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Just this week, Fairfield University in Connecticut lost a sophomore to suicide. The student's death again highlights the lack of mental health care knowledge and resources on college campuses — a problem also in the headlines because Jared Lee Loughner (the gunman who shot U.S. Rep. Gabrielle Giffords) received far too little psychiatric help as a college student.
I have long worried about the preparedness of university health services to educate the student body about psychiatric disorders, prevent those disorders from developing or worsening whenever possible, identify serious cases when they do occur and render healing treatment.
Universities should anticipate that psychiatric disorders will be prevalent in student populations because they affect young adults so frequently, because college students may face real academic and social pressure and because they may also jeopardize their mental health by using alcohol or illicit drugs. A coordinated program to educate the student body about the signs and symptoms of depression and other conditions, along with robust clinical services on campus (or close ties to a community program) are essential.
Students should be told (and perhaps this blog will even find its way to college campuses) that it is not "wrong" or an invasion of privacy to ask whether someone on their floor in a dormitory or in a class with them is "doing OK," if they notice that that individual seems confused or quite sad or lethargic or suspicious of others. It isn't wrong to offer to walk over to student health services with someone who doesn't give any convincing reassurance that they feel well. It isn't wrong to let a teacher know about one's concerns, or that individual's parents. Generally, once symptoms of psychiatric illnesses become apparent to others, they are already advanced and merit bringing real resources to them.
Families also have to be alert to the potential that their college-aged children will develop major depression or panic disorder or even a psychotic disorder (like schizoaffective disorder). For many of their sons and daughters, college is the first time away from home and the first time they have faced substantial academic challenges.
Here are 10 of the most important signs and symptoms to look for:
• Decreased mood and tearfulness
• Decreased concentration
• Decreased interest in activities that used to be pleasurable, like hobbies or socializing
• Expressions of decreased self-esteem, like "I'm worthless," or "I'll never make it."
• Changes in sleep patterns, with difficulty sleeping or excessive sleep
• Decreased appetite
• Confusion or "not making sense"
• Falling grades
• Attempts to "treat" low mood or anxiety with alcohol or other drugs
• Suspiciousness about the intentions of others
Whenever friends or families notice at least two of these symptoms, it's important to urge those they care about to visit with a therapist on campus or off campus. But it is also important to keep checking in to see whether their symptoms are improving or worsening. If necessary, a mental health evaluation should be scheduled for the person and support given to that individual to keep that appointment.
It is also very important that friends and families not be afraid to ask these really tough questions:
• "I don't mean to imply that you would be thinking this, but some people who are depressed do . . . Are you feeling hopeless? Are thinking of hurting yourself? Because we care about you too much to have anything bad happen when we know how to get you the help you need."
• "You keep talking about how people are trying to hurt you. Are you thinking that you're going to have to defend yourself somehow?"
• "Are you having trouble thinking clearly? Depression can do that to people, and you can get rid of depression within weeks."
Part of the tragedy of losing a college student to suicide or seeing a mentally ill college student hurt anyone else is that mental disorders are very treatable. More than 90 percent of those with major depression, for example, recover fully. There is every reason for hope, and every reason to intervene out of love or concern.
Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. He is a New York Times best-selling author, and co-author, with Glenn Beck, of the book "The 7: Seven Wonders That Will Change Your Life". Dr. Ablow can be reached at firstname.lastname@example.org.