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Source: (consider it) Thread: Purgatory: Mentally ill students at universities
Moo

Ship's tough old bird
# 107

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I have been thinking and reading a great deal about the shootings at Virginia Tech. They happened less than a mile from my house.

I came across a very interesting statement in a Roanoke Times article yesterday. The part I'm interested in is several paragraphs into the article and begins with the words 'Gerald Amada'

He says that VT made the mistake of
quote:
... letting Cho's escalating antisocial behavior be treated as a mental health issue.

Mental health is not an area that most universities are equipped to handle, Amada said. Like Tech's, many university health centers won't take court referrals because these usually are cases where treatment may need to be compelled, something a school is not set up to do.

But universities do have plenty of power to expel students who do not meet codes of conduct, Amada said.

This goes against many people's idea of compassion. However, if Cho had been expelled, he would probably be alive, and his victims certainly would be.

What do you all think about this?

Moo

[ 15. June 2016, 18:40: Message edited by: Belisarius ]

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seasick

...over the edge
# 48

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quote:
Mental health is not an area that most universities are equipped to handle.
Seems to be the critical bit to me. Expulsion sounds harsh, but I think there comes a point when the University has to be able to say that they cannot deal with the student's condition, and that in the interests of the student's safety and that of other students and staff they should no longer be an active student of the University. Ideally this should be in combination with arrangements for the student concerned to receive appropriate treatment somewhere that can handle it. It could be made possible for the student to return to the University and pick up where they left off, if and when they were recovered.

[ 17. June 2007, 19:10: Message edited by: seasick ]

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Jengie jon

Semper Reformanda
# 273

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From my observations, as a member of university staff, is that university is one of the better places to be mentally ill.

  1. They have counselling services and disability support departments, both open for students to use
  2. There is a student welfare office, who like to keep track of students in difficulties
  3. Academic Staff are specifically given some pastoral responsibility. Normally very light touch but it is there.
  4. Someone will start a chase to contact you if you persistently miss lectures.
  5. Although not stated some students are given space in Halls of Residence precisely because there are worries over their mental health and it allows a closer watch to be kept.
  6. They have access to the student health services who will not just know about the same level as any GP but also are integrated into the University support system and capable of referring that way.
  7. Some university even have a student-student mentoring systems, with older students mentoring younger ones. As far as I am aware, not common but at least two places in the UK have one.

No, I am not saying that Universities are great, in my opinion the whole of society is ill prepared to support/cope with the severely mentally ill. However being mentally ill while at University is probably better than being mentally ill outside them. So expelling a student on mental health grounds may actually worsen that students plight.

Jengie

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WatersOfBabylon
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# 11893

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I know of a few cases of enforced mandatory counselling at my college. They were told they would be expelled unless they saw the school's recommended psychological professional.

However, my school is a private institution with fewer than a thousand students. There are very few students who live off-campus, and even most of the faculty and staff live on campus. Under these circumstances, it is much easier to keep an eye on the "at-risk" students and also easier to enforce mental health policies.

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Jenn.
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# 5239

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I withdrew from university voluntarily when I became very depressed and felt that continuing to push myself through the exams would have been detrimental to my health. I tried to explain this to my tutor who said "what is depression?" and "so why do you need to leave?". I did leave, but encountered problems when I tried to return, as I didn't have the right paperwork (they wanted proof that I was better - like what, blood tests or something?!). It took a lot of pushing to get them to readmit me, about 2 days before the admissions deadline fell.

That was with a relatively minor mental health issue, and the uni could not deal with it appropriately. Their counsellors were rubbish, and what I actually needed was time and space to get my head around some things, not to continue to push myself through difficult exams when I was depressed.

People at universities are young and put under a lot of pressure. Those whose mental health is fragile can suffer. Universities need to recognise where their limits are and make it easier for people to withdraw for a year or two if necessary. Those who don't or won't may need to be told to withdraw. Such withdrawals need not be permanent, but should be more common.

[cross posted with Jengie - my experiences are clearly different, things are not the same at all unis. Perhaps people shouldn't be put under so much pressure to attend their teachers/parents favoured unis in place of those who actually give more support to their students. I so wish there didn't seem to be that distinction, but it does seem to be there]

[ 17. June 2007, 19:38: Message edited by: Jenn R ]

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Hazey*Jane

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# 8754

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Slight tangent, but the quote in the OP made me reflect on how 'mental health problems' is a pretty useless term really, if you're trying to formulate any kind of moral/policy type response to something. If one talked about 'physical health problems' that covers everything from a cold to a neurodegenerative condition. I'm not being trying to get all PC about this - I just think that universities etc aren't going to get far working out how to deal with students with 'mental health issues' if they're all lumped in together.

As for my own experiences, I was referred to the university counselling service after presenting at the uni GPs with mild depression. It was fairly helpful but somewhat brief. University counselling services in the UK are generally very oversubscribed (I was 'lucky' that I'd 'timed' my collapse when things were a bit quieter at the service). So it's an area that universities are probably going to have to consider putting more resources into. But there is going to need to be a range of approaches to respond to the range of conditions.

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Jengie jon

Semper Reformanda
# 273

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I think there is a mistake being made. The fact is students have access to all the external services for mental health as well as the University's counselling services etc. For instance if the Student Health Service Doctor decides a student needs referral to a psychiatrist, he can make that referral, or to a community mental-health team he can do that. If a student wants to pay for counselling a student can and go to any of the fee taking counsellors there are or even use some of the free services if they can make a case.

In other words the counselling may be poor, limited and all the rest, but it is that on top of what the student could access if they were not a student.

Having twice seen a guy go through a major mental health breakdown, once as a student and once not, I can say that it was far easier to access help for him when he was a student.

The other thing is to realise that with the age of legal maturity dropping from 21 to 18 in the UK it changed hugely the way Universities understood their relationship with students. They stopped being loci-parentii for a group of generally mature children, and became a provider of education to young adults many of whom were not used to being adults. The contract changed from being with the parents to being with the student.

Jengie

[ 17. June 2007, 20:28: Message edited by: Jengie Jon ]

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Jenn.
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# 5239

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In some ways Jengie I think you are right, there is the ability to access counselling services etc in a very easy way in a uni, whereas there isn't in the outside world. Sometimes though what a student needs most of all is a break from study, and getting that can be very difficult. Also some students aren't willing to access that support. I think Water's comment about compulsory psychiatric help is an important one, although I worry that implementing such a system might lead t people bottling things up even more, thus increasing pressure and risk.
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Ethne Alba
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# 5804

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Peeking my head round the corner and fearing it'll be punched....am going for it all the same.

My take on this is that "this is a mental health issue" .. does not result in a one-size-fits-all solution.

Someone who is chronically depressed and utterly unable to cope is, in my eyes, light-years away from someone whose behaviour is repeatedly frightening and menacing to others.

Maybe I don't know what I'm talking about, but in my experience the first is treated with understanding and help.
And the second requires firm guidlines and enforced behavioural boundaries.

If universities are not the place to be able to legally deliver this. Then maybe universities are not the place for the second group of people.

Harsh. But...

[ 17. June 2007, 20:56: Message edited by: Ethne Alba ]

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Low Treason
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# 11924

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My experience (albeit quite a while ago) is that my university was used to the problem and dealt with it very well indeed.

Leaving home, often for the first time, being faced with the daunting task of working without the close supervision given at school, matching up with parental expectations etc etc. Many of my fellow undergraduates found it all very difficult to cope with.

I recall that most if not all of these 'casualties' were dealt with professionally and sympathetically with the back-up of a world-class medical establishment.

I cannot say what the situation is now - times have changed and I have a horrible suspicion that many students are just left to sink or swim.

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Hazey*Jane

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# 8754

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quote:
Originally posted by Jengie Jon:
From my observations, as a member of university staff, is that university is one of the better places to be mentally ill.

  1. There is a student welfare office, who like to keep track of students in difficulties
  2. Academic Staff are specifically given some pastoral responsibility. Normally very light touch but it is there.
  3. Someone will start a chase to contact you if you persistently miss lectures.
  4. They have access to the student health services who will not just know about the same level as any GP but also are integrated into the University support system and capable of referring that way.

Sounds like your employer has a pretty good approach. And I definitely see your point about it being better to be mentally ill at uni than elsewhere, in terms of access to support. I wonder, however, how well this set-up is replicated elsewhere in the UK? In contrast to the points above, my experiences as a student were
  • Everyone in my dept had an academic who was their 'personal tutor' who they were supposed to see at least one a term (largely to tick off 'key skills' type appraisals [Roll Eyes] ) but could see more often if need be. I did go once a term, and had a helpful tutor, but I know a lot of people never bothered making appointments with theirs, and were never chased up about it.
  • No one would notice if you didn't go to lectures. Some of my courses had 300 students on them. There was no way of the uni keeping track of you unless you persistently didn't turn up to tutorials (far less frequent than lectures) or didn't hand in coursework. Thus I imagine one could slip below the radar for quite a while.
  • I'm sure Student Welfare are great, but they're got to somehow find out that a student needs monitoring/support in the first place, which is the tricky bit.
  • I had to move for my final year due to family circumstances. When I turned up at the uni doctor's at the start of that year I was told that because I was no longer in the catchment area I was no longer entitled to use their services. They did let me use the walk-in clinic on that day, though - probably cos it was quiet. It was on that occasion that I got my referral to uni counselling and started seeing someone within about a month. Had I had to wait until I could have registered at a local GP and been referred to my local counselling services, it could have been a good few more months before I was seen.
In short, there are plenty of places to go if you are looking for help. But if you don't realise you need help, or don't feel capable of seeking it, you could very easily slip through the net.
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Amorya

Ship's tame galoot
# 2652

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quote:
Originally posted by Jenn R:
Universities need to recognise where their limits are and make it easier for people to withdraw for a year or two if necessary. Those who don't or won't may need to be told to withdraw. Such withdrawals need not be permanent, but should be more common.

Of course, that's dangerous ground. Telling a student to withdraw can be challenged under the DDA, just like firing someone from a job for mental health reasons. They'd better be damn sure those concerned are actually a threat to others...
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daisymay

St Elmo's Fire
# 1480

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In the centre where I used to work (UK), we had students at uni or college referred to us by their academic places (not always having enough counselling time for everyone), and also ones we had worked with before they went off to uni.

Sometimes we needed to write "official" letters to the unis/colleges to allow the students extra time to complete their work, or even to have a year off and get through their problems so that they would then be able to go back to uni and manage to be OK enough to get through their studies.

We also used to refer student to uni counsellors because we knew and the clients knew that they required that support.

Most times it worked pretty well.

We had a few clients with serious mental problems who definitely needed psychiatric medication and also we got letters from their doctors to se that they got the support and checks they needed.

Maybe we were working with mostly young adults who were obviously in need of help and we managed, and they were sensible or worried enough, to get them supported and helped and conformed to reasonable behaviour - which is defintely not what all "mentally normal" students do. [Biased]

But students who are in such an awful state that they act horribly violently to others and/or themselves might not want any "support" from officials... and they might not all be noticeable... [Frown]

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Moo

Ship's tough old bird
# 107

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quote:
Originally posted by Ethne Alba:
Someone who is chronically depressed and utterly unable to cope is, in my eyes, light-years away from someone whose behaviour is repeatedly frightening and menacing to others.
{snip}
And the second requires firm guidlines and enforced behavioural boundaries.

If universities are not the place to be able to legally deliver this. Then maybe universities are not the place for the second group of people.

Harsh. But...

Cho definitely fell into the second group. He was in a writing class where his work was so disturbing to listen to that other students wanted to drop the class. He sometimes sat in class with a camera in his lap and photographed the legs of women students.

He was committed to a mental hospital overnight because psychologists had determined that he was a danger to himself and others.

When it comes to things like non-suicidal depression, the university mental health services are fine, but anyone who is considered a danger should be required to withdraw.

Moo

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Max.
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# 5846

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I've never seen anybody about it but I sometimes find myself in situations where I get depressed - only a couple of months ago I didn't actually leave my room for anything except food, occasional college classes and church services once a week because of depression.

Thankfully I had really good friends who were genuinely worried about me, forced me to get out a bit, stole my alcohol from me and in the end got me to confront my problems! I was acting like a major jerk, I was getting obsessed by really stupid little things in my life which weren't really important yet those little things still make me feel bad about myself and I suppose that I am still only a stones throw away from locking myself in my room once again and not communicating!

My college has no idea about what I went through, I think we have some kind of support unit but I don't know where it is and I doubt that when I was going through it all I would've actually made the effort to go and speak to them, much easier to lay in my bed watching DVDs, listening to Emo Rock and dying my hair strange colours!


Max

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Hazey*Jane

Ship's Biscuit Crumbs
# 8754

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It's hard to say without more details of the case, but based on your summary there, Moo, I'd say that the health service who dealt with him were at least as, if not more than, culpable as the university. But then it's hard to know what communication went on between the two.
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Moo

Ship's tough old bird
# 107

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quote:
Originally posted by Hazey*Jane:
It's hard to say without more details of the case, but based on your summary there, Moo, I'd say that the health service who dealt with him were at least as, if not more than, culpable as the university. But then it's hard to know what communication went on between the two.

It's not certain that he ever went to the health service. He was ordered by the court to undergo psychotherapy, but the university health service does not accept court orders; it has no means of enforcement.*

There was certainly a massive snafu, but I'm particularly interested in the idea that people who might harm themselves or others should not be permitted to stay at the university. If their health improves, of course they should be re-admitted.

*The question of what the judge thought he was doing when he issued that order remains to be answered.

Moo

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Doublethink.
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# 1984

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Say you check said student out of college, they still don't get treatment, what stops them coming back on campus.

Fact is this guy exhibited behaviour so rare we're unlikely to be able to predict it. Many other people who act like him do not kill large numbers of people.

However, he was clearly disturbed and didn't get the service he needed. But that may be a broader problem with the delivery of services - do you have assertive outreach teams in the US ?

(I am unclear why he wasn't arrested re the videoing women thing.)

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Moo

Ship's tough old bird
# 107

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quote:
Originally posted by Doublethink:
Say you check said student out of college, they still don't get treatment, what stops them coming back on campus.

He would have had to find a place to live in this area and the money to pay for it. His family lives more than two hundred miles away.

If he had stayed in the area the university could have gotten a court order barring him from campus. If he violated the order he could have been arrested.

There were mental health services available, but he apparently didn't want them. On campus he lived in a suite of rooms with three other students. They shared a living room and bathroom. He usually did not answer his roomates when they said hello. Sometimes he did not speak to any of them for weeks on end. They knew something was seriously wrong with him.

Moo

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Beautiful Dreamer
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# 10880

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When I was in uni I was diagnosed with depression (I now have bipolar). I availed myself of the counseling services on campus, but when it came to anything beyond the initial diagnosis and prescription, I was referred off campus. I guess my uni was more equipped to handle shorter-term cases than mine. I was not a danger to myself or anyone else, but I knew I had a problem a long time before I actually got help. That is something very common I hear among people with mental health problems-they usually have some sense that they have a problem a long time before they discover that there is a name for it and that it can be treated. Sometimes that realization alone is a help.

I too agree that, if a student is a danger or threat to himself or other people, he should be at least put on suspension to work out his problems. The university system might be good, but they usually are not equipped to handle cases like this.

And as for the videotaping ladies without their consent, I wonder why he wasn't arrested.

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saysay

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# 6645

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quote:
Originally posted by Moo:
When it comes to things like non-suicidal depression, the university mental health services are fine, but anyone who is considered a danger should be required to withdraw.

True. Which is exactly why most university counseling services explicitly state that they do not provide long-term counseling or care but will happily provide you with a list of references to local psychologists/psychiatrists who are equipped to offer such services. Just as most student health centers only treat certain conditions, and anyone needing more extensive treatment is referred off-campus. And, of course, you have the problem of determining who is considered a danger to themselves or others.

It sounds to me like there was some sort of centralization/coordination problem (of the type that often afflicts large universities) going on here. His room-mates knew something was wrong with him. A couple of professors and his academic dean knew something was wrong with him. Student judicial services may have had a record on him (although if the women he harassed declined to press any charges as long as he stopped contacting them, they may not have had the authority to do anything about his behavior). The counseling center may have known something was wrong with him (I'm not clear on whether or not they were ordered to provide counseling services and therefore would at least have had his name, or if Cho was ordered to seek counseling services and people have assumed that he would have sought them from the counseling center, even though the counseling center is not equipped to deal with that sort of problem). Even if the counseling center had known, they wouldn't have been able to release the information to anyone else without Cho's consent, but if everyone else had been sharing information, they might have been able to find a way to get him into counseling or out of school.

The problem with suspending students or putting them on an involuntary leave of absence is that they have to have done something wrong for it to be justified. If their grades get low enough, or they consistently break residence hall rules, etc., they can be ordered into counseling or off campus. But it sounds like Cho's behavior, while creepy, didn't cross the line that would have allowed administrative action.

quote:
Originally posted by Doublethink:
Say you check said student out of college, they still don't get treatment, what stops them coming back on campus.

There's generally a clause in the suspension notice that the student is not permitted on campus during the period of their suspension. Actually enforcing it involves someone knowing that the student isn't supposed to be on campus, seeing them on campus, and calling the campus police (which doesn't generally happen unless the suspension is a consequence of stalking or somesuch and the person tries to contact their victim). They can usually then be arrested for trespassing, as well as for violating any other restraining orders that have been put in place. Generally, for students who hope to be readmitted/ allowed to return, the knowledge that if they get caught on campus, they will probably not be allowed to return is enough to keep them off campus. Had Cho been suspended, he might have snapped and gone on his rampage before the university kicked him out of housing, or after he found a place nearby to stay. Or his parents might have been alerted to his mental health problems and sought help for him. Or any number of different scenarios might have played out.

Or, like the GW student suspended for being a danger to himself after voluntarily committing himself to the hospital, he could have sued the school and settled out of court.

quote:
(I am unclear why he wasn't arrested re the videoing women thing.)
When did it become a crime to photograph people without their consent?

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Posts: 2943 | From: The Wire | Registered: May 2004  |  IP: Logged
saysay

Ship's Praying Mantis
# 6645

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quote:
Originally posted by saysay:
(I'm not clear on whether or not they were ordered to provide counseling services and therefore would at least have had his name, or if Cho was ordered to seek counseling services and people have assumed that he would have sought them from the counseling center, even though the counseling center is not equipped to deal with that sort of problem).

Obviously, if I hadn't done a million other things between skimming the article and composing my response, I might have been a little more clear on that. But since I work in higher ed and have a lot of dealings with the counseling center, I find it a bit surprising that anyone - much less someone in a position to issue a court order - doesn't know that university counseling services usually don't/can't handle serious, long-term care, as that's been explicitly stated at every university I've attended/ worked. Maybe VA Tech does need to make that more clear (or maybe people need to pay a bit more attention to what they have said).

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Pastorgirl
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# 12294

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The assumption behind the OP seems to be that if the university hadn't been in place to provide some counseling services, Cho would have been forced outside of that sheltered community where he would have received more adequate services. That's the erroneous part of the equation.

The root issue that the VA Tech tragedy reveals is not the inadequacy of university counseling services, which, while not intended to deal with issues of this severity, as others have noted are better than what is generally available. The root issue is the lack of any sort of adequate mental health system period.

In terms of compulsory mental health care, which is what would be required here since Cho refused treatment, it simply doesn't exist. To get an involuntary placement in a mental health facility one must be an immediate threat to self or others. The way this works out in real life is such that it really isn't going to happen until after the tragedy has occurred. Anything less than a gunshot wound is not usually considered an "immediate" threat. When I was working in the mental health field we cynically referred to this policy as "show me the blood".

This is why we have so many homeless mentally ill. Many would be capable of caring for themselves, self supporting even, if they lived in some sort of halfway house with oversight to insure they stay on their drugs. But because there is no such system, and in fact the system hinders such oversight, literally thousands of patients are on the streets here in L.A. alone.

Other countries it seems to me do a better job of balancing the patient's need for autonomy with the need to protect and care for people suffering from mental illness. We can and should do better.

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churchgeek

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quote:
Originally posted by Amorya:
quote:
Originally posted by Jenn R:
Universities need to recognise where their limits are and make it easier for people to withdraw for a year or two if necessary. Those who don't or won't may need to be told to withdraw. Such withdrawals need not be permanent, but should be more common.

Of course, that's dangerous ground. Telling a student to withdraw can be challenged under the DDA, just like firing someone from a job for mental health reasons. They'd better be damn sure those concerned are actually a threat to others...
Excellent point. I assume the DDA is similar to the ADA (Americans with Disabilities Act) in the US.

As someone who's mentally ill myself (bipolar), I get nervous whenever I hear "the mentally ill" painted with one brush.

I was disturbed when I heard right after the V. Tech incident that people were proposing to not allow "the mentally ill" to buy guns. My dad (who isn't mentally ill) owns guns and enjoys target shooting at ranges. I went with him once, and found I enjoyed it too, although certainly not enough to invest money in purchasing a gun. (I shot a couple bulls-eyes!) Under that hypothetical ban on mentally ill people owning guns, I wouldn't be able to anyway. Which would be no problem, really - small price to pay if it could really help. But as we know, guns are obtained illegally all the time. Now I'm the only person in my family who's actually been diagnosed with a mental illness. I'm not the only person in my family who has one, by any stretch. What if I had already enjoyed target shooting before I had a diagnosis, and took it up as a hobby? If I knew I couldn't own a gun if I had a diagnosis, that might be enough to prevent me getting help I need - because being officially labeled "mentally ill" would get in the way of pursuing my hobby. Stuff like that already happens - e.g., when people who need treatment avoid/delay getting a diagnosis which will label them with a "pre-existing condition" which will prevent them buying their own health insurance policies.

What I'm getting at, rather circuitously, is that on top of the potential to infringe on people's rights (per DDA / ADA type laws), there is also the potential of putting something in place that might keep a person with an undiagnosed problem from seeking help. So the proposal people are making to force certain mentally ill students to take time off would have to be very, very carefully done. Students who are goal-driven and under pressure in competitive fields would be especially tempted to ignore their own mental health issues if it would interfere with their academic goals - and I'm living proof that a student can get through 4 years of university (in my case, University of Michigan) without her mental illness detected by anyone in a position to offer any help. And I lived in university housing!

Although ADA- / DDA- compliance shouldn't be an insurmountable challenge. For example, even under ADA & similar laws, a blind person (or even a person with poor eyesight) can't get a job flying airplanes... There must be an analogous way to deal with people with mental illnesses.

[eta: bravo, Pastorgirl!]

[ 18. June 2007, 04:51: Message edited by: churchgeek ]

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infinite_monkey
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quote:
Originally posted by saysay:
When did it become a crime to photograph people without their consent?

Behold.

I think most laws are clear about the difference between idle tourist snapshotting, and what was going on here, which would probably also fall under some kind of sexual harassment thing.

But as this thread demonstrates, there's a wide gap between what's "on the books" and what happens "on the ground".

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Moo

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quote:
Originally posted by infinite_monkey:
Behold.


The site you linked to says that the following states (including Virginia) have laws forbidding
quote:
...recording of persons in a state of undress or nudity...
The women whose legs he photographed were presumably wearing shorts or short skirts. They were not 'in a state of undress'.

Moo

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Esmeralda

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ISTM that no one is stating the obvious - that as much as they are caused by lack of adequate, proactive mental health services, these student/school shooting tragedies are caused by the ease of obtaining a gun in the USA. Britain also has an inadequate mental health system, but shootings are much rarer here because it's much harder to get a gun.

True, guns seem to be fairly freely available in certain South London pubs, but you have to be in the right circles and a loner like Cho would be very unlikely to get one. Surely a huge contributory factor to such incidents in the US is that the US has a culture where having firearms is considered a human right?

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Pastorgirl
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Bingo.

It is the correlation of two insane public policies-- inadequate mental health services and a gun lobby run wild-- that have led to these tragedies.

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Moo

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I started this thread because I wanted to discuss how universities handle their students with dangerous mental illnesses. As far as I know, this has never been discussed on the ship.

Gun control, however, has been discussed at great length.

Moo

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Zwingli
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First, thanks to Pastorgirl, saysay and Churchgeek for the insights.

I have some first hand experience of this. I've suffered from depression most of my life, and I suffered a mental breakdown during honours year of Uni. I managed to get through mid year exams, but then about half way through second semester I dropped out entirely, and ended up long term unemployed. The breakdown wasn't caused by prior depression - there were some other specific problems that precipitated it - but it did exacerbate it.

In hindsight the university didn't handle things at all well, though at the time I thought that was fairly much par for the course. The worst part was that, after I didn't respond to an email, they unenrolled me, with no prior warning and without telling me afterwards, only for me to find out almost by chance and re-enroll, just to then stop showing up a month later. I don't know how I looked to the lecturers and professors, but it must have been clear something was wrong, as I couldn't concentrate on anything for more than a few minutes at a time, and my friends and church were all acutely aware something was wrong.

Anyway, the point is I doubt that University staff are really competent to even identify, much less deal with, mental health issues among students. They had, for example, far less of an idea what I did outside hours and who I lived with than my supervisors at work do. I still only had about 12 contact hours a week. If I missed them, the may or may not have been consequences, depending on what I missed and how often, but it really can't be compared to work where someone notices if I show up 15 minutes late or if I happen to look too down one day. Also, I can't see how they can raise these issues without it seeming like a case of singling out the oddballs and social misfits. A few of them might be in genuine need of psychiatric care, but most are just people who are a bit different or are struggling and who really don't need any stigma or negative academic consequences attached to them. At work, to an extent, managers can force some sort of socially normal behaviour on people during office hours, but I don't think it is the role of a Uni to try to do the same with students.

*Crosspost. Wasn't complimenting Pastorgirl for her views on gun control, but for her earlier posts.*

[ 18. June 2007, 13:40: Message edited by: Zwingli ]

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sabine
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quote:
Originally posted by Jengie Jon:
From my observations, as a member of university staff, is that university is one of the better places to be mentally ill.

  1. They have counselling services and disability support departments, both open for students to use
  2. There is a student welfare office, who like to keep track of students in difficulties
  3. Academic Staff are specifically given some pastoral responsibility. Normally very light touch but it is there.
  4. Someone will start a chase to contact you if you persistently miss lectures.
  5. Although not stated some students are given space in Halls of Residence precisely because there are worries over their mental health and it allows a closer watch to be kept.
  6. They have access to the student health services who will not just know about the same level as any GP but also are integrated into the University support system and capable of referring that way.
  7. Some university even have a student-student mentoring systems, with older students mentoring younger ones. As far as I am aware, not common but at least two places in the UK have one.

No, I am not saying that Universities are great, in my opinion the whole of society is ill prepared to support/cope with the severely mentally ill. However being mentally ill while at University is probably better than being mentally ill outside them. So expelling a student on mental health grounds may actually worsen that students plight.

I'm not sure that being in a university is always a better place--at least not at state schools in the US. For example, I attended graduate school at a university of 35,000. Yes, there was a student health center, constantly underfunded; no such thing as a student welfare office, but there was a "campus life office" which basically scheduled extra-curricular events; classes (especially for undergraduates) often were large (over 100 students) and most professors wouldn't really know if a student had a problem or not--missing lecures simply meant a failing grade--and under pressure to publish or perish, hardly had time to do the sleuthing required to find out what was going on in students' personal lives.

And the only way in which residence halls came into play was through the existence of what we called the "suicide dorm," a nine-story graduate residence where people periodically plunged to their deaths when life became too much.

Now, I'm making it seem as though I went to grad school in hell--it was a good place and offered a great education. It's a fairly typical Big-10 university.

And it's just too large to keep tabs on its students in a personal way.

Add this to the fact that the university is situated in a very small town, and you don't have much in the way of resources for dealing with the kind of deeply troubling events as unfolded at Virgina Tech.

sabine

[ 18. June 2007, 17:17: Message edited by: sabine ]

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Soror Magna
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Just out of curiosity, Moo, why do you wish to focus our discussion on universities (or higher education in general)? From what I have read, Mr. Cho showed clear signs of mental illness long before he attended university. Before he became an adult, his parents and public school authorities had many more options for helping him (or controlling him, if necessary) than any university has over its adult students. OliviaG

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Beautiful Dreamer
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I too am wondering why something wasn't done to help him earlier. Surely he showed signs of a problem long before university. I know I did. And I was never dangerous to myself or anyone else. My sister, who is also bipolar, showed signs of breakdown much earlier than I did. Was he ever diagnosed with any specific illness? Because there are some that have adult onset (i.e. schizophrenia in some cases), but there is usually a sign of a problem long before the illness is full-blown. But then, I am not a doctor, just a person with an illness herself who comes from a long line of illness.

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Choirboy
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I lean towards saying that universities are better places than the general public square for getting someone in to treatment. They may or may not be the best place for someone who is in treatment as there can be a lot of stresses not present elsewhere.

But I'd be horrified at any suggestion that those with mental illness should be prohibited from attending university.

The problem in the case of severe mental illness is dealing with someone who is a danger to himself or others. That's very hard in this country - you pretty much have involuntary committal as your only path; the legal barrier is high for good reason; the resulting hospital stay is not always long enough to get someone stabilized on meds before being released, etc.

But I'm not sure this is any worse of a problem at a University than say, at the post office.

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Moo

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I agree he showed clear signs of having problems long before he came to Tech.

I think his early life was unusually stressful. AIUI he came to America with his family when he was eight years old.

People who remember him as a child in Korea say that he had a speech defect. People who knew him at Tech say he had a weird voice. Apparently he was teased unmercifully in middle school. Once in a class a teacher insisted that he speak although he was extremely reluctant to do so. He began talking in this weird voice and the other kids started laughing at him. Then one of them said, "Go back to China where you belong." This was in the days before schools started to crack down on bullying; apparently the teacher did nothing to defend him.

I'm convinced he had a predisposition toward mental illness, but experiences like this greatly aggravated matters.

quote:
Originally posted by Olivia G
Just out of curiosity, Moo, why do you wish to focus our discussion on universities (or higher education in general)? From what I have read, Mr. Cho showed clear signs of mental illness long before he attended university.

The problem as I see it is that university students have much more freedom than younger students. This makes it more difficult to establsh the fact that a student is dangerous and the community must be protected.

In this case it was partly a procedural problem. The judge ordered therapy at the Tech health center, although the health center does not accept court-ordered referrals.

ETA: I have heard that the Korean community does not think of mental illness the way we do. If someone behaves badly because of mental illness, the focus is on the bad behavior. Mental illness is no excuse. This attitude may have prevented his parents from seeking help for him.

Moo

[ 18. June 2007, 19:12: Message edited by: Moo ]

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Moth

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I am a lecturer in a university in the UK. I agree with what Jengie Jon says, but I do think it is easy to fall through the gaps at uni if you have no wish to tell anyone about your problems. Frankly, we have very little time to chase up students, so a student who wants to sit in their room and cry is likely to do it for some time before we really take action, especially if they ignore e-mails and letters.

Years ago, and at a different university, I did teach a very disturbed young man. I was sufficiently concerned by his behaviour to report him, and he was sent for evaluation by a psychiatrist. He was declared fit to continue his course, and two weeks later stabbed a fellow student. I wasn't much impressed by the professional advice we'd been given!

I do think there are problems in identifying the dangerous from the odd. Lots of young people sit in their rooms listening to miserable songs and writing depressing drivel. Some really are depressed, while others are just acting up! They all dress oddly, and many of them behave oddly too, at least to my middle-aged eyes. I'm not sure I, or even an expert, can always tell the difference.

[ 18. June 2007, 19:26: Message edited by: Moth ]

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Soror Magna
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quote:
Originally posted by Moo:
The problem as I see it is that university students have much more freedom than younger students. This makes it more difficult to establsh the fact that a student is dangerous and the community must be protected.

How is a university different from any other workplace, or a church, or any other community group or institution? A mentally ill student attending a university is also a mentally ill citizen of the country and a mentally ill resident in the larger community. If s/he is employed, that makes the student a mentally ill employee. If s/he goes to church, that student is a mentally ill Christian. Maybe instead of asking what all these communities can do about mental illness, we should be seriously examining what the health system isn't doing.

And again, if we were talking about a physical illness - and let's make it a contagious one, so there's a public health element - would we be having a debate on how universities - and only universities - should deal with students with TB? Isn't that why we have public health departments? OliviaG

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deano
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I don't like this "mental illness" blanket term. What would the state of medicine be if we only had the phrase "physical illness" to describe everything from a cold to cancer, from haemeroids to heart disease?

There are many different types of "mental illness" and I think it's high time that we started teaching people a little more about it, starting in schools. There are kids books about broken bones. Why not have them on depression as well. I'm sure many of them have parents with it.

If the students at Virginia Tech knew more about "mental illnesses" themselves then maybe they would have intervened earlier rather than leaving it to staff and policies. After all they interacted with the guy far more than any lecturers. If a fellow-student came into class with a mole on the face that was growing by the day, itching and bleeding, don't you think they would have driven them to the nearest hospital for skin-cancer tests?

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Doublethink.
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I agree with you very strongly about making a distinction about severity and character of different mental health problems.

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Pastorgirl
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deano writes:

quote:
If the students at Virginia Tech knew more about "mental illnesses" themselves then maybe they would have intervened earlier rather than leaving it to staff and policies.
And what exactly would they have done, other than be alarmed?

As has already been noted, Cho was identified-- several times-- as someone with severe psychological problems. Resources were made available to him, but he refused treatment. The problem was not one of identification, it was with the US mental health system that has no process for involuntary admittance of high-risk individuals w/o a pre-existing tragedy.

I would, of course, agree that more education about mental health issues is important and needed. However, it doesn't do all that much godd without a broader reform that provides access to mental health care. To use your analogy, how much good does it do to be able to identify a mole as pre-cancerous if there is no medical care available to your friend?

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ken
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quote:
Originally posted by Moo:
When it comes to things like non-suicidal depression, the university mental health services are fine, but anyone who is considered a danger should be required to withdraw.

Why stop at students?

So should someone "considered a danger" but who has not actually hurt anyone automatically lose their job in order to protect others?

Should they be required to leave their home in order not to be a danger to other residents?

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Moo

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quote:
Originally posted by OliviaG
How is a university different from any other workplace, or a church, or any other community group or institution? A mentally ill student attending a university is also a mentally ill citizen of the country and a mentally ill resident in the larger community.

People spend about forty hours a week at their workplaces. People spend less than two hours a week a church services, although they may also spend time at church for other purposes.

Most students who take classes and live on campus probably spend more than a hundred and fifty hours a week on campus. There is much more time for a disturbing person to disturb people.

Moo

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cattyish

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Ken, it's not to infringe on someone's rights that I have recommended their detention under mental health laws but to protect the person who is ill or to protect other people. As soon as the reason for detention ceases (cessation of danger or cessation of illness) the detention should be lifted. It's always a difficult decision to act against a person's expressd wish. I don't know anyone who takes it lightly.

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Pastorgirl
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cattyfish--

Again, there seems to be a cross-pond difference that's at play here. In the US it's simply not legal to detain someone involuntarily in that way. A major problem, that leads to all sorts of tragic results.

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mousethief

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quote:
Originally posted by Pastorgirl:
Again, there seems to be a cross-pond difference that's at play here. In the US it's simply not legal to detain someone involuntarily in that way. A major problem, that leads to all sorts of tragic results.

And prevents relatives from locking up family members for ill gain. It is possible to detain involuntarily, there are just checks and balances to the process to avoid abuse.

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Amazing Grace

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Yes, the standards for an involuntary 72-hour hold are very, very high. I imagine even more so for determining whether the hold continues beyond 72 hours.

I imagine that states will be looking at their criteria.

Charlotte

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Squirrel
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As somebody who has worked in the field of mental health, I find it sad that people think sociopaths like this guy should be required to undergo counseling. Not only is coerced counseling about as meaningful as mandatory prayer, but even Freud himself would not be able to "cure" somebody with such deep-seated personality problems. Nor do I think that a little Prozac or some other drug would work.

What to do about sociopaths? Well, making it tougher to get guns would surely help. And screw "civil liberties." The really bad ones need to be locked up.

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ken
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quote:
Originally posted by Pastorgirl:
In the US it's simply not legal to detain someone involuntarily in that way.

Yes it is. In some states its easier to do than in England (where we call it being "sectioned" for obscure historical reasons). This website claims to be a summary of the laws in different US states.

What seems to be being suggested above is some intermediate stage between being diagnosed as mentally ill in some way, and being subject to a legally enforceable involuntary detention (who are by definition our of your hands). So the student is excluded from the university and told to seek medical treatment and not some back until they have.

Of course a university, like any workplace, has the right (maybe the duty) to keep out someone who is actually causing danger to others. But we weren't, I think, talking abut that. We were talking about someon who is thought to be a possible danger but hasn't actually done anything bad yet.

This intermediate state seems really dodgy to me. Who diagnoses the problem? Who decides when it has gone away? Who ensures that the excluded student really is seeking treatment and not sitting alone in their room getting more and more desperate?

Also it blur the boundaries between counselling and student services on the one hand, and disciplinary controls on the other. And it might tend to make the mentally disturbed student even less likely to let anyone know about their illness.

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ken
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# 2460

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Sorry, I was being unclear there. The website I linked to:
quote:
Originally posted by ken:
This website claims to be a summary of the laws in different US states..

is a summary of involuntary outpatient commitment laws, in other words compulsory treatment of patients "living in the community" (bureacrat speech for "neither in hospital nor locked up")

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Ken

L’amor che move il sole e l’altre stelle.

Posts: 39579 | From: London | Registered: Mar 2002  |  IP: Logged
Pastorgirl
Shipmate
# 12294

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quote:
And prevents relatives from locking up family members for ill gain. It is possible to detain involuntarily, there are just checks and balances to the process to avoid abuse.
Yes, technically it is possible, but it goes far beyond checks and balances... those of us who work in the field have found it to be virtually impossible until after a tragedy has occurred (e.g. after a failed suicide attempt or homocidal act). Involuntary admits are otherwise pretty much impossible to secure. I know, I've tried-- many times. And apparently, so had many others who had been alerted to the problem re: Cho. But it just isn't possible to do an involuntary admit w/o an "immediate" threat-- which means a gunshot wound. Again, this is why we have so many homeless mentally ill, many of whom only need oversight/meds to be fully functioning.

It is true that the reason behind the more restrictive legislation (which came about in the 70s) was the abuse of the system to put away inconvenient relatives, rebellious teens, etc. As I said, balance is needed. The problem is, there is no such balance in the US.

When a Canadian relative became incapacitated due to Alzheimer's I was amazed at the difference in the two systems. From my limited exposure to their system, it seemed much better equipped to acheive the balance you are suggesting-- the rights and autonomy of the patient vs. interceding for their own wellbeing.

Posts: 757 | From: L.A. | Registered: Jan 2007  |  IP: Logged



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