A year after Virginia Tech, sharper focus on troubled students

April 16. The date of Virginia Tech's tragedy resonates for campus leaders the way Sept. 11 does for the nation.

The fatal shootings of 33 students and faculty there a year ago have put colleges and universities on high alert for potentially troubled students. On many campuses, that means more support is available. But the incident has also caused a reaction in some places that mental-health professionals view with concern. When students with serious mental issues are unfairly barred from campus, they say, it doesn't improve campus safety and could drive the problems underground.

"We are seeing the campuses really trying to understand who needs help ... so they don't fall through the cracks," says Kevin Kruger, a spokesman for the National Association of Student Personnel Administrators, based in Washington. But he says a growing number of faculty have been calling administrators about disruptive students, saying things like, "I want them out of there."

One student took an overdose of pills and then threw them up and sought counseling. The next day, the school placed her on leave.

"I felt I was being punished for my depression," she wrote in a letter to Karen Bower, senior staff attorney at the Bazelon Center for Mental Health Law in Washington. "Instead of trying to learn more about me, they kicked me out so someone else could deal with me."

The Bazelon Center sued George Washington University in 2005 on behalf of a student placed on leave after seeking emergency psychiatric care for depression. The suit was settled. As a result of the suit, Virginia legislated that public universities could not penalize or expel students solely for suicide attempts or treatment for suicidal thoughts.

If struggling students are automatically placed on leave, others won't want to come forward about their own or a friend's troubles, "and that breakdown of communication will be very harmful," says Gary Pavela, who teaches at the University of Maryland, College Park, and has written about college mental-health issues.

Of course, colleges do have to decide where to draw the line if a student's problem is beyond their capacity to help or if their behavior violates conduct codes. A student's severe troubles can at times put a burden on roommates and classmates, even if it's not violent.

"Going to school is not a right; it's a privilege," says Carolyn Reinach Wolf, director of Campus Behavioral Health Risk Consultants and a lawyer in New York State. "There comes a point in time where a student just can't remain on campus."

Still, people with mental illness shouldn't be pegged as violent – they are more often victims of crime than perpetrators, Ms. Wolf says.

Students with mental illnesses have a right to ask for reasonable accommodations under the Americans with Disabilities Act. "There are things that can be done so a student can stay and succeed," Ms. Bower says. She recalls a school that allowed parents to stay in the dorm so a student in crisis could finish final exams before leaving.

If people can continue their education, they are less likely to have long-term mental disabilities, says Cheryl Gagne, a senior training associate at the Center for Psychiatric Rehabilitation at Boston University, which works with colleges nationwide to help their students stay enrolled in school.

One key to deciding how to handle students with severe problems, these experts say, is to have a team assess each case based on the medical, legal, and ethical issues at stake. Many schools have formed such teams since the Virginia Tech shootings. Among the new laws signed by Virginia Gov. Tim Kaine April 9 is a requirement that colleges create threat-assessment teams, as well as policies about informing parents of dependent students at imminent risk of harming themselves or others.

When Boston University formed a task force in the wake of Virginia Tech, it was already "ahead of the eight ball" with coordinated mental-health efforts, says Ms. Gagne.

BU launched a website recently called Helping Students in Distress, part of a larger trend on a number of campuses to encourage everyone – roommates, cleaning staff, police – to watch for signs of mental-health problems and connect people with support.

"Nobody is at all interested in keeping people out, but they just want to be helpful and aware and protective of the community," says Margaret Ross, BU's director of Behavioral Medicine (a term for mental health). She's part of the "care team" set up last year to assess situations that might be dangerous.

The team, including police and senior administrators, met recently after a student communicated to someone on campus in a way that seemed threatening. Two people had interviewed the student to see if there might be psychological issues. A background check found no history of violence, which generally would lower the threshold for imposing a leave, Dr. Ross says.

The team agreed there was no threat after all. But it was an opportunity to realize that incidents like the shootings at Virginia Tech may not be as top of mind for students as they are for college staff. Ross says that when she asked the student to be more mindful that certain statements might appear threatening, she said, " 'You probably remember Virginia Tech?' And [the student] said, 'Oh, I hadn't even thought of that.' "