BOSTON, April 23 (UPI) -- While the tragic shootings at Virginia Tech were the result of unique circumstances, the incident highlighted the need for more schools to make mental-health services a priority and for mental-health experts to have a clear plan for early detection of troubled students, with adequate follow-up.
And that need is urgent in the face of grim statistics suggesting severe depression has doubled and suicidal thoughts have tripled in the past several years.
"It's scary data. There is not enough staff and many more disturbed students," Richard Kadison, a psychiatrist and chief of mental-health services at Harvard University, told United Press International.
Yet while the demand for services has increased, many college mental-health units haven't been able to keep up, Jerald Kay, chair of the department of psychiatry at Wright State University in Dayton, Ohio, told UPI. "We do really need to attend to this," he said. "Some schools have very little or no programs for students."
About 58 percent of colleges currently offer counseling services, Kay said, and some can afford to offer just a limited number of therapy sessions, with the students themselves having to pay for them.
The federal government has offered some relief via The Garrett Lee Smith Memorial Act, which previously provided $82 million in funds for suicide prevention among teens and college students and is now before Congress for reauthorization.
However, while budget issues remain a major stumbling block for some schools in addressing the rising rates of depression and mental illness on campus, those universities that currently do offer mental-health services must ensure that the services are well organized and coordinated, Kadison told UPI.
In the case of Virginia Tech shooter Cho Seung-hui, it appears that university mental-health counselors did not follow up with him after he was released from a psychiatric institution and came back to campus.
"I don't blame the university. But when someone is hospitalized, it raises the amount of vigilance needed. At Harvard, the students have to come back to our counselors, to see if they are ready and safe to be back in school," Kadison said.
"The hospital staff can say, 'Yes, he is ready to leave,' but that doesn't mean he is ready to move back into the dorm," Kadison said.
"It's so hard to figure out how much of this would have made a difference; if someone had been able to make a connection with this young man, and get him to see a counselor," Kadison said.
Cho was found to be disruptive to female students in an English class. At that point, he was removed from class and tutored by the chair of the department.
Kadison said that, at Harvard, when students are repeatedly disruptive in class or in a dorm, they may be walked over to the counseling center.
But while mental-health experts and school officials continue to dissect how the system may have failed at Virginia Tech, recent data suggest the problem on a national scale is worsening.
A study at Kansas State University found that between 1988 and 2001, the number of students with symptoms of serious depression doubled and those with suicidal thoughts tripled over the length of the study.
What's more, an annual survey of 47,000 students by the American College Health Association -- in which students fill out reports about their mental states -- has found that for the past five years, 45 percent of students reported being so depressed at times that it was difficult to function. By comparison, the national average for depression is 10 percent to 20 percent.
"This doesn't mean that 45 percent of the students are clinically depressed, but they are very stressed out," said Harvard's Kadison. About 1,100 students commit suicide each year.
There is no clear answer why so many more students today report being depressed. In terms of the high demand for campus mental-health services, one factor is that more students with a history of mental illness are able to attend college because of medications available.
"Many of these students may not have made it into college a quarter of a century ago -- students with bipolar disorder and schizophrenia," said Wright State's Kay.
At Wright State, the demand for services has increased "exponentially," he said, with students there seeking help with substance abuse, eating disorders and sexual-assault trauma.
In any event, does the Virginia Tech case also illustrate the need to tailor mental-health services to cultural needs?
Wonju Cha, program director of the Korean American family service center in Los Angeles, said culturally appropriate counseling definitely helps people open up.
One common source of stress among immigrant families is that the children readily adopt mainstream American culture, while the parents remain traditional, Cha said.
"Sometimes these kids here have a harder time because their parents are not able to guide them in social interactions and the social system," Cha told UPI. But, "these kids are average."
With Cho, it's not the fact that he's South Korean or that he's first generation -- it has to do with him being severely emotionally disturbed. "This is more a factor than any cultural influence," Cha said.
Even with the best mental-health services available, stigma may prevent students from getting that care, said Alison Malmon, founder and director of Active Minds, a group that works on college campuses to teach students to recognize mental illness and get treatment. Malmon started the organization after her brother committed suicide in college.
"Students are in touch with each other much more than teachers. Friends may notice something, but not know what to do," she told UPI. There is an Active Minds chapter on the Virginia Tech campus, Malmon said.
The Cho tragedy points out the need for peers to feel comfortable intervening with a distressed roommate. "Students should know the warning signs," Malmon said.
"The education of everyone around him was needed (for example), his roommates, so they can go up to him and say, 'Hey are you alright? What's going on?'" Malmon said.
Malmon added she is concerned that the public and college students will erroneously link violence with mental illness as a result of Cho's story.
"He was not typical of a college student suffering from depression," she said.
