Changing the Mental Health Conversation

April 27, 2007

There's lots of talk in these post-Virginia Tech tragedy days of the need to better identify students who are disturbed, just as there are plenty of calls from politicians and others to find ways to quickly remove them from colleges. An advocacy group for people with mental illness thinks the talk has gone too far.

"It's sad that in the wake of a tragedy like this, there's the hunger for quick fixes and quick legislation," said Robert Bernstein, executive director of the Bazelon Center for Mental Health Law, at a press conference Thursday.

Added Chris Koyanagi, the center's policy director: "I'm disappointed that the conservation has been about what could have been done right before to prevent this [shooting spree]. What about earlier?"

Cho Seung-Hui, the Virginia Tech shooter, entered a mental health facility in late 2005. Several leaders of the Bazelon Center said the real story is that police didn't know where to turn when alerted of Cho's stalking and threat of suicide, and that professors who saw the student's disturbing writing didn't find the right resources in the public health system.

Center advocates say changes have to be made at colleges so that everyone is aware of protocol when dealing with a student who is deemed a threat. Leaders of the center are working on a best practices report that urges colleges to avoid blanket policies that limit a student's likelihood of seeking help but that still allow officials to intervene when needed.

Bernstein said the larger issue is fixing what he calls large gaps in service availability. Too few counselors are available to students at many campuses, he said.

Many administrators worry about legal problems if their institutions violate the Family Educational Rights and Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, meant to protect privacy of health information. At a Senate hearing this week, both lawmakers and college officials underscored the dilemma: Share personal student health records and face potential legal action. Do nothing and face the possibility of lawsuits for inaction. Sen. Joe Lieberman (I-Conn.) appeared open to amending the legislation to include liability protection for colleges that follow a set procedure in dealing with troubled students.

But Bernstein doesn't understand the "damned if you do, damned if you don't" argument, because he said the privacy laws have clear exemptions for releasing health information in emergency situations.

"Liability is a red herring," added Karen Bower, senior staff attorney at the center. "To go down the road of saying there should be more liability protection is presuming that there is liability in these cases." She said no court has found a college liable for failing to prevent violent outbursts.

Ira Burnim, the center's legal director, said colleges sometimes have the misguided view that the less they know about their students, the better. "That puts them at the most risk," he said.

The center made its case for student protection in a recent case involving George Washington University that settled in November. It helped represent Jordan Nott, a student who sued claiming that he was forced to leave the university after seeking help for depression at the university’s counseling center. George Washington officials defended the removal as necessary to protect both Nott and other students.

A year ago, the Massachusetts Institute of Technology announced a confidential agreement to resolve a lawsuit brought by the family of a student who lit herself on fire in her dorm room and died in 2000. Last summer, Hunter College agreed to pay $65,000 to settle a suit challenging the college’s policy governing students deemed to be at risk of suicide.

"We do have concerns that colleges continue to overreact and seek to place students on involuntary leave," Bower said.

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