Trying to end the suicide cycle

Early in the morning on Halloween 1999, Branford College senior Gregory Norris was drunk, wandering around Union Station without any Yale identification, according to the New Haven police who found him there.

He checked into Yale-New Haven Hospital for detoxification at 5:10 a.m., checked out at 2:25 p.m., and was never seen alive again. At no point were his college master or dean called: not by the police because they didn’t know he was a student, not by the hospital because they don’t have the same ties to Yale’s administration as University Health Services.

Sixteen days later, a Metropolitan Transit Authority track foreman discovered Norris’ body on the Bronx shoreline. It prompted a ripple of disbelief through campus, with students wondering whether this sort of thing was unavoidable or if it was negligence.

It was bad luck, UHS director Paul Genecin said, part of the “wheel of fortune with respect to suicide.”

Yale has in place an intricate “safety net,” layers upon layers of prevention to catch the most serious mental illness before it is too late. But in cases like Norris’, tragedy may be arbitrary, according to administrators and some students who have been close to it. And, as a means of prevention, the levels of therapists, deans, masters, counselors and friends may find themselves impotent.

The suicide cycle

Since 1990, 12 students at the Massachusetts Institute of Technology have committed suicide. One of them, a 19-year-old sophomore named Elizabeth Shin, set herself on fire in April 2000 the day after her parents came to visit. She sustained burns over 60 percent of her body and died shortly thereafter.

In that year, the school’s Medical Mental Health Service saw 50 percent more students than in 1995 and had a 69 percent increase in student psychiatric hospitalizations but kept the same number of mental health staffers, the Boston Globe reported at the time. As the accusations of misconduct were surfacing, the school’s chancellor, Philip Clay, declared mental facilities available to students remarkably inadequate.

Now, the director of MIT mental health services, Peter Reich, said, the school’s lawyers have put a gag on all administrators preventing them from speaking to the press.

MIT is currently involved in a lawsuit filed by Shin’s parents claiming that the school is culpable for their daughter’s death, since Shin had been in counseling at their mental health clinic.

MIT is also in the middle of what Genecin calls “the suicide cycle.” There is a palpable distinction between students who are gesturing, he said, and those who really mean it when it comes to suicide.

“It is the difference between someone who takes eight Tylenol and calls an ambulance,” he said, “and someone who goes and gets a gun.”

Yale had it with Norris — the bad luck, its moment in the cycle that rotates around the Ivy League plus Stanford plus Duke and a few others — and now the misfortune is at MIT.

“It’s their turn in the queue to have students who really mean it,” Genecin said.

Among students interviewed who have attempted suicide or spent time in the former Yale Psychiatric Institute, many said their breaking point was the result of symptoms developing over long stretches of time, frequently while they were seeing UHS therapists. One senior, who asked to remain unnamed, said she went to YPI after six therapists and two years of using Mental Hygiene services. Another, now a sophomore, said his serious problems developed early in his freshman year after seeing therapists all through high school.

But included in Genecin’s declaration of unpredictability are only those who follow through, and though other Ivy League administrators say they haven’t heard of the cycle in so many words, it is a phenomenon they know well.

“We found, and other schools have found, that many of the people who commit suicide have never sought care anywhere,” said Richard Kadison, the director of Harvard’s Student Health Services. “What we’ve tried to do, recognizing it’s impossible to stop suicides altogether, is have more people around, watching for behaviors that put people at risk.”

The safety net

The first layer of intervention for Norris or Yalies like Shin should have been friends, masters and deans, according to Genecin. After that, there were — and still are — the gently named anonymous campus hotlines: the Eating Concern Hotline and Outreach, or ECHO, for eating disorders; Walden for general counseling; and Consent for sexual abuse, among others. Still deeper, there are UHS and Mental Hygiene. Then there is a 24-hour facility, then a semester off, and ultimately a see-what-happens readmissions policy.

But it is ultimately always the student’s responsibility to seek help, so the University’s mission is outreach.

Despite unprecedented levels of demand for mental health services at UHS, chief psychiatrist Lorraine Siggins said her biggest concern is getting suffering students to talk to someone.

Siggins said the increased outreach effort has been in place for the last four years, a time frame over which schools around the Ivy League reported nearly a 50 percent increase in the number of students seeking therapy. In place of numbers, Genecin said Yale’s situation is “really, really similar” to those schools.

Siggins declined to speak on whether outreach programs were part of what is bringing in many more noncritical cases, saying only, “The goal is to try to educate the community in terms of student concerns, to make sure they know where to get help and that it’s readily available.”

In addition to proactive measures during the year, the clinic, hoping to catch the youngest Yalies as early as possible, also runs a training program for freshman counselors as part of their one-week orientation before the start of each school year.

Timothy Dwight College freshman counselor Caitlin Bair ’02, like many, said the program made her feel capable of catching problems and advising students.

“I often tell my freshmen that it’s very common for Yale students, who are at this very high stress university, who are constantly dealing with questions of success, to just go and talk to someone at [UHS],” she said.

But even with layers of trained help, there remain those who, as Genecin said, fall through the cracks.

Remembering the rest

Last year, one of six freshmen in Anya Raredon’s ’04 Lawrance Hall suite attempted suicide, she said. UHS was in top form, responded immediately, ushered the student out, and kept her confidentiality impeccably.

But, as Raredon tells it, they totally forgot about the roommates, the ones who came home on a Friday afternoon and weren’t told anything until Saturday night.

“We were all affected by it too,” she said. “No one from the administration came in to help us deal with it. She was well taken care of, but the five others of us were pretty much left in the lurch.

In matters of mental health, Yale officialdom is persistently bound by often murky confidentiality obligations: there is the question of what statistics can be made available, what detail can be released, and what should be told to other students, with the mentally ill’s privacy as paramount.

While Raredon’s dean was unavailable for comment yesterday, Silliman College Dean Hugh Flick said there’s no official protocol for dealing with roommates of the acutely mentally ill, but he always makes a point of talking to them.

“It’s just sort of natural,” he said.

Keally Dewitt, a former Silliman student, spent 10 days in YPI after writing a suicide note to her family and friends. She left the note on her desk in room 1845 and took an hours long walk, which found her in front of the undergraduate admissions office cursing them for their decision and which left her roommates searching the campus.

One of them, Betty Chen ’03, said Flick and then-Master Kelly Brownell, who is the current director of Yale’s Center for Eating and Weight Disorders, handled the situation gracefully. There was a meeting in the master’s office, she said, a discussion of what Dewitt had been going through, the promise of an open ear if they needed it.

“As the master, I wasn’t in a position to provide any therapy,” Brownell said, “but I could certainly express concern, educate people, and let them know what help would be available for them.”

In the end

Regardless of the skyrocketing numbers, of the fact that one in six Yalies will sit against the wall in Mental Hygiene this year and if the trend holds, even more will in years to come, there is the imperative of adequate treatment. For everyone who needs it.

There are concerns about the reception of mental illness on campus (starting with the name, which, said Dewitt, aligns the treatment of biological illnesses with the removal of plaque from one’s teeth); there are concerns about competitive students in elite universities (mental health services at MIT and Harvard have started contacting incoming students); and there are concerns about these universities’ ability to handle the influx.

Ultimately, masters and deans, doctors, students, patients and professors seem to agree, though, that the critical work of mental health services is to be accessible to the community at large and to treat all of those most desperate within it. But it remains to be seen, according to some, whether Yale and others will be able to meet the needs of the Therapy Generation.

“This is a real issue,” said Brownell, “and it’s sort of endemic across the country. Many people are still not able to get as much help as they need.”

Yale tries to create a
Alexandra Romero
Yale tries to create a "safety net" for students to prevent suicide, but since it ultimately falls on the student to seek help, some individuals can slip through, unaffected by University Health Services' attempts at outreach.

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