With the recent tragedy allegedly perpetrated by suspended college student Jared Loughner in Tuscon, AZ, the role of colleges’ and universities’ student counseling centers has taken center stage. This is a little odd, given that Mr. Loughner attended a community college that lacked a student counseling center. Most community colleges — catering to part-time students who often have families or hold down full-time jobs — don’t seem to have the mental health counseling centers that most traditional universities and colleges have.
Dr. Emily Gibson, a family physician who apparently works with students at a college, recently wrote a blog entry about mental illness in the college student. In this entry, she seems to bemoan the fact that students have come to expect a certain level of psychiatric care and treatment for their mental health concerns — even while at college. Of course, universities have limited resources to offer such care.
Indeed, she asks — but never answers — some compelling questions:
“Didn’t the college understand that removing him from school would make things worse and remove him from daily monitoring of his behavior? Wasn’t there a way to compel him to get psychiatric assessment and treatment?”
The answers to these questions would be interesting and help inform future policy at schools. Let’s tackle the first question…
Universities are traditionally very campus-oriented. What happens on-campus is our problem. What happens off-campus is none of our concern. By having a purposely myopic view of the world, most universities and colleges can pretend that they’re not a part of a community — they are the community.
This benefits most colleges because then they don’t have to deal with larger community issues (such as growth within the town, economic development, care of others within the community, etc.). Sure, they pay lip service to being a part of a community, but having grown up in a college town, it seems that many colleges have a shallow appreciation for the symbiotic nature between college and town.
So when it comes to their students, universities are pretty straightforward — you’re our problem when you’re paying tuition. The minute you stop paying tuition, you’re no longer our problem.
Although it may seem a little heartless, we have to keep in mind that even non-profit colleges and universities are big businesses. They may not make a “profit,” but they are still run like any corporation that takes in hundreds of millions (or even billions) of dollars. A business must be run efficiently, and so anything that doesn’t directly have to do with educating others is an expense. Keeping expenses down is the goal of any business.
Now, of course, the therapists and psychiatrists who work at student counseling centers don’t care about any of this. They will help a student as much as they can, even going above and beyond whatever traditional resources they may have available. But there’s one thing they can’t do — continue to treat or counsel a person who’s no longer a student (e.g., a customer of the university’s services).
The apparent problem with Jared Loughner was that he was primarily categorized as a criminal problem, not a mental health concern. Despite his odd outbursts and nonsensical questions, nobody at the school seemed to think this was a mental health issue. Instead, the police were called. Again and again.
Nobody apparently thought to order a psychiatric evaluation, which the police can do very easily in most states.
So the answer to the second question is that any mental health professional or police officer can compel a psychiatric evaluation if they have reason to suspect the person may be a potential harm to themselves or others. And in this case, from all the media reports, it appears there were professors at the school who felt threatened (and in harm’s way) of Loughner.
Why the police didn’t take these threats seriously remains a big question mark. (Perhaps because they were campus policy? They weren’t properly trained in assessing risk? We don’t know.) Had the police ordered a psychiatric evaluation for Loughner, he may have caught the attention of mental health professionals who could have recognized the danger. Or perhaps not — a psychiatric evaluation may just as easily resulted in little change in Loughner’s plans or behaviors. It didn’t much help in Seung-Hui Cho’s case, the Virginia Tech shooter who killed 32 people.
What’s a University to Do?
I guess that’s one of the key take-aways of this — and any — tragedy. Even had everything been in place and firing on all cylinders, the systems may still not have caught Loughner’s intentions. And all of this is somewhat a moot point in Jared Loughner’s case, however, since the community college he attended didn’t even have a student counseling service.
Last, we have to remember that violence is random and rarely follows any sort of coherent pattern (except around criminal and drug activity). Most criminals don’t have a mental illness and mental illness alone is not a significant predictor of increased violence, so let’s not stereotype those most in need.
Instead, let’s work to increase the resources available to students — especially since we already have access to them on campus. Most colleges and universities already provide student counseling services. Since college tuition has already been on the increase, what’s a few more dollars per student in increased student fees to ensure we offer students the best care possible during this important, transitional time in their lives?
The fact that some university counseling professionals seem to complain about the increasingly complex psychiatric needs of students attending their school seems to me to be pointing a finger of blame at the wrong side. Why wouldn’t students expect a certain level of mental health care while at school? They certainly expect a certain level of security and health care — why should mental health care be any different? And if mental health care needs are increasing, why wouldn’t a school properly plan for these increases and cater to the needs of their students?
After all, a school is there to provide education services to students. Isn’t learning about yourself and developing a coherent and stable personality a part of the learning process of life?
Rather than offer increased mental health services, I suspect some colleges and universities will go in the other direction — increased screening for mental health concerns prior to admissions. Any red flags on such screenings will be used (at least informally) to deny admission to the student, reducing the college’s liability in the future. Because that path is far easier and less expensive than catering to the complex mental health needs of your students.
Read the blog entry by Dr. Emily Gibson: Mental illness in the college student