The most important thing when responding to mental health or suicide crises is to contain the situation, make it safe for the individual in crisis and others; and to listen to the person in crisis.
It seems no matter what higher education publication you read or what lists you might subscribe to, there is increasing interest from campus health and safety professionals about how to best provide mental health services and support to students. Issues ranging from legal rights and medical leave policies, to 24-hour emergency services and online assessments, are in the headlines. Campuses are working toward coordinating efforts so that students are identified early, have professional support, and do not feel isolated as part of the community.
Suicide is a major public health problem, and colleges and universities are ideal venues for making an impact. Campuses need a comprehensive approach to suicide prevention – one that is based in research and sustained over the long-haul. Teamwork among students, faculty, staff, and leadership is needed – it can’t just be the effort of one part-time person working in a basement somewhere.
Safety and Health Professionals come into contact with people in physical and mental crises every day. Your community often reaches out to you first and depends on you to know what to do when an individual is in a suicide crisis (whether their own suicidal behavior or bereavement by suicide).
First Responders | Healthcare Professionals | Health Promotion Professionals
To download an open letter to First Responders, click here.
Special Issues For First Responders:
- De-escalation and containment when you first arrive on a mental health crisis scene
- You may be called upon to look beyond the overt signs of injury to the possible underlying suicidal intent
- A Gatekeeper is trained to recognize behavioral patterns and other warning signs that indicate that a person may be at risk of suicide.
- How to assess lethality and be aware of warning signs
- How to effectively communicate while on a mental health crisis scene
- Operational Safety Procedures
- Death notifications and working with distraught survivors
- Contamination—vicarious trauma/PTSD
For more information, please check out the following links.
- Suicide Prevention Resource Center (SPRC) – First Responders
- SPRC- Law Enforcement Personnel
- Suicide Postvention for Police Suicide
- Suicide Prevention and Gatekeeper Training – QPR Institute
- Suicide First Responder Resource Page – University of Montana
As healthcare professionals you may come into contact with college students contemplating suicide in your day-to-day practice. Most people reach out to someone in the week preceding a suicide attempt. You may be the person a suicidal student reaches out to. Your patients may reach out in some form of warning sign: verbal or behavioral, of their intent to kill themselves.
What to do if you encounter a suicidal patient
At-A-Glance information for
- Primary Care Physicians (PCP’s)
- School-Based Health Care Providers
For more information, click on the following links:
- The Role of Nurses in Preventing Suicide (SPRC)
- The Role of Primary Care Physicians in Preventing Suicide (SPRC)
- School-Based Health Care Providers (SPRC)
Health Promotion Professionals
Whether students arrive on campus with pre-existing mental health conditions, or develop problems during the college years, prevention activities and support services can assist students in getting the help they need to stay in class. A common question posed by campuses, “Are today’s students really more disturbed than those in years past?” Silverman (2004) suggests that improved diagnosis, assessment, earlier intervention, and decreased stigma toward mental illness account for some of the increases. These factors may bring students to college who might not previously have considered postsecondary education as an option.
For any student, college is a time of transition. Many students are away from home for the first time, academics become more rigorous and there are new financial pressures and extra-curricular activities. The pressure of college life can be overwhelming at times. As a result, depression and other associated disorders, such as eating disorders, substance abuse and anxiety disorders, may appear. Often these problems are disregarded as feelings of stress or being overwhelmed. No one fully understands how the brain works and why, at times, it works differently in different people. In general, people do not have the same acceptance about brain disorders as they do to other illnesses.
As with other health risks, a comprehensive and collaborative approach must be used in defining services for a wide range of mental health conditions. A first step is for campuses to assess where they are on mental health support. In Safeguarding Your Students Against Suicide, Expanding the Safety Net a checklist is provided for institutional review that addresses areas of the campus community such as: administrative policies, risk identification programs, on-campus support, and community-based services.
Walking through this checklist with an all-college committee on mental health can identify strengths and areas for improvement and help direct outreach and education efforts to all members of the campus community. What is clear is that many campus and community resources must work together to provide support. Part of a comprehensive approach also involves students. Student peer leadership can be a key to raising awareness of mental health issues on campus. Peer education and mentoring are very important parts of the college experience, and have proven to be effective outreach methods for many different issues including mental health and wellness. Peer educators are also the type of leaders needed on an all-college committee as they have good perspective on attitudes and previous experience in dealing with challenging health behaviors.
In the Fall 2006 NASPA Leadership Exchange, Gary Pavela, Director of Judicial Programs at the University of Maryland, College Park states, “The mental health issue opens a window on other aspects of student life—stress, fragmented care, lack of communication. It gives us an appropriate reason to re-examine the type of culture that exists on our campuses. We are missing the opportunity to re-evaluate other aspects of student life contributing to isolation and depression. Students need to be engaged in these discussions as well.
If you are considering adding suicide prevention to your prevention work consider the following:
- Screenings: Conduct screenings for depression, alcohol abuse, eating disorders, and/or anxiety disorders. (Your local Mental Health Association can help conduct screenings.) Discuss mental illness and mental health as they relate to other high-risk behaviors (such as alcohol and substance abuse and eating disorders).
- Speaker Series: With the help of the local Mental Health America, or the National Mental Health Awareness Campaign, identify potential speakers to make presentations on mental health subjects. Be sure that support is provided at the event from professionals trained to deal with mental health issues.
- Mental Health Education and Training for Key Groups: Conduct mental health education and training for resident assistants and Greek leadership so campus leaders better understand mental illness. Educate faculty, staff, coaches, and others who spend time with students. [link to educational program page]
No matter what outreach is offered, be sure to collaborate with campus and local mental health providers, provide students with resource information such as contact information for local mental health providers and crisis hotlines (i.e., the National Suicide Prevention Hotline, 1-800-273-8255 (TALK) and have trained professionals available at your programs.)
- Kadison, R. & DiGeronimo, T.F. (2004). College of the overwhelmed: The campus mental health crisis and what to do about it. San Francisco: Jossey-Bass.
- Silverman, M.M. (2004). College student suicide prevention: Background and blueprint for action. Student Health Spectrum, pp. 13-20.
- Safeguarding Your Students Against Suicide, Expanding the Safety Net. (2002). Proceedings from the National Mental Health Association andThe Jed Foundation. An institutional checklist is provided, p. 12.
- NASPA Leadership Exchange. (Fall 2006). Mental Health Interventions. An Interview with Gary Pavela.
- Pavela, Gary. (2006) Questions and answers on college student suicide: A law and policy perspective. College Administrative Publications.
- Harper, R. & Peterson, M. (2005). Mental health issues and college students. NACADA Clearinghouse of Academic Advising Resources.
- American College Health Association. (2006). National College Health Assessment Web Summary. www.acha.org
- Substance Abuse and Mental Health Services Administration:www.samhsa.gov
- National Mental Health Awareness Campaign: www.nostigma.org
- Mental Health America: www.nmha.org
- American Foundation for Suicide Prevention: www.afsp.org
- National Institute of Mental Health: www.nimh.nih.gov
For more information, please check out the following links.
- Safeguarding Your Students Against Suicide, Expanding the Safety Net (Jed Foundation)
- Promoting Mental Health and Preventing Suicide in College and University Settings (Suicide Prevention Resource Center)
- College Student Depression and Suicide (American Foundation for Suicide Prevention)
- Falling through the Cracks – Virginia Tech and the Restructuring of College Mental Health Services (New England Journal of Medicine)
- The Mental Health Needs of Today’s College Students: Challenges and Recommendations (National Association of Student Personnel Administrators)
- Promoting Mental Health and Preventing Suicide in College Settings (Suicide Prevention Resource Center)
- College Mental Health News (Villanova University)
Resources for survivors of suicide loss:
- Parents surviving suicide (Compassionate Friends)
- SOS Handbook
- On-line resources including discussion boards