Suicide at College

Shocking Statistics

Certainly, suicide is not something you want to think about as you pack your child off to college, but it is a fact of college life. The scariest statistic that I have encountered is from American College Health Association data reporting that 9 percent of all college undergraduate students seriously think about suicide.

That is a frightening piece of information; it means that in a college with ten thousand students, nine hundred of them will report thinking seriously about suicide. The good news is that actual suicide is a rare event. The bad news is that it happens, and sometimes it is unpredictable and unstoppable. It is every parent, college, and counselor's worst nightmare, but fortunately, there are things we can do to minimize the risk. And parents can help.

The statistics on college-age suicide make this a subject that can't be ignored. A significant number of college students find the pressures of college life too great to bear; feeling helpless and hopeless, they think about, attempt, or complete suicide. The facts are shocking:

• Suicide is the second leading cause of death among twenty to twenty-four year olds (after accidents and homicides).
• More teenagers and young adults die from suicide than from all medical illnesses combined.
• The suicide rate peaks among young adults (ages twenty to twenty-four).
• One in twelve U.S. college students makes a suicide plan.

Who Is at Risk?

Two distinct groups of students are at risk for suicidal thoughts and attempts: those who come into the college with preexisting mental health problems and those who develop mental health problems during the college years.

Students who come to college with diagnosed mental illnesses usually keep this fact a secret. Although there are laws protecting people with any sort of disability from discrimination, the students and their families do not advertise a psychological problem in the application process and after acceptance usually keep the facts to themselves. We may suspect a problem based on the prescribed medications listed on a student's health form or the acknowledgment of certain needs on their housing applications. But for the most part, we do not know which of our incoming students have diagnosed conditions, such as depression or bipolar disorder, that put them at risk for suicide.

But we do know the numbers of these students is rising as the number of high school students suffering mental health problems increases. The Youth Risk Behavior Survey in 2001 polled 13,601 students nationally in grades 9 through 12. It found that in the twelve months before the survey, 28.3 percent of high school students acknowledged feeling so sad or hopeless almost every day for more than two consecutive weeks that they stopped doing some usual activities. Nineteen percent of students reported that they seriously considered attempting suicide, and 14.8 percent had made a specific plan to attempt suicide. And 8.8 percent had attempted suicide in the previous year.

Although these numbers are startling, students with mental illnesses and learning disabilities now succeed in high school and move on to college as never before because of improvements in early diagnosis, competent therapy, and pharmacology. But when they move into the college system, they need ongoing, intensive care that not all schools are able to offer. The typical unstructured environment, erratic sleeping patterns, and academic stresses can ultimately push these students to the edge.

Then there is the group who develop mental health problems while in college. The common risk factors for attempted suicide that may begin during the college years include depression, alcohol or other drug use, and physical or sexual abuse. In fact, research has shown that more than 90 percent of people who kill themselves have depression or another diagnosable mental or substance abuse dis­ order. Unfortunately, students often ignore these high-risk signals until they find themselves on the edge of hopelessness and despair.

Students' gender can also put them in the high-risk category. Among those age twenty to twenty-four, more than seven times as many men as women die by suicide. Women report attempting suicide during their lifetime about three times as often as men. So a daughter is far more likely to talk about suicide or attempt suicide, but a son is more likely to use a lethal means (most commonly firearms) to go through with it.

Although it's impossible to create a foolproof profile of at-risk students, many of them feel driven to achieve more than is humanly possible; some are perfectionists who cannot bear failure; others have a history of mental illness in the family; some simply lack adequate coping skills to get them through tough times; and others have no identifiable traits at all. Whatever the cause, specific signs of potential suicide include

• Talking openly about committing suicide
• Talking indirectly about "wanting out" or "ending it all"
• Taking unnecessary or life-threatening risks
• Giving away personal possessions

Ideally, troubled students receive help long before they get to this final stage. That's why it is so important for us to pay very close attention to students like the 66.2 percent of college students who said they felt overwhelmed by all they had to do in the last year and the 46 percent who felt so depressed that it was difficult to function. These are all at-risk students.

The Hard Facts

The American College Health Association survey of 29,230 college students found that a significant portion of college students had been previously diagnosed with clinical depression: 11.7 percent had been diagnosed with depression, 24 percent of those were in therapy for depression, and 35 percent of those were taking medication for depression.^* (The full survey results are available in Appendix A.)

^*American College Health Association, National College Health Assessment: Reference Group Report (Baltimore: American College Health Association, 2002).

Web Sites for More Information About Suicide Prevention

• American Association of Suicidology, www.suicidology.org
• American Foundation for Suicide Prevention, www.afsp.org
• National Organization of People of Color Against Suicide, www.nopcas.com
• Suicide Prevention Advocacy Network, www.spanusa.org
• HOTLINE: 1-800-SUICIDE, which provides access to trained telephone counselors, twenty-four hours a day, seven days a week

The Goal is Prevention

Research estimates project that 1,088 suicides will occur on college campuses in the United States each year and that 9.5 percent of surveyed students seriously contemplated suicide. These are an insurmountable number of cases for colleges to handle adequately. And this does not address the needs of the many students who are suffering from mental health problems but do not seek help from a counselor.

This is why your role in the prevention of mental health problems is so important. Because it's too easy for a student in crisis to get lost in the crowd at college and because you will not be notified of identified mental health problems without the expressed consent of your "child," who is now an adult, you will need to be aware and vigilant in order to monitor his or her health. In almost all cases, the signs and symptoms of mental health problems are there long before a crisis situation develops, and they are treatable"but they must first be identified.