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Source: (consider it)
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Thread: Purgatory: Mentally ill students at universities
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Pastorgirl
Shipmate
# 12294
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Posted
One thing Ken's link demonstrates is that even compulsory outpatient care comes about only as the result of a very long, lengthy, and time-consuming legal process. It requires some very dedicated individuals, generally close relatives. I've known a few people who have navigated that process and it took years, and thousands of dollars. More disinterested third parties are not as likely to take on such a feat.
In Cho's case, though, I suspect that anything less than inpatient care would have been inadequate. Most of the states listed the familiar " immediate threat to self or others" as the only criteria. Now it may be that some states interpret that more generously than here in Calif., but from the people I've talked with, so far I've not encountered any states where this is the case.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Pegasus
Shipmate
# 1966
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Posted
quote:
Originally posted by Amazing Grace:
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
72 hours? Blimey, here in the UK an initial detention for assessment (called a S2) is for 28 days. At the end of this period, or if you are known sufficiently well by the authorities that assessment isn't thought necessary, than you can be detained under an S3 which lasts for 6 months.
[ETA] An S3 can be extended, first for 6 months, and then in 12 month increments.
[ 19. June 2007, 16:00: Message edited by: Pegasus ]
Posts: 1207 | From: Ruritania | Registered: Apr 2004
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Josephine
Orthodox Belle
# 3899
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Posted
In this country, it can be exceedingly difficult to get inpatient psychiatric care even if it's voluntary.
I know one mom whose child is frankly psychotic. He's failed most of the traditional antipsychotic medications, and was hospitalized for 10 days so they could take him off his current meds and start him on a last-ditch drug. At the end of the ten days, he was still not at a therapeutic dose of the new drug, but he was sent home anyway, in spite of the fact that he was suffering auditory hallucinations and paranoid delusions.
His mom has been desperately trying to get help for him, but her insurance won't pay for more than 10 days inpatient care, and she doesn't have the money to pay for it herself. The only way she can get him the care he needs is to give up custody to the state, and hope that he will be able to get the care he needs through the foster-care system.
An adult who needs inpatient care doesn't even have the foster-care option, of course, as bad as that option is.
A few states are beginning to require what is called "mental health parity" -- mental illness has to be covered to the same extent as any other illness. But in general, in this country, psychiatric hospitalization of more than a few day's duration is simply not available, even on a voluntary basis, and even if you have insurance, unless you are an immediate danger to yourself and others.
It's a terrible system. But since that's the system we have, I honestly don't know what Cho's family, friends, or teachers could have done for him. It would be illegal to remove him simply because he was mentally ill. But because his behavior disturbed other people, it's possible that he could have been removed from the school through disciplinary channels.
I do wonder, though, about the schools he attended in elementary school and high school. Under IDEA (the Individuals with Disabilities in Education Act), schools have an obligation to identify students with disabilities (including mental illness), to determine whether the disability is interfering with the child's ability to acquire a free and appropriate public education, and to provide specially designed instruction, related services, and supports so that the child can receive such an education.
Did the schools Cho attended ever fulfill their obligations? I'd put money on their not having done so.
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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ken
Ship's Roundhead
# 2460
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Posted
quote:
Originally posted by Pegasus:
An S3 can be extended, first for 6 months, and then in 12 month increments.
Similar-but-different rules in most US states. I just looked up some figures for California. Apparently in 2000 there were about 80,000 72-hour detentions, about 6,000 14-day renewals, almost as many longer renewals, and 200-odd people detained indefinitely.
I'm not sure if the same person committed twice counts as one or two. Two I guess.
Anyone know the numbers for the UK?
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Ken
L’amor che move il sole e l’altre stelle.
Posts: 39579 | From: London | Registered: Mar 2002
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Pastorgirl
Shipmate
# 12294
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Posted
Josephine, that has been my experience here in the States as well. It is heart-breaking. We can do better.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Pegasus
Shipmate
# 1966
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Posted
I've done a bit of googling and found some figures here for numbers Sectioned under the Mental Health Act in England.
In essence, for the financial year 1999-2000 26,700 were admitted under Section, and another 20,800 were Sectioned after being admitted informally.
What the figures don't show is the number of people detained under Sections 4, 135 and 136 which last 72 hours and are used in an emergency.
[ 19. June 2007, 20:28: Message edited by: Pegasus ]
Posts: 1207 | From: Ruritania | Registered: Apr 2004
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saysay
Ship's Praying Mantis
# 6645
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Posted
quote:
Originally posted by Josephine:
It's a terrible system. But since that's the system we have, I honestly don't know what Cho's family, friends, or teachers could have done for him. It would be illegal to remove him simply because he was mentally ill. But because his behavior disturbed other people, it's possible that he could have been removed from the school through disciplinary channels.
University officials can require students to seek mental health treatment and/or be removed from the university, but they can only do this if it has become obvious that their mental health problem is affecting their ability to participate in the community. Students who seek a late or retroactive withdrawal for mental health problems are almost always required to document that they are actively trying to manage their disease; some of these students probably wouldn't have sought therapy if it weren't required, but they're not usually hostile to it. Students who are, say, required to take an anger management course after destroying dorm property are often less enthusiastic, but don't actively resist.
The problematic cases are those in which the student hasn't broken any written rule, but whose behavior breaks basic unwritten rules. There isn't actually a rule against interrupting your professor every two minutes, talking over all your classmates in discussion, or periodically standing up and jumping off your desk because the assumption is that if you've gotten to college, you already know these things (although you might be able to find some vague, highly interpretable language about maintaining an appropriate learning environment somewhere). Similarly, there isn't a rule against taking pictures of your classmates even if they've asked you not to - it's just not something people do, unless you are a tabloid photographer and I am a celebrity. Some of Cho's classmates found his behavior so disturbing that one of his professors had him meet privately instead of in class; I would have thought that somewhere in all that, there might have been some technicality to hang him on. Except I've seen other cases where students basically couldn't be in a classroom for the sake of the rest of the class, but hadn't really broken any rule, since there isn't a rule against disturbing or annoying others. The scary part is that when they do break a rule, it's often "don't hurt or attempt to kill other people."
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"It's been a long day without you, my friend
I'll tell you all about it when I see you again"
"'Oh sweet baby purple Jesus' - that's a direct quote from a 9 year old - shoutout to purple Jesus."
Posts: 2943 | From: The Wire | Registered: May 2004
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Campbellite
Ut unum sint
# 1202
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Posted
quote:
Originally posted by Squirrel:
And screw "civil liberties." The really bad ones need to be locked up.
The mantra of the current White House, no?
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I upped mine. Up yours.
Suffering for Jesus since 1966.
WTFWED?
Posts: 12001 | From: between keyboard and chair | Registered: Aug 2001
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RuthW
liberal "peace first" hankie squeezer
# 13
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Posted
quote:
Originally posted by Moo:
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.
No, the disturbing person has the same number of hours in a day as everyone else. All you're really proposing is that a disturbed student be shifted off-campus so he/she can disturb different people.
Posts: 24453 | From: La La Land | Registered: Apr 2001
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by RuthW
No, the disturbing person has the same number of hours in a day as everyone else. All you're really proposing is that a disturbed student be shifted off-campus so he/she can disturb different people.
That is part of it, but not all of it. I see nothing wrong with spreading the stress around, rather than piling it all on one group.
More importantly, a university is not well-equipped to deal with someone with a dangerous mental illness. Students enjoy a great deal of independence. If a mentally ill student does not want therapy, the only thing the university can do is suspend him. Up until now very few universities had a policy of suspending the dangerous mentally ill. That policy is going to change in Virginia, and probably in other states.
Moo
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Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Pastorgirl
Shipmate
# 12294
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Posted
Ruth is right, all that does is move the problem off campus. The real problem is the lack of mental health services, the inability to get real help for someone before it has reached the level of suicide/homicidal actions.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Josephine
Orthodox Belle
# 3899
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Posted
quote:
Originally posted by Moo:
If a mentally ill student does not want therapy, the only thing the university can do is suspend him.
I don't think a university can legally suspend a student because the student is mentally ill, or even because the student is mentally ill and refusing treatment. Nor should they be able to. Most mental illness is not a problem to anyone other than the person who is ill.
quote:
Up until now very few universities had a policy of suspending the dangerous mentally ill. That policy is going to change in Virginia, and probably in other states.
How will that work? Who will decide that a student is dangerously mentally ill? On what basis? I don't think universities are qualified to make that determination.
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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Sir Pellinore
Quester Emeritus
# 12163
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Posted
quote:
Originally posted by saysay:
...University officials can require students to seek mental health treatment and/or be removed from the university, but they can only do this if it has become obvious that their mental health problem is affecting their ability to participate in the community. Students who seek a late or retroactive withdrawal for mental health problems are almost always required to document that they are actively trying to manage their disease; some of these students probably wouldn't have sought therapy if it weren't required, but they're not usually hostile to it. Students who are, say, required to take an anger management course after destroying dorm property are often less enthusiastic, but don't actively resist.
The problematic cases are those in which the student hasn't broken any written rule, but whose behavior breaks basic unwritten rules...
Well said, Saysay! ![[Overused]](graemlins/notworthy.gif)
Mental illness - besides being widespread, as it includes anxiety & depression - was also, until fairly recently, the equivalent of leprosy in the Middle Ages in our society.
Fortunately, attitudes seem to be changing. ![[Yipee]](graemlins/spin.gif)
Universities - Australian & British are better known to me than ones in the USA - have been described as "neurotic subcultures" (the words of a friend who worked in the Student Counsellor's Office at Monash University, Melbourne, in the 1970s).
So many of our professors and lecturers in the Faculty of Arts at the University of Melbourne in the late 1960s-early 70s were extremely eccentric/bordering on the verge of nuttiness/seriously needing help.
Vincent Buckley - a famous Australian poet with a Personal Chair in English - was a chronic alcoholic as was the Sub-Dean of the Arts Faculty - a lovely, lovely guy & well known literary critic both in print & on the ABC: Dinny O'Hearn.
Both are dead now. Both had had traumatic times -Vince was in the RAAF in WWII (extremely hazardous with the constant danger of death) & Dinny had had a bugger of a life, including passing through the hands of the Christian Brothers. Need I say more? Both needed help. Would they have sought it? Well, as Australian males, heirs to the Anzacs, we didn't.
Both were Catholic & we had two Jesuit priests on the English Department. Peter Steele was a man who seemed totally up in the air & spoke a sort of "literaturecritiquese" which was incomprehensible. Tim Kelly - later laicised, thank God! - was a tall, gaunt Irish-Australian who looked like an undertaker and had the sensitivity & interpersonal skills of a charging rhino. I once sought his hearing on a minor administrative matter. Why? I wonder.
Could they have helped anyone? Only if they were writing something on Thomas Aquinas' influence on William Shakespeare, or such...
The late Professor Sam Goldberg, like so many academics at Melbourne then, seemed to be intent on two things: screwing his female students & purging the Department of anyone who disagreed with the long dead school of F R Leavis.
Professors Macartney & Maxwell were a couple of senile old failed actors relentlessly hamming their way through irrelevant recitations of forgotten or irrelevant verse.
Ian Maxwell, complete with clan tie, declaiming Scottish Border ballads was a sight out of a lunatic asylum. He once distributed tissues prior to one of these performances, thinking we would all weep. My eyes were dry. He was a pathetic sight.
Would these nutters have been able to assist ANY fellow staff or students needing help with mental problems? No!
Andrew Deacon, a very bright & highly troubled young lecturer in the Department committed suicide. Their fault? I wouldn't directly blame them, but the "tone" they set, as my old GPS Headmaster, the late Sir Brian Hone, used to say, was atrocious.
Some: Hume Dow, Jock & Maggie Tomlinson & others were pretty normal, but, unfortunately, they had little influence.
Even then, Student Services were underbudgetted & overstressed. Dennis Kelynack, the Student Counsellor & his staff were superb but there was only so much they could do.
I myself had a mild anxiety problem which could've easily been dealt with by meditation & talk therapy. Unfortunately, I got referred to a psychiatrist whose forte was group therapy. It was terrible! One of the girls in the group ended up getting electro-convulsive shock therapy at Royal Park Psychiatric Hospital.
Universities these days are still stressed as far as Student Services go, but their is much more awareness of mental health problems at the university & in the community; vastly more sympathy & psychiatric & psychological help available. The Australian Medibank system is very good in reimbursing costs.
Long may this continue!
Sorry about the long personal anecdotes, but it was necessary to set the scene. ![[Smile]](smile.gif)
[ 21. June 2007, 08:59: Message edited by: Sir Pellinore (ret'd) ]
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Well...
Posts: 5108 | From: The Deep North, Oz | Registered: Dec 2006
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by Josephine:
I don't think a university can legally suspend a student because the student is mentally ill, or even because the student is mentally ill and refusing treatment. Nor should they be able to. Most mental illness is not a problem to anyone other than the person who is ill.
I should have made it clear that I was talking about mentally ill students who are disruptive or dangerous. The university has a right to insist that other students be allowed to pursue their education in safety and without interference.
quote:
How will that work? Who will decide that a student is dangerously mentally ill? On what basis? I don't think universities are qualified to make that determination.
I agree that universities are not qualified to make that determination. The university has the same right as any private citizen to report that someone appears to be a danger. The mental health authorities have the responsibility of dealing with the situation.
In Cho's case the mental health authorities ruled that he was a danger. Then they released him with a court order to undergo outpatient psychotherapy at the university health service, which had a policy of not accepting court orders because they could not enforce them. ![[Frown]](frown.gif)
Moo
[ 21. June 2007, 12:41: Message edited by: Moo ]
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Pastorgirl
Shipmate
# 12294
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Posted
This is the catch-22 that virtually every human services organization-- chuches, homeless shelters, free clinics, and, yes, universities-- faces. You can declare someone dangerous and "at risk" all you like, you can order treatment, but w/o the legal ability to compel treatment, it's all hot air.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by Pastorgirl:
You can declare someone dangerous and "at risk" all you like, you can order treatment, but w/o the legal ability to compel treatment, it's all hot air.
The judge had the ability to order Cho to be treated by a facility which did have the legal ability to compel treatment. There are some in the area. However the Tech student health service is not such a facility.
I assume that when the commission investigating this matter submit their report, it will contain the judge's explanation of why he ruled as he did. I look forward to reading it.
Moo
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Doc Tor
Deepest Red
# 9748
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Posted
I remember two students during my undergraduate time who were increasingly severely mentally ill.
The burden of caring for them fell on us, the students. No one else seemed particularly bothered. I would hazard a guess that this has not changed in the intervening twenty years.
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Forward the New Republic
Posts: 9131 | From: Ultima Thule | Registered: Jul 2005
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Duck
Shipmate
# 10181
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Posted
Why should being a danger to *oneself* be grounds for suspension / expulsion?
Many students with physical difficulties successfully manage university, and may or may not need accommodations on the way (special arrangements for exams, etc). So do many students with mental health problems, which may include self-harm or suicidal tendencies. Given most people wouldn't suggest expelling a student who needed to use a wheelchair, why would a student who sometimes became suicidal be expelled, so long as they were able to cope academically? Any decision beyond the narrowly academic about whether it is in the interests of the student to complete the course of study should surely be left to the student themselves, with input from health professionals and those directly supporting the student, not university administration.
IME university isn't a great place for people with long-term complex mental health problems (UK experience). My course last term averaged 2 hours contact time per week in a class size of ~50, with no register taken of attendance (that's final-year - previous years ~140 students per class). Believe me, no-one does anything if you turn up to class late, in the clothes you've slept in for 3 days, or not at all. The university counselling service and student health centre are geared up to deal well with problems which typically affect a population previously selected to be mostly young, healthy, & high-functioning. They are good at dealing with exam stress, mild cases of 'the blues', homesickness, that sort of thing - not long-term illness.
Non-university health services IME have problems dealing with students. I have seen someone sent away from a psychiatric ward after housemates called an ambulance at 3am because 'she wouldn't fit in' 'would have nothing in common with the other patients' who were from a working-class area - not because she didn't need treatment, just that the service decided it couldn't be provided because she was a student. Being articulate, well-informed about your illness, and studying at degree level, seems to convince health professional that you can't be properly ill, even if you are functioning significantly below pre-morbid levels. If you are studying a related degree subject it's even worse - IME most health professionals don't appreciate patients who have done more recent study in more depth into their illness than the health professional, and fluctuate between patronising, ignoring, and if you are really unlucky assessments for Munchhausen's. You may be treated by people who are / will be involved in your academic and career progression. If you've studied the standard diagnostic interviews for your illness then it's hard to give 'natural' answers, and many standard screening tools simply aren't normed to deal with a population who have been pre-selected for excellent functioning.
Practically it's difficult to get care if you live in one place in term-time and another in the holidays - Uni facilities shut down, and usually you can't be referred for a month or three months to services near parents and then return straightaway to services in the university area - if you try you may get knocked back and forth from the bottom of one waiting list to another, as if the lack of stability from spending half the year in one place & half another wasn't detrimental enough. Unstable postal addresses make accessing health services still more difficult. Universities also run on the basis that students will get support from family during holidays. Not everyone does.
University is a demanding place to be, and to succeed you need to be not just functional but working to capacity. Living with a fluctuating long-term mental illness makes that really rather difficult, but with appropriate support & flexibility from the university then it's possible, and universities _could_ be a positive & enabling environment. Unfortunately they aren't always.
I'd echo those posters who have suggested that 'mental health' is much to broad a term to be talking about here. Killing strangers is much more likely to be related to drug and alcohol use by young men, than people with mental health problems.
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'Truth is my authority, not authority my truth' - Mary Dyer, Quaker martyr.
Posts: 1014 | From: Lots of planets have a north | Registered: Aug 2005
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welsh dragon
Shipmate
# 3249
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Posted
I don't know whether me chipping in is really going to effect much change in the course of this discusion but here goes.
1. most people with a mental illness are not a danger to themselves or anyone else
2. 1 in 4 people develop a mental illness in their life time. Up to 20% adolescents have been shown in studies to have a mental health diagnosis. How many people could you tolerate excluding and where do you draw the line?
3.prediction of behaviour is very difficult in mental health. This is because "harm" acts are rare. For example, in a particular case, we can look up the the factors in the research literature that suggest someone might kill themselves. We can add them up - and our calculations might indicate relatively high risk. But these factors are fairly common (amongst others, recent discharge from hospital, drug/alcohol abuse, history of suicide in the family) and completed suicide is relatively uncommon. So there is a lot of false "noise". You might have 100 "high risk" patients but only 1 is going to carry through.
4.With homicide, the completed act is much rarer. So we are talking 1 in 10,000* perhaps. So, 10,000 individuals might be at relatively high risk of carrying through such an act, judging from their mental history and behaviour but only 1 will actually do it.
So do you lock up the 10,000?
5. Personality disorder (PD). Very common as a percentage of the population. In so far as this is described in the illness books, this is technically an illness. But it effectively isn't amenable to medical treatment in the way other mental illnesses are (though there are options).
The UK government wants us (psychiatrists) to be able to lock up PD patients. We don't want that. I think innocent till proven guilty is a good way to go.
Many people who commit a violent crime might have a troubled past - maybe they were hit by their father or bullied at school or used drugs as a teenager. You might see these as "psychological problems" - maybe we all have some sort of psychological problem. Not the same as mental illness though.
For the most part, I think that there are good reasons why psychiatrists are really lousy at predicting risk. No we don't have crystal balls. And we can't read minds. People are responsible (for the most part) for their own actions. Just because someone commits a heinous act does not mean they automatically have a mental health diagnosis. And just because they have a mental illness doesn't mean they should be discriminated against or denied opportunities.
(I think that's enough for now).
*as I recall, I'm afraid rather vaguely, from an academic meeting about 10 years ago
[ 23. June 2007, 21:15: Message edited by: welsh dragon ]
Posts: 5352 | From: ebay | Registered: Aug 2002
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Pegasus
Shipmate
# 1966
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Posted
Further to what Welsh Dragon has said, it's a mistake to assume that a psychiatric ward is automatically the bast place for someone who is suffering mental health problems. Over-worked nurses, over occupancy on beds, lack of privacy and autonomy, being in the constant company of seriously disturbed individuals... none of it makes for a therapeutic environment.
Associating exclusively with psychiatric patients also gives one a very distorted idea of what is "normal": self harm, poor (or non-existent) personal hygiene, refusal to eat etc all become par for the course.
Posts: 1207 | From: Ruritania | Registered: Apr 2004
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saysay
Ship's Praying Mantis
# 6645
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Posted
quote:
Originally posted by Duck:
Why should being a danger to *oneself* be grounds for suspension / expulsion?
In the US, the legal obligation of universities to act in loco parentis is a bit murky. Parents have successfully sued a university because their child killed themselves while at school. I think most people would prefer it if universities didn't have that legal liability, but right now they do. Also, the suicide of a student on campus tends to affect the rest of the community a lot more than the suicide of former student; the former is much more likely to trigger other suicide attempts than the latter.
I don't think students should be suspended for thinking or voicing suicidal thoughts. But universities do have an interest in the matter, and it's a very tricky area.
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"It's been a long day without you, my friend
I'll tell you all about it when I see you again"
"'Oh sweet baby purple Jesus' - that's a direct quote from a 9 year old - shoutout to purple Jesus."
Posts: 2943 | From: The Wire | Registered: May 2004
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pimple
Ship's Irruption
# 10635
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Posted
Is suicide illegal in all, or most, US states? I know that it is common for mental patients to sign a contract which binds them to taking medication, or even hospita;izing themselves, if they feel suicidal. This somehow sounds more like the caring community watching its (financial?) back than anything else. Am I stereotyping, though?
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In other words, just because I made it all up, doesn't mean it isn't true (Reginald Hill)
Posts: 8018 | From: Wonderland | Registered: Nov 2005
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Josephine
Orthodox Belle
# 3899
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Posted
quote:
Originally posted by pimple:
Is suicide illegal in all, or most, US states?
No. According to The Straight Dope, attempted suicide was illegal in only six states in 1963. I didn't see anything more recent with a quick Google, but I'm sure you could get current info if you wanted to take the time to find it.
quote:
I know that it is common for mental patients to sign a contract which binds them to taking medication, or even hospita;izing themselves, if they feel suicidal. This somehow sounds more like the caring community watching its (financial?) back than anything else.
I don't understand what you're saying. The reason for getting the contract from someone with suicidal ideation is that it makes the person far less likely to actually commit suicide. It's an effective prevention strategy.
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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pimple
Ship's Irruption
# 10635
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Posted
Sorry, Josephine, I didn't make myself clear. The impression I've had from time to time is that carers in the states are quicker to "take over" what some might regard as the rights of mental patients - for their own good, of course.
Patients may then sometimes regard themselves as prisoners, who may be punished for not acceding to the regime prescribed for them. It's a tricky business for everyone, I think. Carers who err on the side of overprotection can be understood.
But from the perspective of those contemplating suicide, it can sometimes feel that even thinking about it is regarded as criminal - in effect if not in law.
There may also be a feeling on the carer's side that not to take custodial action or demand "safe" sedation would be tantamount to negligence at best or make them morally or legally culpable if the patient did kill him'herself.
[ 24. June 2007, 21:46: Message edited by: pimple ]
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In other words, just because I made it all up, doesn't mean it isn't true (Reginald Hill)
Posts: 8018 | From: Wonderland | Registered: Nov 2005
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pimple
Ship's Irruption
# 10635
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Posted
I hope this is not too tangential. But getting back to the university situation, a student would obviously benefit from talking to a counsellor if they felt depressed. But they might be discouraged from being completely open if the default remedy for suicidal ideation was heavy sedation or hospitalization - both of which would seriously interrupt their studies.
(I'm not saying that woldn't in some cases be necessary. The son of a friend had to take a whole year off. He still managed a "first" when he got back. But the year off was advised, not demanded. It was he himself who decided that was what had to happen.)
[ 24. June 2007, 21:56: Message edited by: pimple ]
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In other words, just because I made it all up, doesn't mean it isn't true (Reginald Hill)
Posts: 8018 | From: Wonderland | Registered: Nov 2005
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ken
Ship's Roundhead
# 2460
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Posted
quote:
Originally posted by welsh dragon:
4.With homicide, the completed act is much rarer. So we are talking 1 in 10,000* perhaps.
[...]
*as I recall, I'm afraid rather vaguely, from an academic meeting about 10 years ago
If there are, say, 500 murders a year in Britain out of 50 million that's 50 in 5 million, 10 in a million, 1 in 100,000... so 1 in ten thousand sounds an order of magnitude too high for the annual chance of killing someone , an order of magnitude too low for the chance you might kill someone in your lifetime.
Whoops, maybe I was misreading your post. Do you mean 1 in 10,000 of the general population or of those showing risk factors for violent crime? If the latter it would, presumably, be in the right ball-park.
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Ken
L’amor che move il sole e l’altre stelle.
Posts: 39579 | From: London | Registered: Mar 2002
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Zoey
Broken idealist
# 11152
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Posted
quote:
Originally posted by pimple:
I hope this is not too tangential. But getting back to the university situation, a student would obviously benefit from talking to a counsellor if they felt depressed. But they might be discouraged from being completely open if the default remedy for suicidal ideation was heavy sedation or hospitalization - both of which would seriously interrupt their studies.
I've never heard of sedation being a treatment for suicidal ideation.
Suicidal ideation varies enormously in degree and type. Many people experiencing suicidal ideation may only be at low to moderate risk of actually making a suicide attempt. In the UK, hospitalisation would usually only be suggested if it was felt (by mental health professionals) that there was a very high risk of the individual making a serious suicide attempt in the immediate future. If that were the case, then the individual's academic studies would almost certainly already be being seriously interupted by their mental state.
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Pay no mind, I'm doing fine, I'm breathing on my own.
Posts: 3095 | From: the penultimate stop? | Registered: Mar 2006
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Pastorgirl
Shipmate
# 12294
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Posted
quote:
The impression I've had from time to time is that carers in the states are quicker to "take over" what some might regard as the rights of mental patients - for their own good, of course.
I believe it is actually quite the reverse. As was detailed in earlier posts, such a "take over", whether benign or malignant (and there are both of course) is much harder to achieve in the US. When an elderly Canadian relative became incompacitated I was absolutely flabbergasted when the provincial authorities stepped in and mandated an involuntary admit. This simply would not happen in the US, which is why we have so many homeless mentally ill.
Prior to deinstitutionalization in the 70s, however, what you described was very much the case.
Posts: 757 | From: L.A. | Registered: Jan 2007
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saysay
Ship's Praying Mantis
# 6645
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Posted
quote:
Originally posted by pimple:
I hope this is not too tangential. But getting back to the university situation, a student would obviously benefit from talking to a counsellor if they felt depressed. But they might be discouraged from being completely open if the default remedy for suicidal ideation was heavy sedation or hospitalization - both of which would seriously interrupt their studies.
(I'm not saying that woldn't in some cases be necessary. The son of a friend had to take a whole year off. He still managed a "first" when he got back. But the year off was advised, not demanded. It was he himself who decided that was what had to happen.)
Well, yes, ideally students would recognize the need to talk to a counselor or take time off (can't say that I've ever heard of heavy sedation or hospitalization for suicidal ideation; AFAIK most people don't get those for suicide attempts). But the 18-22 set sometimes overestimate their ability to "just get over it."
For example, I had a student A. A's room-mate killed himself in their dorm room; A. found the body. A was understandably traumatized, but decided to continue with the semester, although he did change dorm rooms. I believe he struggled with depression before the incident, but he became severely depressed and started failing his classes. At his request, the counseling center recommended that he be allowed to withdraw from the classes he was failing (so that those failing grades wouldn't bring down his GPA, since his failure was probably due to unforseeable circumstances not within his control), and required him to continue to get counseling. We talked about whether or not he wanted to go on a leave of absence for the next semester; he didn't think it was necessary (he had the summer in between semesters to recover).
But when he returned he was depressed and, I believe, suicidal. He again failed his classes. If he hadn't been granted a medical withdrawal the previous semester, he would have been eligible for academic suspension. Since he had been, he wasn't. The counseling center recommended another medical withdrawal, but only if A. agreed to go on a leave of absence. There's a small chance that he would have come back spring semester and done well. The alternative would have been to either allow him to flunk out, or to allow him to continue paying the university upwards of $35, 000 a year to make no progress towards his degree. I know it sound horrid to talk of suspending students/ forcing them to go on a leave of absence for mental health issues. But we're not talking about suspending everyone who mentions to a counselor that they've thought about suicide.
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"It's been a long day without you, my friend
I'll tell you all about it when I see you again"
"'Oh sweet baby purple Jesus' - that's a direct quote from a 9 year old - shoutout to purple Jesus."
Posts: 2943 | From: The Wire | Registered: May 2004
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Jason™
Host emeritus
# 9037
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Posted
Many people are talking about how obvious it was that Cho was disturbed. Does anyone have any of the references for why we think this?
Posts: 4123 | From: Land of Mary | Registered: Feb 2005
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by Professor Kirke:
Many people are talking about how obvious it was that Cho was disturbed. Does anyone have any of the references for why we think this?
I've got tons of them. The Roanoke Times published an enormous number of stories after the shootings, including interviews with people who knew Cho. Here is the text of an interview with someone who lived with him.
He was in a writing class where the students' writings were read aloud. Cho's writings were so disturbing that some of the other students left the room. Finally the professor told the university that if they didn't get Cho out of her class, she would resign. The head of the English department volunteered to tutor him privately. He spoke very little during the tutoring session and never looked at her.
Somewhere on the internet there is a story he wrote. The URL was on the newspaper website along with a warning that this was extremely disturbing. Sensitive people were advised not to read it, so I stayed away.
Moo
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Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Moo
Ship's tough old bird
# 107
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Posted
There is one aspect of the situation that just occurred to me.
No single individual at Tech knew everything that Cho was doing. When the professor threatened to resign if Cho were not removed from her class, the head of the English department dealt with the situation. I don't know whether the dean was notified.
If someone had known how he was behaving in class and that he was stalking some women students, action would probably have been taken.
I think that in general the university should not ask students about the behavior of their roommates. However, in cases like this, they should.
Moo
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Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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welsh dragon
Shipmate
# 3249
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Posted
But the problem is that there are loads of students out there behaving oddly, at times very oddly. That is what student life is like. You would have to nobble thousands of students to pick up one Cho, and even then you might miss him.
Oh hindsight is a very wonderful thing but none of Cho's room-mates and none of the girls he is said to have stalked took it further and went to the police or the college authorities did they? So what he was doing wasn't so out of context or unusual. Male students who are decidedly solitary or completely inept with girls were certainly thick on the ground at the universities I attended.
As for producing literature that is "disturbing" or violent, well after the fact , yes you can read something into it. But people like Stephen King or Quentin Tarantino, no doubt both eccentric in their own way, do not have "I am a future mass murderer" inscribed on their foreheads. (If they did do something violent I guess people would say "ooh you could see that in their work" but that's the way round it goes"). Even the most concerned professor could not have predicted the actual outcome at Virginia Tech.
Human nature seems to have a dark side that comes out sometimes - you just can't predict with accuracy who will turn around and do something like this out of many thousand "weird" students. And there would be a huge cost to clamping down on the eccentrics and the misfits - I don't mean financial but in terms of freedoms - which our societies can't afford to pay and which would outweigh any speculative benefit.
So I think on the one hand, breezily sending people away from college would be daft and cause more problems than it solves. 'Course putting in more mental health resources for students is likely to be a good thing...
[ 28. June 2007, 05:36: Message edited by: welsh dragon ]
Posts: 5352 | From: ebay | Registered: Aug 2002
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Ethne Alba
Shipmate
# 5804
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Posted
When many students and lecturers go to hierarchy of a Uni and say :
Something's wrong here, I am uncomfortable, this feels dangerous, I am unhappy, I am scared, I am desperately concerned, I am so worried that I would like to drop the course...
.......and nothing is done.
Then the university has problems with its management.
Posts: 3126 | Registered: Apr 2004
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MerlintheMad
Shipmate
# 12279
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Posted
quote:
Jengie Jon: ...in my opinion the whole of society is ill prepared to support/cope with the severely mentally ill....
That line sort of leaped out at me.
Imho, people who go to universities in the first place are a bit whacked. But it isn't our fault; society makes us go, more or less forces us to. It's all about competition. The pressure is incredible, and starts for most kids before they are even half way through grade school, sometimes even in preschool (and not "fergwadsakes", but quite the opposite). That so few wig out as badly as Cho did, is, quite frankly, a surprise to me.
Posts: 3499 | Registered: Jan 2007
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Jengie jon
Semper Reformanda
# 273
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Posted
quote:
Originally posted by Moo:
There is one aspect of the situation that just occurred to me.
No single individual at Tech knew everything that Cho was doing. When the professor threatened to resign if Cho were not removed from her class, the head of the English department dealt with the situation. I don't know whether the dean was notified.
If someone had known how he was behaving in class and that he was stalking some women students, action would probably have been taken.
I think that in general the university should not ask students about the behavior of their roommates. However, in cases like this, they should.
Moo
Moo you do realise what this requires don't you?
It requires a real and deep change in society where it is held as normal and healthy to hold oneself accountable to someone else or a surveillance effort like in East Germany during the cold war.
Why so? Because for there to be full information on Cho there has to be full information on every other student. The only way to get that is either to have half the populace spying on the other half, or for it to be felt normal for a person to have a mentor who they share everything with.
In other words you have to strip everyone of their individualism and privacy to some extent.
Privacy is not today guarded by secrecy it is guarded by the fact that the information gathering groups are fractured and do not hold a cohesive knowledge of anyone. They interpret data on a need to know basis. As long as facts remained separate there was nothing to set the process of building a picture going.
No University today is going to organise itself along those lines, just because of the cost implications.
Jengie
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"To violate a persons ability to distinguish fact from fantasy is the epistemological equivalent of rape." Noretta Koertge
Back to my blog
Posts: 20894 | From: city of steel, butterflies and rainbows | Registered: May 2001
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Moo
Ship's tough old bird
# 107
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Posted
I have not suggested surveillance on anyone.
I have suggested that when a student's behavior is extreme enough that a faculty member threatens to resign, the other people this student is in contact with should be asked whether his behavior is disturbing when he is with them.
I agree that privacy is very important, but when one danger sign is noticed, it is appropriate to see if there are other danger signs.
Moo
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Jengie jon
Semper Reformanda
# 273
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Posted
Believe it or not Moo the only way of knowing who to ask whether his behaviour is bizarre is surveillance or him telling who he has had fixations on.
I have on occasion had to put this data together after serious complaints, worse than those of intimidating a member of the University Staff. It has been very difficult and I have had to use all my social networking skills to do it.
My experience is the sharing that needs to happen between health professionals, social services, law enforcement agencies and the lay people involved in a case does not happen.
I broke silence as an observer on one case, simply because I needed information about the case to help one of the victims. That resulted in the foster parents of a child realising that one of his grandfathers was alive and relatively sane. Still because others have not met me, we have not moved further in finding out what involvement this grandparent would like if any. The child is around fifteen.
Jengie
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"To violate a persons ability to distinguish fact from fantasy is the epistemological equivalent of rape." Noretta Koertge
Back to my blog
Posts: 20894 | From: city of steel, butterflies and rainbows | Registered: May 2001
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Pastorgirl
Shipmate
# 12294
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Posted
quote:
When many students and lecturers go to hierarchy of a Uni and say :
Something's wrong here, I am uncomfortable, this feels dangerous, I am unhappy, I am scared, I am desperately concerned, I am so worried that I would like to drop the course...
.......and nothing is done.
Then the university has problems with its management.
Again, given the legal constraints in the US, I don't know of anything they could have done that wasn't done.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Ethne Alba
Shipmate
# 5804
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Posted
That being the case, my kids won't be going to uni in the states!
Posts: 3126 | Registered: Apr 2004
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Josephine
Orthodox Belle
# 3899
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Posted
Why is that? Killings at schools (from elementary through university) get an enormous amount of publicity because they are exceedingly rare. In reality, a university campus is one of the safest places you can be.
The fact is, the risk of injury and death from almost anything else you'd let your kids do is greater than their risk of being injured or killed by a mentally ill student at an American university. Do you let them drive, or ride in, a car? Would you let them swim in the ocean, scuba dive, surf? What about rock climbing or hang gliding or horseback riding? Would you let them play sports?
If you'd let them do those things, why not let them attend an American university? Seriously -- why not?
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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Ethne Alba
Shipmate
# 5804
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Posted
Because.......huge sigh here, don't want to upset the states friends.....over in the UK I think that something could have been done and that young man would have been stopped.
But I am Quite Possibly wrong.
Big Time.
Others with more knowledge than me will no doubt come along soon.
Pastorgirls response shocked me.
It seems so unfair
and
mostly because the system seems to have failed the young man in question Most of all.
Of course I am dreadfully upset for the families of the people he killed. Of course.
But
For me
The question is about Cho.
He was left, no one interveined, no one was able to help him and actually
I think that's appalling.
So that would be the reason.
He could have been anyones son.
And his victims could be anyones children.
Legal systems have to protect all.
Sorry. That was a rant..
Posts: 3126 | Registered: Apr 2004
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Pastorgirl
Shipmate
# 12294
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Posted
quote:
Because.......huge sigh here, don't want to upset the states friends.....over in the UK I think that something could have been done and that young man would have been stopped...
It seems so unfair and mostly because the system seems to have failed the young man in question Most of all.
Yes, I agree with you here. Yes, the system DID let Cho and his family down-- as it has let down so many of our homeless mentally ill. As it let down Andrea Yates. And, as I said before, I do think other countries do a much better job of balancing the right to autonomy with the need to intervene to protect people even from themselves.
That being said, Josephine is correct-- statisticly, the odds of your child getting harmed by a mentally ill student at an American university are exponentially minute compared to the odds of him/her dying in a car crash during the drive to the airport.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Soror Magna
Shipmate
# 9881
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Posted
quote:
Originally posted by Ethne Alba:
Because.......huge sigh here, don't want to upset the states friends.....over in the UK I think that something could have been done and that young man would have been stopped.
But I am Quite Possibly wrong.
Big Time.
Others with more knowledge than me will no doubt come along soon.
Hopefully not. I don't feel the need to be reminded of other school shootings in other countries, including the UK. It's enough to know they happen.
On a slightly different angle, we know that Cho was bullied in middle and high school (and bullying has been an element in many other tragedies of this sort). Why are those bullies and those schools off the hook? They may have exacerbated his condition and made it harder for him to ask for help, and, as I've mentioned before, there were many more options available to his family and his community when he was a minor. There are probably more bullies in any educational institution (and not just among the student body) than there are mentally ill students. OliviaG
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"You come with me to room 1013 over at the hospital, I'll show you America. Terminal, crazy and mean." -- Tony Kushner, "Angels in America"
Posts: 5430 | From: Caprica City | Registered: Jul 2005
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Chorister
Completely Frocked
# 473
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Posted
I read this sad story today which made me think about the role of parents in situations of risk. The student is treated as an adult which is good and proper (she was 22, not 18 years and 1 day which might have been more of a grey area) and she did express a wish that they should not be contacted.
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Retired, sitting back and watching others for a change.
Posts: 34626 | From: Cream Tealand | Registered: Jun 2001
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Amorya
Ship's tame galoot
# 2652
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Posted
quote:
Originally posted by Ethne Alba:
Because.......huge sigh here, don't want to upset the states friends.....over in the UK I think that something could have been done and that young man would have been stopped.
No, nothing would have been done in a UK university.
The States actually have universities with more power in such situations I believe, due to lawsuits forcing them to act in loco parentis. In the UK, students are adults, so the parents can't be informed about behaviour without the student's permission. A university can't force someone to have mental health treatment, and they can't throw someone out for mental health issues due to discrimination risks. Not to mention the difficulty in spotting such things - most students aren't known by name by any of the staff except possibly their personal tutor.
The university isn't supposed to look after its students in that way. Students are adults -- the university doesn't have to do any more pastoral care than an employer would.
Amorya
Posts: 2383 | From: Coventry | Registered: Apr 2002
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Josephine
Orthodox Belle
# 3899
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Posted
quote:
Originally posted by OliviaG:
On a slightly different angle, we know that Cho was bullied in middle and high school (and bullying has been an element in many other tragedies of this sort). Why are those bullies and those schools off the hook?
I think it would be next to impossible to establish a causal relationship between their action or inaction and what Cho did. The fact is that many thousands of kids get bullied when they're in school. Lots of people on the Ship readily admit to having been bullied as kids. But most of them do NOT go on to commit violent crimes.
quote:
as I've mentioned before, there were many more options available to his family and his community when he was a minor.
In theory, yes. In reality, probably not. The schools are responsible for identifying and providing services for children with disabilities (including mental illness) only if the disability prevents the child from receiving a free and appropriate public education. And even then, if the necessary services are complex, expensive, involve the family, or affect the child's education indirectly, the school is likely to do nothing.
So that leaves it to the family. Who may not have had insurance. And if they had insurance, the insurance may not have covered mental illness. And if it did cover mental health, it may not have provided enough coverage to be meaningful.
And that's if the family was willing to acknowledge that their child was mentally ill. Because of the stigma attached to mental illness, they may have been in absolute denial (and have been facilitated in that denial by the schools, who wouldn't have wanted to provide the services he needed).
I know families who are desperately trying to get care for seriously mentally ill children. Often the only choice is giving up custody of the child to the state, allowing the child to be put in foster care, and hoping that the foster family and the state will provide the necessary care. That's not an option all families are willing to accept. And if they're thinking about it, they may end up reading something like this (worksafe, but not for the faint of heart), and change their mind.
The fact is, mental health care in this country is simply not available to most people, and the more serious the mental illness, the less likely it is that the person will be able to access care. Our system for providing mental health care is broken beyond repair. And sadly, I don't think we're going to get a new system any time soon.
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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!
Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003
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Pastorgirl
Shipmate
# 12294
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Posted
Well said, Josephine. That is exactly the dilemma in this country.
Posts: 757 | From: L.A. | Registered: Jan 2007
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Pastorgirl
Shipmate
# 12294
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Posted
quote:
In the UK, students are adults, so the parents can't be informed about behaviour without the student's permission. A university can't force someone to have mental health treatment, and they can't throw someone out for mental health issues due to discrimination risks.
All of this is true in the US as well.
Posts: 757 | From: L.A. | Registered: Jan 2007
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