Schools reach out to suicidal
Online program helps break the ice
Jane Stancill, Staff Writer
College students' e-mail in-boxes are filled with mundane chatter, but a subject line that asks, "Are you depressed?" gets attention -- and could save a life.
Universities are reaching out to troubled students where those students feel comfortable: the Internet. Researchers at UNC-Chapel Hill and Emory University have sent e-mail to thousands of students in recent years, directing them to an online questionnaire that helps screen for depression.
About 8,000 UNC-CH students got the e-mail message this year and last year, and 433 responded. Eighty-five came for more evaluation or treatment, and more than three-quarters said they would not have done so without the e-mail contact, said researcher Jan Sedway, an assistant clinical professor of psychiatry at UNC-CH.
An encrypted code protected the students' identities. The exchange between counselor and student started anonymously, but Sedway said the e-mail communication fostered a trusting relationship in most cases.
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There's still a stigma attached to mental health issues, though. Sometimes a good bit of online coaxing was needed before a student would agree to face-to-face counseling.
"I was surprised by how reluctant some of them were to seek help," Sedway said. "With many of them, it took 10 e-mail exchanges before they would come in. Many of them said they came in because they felt they knew me."
In one case, Sedway communicated with a student by e-mail for a year while he studied abroad. "He sent me e-mail that was five pages long and told me all kinds of things that he had never told another person," she said.
Eventually, when the student returned to the United States, he came in for counseling, she said.
The study, sponsored by the American Foundation for Suicide Prevention, ended in May. But UNC-CH's counseling service has received a grant for suicide prevention programs and plans to continue the e-mail experiment on a more limited basis.
It's one of several initiatives by UNC-CH after the suicides of at least six students in about a year and a half from late 2002 to 2004. Relatives of some of the victims complained about the university's overburdened counseling service and policies toward students struggling with mental illness.
A university task force studied the problem and recommended better screening to identify depressed students, better follow-up for students who are referred to private doctors, adequate health insurance coverage for students and a campuswide survey on mental health services. The university also created a permanent committee to monitor mental health issues.
UNC-CH also has increased its student fees to hire more psychiatrists and counselors, and the campus is looking for ways to make sure students know how to get help, said Melissa Exum, associate vice chancellor and dean of students. Freshmen often don't use the university's counseling service because they don't know about it.
"Everyone says, 'Take away the stigma,' " Exum said. "We're even looking at ways to take counselors to the students in the dorms or before student groups."
At the very least, Exum said, the university will do more to advertise its psychological services to students throughout the year. That's where e-mail and the Internet come in. It's a natural way to connect with students, Sedway said.
"This is how they're used to communicating," she said. "This is what makes sense to them."
Across the country, universities have reported a rise in student depression and students seeking mental health care. Suicide is the third-leading cause of death among college-age Americans, according to the Centers for Disease Control and Prevention. A 2002 study by the National Mental Health Association and the Jed Foundation reported an estimated 1,088 suicides annually on college campuses.
The Jed Foundation, created five years ago to help prevent student suicides on college campuses, developed Ulifeline.org, a Web site that offers a self-screening test developed at Duke University's medical school. The service is offered free and used by 580 colleges, said Donna Satow, founder of the Jed Foundation, named for her son who committed suicide.
Screening tests are important because students may not understand symptoms of depression, Satow said.
An easy, Web-based questionnaire is a way to help students recognize they're in trouble.
"It may give them that little bit of extra knowledge to say, 'I need to go see somebody,' " Satow said.
Staff writer Jane Stancill can be reached at 956-2464 or
[email protected].
