I need to begin by making a few revelations.
I do not use the pharmacy at my university health center because it is staffed by undergraduate students, and I do not have any interest in students knowing what medications I take.
I stopped using the counseling services at a former university because the receptionists were undergraduate students, and that seemed like an incredible violation of confidentiality. In addition, the counseling center's waiting room sat behind a massive glass wall on a main corridor in the student services building.
I have written stories with violence in them in creative writing classes. I even now maintain a blog that contains stories that contain violence.
I may have been, at times in my life, one of "those students" that universities might worry about.
In the wake of the massacre at Virginia Tech there will be many, many calls for action. Many of them have been made on this Web site. And many, I can agree with. I believe that universities need much better communication plans. They need much better security training. And I agree that they need, far more often, to err on the side of student safety instead of "business as usual" and concerns about image.
But what I fear most is a witch hunt for non-conformist students, and policies that chase students underground, away from counseling they need, services they need, and the help with self-expression that they need.
Already, in my work with incoming university freshmen with disabilities, I often advise them to be very careful of on-campus counseling services. I explain that they are often not confidential in the ways they might expect, and that things said to counselors all too often end up being repeated to the offices of the Dean of Students. I alert them to this for themselves and for their friends, and suggest that the first thing they do upon arriving on campus is to begin to discover off-campus, truly confidential resources that they can depend on.
I also warn them in general about "disclosure" on campus. College students can feel very safe and open in a campus environment, but that openness is often rewarded with the inappropriate spread of information. There is nothing like receiving a supposedly "helpful" e-mail from a professor, when that professor has heard about your needs from someone you gave information to in confidence. There is nothing like meeting a faculty member for the first time and realizing that they "know all about you."
I offer these warnings to students because because many, many adolescents (and adults) need help. They need real help to manage the pressures that overwhelm them as they balance school and work and life. And they will only seek that help if they are sure that it will help, and not hurt.
In the United States today this is a real concern. Because of a failed national health policy, anything recorded about one's physical or mental health can, and probably will, be used against them. It can eliminate job opportunities. It can halt the acquisition of health insurance. It may eliminate educational opportunities. It could even, if combined with certain ethnicities, block the ability to fly on airlines. And on campuses it can have you dropped from courses, removed from student housing, or expelled from school.
If we want those in trouble to seek help, we must assure them that these things will not happen. I am not saying that counselors, faculty and administrators should not take action when imminent threats arise -- that they must continue to do. But I am saying that universities would best protect their students by ensuring that their mental health services are available, accessible, free, and fully confidential.
A troubled student must know that his or her friend down the hall will not be the one handing them birth control pills or the morning after pill, or anti-depressants, or the person making the urgent counseling appointment. They must know that their confidential communications are indeed kept confidential, absent extraordinary circumstances. They must know that they will not be penalized, immediately or in the long term, for seeking help.
If that is not the case, troubled students will not take advantage of these services, or they will lie to therapists or doctors. From personal experience I can tell you that all it takes is one bad experience to teach you to lie, to give the safe, rehearsed answers. And that does nothing for the student, and nothing for student safety.
So, in this time of crisis, as I read many calls for loosening the limitations placed by FERPA and HIPAA, I beg American higher education to go the other way.
The best way to ensure that your students are healthy is to make sure they can safely and easily avail themselves of care. And the best way to do that is to review all of your campus health and mental health procedures with an eye toward making them appear as unthreatening as possible.