Universities pushed to address mental health concerns on campus after student suicides

Geoff Bennett:

Higher education is facing a student mental health crisis.

That's the focus tonight of our series Rethinking College and our reporting on Early Warnings: America's Youth Mental Health Crisis.

We start with Yale University, which earlier this year settled a lawsuit following the death of a student by suicide in 2021. According to the agreement, the university will now allow students more flexibility to take lighter course loads and to keep their health care while on medical leave.

Yale agreed to the policy after a group of alumni and students sued the school, arguing the policies discriminated against students with mental health issues.

Willow Sylvester is a Yale graduate who was part of that lawsuit. She explained what things were like before the settlement.

Willow Sylvester, Former Student, Yale University:

When I started at Yale, I had to stop seeing my therapist, and I felt super isolated.

Fast-forward to my senior year. I was a first-year counselor. I was working directly with first-year students. And almost every single one reported these same feelings of feeling isolated on campus. Mental Health Justice at Yale was founded in the immediate aftermath of Rachael Shaw-Rosenbaum's passing by suicide.

She was a first-year student. The resources that she lacked and the policies that made her feel like she didn't have the help that she needed were very, very clear. She had spoken publicly about feeling this need to move down to a part-time course load, and if she could just move down to part-time courses, she would be able to get on top of her mental health, but that that was not an option at Yale.

Another thing which was also related to why Rachael wanted to go part-time is maintaining access to Yale's health insurance when you're on leave or withdrawal. If she had gone home and taken a leave for her mental health, she would lose access to her Yale health resources and also her Yale mental health resources while she was home. And she knew that she needed those.

Both of those, as a result of the settlement, are now something that students can do. So students on leave maintain access to their Yale health insurance and students can go down to a part-time course load.

We absolutely should not have had to lose a life to get these changes rolling.

Geoff Bennett:

Last year, North Carolina State University saw 14 student deaths, including seven by suicide, leading to concern and criticism about the level of student support.

In a statement to the "NewsHour," North Carolina State said it has expanded mental health resources and access both on campus and to the broader school community. That includes nearly 30 more counselors and clinical positions in recent years, additional wellness days, greater peer support, and new telehealth options.

Ireland White is a student who started a mental health support group called the Self Love Club and wants to see even more changes.

Ireland White, Student, North Carolina State University:

I started the club in January of this year because of the recent suicides on campus.

I thought one of the easiest ways I could give back to my community was to start a club. We're just trying to build a community of people who want to focus on themselves and try to do something as a collective and create a safe space for people on campus to talk.

There's a lot of anxiety with students today of not being cool enough, not fitting in, not belonging. I also think that schoolwork and just the amount of pressure there is for deadlines in college really contributes to this feeling of anxiety. Not only are you missing out socially. You're missing out academically.

And then there's also who's doing the best in the class and this kind of competitive aspect that you don't even realize takes a toll on how you feel about yourself and your self-esteem. It was really strange to just get an e-mail saying, like, all these students had passed away, instead of having a big community meeting or a community gathering, where we could actually discuss about how we can go about this and how people are feeling.

They just kind of introduced the student mental health task force and kind of called it a day. Doubling the amount of counselors does not translate to people are getting more help. No matter what you're doing on any day of the week, State has an event that's going on right now that you could just go to later tonight or in the morning.

There's always something going on. But there's an absence of people really talking about mental health and how it affects them.

Geoff Bennett:

Let's hear more about what schools may need to do.

Dr. Jessi Gold is assistant professor of psychiatry at Washington University in St. Louis.

Dr. Gold, what's the main thing you hear from the students you work with in terms of what they're struggling with?

Dr. Jessi Gold, Washington University in St. Louis: I mean, college students have always struggled. It's nothing new. The pandemic has definitely made it worse.

But I see anxiety. I see depression. College is also a time of exploration. So we say substance use. We see trouble with concentration. And then, obviously, all of that's compounded by all of the changes that have happened in the pandemic and then all of the changes that continue to happen in the world. So it's just been really hard.

And college students feel things and feel things really strongly.

Geoff Bennett:

Well, rates of anxiety, depression, suicidal ideation on college campuses have never been higher. What accounts for that?

Is this a generational thing? I mean, to your point, there's something about attending college that is inherently stressful. That's always been true. What's different about the current moment?

Dr. Jessi Gold:

I wish we could pinpoint one thing and blame that one thing, because I know people would love to blame things social media and say it's just social media and that's the one difference.

And I don't think that's true. I think we definitely can say that has to be a factor, because we didn't have social media before. And that affects our mental health. And we're looking at news more often, more — and the information we're taking in is different, and the way that we're thinking about things is different.

But then there's also the way that we are interacting with each other and socializing is also different, and there's a lot of loneliness. And that's contributing. I think that we talk about mental health more. And, sometimes, that leads to overpathologizing meaning that we're calling things depression and anxiety with a big D and a big A, meaning the diagnosis, as opposed to the symptom.

So I think it's good that we talk about it more, but it might mean that people then associate with the actual diagnosis, as opposed to just the symptoms. So we're getting in this situation where it's hard to know, is the person just struggling with the actual feelings or are they actually struggling something where they need to come see me?

Geoff Bennett:

So, what more can universities and colleges do to address the academic pressure, the loneliness that students are feeling? Is this a structural thing that colleges have to address?

Dr. Jessi Gold:

There's definitely structural points to it.

So we talk about, how is mental health included in everything that we're working on in college campuses, right? So, things leave policies, if someone's really struggling, how do we make sure that, when they leave, they feel comfortable asking for help, that they feel comfortable coming back on campus, that they're able to do that?

That's really important. There's mental health in everything that we're doing. But it's also, how do students feel comfortable talking to faculty to begin with, to know that those faculty feel comfortable even talking to those students?

Because I see faculty too, and they don't — they haven't had training in mental health. They're not psychiatrists. And they're often the first people that come to students. And they're supposed to support them through their mental health experiences as coaches, as faculty members, as administrators. And they need the support to be able to do that too.

So how do we make it easier for faculty to talk to students, for students to feel comfortable talking to faculty, for them to notice stuff, so they get seen earlier, so then they come to me and they can talk to each other earlier too?

Geoff Bennett:

We have heard how students say they want more transparency.

School administrators obviously have to abide by health privacy and confidentiality laws. There might be concerns about reputational damage to the colleges and universities. Some administrators have a concern that the more they talk about suicide, that that might in some ways encourage or might lead to more deaths by suicide.

How should university and college leaders, how often should they talk about this and how should they talk about it?

Dr. Jessi Gold:

So there's no evidence that the more we talk about things and the more we ask about things, the worse it is.

So, as a psychiatrist, we're encouraged to always ask our patients about suicide. It doesn't mean that we're going to make patients then think about it. We don't implant those ideas. In fact, we support people by asking about those things. So it's important for college to be a safe place to have those conversations and for students to feel safe from the minute they get on campus, to talk about mental health from prevention to intervention.

The only way you do that is to change the culture of how we talk about these things. And you can't be scared to talk about it. And we can't be just super reactionary, where the only campuses that are doing things are the campuses where something really bad happens.

Geoff Bennett:

The campuses that are getting it right, what are they doing, the schools that help students do their best and feel their best?

Dr. Jessi Gold:

I wish I could tell you there's one good example, and that that's the one to emulate across the country.

And I don't know that we have, like, a perfect college yet. And I think that's because every college is probably a little bit different. And so I think colleges need to figure out exactly what their population wants. So, instead of just making a cookie-cutter mold of what everybody wants and should be doing, we need to do that.

I think we need to have available resources, of course, so that, if people need care,they can get it. But that can't be the only thing we're doing, right? We can't just say the answer is more therapists, because you could always have more therapists, and people will always use more therapists, but you will run out of that as a resource.

So you have to start earlier with peer support, with supporting faculty and staff and helping students earlier, with helping students feel comfortable talking to each other and noticing signs and symptoms in themselves. That sort of thing is really easy, and it's not that expensive, and can make pretty big changes to how we talk to each other and how we make changes on campus.

Geoff Bennett:

Dr. Jessi Gold, assistant professor of psychiatry at the Washington University in St. Louis, thanks for your time.

Dr. Jessi Gold:

Thanks for having me.

Geoff Bennett:

If you or someone you know is in crisis and may be considering suicide, call or text the suicide and crisis hot line at 988. You can also visit 988lifeline.org.