Content warning: This article contains references to suicide.

The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255.

Crisis Text Line is a texting service for emotional crisis support. To speak with a trained listener, text HELLO to 741741. It is free, available 24/7 and confidential.

To talk with a counselor from Yale Mental Health and Counseling, schedule a session here. On-call counselors are available at any time: call (203) 432-0290. 

Students who are interested in taking a medical withdrawal should reach out to their residential college dean.

Additional resources are available in a guide compiled by the Yale College Council here.

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In her article, “Toward a Better Yale”, Eui Young Kim writes, “I wonder what it says about Yale that removing myself from it was the best thing to happen to my mental health since the beginning of college.” Her essay, a response to the death of Rachael Shaw-Rosenbaum, a first-year student at Yale University who died by suicide in April 2021, is among one of many that condemn the systems that allow tragedies like this to happen. Hearing Rachael’s story transported me to my first-year self, when I grieved alongside my classmates over the death of an upperclassman who also died by suicide. It is inconceivable to me that years after graduating Yale, my community continues to grieve over students lost too soon. 

Sadly, Rachael’s story is not unusual: suicide is the second-leading cause of death among college students, with approximately 1,100 suicides on college campuses per year. A 2020 online survey of college students’ mental health paints an even bleaker picture: 82 percent of students are anxious, 69 percent face isolation or loneliness, 63 percent are depressed, and 19 percent have had suicidal thoughts within the past month. COVID-19 has only made things worse, with 63 percent of students reporting their emotional health as being worse now than before the pandemic. Rachael’s reflection of her first days on campus is now even more heartbreaking to read: “People are on quarantine schedule, so there wasn’t anyone to talk to. So I moved myself in for a couple of hours, and cried.” 

The common response of university administrators and policymakers to mental health crises is to focus on increasing the capacity of campus mental health centers (CMHCs). This was what happened after Rachel’s case: the Yale administration unveiled its Yale College Community Care (YC3) program, increasing the number of full-time MHC staff and expanding the types of therapy made available to students in a number of different settings. While this is vital to mental health reform, it cannot be the only step to tackle what should be seen as a system-based, public health problem. Using a public health framework — such as the Social-Ecological Suicide Prevention Model (SESPM) — to decrease suicide-related behavior (SRB) allows us to tackle this issue from a multilevel perspective, address both SRB rates and prevention, and decrease the burden of responsibility on CMHCs. Using this model, I propose a three-pronged approach with interventions at the interpersonal (CMHCs), community (overall campus culture), and structural (university-wide administration and policies) levels. Each level’s interventions target widely documented gaps in each system. 

At the interpersonal level, CMHC staff must be appropriately scaled to match current enrollment rates.  They should hire more people of color (POC) and those trained in LGBTQIA+ affirming care, and decrease the wait time for appointments to no more than two weeks. At the community level, administration, faculty and student leaders need to normalize failures and mistakes in order to dismantle the culture of striving for perfection at the expense of mental health. Both faculty and the administration can play their part by granting homework extensions for students undergoing a mental health crisis and giving students adequate breaks during the academic year. Professors and deans also need to be trained to recognize symptoms of mental health disorders and how mental health relates to students’ success and learning outcomes to create a supportive campus environment and to promote treatment-seeking behaviors. At the structural level, university administrators and policymakers need to reform medical leave of action policies that prioritize returning students’ wellbeing and opportunity for academic success, instead of current policies that prioritize minimizing legal liability for the university and force students into involuntary medical leave without adequate medical, financial, and social support. 

For many students, going to college is both a transitional and transformative event in their life. The setting of college is also unique because it serves as a single integrated environment where both career and social activities occur and where many health, support and social resources are readily available. The fact that 75 percent of lifetime mental health disorders have their first onset during ages 18-24 — the typical age-range for college students — means that colleges have even more work to do in addressing the current mental health crisis. That suicide has happened enough times on this campus to become a part of the routine college experience is beyond inexcusable. 

We must break this cycle of loss and grief. As Eui Young Kim writes, “This isn’t normal. We are not fine.” Yale must do better. Institutions must do better. SRBs on college campuses must be approached with a public health framework because they are a public health issue, one that requires interventions at the interpersonal, community and structural levels. By taking a three-pronged, public health-centered approach that focuses on addressing the current rate of SRBs and their prevention, we can take steps now to save the future lives of thousands of college students in the United States. As said by Elis for Rachael, an organization formed by Rachael’s family, friends and Yale alumni dedicated to mental health reform at Yale – “We fight, so that Rachael’s suicide is the last.”

Nealie Ngo is a ’18 Yale graduate currently studying at the University of Toledo College of Medicine and Life Sciences and pursuing a masters of public health at Columbia University.  Contact her at nealie.ngo@aya.yale.edu.