 2003: Stephen Bohler, 18, jumped from the 10th floor of Bobst Library. Bohler's death was later ruled a drug-related accident.

October 18, 2003: Michelle Gluckman, 19, jumped from a sixth-floor apartment at 1 University Place.

March 9, 2004: Diana Chien, 19, jumped from the roof of a 26-story apartment building at 36th Street and Sixth Avenue.

June 18, 2004: Charlene Lat, 24, jumped from the roof of a 25-story apartment building at 159 West 53rd Street.

September 9, 2004: Joanne Leavy, 23, jumped from the roof of the 12-story Tisch School of the Arts building.

As the FDA is reconsidering antidepressants and young users, so too are universities weighing steps to better help students, a task that has been difficult for NYU amid the frenzy over campus suicides. "The press has been all over the map," Beckman says, adding that the school "holds its breath" when some stories are published. NYU, and suicide experts, are wary of glamorizing suicide in any way, particularly by media attention and "misdirected" campus dialogues. The school has a policy against holding memorials.

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