NAMI: Challenging Mental Health Stigma In The Black Community

In the black community, there is a negative stigma surrounding mental health. Instead of seeking professional help for conditions such as depression and anxiety, many in the community resort to self-medication (drugs, opioids, alcohol, etc.) or isolation in an attempt to solve their problems on their own. This issue of masking pain is especially prevalent amongst black men.

Speaking from experience, I know how black men grow up in culture that tells us “men are not supposed to cry,” that we “should deal with problems on our own.” This only enforces the idea that it’s not okay for us to say we are hurting inside. I’ve spoken to countless friends who, out of fear of being labeled as weak or less than a man, don’t want to acknowledge or vocalize any of their pains. This is true for me as well, as there have been moments in my life when I was afraid of sharing my true emotional well-being (or lack thereof) to close family and friends.

These are topics I talked about on my show, The Roommates Podcast. Due to my openness talking about mental health challenges, I received countless emails from young adult, black listeners who shared with me their struggles in the darkness. The more I used my platform to discuss topics relating to mental health in our community, the more others felt empowered to speak up and seek help for their own issues. This led to my desire to challenge stigma and bring light to mental health in the black community.

“Help”

Last May, I wrote and directed “Help,” a film created with the intention of beginning a conversation about mental health in the black community. The film follows the fictional story of a young black man named Raheem, who appears to have it all together on the outside, but has hidden struggles within.

Raheem is a successful man living in the Houston area; he is loved and respected by his community. He has a great career as an oil broker, a supportive wife and a large community of supportive friends. Though when Raheem is alone, you see his struggle with depression.

Raheem struggles to decide whether he should seek help from a mental health professional. When he shares this with his friend Kendrick, he’s told that “black men don’t go to counseling.” This scene is powerful because not only does it reinforce Raheem’s negative perception of getting help, but it also sheds light on the attitude towards mental health in the black community.

While he is by himself, there are thoughts in his head that constantly reinforce everything negative he believes about himself. Yet, whenever someone asks him what is wrong, Raheem says: “Nothing, I’m fine,” and then redirects the conversation with a joke. Sadly, Raheem’s story is reflective of many in the black community—millions of men who are suffering on the inside, but are too afraid to reach out for help.

Lift Up Your Voice

This year alone, there have been over 6.8 million black Americans who had a diagnosable mental illness. If we are unable to remove the negative stigma surrounding mental health in the black community, we are willingly allowing another generation to grow up without access to counseling and mental health improvement resources that can help them live a happy, healthy life.

Out of my desire to create long-lasting change in the black community, I am using my voice and platform to help others. I have heard one story too many of people in the black community struggling in the darkness, and I don’t want that to continue any longer. Anyone, regardless of how strong they are or how much they appear to “have it together” may be struggling with their mental health. You are not alone in your pain and you are not “weak” or “less than” because you are hurting. It’s time we reach out and ask for or offer help—because that’s what it takes to achieve the true healing we need.

 

Hafeez Baoku is an author, director and host of The Roommates Podcast. His work has been featured on OWN Network, The Houston Chronicle, Fox News 26, Houstonia Magazine, and Houston Style Magazine. You can connect with him at roommateshtx.com

Teen Mental Health Books

Abuse/Assault (PTSD)

Reality Boy by A. S. King

Call Number: YA FIC KING,A

“An emotionally damaged seventeen-year-old boy in Pennsylvania, who was once an infamous reality television show star, meets a girl from another dysfunctional family, and she helps him out of his angry shell”– Provided by publisher.

Complicit by Stephanie Kuehn

Call Number: YA FIC KUEHN,S

Jamie’s mother was murdered when he was six, about seven years later his sister Cate was incarcerated for burning down a neighbor’s barn, and now Jamie, fifteen, learns that Cate has been released and is coming back for him, blaming him for all the bad things that led to her arrest.

Charm and Strange by Stephanie Kuehn

Call Number: YA FIC KUEHN,S

A lonely teenager exiled to a remote Vermont boarding school in the wake of a family tragedy must either surrender his sanity to the wild wolves inside his mind or learn that surviving means more than not dying.

Sex and Violence by Carrie Mesrobian

Call Number: YA FIC MESROBIAN,

“Sex has always come without consequences for Evan. Until the night when all the consequences land at once, leaving him scarred inside and out”– Provided by publisher.

Stronger Than You Know by Jolene B. Perry

Call Number: YA FIC PERRY,J

After fifteen years of horrific abuse and neglect by her mother and her mother’s boyfriends, Joy struggles to understand and accept a normal life with relatives, at school, and with a boyfriend.

Scars by Cheryl Rainfield

Call Number: YA FIC RAINFIELD,C

Fifteen-year-old Kendra, a budding artist, has not felt safe since she began to recall devastating memories of childhood sexual abuse, especially since she cannot remember her abuser’s identity, and she copes with the pressure by cutting herself.

Stained by Cheryl Rainfield

Call Number: YA FIC RAINFIELD,C

A teenaged girl bullied for her port-wine stain must summon her personal strength to survive abduction and horrific abuse at the hands of a deranged killer.

Addiction

Other Broken Things by C. Desir

Call Number: YA FIC DESIR,C

Forced to attend Alcoholics Anonymous meetings, where she bonds with a much older man, seventeen-year-old Natalie, a recovering alcoholic, confronts issues in her family and life as she tries to turn her life around.

Crank by Ellen Hopkins

Call Number: YA FIC HOPKINS,E

Kristina Snow is the perfect daughter, but she meets a boy who introduces her to drugs and becomes a very different person, struggling to control her life and her mind.

Anxiety Disorders

Compulsion by Heidi Ayarbe

Call Number: YA FIC AYARBE,H

Poised to lead his high school soccer team to its third straight state championship, seventeen-year-old star player Jake Martin struggles to keep hidden his nearly debilitating obsessive-compulsive disorder.

A Scary Scene in a Scary Movie by Matt Blackstone

Call Number: YA FIC BLACKSTONE,M

Rene, a high school freshman with obsessive-compulsive disorder, finds life to be like a scary movie, and even after he makes friends with the ultra-cool Giovanni he still feels responsible for saving his favorite teacher, dealing with his missing father, courting the beautiful Ariel, and trying to pretend to be normal for the school psychologist.

The Great American Whatever by Tim Federle

Call Number: YA FIC FEDERLE,T

Quinn Roberts’ only worry used to be writing convincing dialogue for the movies he made with his sister Annabeth. Of course, that was before the car accident that changed everything. Enter Geoff, Quinn’s best friend who insists it’s time that Quinn came out– at least from hibernation. Geoff drags Quinn to a party where he meets a guy– okay, a hot guy– and falls, hard. And Quinn begins imagining his future as a screenplay that might actually have a happily-ever-after ending– if he can finally step back into the starring role of his own life story.

OCD Love Story by Corey Ann Haydu

Call Number: YA FIC HAYDU,C

In an instant, Bea felt almost normal with Beck, and as if she could fall in love again, but things change when the psychotherapist who has been helping her deal with past romantic relationships puts her in a group with Beck–a group for teens with obsessive-compulsive disorder.

Finding Audrey by Sophie Kinsella

Call Number: YA FIC KINSELLA,S

Fourteen-year-old Audrey is making slow but steady progress dealing with her anxiety disorder when Linus comes into the picture and her recovery gains momentum.

The Boyfriend List by E. Lockhart

Call Number: YA FIC LOCKHART,E

A Seattle fifteen-year-old explains some of the reasons for her recent panic attacks, including breaking up with her boyfriend, losing all her girlfriends, tensions between her performance-artist mother and her father, and more.

Virtuosity by Jessica Martínez

Call Number: YA FIC MARTINEZ,J

Just before the most important violin competition of her career, seventeen-year-old prodigy Carmen faces critical decisions about her anti-anxiety drug addiction, her controlling mother, and a potential romance with her most talented rival.

Say What You Will by Cammie McGovern

Call Number: YA FIC MCGOVERN,C

Born with cerebral palsy, Amy can’t walk without a walker, talk without a voice box, or even fully control her facial expressions. Plagued by obsessive-compulsive disorder, Matthew is consumed with repeated thoughts, neurotic rituals, and crippling fear. Both in desperate need of someone to help them reach out to the world, Amy and Matthew are more alike than either ever realized. When Amy decides to hire student aides to help her in her senior year at Coral Hills High School, these two teens are thrust into each other’s lives. As they begin to spend time with each other, what started as a blossoming friendship eventually grows into something neither expected.

Fangirl by Rainbow Rowell

Call Number: YA FIC ROWELL,R

“Cath is a Simon Snow fan. Okay, the whole world is a Simon Snow fan … But for Cath, being a fan is her life–and she’s really good at it. She and her twin sister, Wren, ensconced themselves in the Simon Snow series when they were just kids; it’s what got them through their mother leaving”–Book jacket.

The Unlikely Hero of Room 13B by Teresa Toten

Call Number: YA FIC TOTEN,T

“Adam not only is trying to understand his OCD, while trying to balance his relationship with his divorced parents, but he’s also trying to navigate through the issues that teenagers normally face, namely the perils of young love”– NLC catalog.

Don’t Touch by Rachel M. Wilson

Call Number: YA FIC WILSON,R

“16-year-old Caddie struggles with OCD, anxiety, and a powerful fear of touching another person’s skin, which threatens her dreams of being an actress–until the boy playing Hamlet opposite her Ophelia gives her a reason to overcome her fears”– Provided by publisher.

OCD, the Dude, and Me by Lauren Roedy Vaughn

Call Number: YA FIC VAUGHN,L

Danielle Levine stands out even at her alternative high school–in appearance and attitude–but when her scathing and sometimes raunchy English essays land her in a social skills class, she meets Daniel, another social misfit who may break her resolve to keep everyone at arm’s length.

The Nature of Jade by Deb Caletti

Call Number: YA FIC CALLETI,D

Seattle high school senior Jade’s life is defined by her anxiety disorder and dysfunctional family, until she spies a mysterious boy with a baby who seems to share her fascination with the elephants at a nearby zoo.

Highly Illogical Behavior by John Corey Whaley

Call Number: YA FIC WHALEY,J

Agoraphobic sixteen-year-old Solomon has not left his house in three years, but Lisa is determined to change that– and to write a scholarship-winning essay based on the results.

Attention Deficit Disorder(ADD)/Attention Deficit Hyperactivity Disorder(ADHD)

Playing Tyler by T. L. Costa

Call Number: YA FIC COSTA,T

Tyler MacCandless is looking at a bleak future. With his father dead and his mother mentally checked out, Tyler is responsible for his older brother Brandon who’s in rehab for heroin abuse–again. With no skills to speak of outside of playing video games, a fast food future is all but a certainty. That is, until the day Tyler’s mentor Rick asks him to test a new video game. A good enough score can earn him a place in flight school. But then Brandon goes missing, and Tyler discovers the game is far more than it seems.

A List of Cages by Robin Roe

Call Number: YA FIC ROE, R

When Adam Blake lands the best elective ever in his senior year, serving as an aide to the school psychologist, he thinks he’s got it made. Sure, it means a lot of sitting around, which isn’t easy for a guy with ADHD, but he can’t complain, since he gets to spend the period texting all his friends. Then the doctor asks him to track down the troubled freshman who keeps dodging her, and Adam discovers that the boy is Julian–the foster brother he hasn’t seen in five years. Adam is ecstatic to be reunited. At first, Julian seems like the boy he once knew. He’s still kind hearted. He still writes stories and loves picture books meant for little kids. But as they spend more time together, Adam realizes that Julian is keeping secrets, like where he hides during the middle of the day, and what’s really going on inside his house. Adam is determined to help him, but his involvement could cost both boys their lives –

Autism Spectrum Disorders

Al Capone Does My Shirts by Gennifer Choldenko

Call Number: JRHI CHOLDENKO,G

A twelve-year-old boy named Moose moves to Alcatraz Island in 1935 when guards’ families were housed there, and has to contend with his extraordinary new environment in addition to life with his autistic sister.

Mockingbird by Kathryn Erskine

Call Number: JRHI ERSKINE,K

Ten-year-old Caitlin, who has Asperger’s Syndrome, struggles to understand emotions, show empathy, and make friends at school, while at home she seeks closure by working on a project with her father.

The Curious Incident of the Dog in the Night-Time by Mark Haddon

Call Number: YA FIC HADDON,M

Despite his overwhelming fear of interacting with people, Christopher, a mathematically-gifted, autistic fifteen-year-old boy, decides to investigate the murder of a neighbor’s dog and uncovers secret information about his mother.

Harmonic Feedback by Tara Kelly

Call Number: YA FIC KELLY,T

When Drea and her mother move in with her grandmother in Bellingham, Washington, the sixteen-year-old finds that she can have real friends, in spite of her Asperger’s, and that even when you love someone it doesn’t make life perfect.

Marcelo in the Real World by Francisco X. Stork

Call Number: YA FIC STORK,F

Marcelo Sandoval, a seventeen-year-old boy on the high-functioning end of the autistic spectrum, faces new challenges, including romance and injustice, when he goes to work for his father in the mailroom of a corporate law firm.

Bipolar Disorder

Every You, Every Me by David Levithan; Jonathan Farmer (Photographer)

Call Number: YA FIC LEVITHAN,D

Evan is haunted by the loss of his best friend, but when mysterious photographs start appearing, he begins to fall apart as he starts to wonder if she has returned, seeking vengeance.

When We Collided by Emery Lord

Call Number: YA FIC LORD,E

Can seventeen-year-old Jonah save his family restaurant from ruin, his mother from her sadness, and his danger-seeking girlfriend Vivi from herself?

Chasing the Milky Way by Erin E. Moulton

Call Number: JRHI MOULTON,E

Lucy Peevey, twelve, and her best friend Cam are perfecting the robot that could win a competition, a scholarship, and a way out of Sunnyside Trailer Park when Lucy’s mother goes off her medication and her manic-depressive disorder goes out of control.

All the Bright Places by Jennifer Niven

Call Number: YA FIC NIVEN,J

“Told in alternating voices, when Theodore Finch and Violet Markey meet on the ledge of the bell tower at school–both teetering on the edge–it’s the beginning of an unlikely relationship, a journey to discover the “natural wonders” of the state of Indiana, and two teens’ desperate desire to heal and save one another”– Provided by publisher.

Bleeding Violet by Dia Reeves

Call Number: YA FIC REEVES,D

A mentally ill sixteen-year-old girl reunites with her estranged mother in an East Texas town that is haunted with doors to dimensions of the dead and protected by demon hunters called Mortmaine.

Wild Awake by Hilary T. Smith

Call Number: YA FIC SMITH,H

“The discovery of a startling family secret leads seventeen-year-old Kiri Byrd from a protected and naive life into a summer of mental illness, first love, and profound self-discovery”– Provided by publisher.

Stop Pretending by Sonya Sones

Call Number: YA FIC SONES,S

A younger sister has a difficult time adjusting to life after her older sister has a mental breakdown

The Museum of Intangible Things by Wendy Wunder

Call Number: YA FIC WUNDER,W

Best friends Hannah and Zoe, seventeen, leave their down-and-out New Jersey town and drive west chasing storms, making new friends, and seeking the intangibles–audacity, insouciance, happiness–that their lives have lacked.

Depression and Suicide

Silhouetted by the Blue by Traci L. Jones

Call Number: JRHI JONES,T

After the death of her mother in an automobile accident, seventh-grader Serena, who has gotten the lead in her middle school play, is left to handle the day-to-day challenges of caring for herself and her younger brother when their father cannot pull himself out of his depression.

Hold Still by Nina LaCour

Call Number: YA FIC LACOUR,N

As Caitlin struggles to cope with her best friend Ingrid’s suicide, she turns inward and quiet, but finding Ingrid’s hidden journal, a new classmate, and new projects help Caitlin find a way to reach out again.

Thirteen Reasons Why by Jay Asher

Call Number: YA FIC ASHER,J

When high school student Clay Jenkins receives a box in the mail containing thirteen cassette tapes recorded by his classmate Hannah, who committed suicide, he spends a bewildering and heartbreaking night crisscrossing their town, listening to Hannah’s voice recounting the events leading up to her death.

The Chance You Won’t Return by Annie Cardi

Call Number: YA FIC CARDI,A

High school student Alex Winchester struggles to hold her life together in the face of her mother’s threatening delusions about being Amelia Earhart.

I Swear by Lane Davis

Call Number: YA FIC DAVIS,L

“After Leslie Gatlin kills herself, her bullies reflect on how things got so far”– Provided by publisher.

Love Letters to the Dead by Ava Dellaira

Call Number: YA FIC DELLAIRE,A

When Laurel starts writing letters to dead people for a school assignment, she begins to spill about her sister’s mysterious death, her mother’s departure from the family, her new friends, and her first love.

Revolution by Jennifer Donnelly

Call Number: YA FIC DONNELLY,J

An angry, grieving seventeen-year-old musician facing expulsion from her prestigious Brooklyn private school travels to Paris to complete a school assignment and uncovers a diary written during the French revolution by a young actress attempting to help a tortured, imprisoned little boy–Louis Charles, the lost king of France.

Tears of a Tiger by Sharon M. Draper

Call Number: YA FIC DRAPER,S

The death of high school basketball star Rob Washington in an automobile accident affects the lives of his close friend Andy, who was driving the car, and many others in the school.

Playlist for the Dead by Michelle Falkoff

Call Number: YA FIC FALKOFF,M

After his best friend, Hayden, commits, suicide, fifteen-year-old Sam is determined to find out why–using the clues in the playlist Hayden left for him.

Suicide Notes by Michael Thomas Ford

Call Number: YA FIC FORD,M

Brimming with sarcasm, fifteen-year-old Jeff describes his stay in a psychiatric ward after attempting to commit suicide.

Will Grayson, Will Grayson by John Green; David Levithan

Call Number: YA FIC GREEN,J

When two teens, one gay and one straight, meet accidentally and discover that they share the same name, their lives become intertwined as one begins dating the other’s best friend, who produces a play revealing his relationship with them both.

Get Well Soon by Julie Halpern

Call Number: YA FIC HALPERN,J

When her parents confine her to a mental hospital, an overweight teenage girl, who suffers from panic attacks, describes her experiences in a series of letters to a friend.

The Last Time We Say Goodbye by Cynthia Hand

Call Number: YA FIC HAND,C

After her younger brother, Tyler, commits suicide, Lex struggles to work through her grief in the face of a family that has fallen apart, the sudden distance between her and her friends, and memories of Tyler that still feel all too real.

Stupid Fast by Geoff Herbach

Call Number: YA FIC HERBACH,G

Just before his sixteenth birthday, Felton Reinstein has a sudden growth spurt that turns him from a small, jumpy, picked-on boy with the nickname of “Squirrel Nut” to a powerful athlete, leading to new friends, his first love, and the courage to confront his family’s past and current problems

Romancing the Dark in the City of Light by Ann Jacobus

Call Number: YA FIC JACOBUS,A

“A troubled American teen, living in Paris, is torn between two boys, one of whom encourages her to embrace life, while the other–dark, dangerous, and attractive–urges her to embrace her fatal flaws”– Provided by publisher.

The First Time She Drowned by Kerry Kletter

Call Number: YA FIC KLETTER,K

Committed to a mental hospital against her will for something she claims she did not do, Cassie O’Malley signs herself out against medical advice when she turns eighteen and tries to start over at college, until her estranged mother appears, throwing everything Cassie believes about herself into question.

Hold Still by Nina LaCour; Mia Nolting (Illustrator)

Call Number: YA FIC LACOUR,N

Ingrid didn’t leave a note. Three months after her best friend’s suicide, Caitlin finds what she left instead: a journal, hidden under Caitlin’s bed.

Not after Everything by Michelle Levy

Call Number: YA FIC LEVY,M

“After his mom kills herself, Tyler shuts out the world–until falling in love with Jordyn helps him find his way toward a hopeful future”– Provided by publisher.

Survive by Alex Morel

Call Number: YA FIC MOREL,A

A troubled girl is stranded in an arctic winter terrain after a plane crash and must fight for survival with the only other boy left alive.

By the Time You Read This, I’ll Be Dead by Julie Anne Peters

Call Number: YA FIC PETERS,J

High school student Daelyn Rice, who’s been bullied throughout her school career and has more than once attempted suicide, again makes plans to kill herself, in spite of the persistent attempts of an unusual boy to draw her out.

Forgive Me, Leonard Peacock by Matthew Quick

Call Number: YA FIC QUICK,M

A day in the life of a suicidal teen boy saying good-bye to the four people who matter most to him.

Sorta Like a Rock Star by Matthew Quick

Call Number: YA FIC QUICK,M

Although seventeen-year-old Amber Appleton is homeless, living in a school bus with her unfit mother, she is a relentless optimist who visits the elderly at a nursing home, teaches English to Korean Catholic women with the use of rhythm and blues music, and befriends a solitary Vietnam veteran and his dog, but eventually she experiences one burden more than she can bear and slips into a deep depression.

When Reason Breaks by Cindy L. Rodriguez

Call Number: YA FIC RODRIGUEZ,C

Elizabeth Davis and Emily Delgado seem to have little in common except Ms. Diaz’s English class and the solace they find in the words of Emily Dickinson, but both are struggling with to cope with monumental secrets and tumultuous emotions that will lead one to attempt suicide.

Dr. Bird’s Advice for Sad Poets by Evan Roskos

Call Number: YA FIC ROSKOS,E

A sixteen-year-old boy wrestling with depression and anxiety tries to cope by writing poems, reciting Walt Whitman, hugging trees, and figuring out why his sister has been kicked out of the house.

This Song Will Save Your Life by Leila Sales

Call Number: YA FIC SALES,L

Nearly a year after a failed suicide attempt, sixteen-year-old Elise discovers that she has the passion, and the talent, to be a disc jockey.

Black Box by Julie Schumacher

Call Number: YA FIC SCHUMACHER,J

When her sixteen-year-old sister is hospitalized for depression and her parents want to keep it a secret, fourteen-year-old Elena tries to cope with her own anxiety and feelings of guilt that she is determined to conceal from outsiders.

The Memory of Light by Francisco X. Stork

Call Number: YA FIC STORK,F

When Victoria Cruz wakes up in the psychiatric ward of a Texas hospital after her failed suicide attempt, she still has no desire to live, but as the weeks pass, and she meets Dr. Desai and three of the other patients, she begins to reflect on the reasons why she feels like a loser compared with the rest of her family, and to see a path ahead where she can make a life of her own.

This Is Not a Test by Courtney Summers

Call Number: YA FIC SUMMERS,C

Barricaded in Cortege High with five other teens while zombies try to get in, Sloane Price observes her fellow captives become more unpredictable and violent as time passes although they each have much more reason to live than she has.

It’s Kind of a Funny Story by Ned Vizzini

Call Number: YA FIC VIZZINI,N

A humorous account of a New York City teenager’s battle with depression and his time spent in a psychiatric hospital.

My Heart and Other Black Holes by Jasmine Warga

Call Number: YA FIC WARGA,J

“Seventeen-year-old Aysel’s hobby–planning her own death–take a new path when she meets a boy who has similar plan of his own”– Provided by publisher.

Belzhar by Meg Wolitzer

Call Number: YA FIC WOLITZER,M

Jam Gallahue, fifteen, unable to cope with the loss of her boyfriend Reeve, is sent to a therapeutic boarding school in Vermont, where a journal-writing assignment for an exclusive, mysterious English class transports her to the magical realm of Belzhar, where she and Reeve can be together.

Falling into Place by Amy Zhang

Call Number: YA FIC ZHANG,A

“One cold fall day, high school junior Liz Emerson steers her car into a tree. This haunting and heartbreaking story is told by a surprising and unexpected narrator and unfolds in nonlinear flashbacks even as Liz’s friends, foes, and family gather at the hospital and Liz clings to life”– Provided by publisher.

I Was Here by Gayle Forman

Call Number: YA M FORMAN,G

In an attempt to understand why her best friend committed suicide, eighteen-year-old Cody Reynolds retraces her dead friend’s footsteps and makes some startling discoveries.

Fall for Anything by Courtney Summers

Call Number: YA M SUMMERS,C

As she searches for clues that would explain the suicide of her successful photographer father, Eddie Reeves meets the strangely compelling Culler Evans who seems to know a great deal about her father and could hold the key to the mystery surrounding his death.

We Are the Ants by Shaun David Hutchinson

Call Number: YA SF HUTCHINSON,S

Henry Denton has spent years being periodically abducted by aliens. Then the aliens give him an ultimatum: the world will end in 144 days, and all Henry has to do to stop it is push a big red button. Only he isn’t sure he wants to. Life hasn’t been great for Henry: his mom is held together by a thin layer of cigarette smoke; his brother is a jobless dropout. And Henry is still dealing with the grief of his boyfriend’s suicide last year. Weighing the pain and the joy that surrounds him, Henry can choose to save the planet… or let it be destroyed.

Impulse by Ellen Hopkins

Call Number: YA FIC HOPKINS,E

Three teens who meet at Reno, Nevada’s Aspen Springs mental hospital after each has attempted suicide connect with each other in a way they never have with their parents or anyone else in their lives.

Two Boys Kissing by David Levithan

Call Number: YA FIC LEVITHAN,D

A chorus of men who died of AIDS observes and yearns to help a cross-section of today’s gay teens who navigate new love, long-term relationships, coming out, self-acceptance, and more in a society that has changed in many ways.

Eating Disorders

Wintergirls by Laurie Halse Anderson

Call Number: YA FIC ANDERSON,L

Eighteen-year-old Lia comes to terms with her best friend’s death from anorexia as she struggles with the same disorder.

Pointe by Brandy Colbert

Call Number: YA FIC COLBERT,B

Four years after Theo’s best friend, Donovan, disappeared at age thirteen, he is found and brought home and Theo puts her health at risk as she decides whether to tell the truth about the abductor, knowing her revelation could end her life-long dream of becoming a professional ballet dancer.

Tides by Betsy Cornwell

Call Number: YA FIC CORNWELL,B

After moving to the Isles of Shoals for a marine biology internship, eighteen-year-old Noah learns of his grandmother’s romance with a selkie woman, falls for the selkie’s daughter, and must work with her to rescue her siblings from his mentor’s cruel experiments.

Perfect by Natasha Friend

Call Number: YA FIC FRIEND,N

Following the death of her father, a thirteen-year-old uses bulimia as a way to avoid her mother’s and ten-year-old sister’s grief, as well as her own.

Perfect by Ellen Hopkins

Call Number: YA FIC HOPKINS,E

Northern Nevada teenagers Cara, Kendra, Sean, and Andre, tell in their own voices of their very different paths toward perfection and how their goals change when tragedy strikes.

Never Enough by Denise Jaden

Call Number: YA FIC JADEN,D

sixteen-year-old Loann admires and envies her older sister Claire’s strength, popularity, and beauty, but as Loann begins to open up to new possibilities in herself, she discovers that Claire’s all-consuming quest for perfection comes at a dangerous price.

Skinny by Ibi Kaslik

Call Number: YA FIC KASLIK,I

After the death of their father, two sisters struggle with various issues, including their family history, personal relationships, and an extreme eating disorder.

Butter by Erin Jade Lange

Call Number: YA FIC LANGE,E

Unable to control his binge eating, a morbidly obese teenager nicknamed Butter decides to make live webcast of his last meal as he attempts to eat himself to death.

Letting Ana Go by Anonymous

Call Number: YA FIC LET

Required by her cross-country coach to keep a food diary, an insecure teen finds that writing helps organize her thoughts, especially about issues that she, her best friend, and her mother face related to weight and eating.

Purge by Sarah Darer Littman

Call Number: YA FIC LITTMAN,S

When her parents check sixteen-year-old Janie into Golden Slopes to help her recover from her bulimia, she discovers that she must talk about things she has admitted to no one–not even herself.

A Trick of the Light by Lois Metzger

Call Number: YA FIC METZGER,L

fifteen-year-old Mike desperately attempts to take control as his parents separate and his life falls apart.

Clean by Amy Reed

Call Number: YA FIC REED,A

A group of teens in a Seattle-area rehabilitation center form an unlikely friendship as they begin to focus less on their own problems with drugs (including alcohol) by reaching out to help a new member, who seems to have even deeper issues to resolve.

How I Live Now by Meg Rosoff

Call Number: YA FIC ROSOFF,M

To get away from her pregnant stepmother in New York City, fifteen-year-old Daisy goes to England to stay with her aunt and cousins, with whom she instantly bonds, but soon war breaks out and rips apart the family while devastating the land.

Skin and Bones by Sherry Shahan

Call Number: YA FIC SHAHAN,S

Jack, who is sixteen and has anorexia, spends the summer in an eating disorder ward for teenagers and befriends both his overweight roommate and a dangerously thin dancer.

Impulse Control/Self Harm

Bleed Like Me by C. Desir

Call Number: YA FIC DESIR,C

Two emotionally scarred teenagers enter into a passionate, dangerous romance

Crash and Burn by Michael Hassan

Call Number: YA FIC HASSAN,M

Steven “Crash” Crashinsky relates his sordid ten-year relationship with David “Burn” Burnett, the boy he stopped from taking their high school hostage at gunpoint.

Break by Hannah Moskowitz

Call Number: YA FIC MOSKOWITZ,H

To relieve the pressures of caring for a brother with life-threatening food allergies, another who is a fussy baby, and parents who are at odds with one other, seventeen-year-old Jonah sets out to break every bone in his body in hopes of becoming stronger.

Last Night I Sang to the Monster by Benjamin Alire Sáenz

Call Number: YA FIC SAENZ,B

Eighteen-year-old Zach does not remember how he came to be in a treatment center for alcoholics, but through therapy and caring friends, his amnesia fades and he learns to face his past while working toward a better future.

Faking Normal by Courtney C. Stevens

Call Number: YA FIC STEVENS,C

Alexi Littrell hasn’t told anyone what happened to her over the summer. When Bodee Lennox, the quiet and awkward boy next door, comes to live with the Littrells, Alexi discovers an unlikely friend in “the Kool-Aid Kid,” who has secrets of his own. As they lean on each other for support, Alexi gives him the strength to deal with his past, and Bodee helps her find the courage to finally face the truth.

Obsessive-Compulsive Disorder (OCD)

OCD Love Story by Corey Ann Haydu

Call Number: YA FIC HAYDU,C

In an instant, Bea felt almost normal with Beck, and as if she could fall in love again, but things change when the psychotherapist who has been helping her deal with past romantic relationships puts her in a group with Beck–a group for teens with obsessive-compulsive disorder.

Fallout by Ellen Hopkins

Call Number: YA FIC HOPKINS,E

Written in free verse, explores how three teenagers try to cope with the consequences of their mother’s addiction to crystal meth and its effects on their lives.

Fig by Sarah Elizabeth Schantz

Call Number: YA FIC SCHANTZ,S

In 1994, Fig looks back on her life and relates her experiences, from age six to nineteen, as she desperately tries to save her mother from schizophrenia while her own mental health and relationships deteriorate.

Every Last Word by Tamara Ireland Stone

Call Number: YA FIC STONE,T

Hidden beneath the straightened hair and expertly applied makeup is a secret that her friends would never understand: Samantha has Purely-Obsessional OCD and is consumed by a stream of dark thoughts and worries that she can’t turn off. When Sam meets Caroline, she has to keep her new friend with a refreshing sense of humor and no style a secret. Caroline introduces Sam to Poet’s Corner, and she is drawn to them immediately– especially a guitar-playing guy with a talent for verse– and starts to discover a whole new side of herself.

The Unlikely Hero of Room 13B by Teresa Toten

Call Number: YA FIC TOTEN,T

“Adam not only is trying to understand his OCD, while trying to balance his relationship with his divorced parents, but he’s also trying to navigate through the issues that teenagers normally face, namely the perils of young love”– NLC catalog.

OCD, the Dude, and Me by Lauren Roedy Vaughn

Call Number: YA FIC VAUGHN,L

Danielle Levine stands out even at her alternative high school–in appearance and attitude–but when her scathing and sometimes raunchy English essays land her in a social skills class, she meets Daniel, another social misfit who may break her resolve to keep everyone at arm’s length.

Don’t Touch by Rachel M. Wilson

Call Number: YA FIC WILSON,R

“16-year-old Caddie struggles with OCD, anxiety, and a powerful fear of touching another person’s skin, which threatens her dreams of being an actress–until the boy playing Hamlet opposite her Ophelia gives her a reason to overcome her fears”– Provided by publisher.

Post-Traumatic Stress Disorder (PTSD)

The Impossible Knife of Memory by Laurie Halse Anderson

Call Number: YA FIC ANDERSON,L

“Hayley Kincaid and her father move back to their hometown to try a “normal” life, but the horrors he saw in the war threaten to destroy their lives”– Provided by publisher.

Something Like Normal by Trish Doller

Call Number: YA FIC DOLLER,T

When Travis returns home from Afghanistan, his parents are splitting up, his brother has stolen his girlfriend and car, and he has nightmares of his best friend getting killed but when he runs into Harper, a girl who has despised him since middle school, life actually starts looking up.

Sex and Violence by Carrie Mesrobian

Call Number: YA FIC MESROBIAN,C

“Sex has always come without consequences for Evan. Until the night when all the consequences land at once, leaving him scarred inside and out”– Provided by publisher.

If You Find Me by Emily Murdoch

Call Number: YA FIC MURDOCH,E

“There are some things you can’t leave behind… A broken-down camper hidden deep in a national forest is the only home fifteen year-old Carey can remember. The trees keep guard over her threadbare existence, with the one bright spot being Carey’s younger sister, Jenessa, who depends on Carey for her very survival. All they have is each other, as their mentally ill mother comes and goes with greater frequency. Until that one fateful day their mother disappears for good, and two strangers arrive. Suddenly, the girls are taken from the woods and thrust into a bright and perplexing new world of high school, clothes and boys. Now, Carey must face the truth of why her mother abducted her ten years ago, while haunted by a past that won’t let her go… a dark past that hides many a secret, including the reason Jenessa hasn’t spoken a word in over a year. Carey knows she must keep her sister close, and her secrets even closer, or risk watching her new life come crashing down”– Provided by publisher.

Boy21 by Matthew Quick

Call Number: YA FIC QUICK,M

Finley, an unnaturally quiet boy who is the only white player on his high school’s varsity basketball team, lives in a dismal Pennsylvania town that is ruled by the Irish mob, and when his coach asks him to mentor a troubled African American student who has transferred there from an elite private school in California, he finds that they have a lot in common in spite of their apparent differences.

Invincible by Amy Reed

Call Number: YA FIC REED,A

Evie is living on borrowed time. She was diagnosed with terminal cancer several months ago and told that by now she’d be dead. Evie is grateful for every extra day she gets, but she knows that soon this disease will kill her. Until, miraculously, she may have a second chance to live. All Evie had wanted was her life back, but now that she has it, she feels like there’s no place for her in it–at least, not for the girl she is now. Her friends and her parents still see her as Cancer Girl, and her boyfriend’s constant, doting attention is suddenly nothing short of suffocating. Then Evie meets Marcus. She knows that he’s trouble, but she can’t help falling for him. Being near him makes her feel truly, fully alive. It’s better than a drug. His kiss makes her feel invincible–but she may be at the beginning of the biggest free fall of her life.

The Things a Brother Knows by Dana Reinhardt

Call Number: YA FIC REINHARDT,D

Although they have never gotten along well, seventeen-year-old Levi follows his older brother Boaz, an ex-Marine, on a walking trip from Boston to Washington, D.C. in hopes of learning why Boaz is completely withdrawn.

Bruised by Sarah Skilton

Call Number: YA FIC SKILTON,S

When she freezes during a hold-up at the local diner, sixteen-year-old Imogen, a black belt in Tae Kwan Do, has to rebuild her life, including her relationship with her family and with the boy who was with her during the shoot-out.

The Marbury Lens by Andrew Smith

Call Number: YA FIC SMITH,A

After being kidnapped and barely escaping, sixteen-year-old Jack goes to London with his best friend Connor, where someone gives him a pair of glasses that send him to an alternate universe where war is raging, he is responsible for the survival of two younger boys, and Connor is trying to kill them all.

The Freak Observer by Blythe Woolston

Call Number: YA FIC WOOLSTON,B

Suffering from a crippling case of post-traumatic stress disorder, sixteen-year-old Loa Lindgren tries to use her problem solving skills, sharpened in physics and computer programming, to cure herself.

Schizophrenia

Chopsticks by Jessica Anthony (Created by); Rodrigo Corral (Created by)

Call Number: YA ANTHONY,J

In a love story told in photographs and drawings, Glory, a brilliant piano prodigy, is drawn to Frank, an artistic new boy, and the farther she falls, the deeper she spirals into madness until the only song she is able to play is “Chopsticks.”

Where the Moon Isn’t by Nathan Filer

Call Number: YA FIC FLIER, N

ISBN: 9781250026989

Publication Date: 2013-11-05

Struggling to understand what happened to his brother years earlier after they both snuck out of the house during the middle of the night, Matthew believes he has found a way to bring his brother back by going off his meds.

Crazy by Han Nolan

Call Number: YA FIC NOLAN,H

Fifteen-year-old loner Jason struggles to hide father’s declining mental condition after his mother’s death, but when his father disappears he must confide in the other members of a therapy group he has been forced to join at school.

A Blue So Dark by Holly Schindler

Call Number: YA FIC SCHINDLER,H

As Missouri fifteen-year-old Aura struggles alone to cope with the increasingly severe symptoms of her mother’s schizophrenia, she wishes only for a normal life, but fears that her artistic ability and genes will one day result in her own insanity.

Schizo by Nic Sheff

Call Number: YA FIC SHEFF,N

A teenager recovering from a schizophrenic breakdown is driven to the point of obsession to find his missing younger brother and becomes wrapped up in a romance that may or may not be the real thing.

Challenger Deep by Neal Shusterman; Brendan Shusterman (Illustrator)

Call Number: YA FIC SHUSTERMAN,N

Caden Bosch is on a galleon that’s headed for the deepest point on Earth: Challenger Deep, the southern part of the Marianas Trench. Caden Bosch is a brilliant high school student whose friends are starting to notice his odd behavior. Caden Bosch is designated the ship’s artist in residence to document the journey with images. Caden Bosch pretends to join the school track team but spends his days walking for miles, absorbed by the thoughts in his head. Caden Bosch is split between his allegiance to the captain and the allure of mutiny. Caden Bosch is torn. Caden Bosch is dealing with schizophrenia… and as fantasy and paranoia begin to take over, his parents have only one choice left.

Belzhar by Meg Wolitzer

Call Number: YA FIC WOLITZER,M

Jam Gallahue, fifteen, unable to cope with the loss of her boyfriend Reeve, is sent to a therapeutic boarding school in Vermont, where a journal-writing assignment for an exclusive, mysterious English class transports her to the magical realm of Belzhar, where she and Reeve can be together.

17 and Gone by Nova Ren Suma

Seventeen-year-old Lauren has visions of girls her own age who are gone without a trace, but while she tries to understand why they are speaking to her and whether she is next, Lauren has a brush with death and a shocking truth emerges, changing everything.

 

KNOW YOUR RIGHTS: CAMPUS STUDENTS UTILIZING COUNSELING SERVICES

Campus Mental Health: Know Your Rights is a guide for college and

university students to your legal rights when seeking mental health services.

It also explains what you can expect in your interactions with mental health

service providers and what obligations you might have.

 

The guide is available online at http://www.bazelon.org/l21/rightsguide.htm

in both HTML and PDF formats.

 

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS!

Introduction

Though we don’t know you, and we may never meet you, Campus

Mental Health: Know Your Rights! was created with you in mind. As

a committee of mental health advocates, we worked together to provide

information to assist you in finding help and protecting your legal rights.

Some of us have had direct experience with mental health problems and

know first-hand how little information is available that is tailored specifically

to the needs of students like you.

If you or someone you love has a mental illness or is experiencing

extreme emotional distress, we know that what you’re going through right

now may be extraordinarily challenging. Although mental illnesses are

extremely challenging, they are treatable, and people recover every day.

We hope the information in this guide will enable you to find and use

mental health resources on your campus and to safeguard your rights.

YOU ARE NOT ALONE

Many college-age students suffer from anxiety, depression and other

mental health concerns. Anxiety is the issue most often mentioned by

college students who visited campus mental health services. Students

also named depression as one of the top ten impediments to academic

performance as well as stress, sleep difficulties, relationship and family

difficulties. In the 2006 National College Health Assessment, 43.8% of the

94,806 students surveyed reported they “felt so depressed it was difficult

to function” during the past year, and 9.3% said that they had “seriously

considered suicide” during the year.

More than 30% of all college freshman report feeling overwhelmed a

great deal of the time—college women, even more (about 38%). In 2006,

more than 13% of college students reported experiencing an anxiety

disorder within the previous year. While anxiety disorders are common for

YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

both genders, women are five times as likely to have them. Eating disorders

affect 5-10 million women and one million men, with the highest rates

occurring in college-age women. Thirteen percent of students reported

experiencing an emotionally abusive relationship in the last school year.1

If you are experiencing depression, anxiety, mood swings, sleep

disturbances, delusions or hallucinations, or if you feel overwhelmed,

immobilized, hopeless or irritable, there is treatment that can help. You

may also benefit from therapy to address common issues such as body

image or low self-esteem, to help with a crisis involving your relationship or

family, or if you are in the middle of a transition, such as beginning a new

school. Students who seek treatment are not “weak” or “crazy.” Therapy is

a hopeful and affirming act of caring for yourself.

Many people have written compelling accounts of their experiences with

mental health issues.2

SEEKING HELP

What can I do? Where do I go? On campus or off?

You should know that, as a college student, it’s easier to get professional

help now than it may be after you leave school. This doesn’t mean you

won’t run into any problems, but now is the time to get help. You’ll find

confidential on-campus resources at your school’s counseling center, health

center and places like a Women’s Center, if one exists on your campus.

Students sometimes feel embarrassed or scared to seek help. Talking

about your problems actually takes an immense amount of strength, yet it’s

important to move past the stigma surrounding mental health issues to get

the help you need.

Often, the best place to start is your school’s counseling center. Visit its

website or call its main number to find out what they can offer you. Most

on-campus centers provide two to eight free visits, so you can use their

confidential services free of charge.

Counseling centers can offer a range of services, from individual sessions

with psychologists or social workers, to group sessions for people who

share a common issue (such as body-image issues, grief and loss, or

academic anxiety), to sessions with psychiatrists. Since services vary campus

to campus, your best bet is to find out exactly what your school offers.

If your school doesn’t have a counseling center, check with the school’s

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS!

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

health center; mental health professionals may be able to see you there.

Campus counseling centers provide a very valuable service. In addition

to asking about the services the counseling center can provide, you may

want to ask about the confidentiality policy and other school policies that

may apply, such as leave policies, or ask the counseling center or dean of

students about school policies and practices. See pages 14-18 for more

information.

You also want to look into what health insurance you have (if you have

it) and what it covers. (Some plans don’t cover mental health care at all

while others have limits on the number of visits.) If you don’t want to see a

clinician on campus, or if the number of visits your counseling center will

allow you isn’t enough, your insurance policy may dictate what outside

options are available for you. Be aware that if you are on your parents’

health insurance, they may learn that you are receiving treatment from

the insurer. You may want to ask your insurance company about its billing

practices. Even if you have no insurance, there are agencies in most

communities that offer services on a sliding scale. You can find them listed

under “counseling,” “social service agencies” and similar categories. Many

religious groups operate family service agencies that provide a range of

counseling services.

If you choose not to seek services on campus, your school’s counseling

center can be a resource for referral to practitioners and programs offcampus.

You may end up seeing a psychologist, psychiatrist or social

worker in a private practice near your campus or in your hometown. You

can also go to a family doctor to discuss your symptoms, though it is a

good idea that you follow-up with a mental health professional since a

general practitioner is not the most knowledgeable about mental health

issues.

If your school participates in ULifeline, an online resource that provides

information about mental health issues and professional resources on and

around many campuses, you can get additional information at http://www.

ulifeline.org. Your school may have other online services; be sure to check

the school’s website.

What will happen when I call to make an appointment?

When you call to make an appointment at the counseling center, the

receptionist will likely take your name, address, student information (class

year) and ask why you are calling. You may not be asked directly, but if you

are experiencing an emergency, you should say so immediately so you get

in to see a clinician as soon as possible.

YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

If you are calling an off-campus resource, spend a few minutes talking

with the clinician on the phone, ask about his or her philosophy and

approach to working with patients, and whether or not he/she has a

specialty or concentration. If you feel comfortable talking further to the

counselor or doctor, then make an appointment. If you call a professional

off campus you may not get a return call right away, if you are a new

patient.

Especially if using an off-campus or independent therapist, use this

checklist as a guide to set your goals for a first conversation. Many of these

questions will probably be covered without your asking, but if not, don’t be

afraid to ask.

 What academic qualifications and training have prepared you to

practice as a therapist?

 What specialized training and/or experience have you had in

working with the issue I am dealing with?

 What professional associations do you belong to?

 What are your fees? Can you accommodate me if I don’t have

insurance? Is any payment required at the time of the visit?

 How will my insurance claim be handled?

 What type of therapy do you do (e.g., mostly talking, medication,

role-playing, visualizing, hypnosis, artwork, “body-work”)?

 Can you prescribe medication? If not, what arrangement do you

have for doing so?

 What are your office protocols (booking appointments, payment for

missed appointments, emergencies, etc.)?

 Can you accommodate my academic or work schedule?

 Can you give me a brief explanation as to what I can expect to

happen in my first session?

What are the steps for choosing a therapist?

If you are using on-campus resources, you may be assigned to a

specific clinician based on your intake interview and the strengths of

your counseling center. Most people at campus counseling centers have

experience and genuine interest in working with college students and

regularly work with students who are dealing with similar issues. You may

be seen by a therapist in training. Ask if you have questions or concerns

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS!

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

about the therapist’s experience. If a specific characteristic in a therapist

is important to you, such as gender, ethnicity, sexual orientation or age,

let the counseling center know and they will likely do whatever they can to

accommodate your requests.

If you are not using on-campus resources, the following steps adapted

from an article by the Substance Abuse and Mental Health Services

Administration entitled “Choosing the Right Mental Health Therapist” may

be helpful:

1. You may want to see your primary care physician to rule out a

physical cause of your problems. If your thyroid is “sluggish,” for

example, symptoms—such as loss of appetite and fatigue—could be

mistaken for depression.

2. Once you know your problems are not the result of a physical

condition, you should find out what the mental health coverage is

under your insurance policy or through Medicaid/Medicare.

3. If possible, it may be helpful to get a couple of referrals (from your

counseling center, friends, online) prior to making an appointment.

If a particular characteristic, such as age, sex, race or religion, is

important to you, you may want to mention that when asking for

referrals.

4. Be sure the psychotherapist takes a unique approach to your

treatment and does not believe that what works for one individual

will necessarily work for another.

5. An important element of successful therapy is rapport. After your first

visit, reflect on how you feel about your therapist.

If you felt comfortable with the therapist, schedule another appointment.

If for any reason the match does not feel right, it is perfectly common to

discuss these concerns openly with the therapist. And, of course, you may

choose to call another mental health professional from your referral list and

schedule another appointment.3

What happens if I call, and they can’t see me

for two, three or four weeks?

If it’s an emergency, you should tell the receptionist right away—just

as you would when making a doctor’s appointment for a physical health

problem. If you say that it is an emergency, they can try to fit you in right

away.

YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

If it is not an emergency but you still don’t feel comfortable waiting weeks

until your first appointment, ask the person at the counseling center if they

can notify you if an earlier appointment becomes available and if there

are any other resources for you in the meantime—for example, a Women’s

Center, an appropriate person at the health center or a peer group.

Otherwise, you may want to seek off-campus treatment through a clinic or

a therapist in private practice that would likely be able to see you earlier.

While it may be frustrating to have to wait, sometimes waiting is

unavoidable because the counseling center cannot give you the time you

need until they have an opening.

If you are in crisis and need immediate help:

If you are contemplating hurting yourself or attempting suicide, tell

someone who can help immediately:

 Call your doctor’s office.

 Call 911.

 Go to the nearest hospital emergency room.

 Call the National Suicide Prevention Lifeline at 1-800-273-TALK

(1-800-273-8255) to be connected to a trained counselor at a

suicide crisis center, or visit http://suicidehotlines.com/national.html.

The toll-free numbers are available 24 hours a day. (Note that the

goal of these hotlines is to keep callers safe. If hotline staff believe

the caller’s life is in danger, they may tell the police or emergency

medical services.)4

What will happen when I get there? What should I expect

at my first visit? What’s the first session like?

If you have never been in therapy before, then it is natural to feel a little

nervous about what will happen. As a result, the first session can feel pretty

intense. However, it is a good opportunity for you to see whether you feel

comfortable talking with a counselor and think you might benefit from

further sessions on a regular basis.

When you get into the counseling center you will check in for your

appointment just like at a doctor’s office. They may have you fill out a form

about family history, insurance and why you are there, or they may just wait

until you are seen by someone. The waiting room is pretty much just like

every other doctor’s office.

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS!

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

If you use off-campus services, you may be asked how you will finance

the visit when you make the appointment. When you arrive, you will

be asked for financial documentation, such as insurance cards, who is

responsible for payments, etc. You may be given other documents, such as

the therapist’s privacy policy.

Your first session will be a time for the therapist to get to know you and

your needs and begin to develop a plan to proceed. It can be a little more

basic than later visits, which should be more therapeutic, though it can also

feel very intense if it’s the first time you are talking about disturbing issues.

Therapy is a long-term process, so don’t expect an instant solution on

the first day. The goal is to help you develop ways to deal with issues over

the long term. The first visit will cover what difficulties you are having, any

changes/symptoms in your life, history of these problems in you and your

family, if you are using drugs or alcohol, or are smoking. The therapist may

have time to ask about your childhood, education, relationships, current

living situation and ability to function in school. The questions may seem

invasive and uncomfortable, but remember that this is your therapist’s

chance to learn as much about you as possible to devise the absolute best

treatment plan for you. If you feel uncomfortable answering a question

honestly, let the therapist know; don’t make up an answer—you will only be

hurting yourself and your chances of dealing with the disorder or problem if

you’re not honest.

You may also discuss length of treatment, methods the therapist will use

and patient confidentiality. At the end, the therapist may ask if you have any

questions.

If the therapist believes you are experiencing a mental disorder then he

or she may ask you to complete a questionnaire to determine what disorder

you are experiencing. This is normal and mental health professionals use

these questionnaires routinely. Afterwards, the therapist may give you a

tentative diagnosis. If so, the therapist will discuss treatment options and

may recommend medication or ask you to speak with a psychiatrist, who

may recommend medication (only psychiatrists, other doctors and in some

instances certain other medical professionals can prescribe medication).

You have a right to full explanation of the diagnosis, prognosis, and nature

and consequences of the proposed treatment, including risks, benefits and

alternatives. If you have questions or concerns, don’t be afraid to ask.

Below is a checklist of questions you

will want answered during the first

session. Many of these will probably

be covered without your asking, but if

not, don’t be afraid to ask.

Top 8 Frequently Asked Questions About

Psychotherapy, Psychotherapy 101 Nancy

Schimelpfening, http://depression.about.com/cs/

psychotherapy/a/whatistherapy_5.htm

YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

 Can you give me a brief explanation as to what I can expect to

happen in subsequent sessions?

 How often will I have therapy sessions and how long will each

session last?

 Do we agree on the goals of my treatment?

 How many sessions is it likely to take to resolve my issue?

 What should I do in case of an emergency?

 How will my confidentiality be assured? If seeing someone on

campus, you may want to specifically ask about whether and under

what circumstances information will be shared with your parents or

the administration (e.g., the dean of students).

Who is licensed to provide therapy?

Many types of mental health

professionals are licensed to

provide therapy. Finding the right

one for you may require some

research. The most common

mental health professionals

are psychiatrists, psychologists,

clinical social workers, licensed

professional counselors, mental

health counselors, certified alcohol and drug abuse counselors, nurse

psychotherapists, marital and family therapists and pastoral counselors.

What are the different types of therapy?

Common types of therapy are psychotherapy, cognitive behavioral

therapy, family therapy, group therapy, psychoanalysis and drug therapy.

You should speak with your mental health professional to learn what may

work best for you. There is no one way for everyone to deal with mental

health issues.53 See box for a description of the different types of therapy.

Depending on the size of your school, your campus counseling or health

center may provide brief individual, group and couples psychotherapy

as well as referrals for students. Long-term, open-ended psychotherapy

and after-hours emergency services may or may not be available through

the school. School counselors are likely available for consultation to both

parents and students, either by phone or by appointment. Parents may want

See Mental Health America for a list of the different

types of mental health professionals and suggestions

for choosing one. http://www.nmha.org/go/help/

finding-help/find-treatment/types-of-mental-healthprofessionals/

types-of-mental-health-professionals

Mental Health America (formerly known as the National

Mental Health Association) 2006.

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS!

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

to be involved if they have any

questions about services offered,

about how to assist their child

or about how to obtain specific

services on campus or in the

community. While parents may

get information about services

and may share information with

the counseling center, information about a student, including whether they

have sought treatment, is confidential and will not be disclosed to parents

without the student’s consent, except in very limited circumstances. For

more information, see the Privacy section below.

What happens if I don’t like my therapist?

You should feel comfortable with and respected by your therapist. If your

first choice in a therapist isn’t working out, you have the right to choose

another one with whom you have better rapport. Remember, the therapist

works for you and it’s appropriate for you to express any discomfort you

feelin fact, talking it through may be an important part of your treatment.

If you feel the therapist is not listening to your concerns or providing

enough feedback, let him or her know. If it still isn’t working for you, don’t

be afraid to change. Although it’s not easy to end any relationship, it helps

to remember that the therapist is a professional.

The best way to find a good therapist is by word of mouth. Satisfied

customers say a lot about the kind of therapy you will receive. Of course a

therapist who was right for someone else may not always be right for you.

Although you might feel embarrassed to ask friends or family for a referral,

you should consider doing it anyway. It increases the odds that you may

find a therapist who will really help you.

PRIVACY

What are my rights to privacy?

Can a therapist share what I have said during therapy?

All mental health professionals, whether on or off campus, are ethically

bound to keep what you say during therapy confidential unless you

specifically authorize the release of information about your diagnosis

Fact Sheet: Mental Illness and the Family, Mental Health

America, http://www.nmha.org/farcry/go/information/

get-info/mi-and-the-family/finding-the-right-mentalhealth-

care-for-you/mental-illness-and-the-familyfinding-

the-right-mental-health-care-for-you, visited

June 19, 2008

10 YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

and treatment. However, therapists may be required to take certain steps

if they believe you might harm yourself or someone else. These steps

could include sending you to a hospital or calling your parents. Also, your

therapist may need to share with your insurer information about your

diagnosis, treatment goals and the anticipated length of your treatment.

And some campus counselors report threats of self-injury or hospitalization

to administration officials.6 You have a right to know about confidentiality

and how information may be shared. Ask your therapist about the limits

of confidentiality and who can be notified without your permission. Some

settings provide brochures describing privacy issues.

Will my parents find out if I seek treatment?

School counseling centers and outside providers generally will not release

your medical information—including to family, parents/legal guardians or

faculty—without your written authorization. However, there are practical

issues. If your parents get insurance statements or bills related to your care,

they will know you are seeing a therapist. Also, as noted above, disclosure

without your consent is permitted to protect your safety and the safety of

others.

School administrators, faculty, disability services coordinators,

resident advisors and other non-clinicians are bound by different

confidentiality restrictions. If mental health information is reported to a

school administrator or disability services coordinator (in the application

process, as part of a request for accommodation or by a mental health

professional in an emergency), the school administrator may be able to

share that information with individuals who the school determines have

a “legitimate educational interest” in the information, as defined by law.7

Those individuals may include the Academic Deans, residential advisors,

counselors, faculty or student judicial services personnel. The school must

provide annual notice to students of the criteria for determining who

constitutes a school official and what constitutes a legitimate educational

interest. School administrators and faculty may also share information

that they personally observe. They may also share information from

your education records with your parents if you are a dependent for tax

purposes.

The law in this area is complex. The federal Health Insurance Portability

and Accountability Act (“HIPAA”),8 Family Educational Rights and Privacy Act

(“FERPA”)9 and Public Health Service Act as well as state laws may apply to

your situation. These laws may allow disclosure of information without your

consent to other treatment providers, payers of health care, other sources

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of financial assistance, public agencies that oversee treatment providers

and others. These laws may also allow disclosure when you are considered

incapacitated.

If you believe that your privacy rights have been violated, you can file

a grievance within the school or a complaint with the Department of

Education, Family Policy Compliance Office, http://www.ed.gov/policy/gen/

guid/fpco/index.html

Given this complexity, you should discuss confidentiality with your

treatment provider to understand if, under what circumstances and with

whom your information will be shared, and how you will be notified if

information is being released.

ACADEMIC ACCOMMODATIONS

What accommodations can I get from the school?

How and whom do I ask for accommodations?

Federal law provides that individuals with disabilities—in general,

those with physical or mental impairments substantially limiting one or

more major life activities—are entitled to academic accommodations

and reasonable modifications in school policies. That means that once

the school is aware of your disability it must take reasonable steps to

revise policies and practices that create obstacles for you because of your

disability.

In general, if you have a mental health problem that substantially limits

you in one or more major life activities (sleeping, working, learning,

speaking, caring for yourself, etc.) even if these symptoms are controlled

by medications or some other form of treatment, or a history of such

a problem, you may be protected by the Americans with Disabilities

Act (ADA). To comply with the ADA, schools must provide academic

accommodations and make reasonable modifications to policies and

rules when necessary to accommodate the needs of students with

disabilities. However, schools need not make such changes if doing so

would fundamentally alter their operations, waive essential academic and

technical requirements or cause them undue financial burden.10

A school also cannot discriminate against a qualified student based

on a disability—for example, by forcing a student to leave because of a

mental health problem if the student meets the school’s basic academic

and technical requirements. Depending on your need, the first place to

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LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

start asking for accommodations is the office of your disability services

coordinator on campus. They will be able to help you with housing,

academics and other accommodations you may need. If your campus

doesn’t have a disability services center, it will still have an individual

named as disability services coordinator. Or you could check with your

resident advisor, academic advisor, counseling center, health center, Dean

of Students office or housing services for what types of accommodations

are available and tell them the types of accommodations you need. Your

request need not take any particular form, but it may be best to put the

request in writing. You may be asked to provide a medical professional’s

statement about your disability, including the nature of the disability and

how it affects your ability to participate in and benefit from the academic

program, before receiving accommodations or modifications. You have a

right to see what this statement says.

If you have trouble obtaining accommodations after contacting the

appropriate people on campus, contact the local or state mental health

department or a local chapter of the National Alliance on Mental Illness,

Mental Health America or, if your campus has a chapter, Active Minds.

Local Protection and Advocacy organizations (http://www.ndrn.org) may

provide legal advice about whether you are protected by the ADA or similar

state laws and what accommodations or modifications would be considered

reasonable.

Academic accommodations

Academic accommodations for people with disabilities vary according to

an individual’s particular needs, but include such measures as:

Allowing additional time to complete exams.

Providing a private environment or alternate location in which to

take exams.

Permitting students to use equipment to take exams (e.g., a word

processor or a machine that enlarges print).

Allowing students to audio record lectures.

Providing modified deadlines for assignments.

Reducing course load or providing alternate work assignments.

Providing preferential classroom seating.

Providing early availability of syllabus and textbooks.

Providing transportation services.

Providing access to extracurricular programs.

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Providing orientation to campus facilities.

Allowing excused absences.

Allowing the student to postpone assignments and exams.

Allowing the student to work from home.

Allowing the student to drop courses.

Allowing the student to change roommates or rooms.

Allowing an aide or helper to stay in the student’s room.

Providing retroactive withdrawals from courses if academic

difficulties were due to depression or another mental health

condition.

Providing a leave of absence.

Check with your school to see if these accommodations are available. At

most schools these services are standard and you shouldn’t be afraid to ask

for them. You will likely be asked to provide a mental health professional’s

explanation of why the accommodation is needed. If the school disagrees,

it may request additional documentation or an independent assessment. If

the school does not provide a needed accommodation, you have a right to

file a grievance or a complaint with the Department of Education’s Office

for Civil Rights (see Resources on page 25).11

What can I expect from my school?

Universities and colleges should offer the following:

access to an environment that is civil and non-discriminatory for

study, work and day-to-day living, and

equal access to all university-sponsored programs, activities and

benefits in the most integrated setting, meaning classes, activities

and living arrangements within the general student population

rather than those that are separate for students with disabilities.

If you have a documented disability—whether you are an undergraduate

or graduate student, full- or part-time, in a degree or non-degree program,

enrolled in credit or noncredit courses—you are eligible for services through

the school’s office of disability services or its equivalent. Your school should

inform all students of the identity of the disability services coordinator and

the location of a disability services office if there is one.

All schools that receive federal funds (or enroll students who receive

federal funds) must have a disability compliance officer who is responsible

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for handling grievances involving disability-based complaints. The school

must also have disability grievance procedures that provide due process

protections—notice, an opportunity to present information on your behalf

and an opportunity to appeal—and must provide for prompt resolution of

complaints. Contact information for the disability services coordinator and

the disability grievance procedure should be in your school handbook or

code of conduct.

Your school officials should provide an environment conducive to your

mental health. This includes working to reduce stigma and discrimination;

training staff to better recognize warning signs and assist students with

mental illnesses; reducing barriers to mental health services; adequately

staffing the mental health or counseling center; and maintaining active

relationships with providers in the community who offer care to students. The

school should appoint an individual and implement a coordinating group

with the responsibility and authority to work toward these goals.

As a concerned college student, you should ask these questions of your

Dean of Students or the director of the counseling center:

 Have staff and faculty received adequate training to identify and

provide support for students who have mental illnesses or are

experiencing extreme emotional distress?

 Are mental health services adequately available on your campus?

 Are support services available to families of students who are

receiving mental health services?

 Have students received training and information about how to

recognize warning signs in themselves or others?

 Does your college or university maintain relationships with available

mental health providers in the community?

 Is there an adequate crisis management plan in place for students

and staff to deal with a suicide or traumatic event?

 What are the school’s policies regarding voluntary and involuntary

leaves of absence, involuntary leaves of absence and confidentiality?

All students have a right to review and inspect their educational records.

The educational record includes academic records as well as those in

the offices of the registrar, residential life and student judicial services,

among others. A request must be in writing and may need to be

directed to multiple departments. The school handbook should instruct

you how to request your records. The school must respond to a request

for records within 45 days and may charge a fee for copies. If the

record contains information that is inaccurate, misleading or in violation

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of your privacy rights, you have a right to request that the school amend

its records. If the school does not do so, you have a right to a formal

hearing. If, after the hearing, the school does not amend the record,

you have the right to place a statement in your educational record

about the inaccurate information.

If you believe your school has discriminated against you, you can file a

grievance with the school disability compliance officer. You can also file

a complaint with the Department of Education’s Office for Civil Rights

at http://www.ed.gov/about/offices/list/ocr/complaintintro.html (see the

Resources section on page 25).

How do I generate awareness?

You have an opportunity to take an active role in reducing the stigma

of mental illness by generating awareness on your campus. One way is to

engage your student peers to team up with the school’s campus counseling

services, disability services coordinator, office of student affairs or office

of diversity to increase understanding of mental health problems and the

importance of good mental health. Orientation, May (Mental Health Month)

and the first week in October (Mental Illness Awareness Week) present

particularly good opportunities to talk about these issues on campus. Some

ideas for generating awareness may include:

hanging signs about mental health problems and support services;

presenting about these issues to classes or groups;

organizing mental health information for student orientation

sessions;

using the media (internet, newsletters, etc) to get the word out;

organizing training opportunities for staff and students;

showing relevant movies;

offering free mental health screening;

organizing an event such as a walk or benefit concert supporting this

topic; or

establishing a formal mental health-related student group/club.

You may want to join Active Minds on Campus, a peer-to-peer

organization dedicated to raising awareness about mental health among

college students. There are chapters at more than 100 college campuses

nationwide.

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DISCIPLINE

What should I do if my school wants to discipline me for

something I think happened because of my illness?

You should not be disciplined for seeking help or because of behavior

that is due to your illness. However, in recent years some schools have

responded to students who have threatened to hurt themselves or who

have had mental health crises by taking disciplinary action for violation of

student codes of conduct. Schools may justify such responses as best for

the student or for other students. Also the school may be concerned about

potential danger and legal liability. School administrators may genuinely

believe they are doing the right thing by removing the student or initiating

disciplinary action.

Without knowing what school you attend, we cannot assure you that

you will not be disciplined for any behavior brought on by a mental health

crisis, but we can say it isn’t the policy at most schools. However, you may

want to ask school administrators about your school’s policies.

If university personnel seek to discipline you for something you think was

caused by your illness, they must provide some type of hearing and/or

appeal process. It may make sense at that point to disclose your illness,

if you have not done so already. Obviously, this is a difficult and deeply

personal decision. It also has legal implications, and you may want to

seek legal counsel (see the Resources section below). However, offering

information about your illness might help the school better understand the

behavior they seek to discipline. As a reasonable accommodation, you can

request that disciplinary action not be imposed or that it be modified when

the offense was the result of your mental health condition. If your school

takes extenuating circumstances into consideration in imposing discipline, it

must take your disability into consideration.

It may be helpful to show that, with specific supports, services or

accommodations, you can comply with university rules and/or the code of

conduct in the future. Also, if a university has a policy that charges students

with violation of university rules or its housing contract for engaging in

behavior that poses a risk to life—the student’s own or others’—a student

with a mental illness can argue that an episode such as a suicide attempt

or other self-injury should not subject him or her to the policy. The policy

would be discriminatory when implemented against a student in need of

mental health services whose behavior was a result of mental illness.

If a student is disciplined for violation of a rule that prohibits disrupting

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a class, the student would need to disclose his or her disability and

demonstrate how the disruption was caused by the disability and how it

would not recur with accommodation in the form of appropriate supports

and services.

In general, the more a student can support a claim that his or her

disability contributed to the action, and the more specific the plan for

addressing the behavior, the more likely it is that disciplinary action for

disability-related behavior will be waived.

Once I’m in trouble, must I tell them everything?

While disclosure and sharing information with university staff may be

one way to help them understand your situation and make them less likely

to discipline you, you are not required to provide a blanket release of all

mental health information, nor should you do so. A blanket release could

lead to a search through old records for evidence of past misconduct or

risk to self. Some students reasonably fear sharing information that might

touch on past sexual abuse or information that is otherwise private. You

have control over what information is being released to the school and

you should release information carefully after assessing what is needed to

demonstrate the existence of your disability and the likelihood of your future

success and safety on campus.

To minimize the risk of disclosing something harmful, embarrassing or

hurtful, it may make sense to write a letter disclosing the disability and

to compile a subset of records (such as a doctor’s letter summarizing

the link between the illness and the conduct in question) instead of

signing a blanket or full release. Additional requests for information

from the administration could be addressed through carefully written

releases permitting the university to converse with a specific provider or

providers. Again, how you should proceed will depend on the situation.12

Finding a lawyer (see Resources on page 25) may be helpful to you in

navigating these issues.

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INVOLUNTARY LEAVE OF ABSENCE

Can my school require me to take leave?

In recent years some schools have responded to students who have either

threatened to hurt themselves, been hospitalized or experienced a mental

health crisis by placing them on involuntary leave or by evicting them from

their dormitories. These practices have been legally challenged. As a result,

some legal standards have been developed.

The decision to impose a leave of absence should only be made in the

uncommon circumstance that a student cannot safely remain at a university

or meet academic standards, even with accommodations and other

supports. The same applies to exclusion from university housing, which

should be imposed only if a student cannot safely remain in the housing,

even with accommodations.

A school should impose a leave of absence or require a student to live

off campus only after an individualized assessment. The assessment should

consider whether there is a significant risk that the student will harm him/

herself or another and whether the risk cannot be eliminated or reduced

to an acceptable level through accommodations. Information from mental

health professionals may be vital in making this assessment. If the school

then does decide to act, the student is entitled to what are called “due

process protections.” These include notifying the student of the action the

school is considering and an explanation of why the school believes that

such an action is necessary. The student and his or her representative

should have an opportunity to respond and provide relevant information.

The school may inquire into a student’s current condition and request

recent mental health information and records. But it can only request

information and records that are necessary to determine whether the

student is a threat. The school cannot insist on unlimited access to

confidential information or records. You have a right to limit a release

of information to specific dates, and you have a right to approve and to

review information that is being made available to the school.

At the very least, the school should provide the same arrangements for

withdrawal from classes, incompletes and refunds of tuition or other costs

as it does for a student who takes a leave of absence or leaves college

housing for physical health reasons.

If the school is considering action against you, you can take several steps

that may turn things around. First, you could obtain an evaluation by a

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psychiatrist or other mental health professional. You could suggest ways to

address the school’s safety concerns; for instance, that you be permitted

to take classes but not live on campus. You should proceed with an honest

and earnest tone and manner. However, if the school administration

disregards your efforts to communicate and does not engage in dialogue

with you, it is probably time for you to obtain competent legal advice. If

you are placed on involuntary leave of absence, you should have a right

to appeal within the school. You can also file a grievance with the disability

compliance officer and/or a complaint with the Office for Civil Rights (see

the Resources section on page 25).

Can a school put restrictions on my returning from leave?

Students on leave, whether voluntary or involuntary, may request to

return to the school. Similarly, students excluded from housing may request

to return to university housing. A university cannot require that your mental

illness be “cured” before you return.

If you were on leave because of a direct threat to the safety of others or

yourself, you will need to demonstrate that the threat no longer exists. The

school may ask you to agree to receive treatment, including prescribed

medication, before returning. A mental health professional, not the school

administration, should make the decision about whether you need to

continue treatment.

School officials may also ask you to sign a behavioral contract and

agree to various conditions before they will allow you to return to school.

For example, they may ask you to agree that you will leave the campus if

there is another incident of self-injury. Keep in mind that a school cannot

require that a mental illness be cured or that disability-related behavior not

recur unless that behavior creates a direct threat that cannot be reduced

to an acceptable level with accommodations. Therefore, be cautious about

signing a behavioral contract that limits your rights. You may want to

negotiate about the terms of any such contract. For example, rather than

agreeing that the school can make you leave if you try to hurt yourself,

you could agree to seek help if you feel like hurting yourself. These types

of contracts may give you flexibility if the future does not go as well as you

had hoped.

A student who wants to return to school after taking a leave of absence

for mental health reasons should not be subjected to more rigorous

standards or procedures than a student who wants to return after taking

a leave for physical reasons. An opinion from the student’s mental health

professional that the student is fit to return should usually be sufficient.

20 YOUR MIND. YOUR RIGHTS.

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In exceptional cases, a school may seek a second opinion.13 The school

may also ask for ongoing access to your mental health provider. In most

cases, once you have demonstrated that you are not a threat, ongoing

contact with your treatment provider is not necessary. However, if you allow

ongoing contact, you may want to limit the communication to verification

that you are attending treatment, without sharing the content of your

treatment.

If your school is placing unreasonable conditions on your return, you

can file a grievance with the disability compliance officer and/or file a

complaint with the Department of Education’s Office for Civil Rights (see

Resources on page 25).

GOING TO A PSYCHIATRIC HOSPITAL

How will I be admitted to a hospital?

Most students seeking help—particularly if they seek help early on—will

not need hospital care. But those who do will want to understand what

occurs. There are different kinds of psychiatric hospitals and different

reasons for going there. Some hospitals provide only psychiatric care.

Often general medical hospitals have special units for psychiatric care,

just as they may for cardiac care or pediatrics. Commonly, admission to a

psychiatric hospital occurs either through a referral by a treating healthcare

professional or by way of an emergency room in a general hospital.

Generally, when a student is admitted to a psychiatric unit it is because

of an immediate concern about harm to self or others. Some people are

admitted to better diagnose a mental disorder and treatment needs or for

monitoring as they go through a change in their medication or treatment.

Some seek admission because they’re having trouble coping with life

and want help. And some are involuntarily admitted on an emergency

basis because they are behaving in such a way as to appear dangerous

to themselves or others. In these instances, state laws differ about how

long a hospital can keep people against their willusually from 24 to 72

hourswithout either a court order or the person’s agreement to voluntary

admission.

Here are some basics: When you arrive at the hospital, a mental health

professional will talk to you to determine whether or not you should

be admitted. Hospital staff will probably require you to surrender your

personal belongings and they may search you to be sure that you don’t

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have sharp objects, lighters, drugs or other objects that could harm you

or other patients. If you have a mental health provider, the hospital may

request that you sign a release of information to allow them to obtain

information from that provider. Many hospitals have a memorandum

of understanding with schools in the community in which they agree to

ask students to release information about their admission to the school’s

campus counseling center. You are not required to sign any releases of

information and you have the right to choose what information is released

and to whom it will be disclosed.

If you have made previous arrangements with your psychiatrist or doctor,

the person admitting you will review why you are there and what you may

hope to gain. If you have a crisis plan or a psychiatric advance directive

(see page 23), now is the time to show it or say where to find it.

It’s very important, if you have a history of trauma, such as sexual abuse,

to tell the triage nurse (if you come in through an emergency room) and

other professionals about it. Not only may this information help them better

understand your problems, but some interventions and practices could

be harmful to you as a result of your trauma history. The hospital should

accommodate your needs.

What’s it like? What can I expect?

Going to a hospital for psychological issues can feel scary and difficult.

In our society there are negative images of psychiatric wards. By definition,

hospitalization is a response to a crisis and can be a jarring experience,

even though the “snakepits” with lifelong confinement you may have seen

in old movies no longer exist. Some people are in the hospital to keep

them safe. For others, it is a place of recovery and respite. Particularly for

someone coming from an environment that does not have an awareness

of mental health issues, it also may be the first place to meet other people

who are visibly undergoing severe emotional distress, drug addiction or

other difficult experiences.

Psychiatric units look pretty much like other hospital units, though some

are locked and have other restrictions. On the unit, there are generally

nursing staff, social workers and administrative staff. You will likely be

supervised by staff at all times, particularly when first admitted. If you are

hospitalized because you have suicidal thoughts or attempted to harm

yourself or someone else, you may be placed on special observation. You

have the right to ask how the staff will decide when you will require less

one-on-one monitoring.

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Early on, you will have assessments by various professionals to better

understand your problems and to develop a treatment plan, setting goals

for your recovery and specifications for treatment. In most hospitals, you

will participate in meetings with your treatment team to help formulate

goals and treatment plans and to review your progress. You may say what

forms of treatment you do and do not want.

Most hospitals have systems to encourage people to cooperate with their

treatment plans. There is usually a set time for everyone to wake up, times

for programs in which to participate, times to eat meals, times when you

may go outside and a time to go to bed. The hospital may determine what

visitors can see you and when. A nurse or social worker will work with you

daily and take notes on your behavior in your medical chart. A psychiatrist

will check in on you as well. You may also be offered group or recreational

activities such as painting, drawing, sports, group therapy and so forth.

You have a right to practice your religion and to consult with clergy.

You can expect to have basic privileges while in the hospital, which may

include using the phone, watching TV, using the computer, taking a leave

from the hospital, eating certain foods and having time outside of your

room. Staff may adjust these privileges as they get to know you better and

understand your needs better. Some of these privileges will be affected

by your situation. For example, if you are hospitalized and in an abusive

relationship, the abuser may not be allowed to visit.

In some hospitals, if you don’t participate in the system they have

established, privileges may be modified.

Unless there is a court order or danger of imminent harm, forced

medication is not allowed (see page 24), though laws on this vary by state.

Most hospitals have a patient advocate to resolve grievances and help

you assert your rights. You can request to speak with an advocate at any

time. If you believe your rights have been violated you can file a grievance

with the hospital and the state department of public or mental health.

You can also consult a lawyer (see the Resources section). As difficult as

hospitalization may be, you should expect to be treated with dignity and

respect and to get the help you need after you are discharged.

What happens and what are my rights

after I leave a hospital?

While you are still in the hospital, a social worker will meet with you

to develop a discharge plan that will likely include referral to follow up

treatment. You may be prescribed medications and asked to get your

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prescriptions filled and to stay on the dosage that worked for you in the

hospital. You can ask that the discharge plan include recommendations for

specific accommodations at school, in your dorm or apartment or at work

that will allow you to succeed. In general, your rights after discharge are

the same as they were before you were hospitalized.

After you leave a hospital there should be appropriate services and

supports in the community to help you recover your independence and

pursue your life goals. If you wish, you should have access to appropriate

psychological and psychiatric care. You should receive information about

and have access to alternative treatments and therapies. You should also

have access to emotional supports (see the section below on resources).

You may have access to financial supports, such as Supplemental Security

Income (SSI), if your disability is severe.

You may want to create a psychiatric advance directive (PAD). An

advance directive is a legal document spelling out the health care you do or

do not wish to receive “if an illness renders you unable to make decisions

about your care.”14 In it, you can designate someone to make decisions for

you in such circumstances. An advance directive, whether for health care or

psychiatric services, should also specify the conditions under which it can be

implemented.

You should provide copies to trusted individuals and health professionals

whom you want to know about the PAD. Laws about advance directives vary

from state to state. You can work with a lawyer, paralegal or advocate to

write a PAD or visit the National Resource Center on Psychiatric Advance

Directives at http://www.nrc-pad.org and create your own. The site has videos

and easy-to-use information to get you started. Detailed information on

PADs is also available from the National Empowerment Center.

You should provide copies of both types of advance directives—for health

care and for mental health treatment—to trusted individuals and to the

health and mental health professionals who are most closely involved with

your care.

What if I have difficulties after leaving the hospital?

You should seek support, whether through local peer organizations,

trusted mental health professionals, family, friends or other supportive

individuals as soon as you detect that you are having difficulties. If you feel

that you need the support of round-the-clock care, you should discuss this

possibility with people you trust to determine whether this is the best option

for you, and whether you can receive the support you need in a community

setting.

24 YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

FORCED MEDICATION

Can I be forced to take medication?

In almost all cases, the answer to this is no. No one can force you to take

medication when you go in for treatment unless you are found to be, or are

on the verge of becoming, dangerous to yourself or others.

In general, states give the power to medicate without consent only to

hospital staff and they must have either 1) a court order permitting it or

2) documentation meeting strict criteria based on safety concerns.15 In the

unlikely event that your doctor seeks a court order for medication, you have

a right to be represented by a lawyer.

Most states have involuntary outpatient commitment (IOC) laws

under which, in certain circumstances, a person can be required to take

medication as a condition of living in the community. A summary of state

statutes (as of 2004) regarding IOC can be found at: http://www.bazelon.org/

issues/commitment/ioc/iocchart.html#statedefs.

What is informed consent?

What are my rights to informed consent?

Informed consent to treatment is consent obtained freely, without threats

or coercion, after appropriate disclosure to the patient of adequate and

understandable information in a form and language understood by the

patient of:

(a) the diagnostic assessment;

(b) the purpose, method, likely duration and expected benefit of the

proposed treatment;

(c) alternative modes of treatment, including those that are less intrusive;

and

(d) possible pain or discomfort, risks and side-effects of the proposed

treatment.16

As a patient, you have a right to an explanation of every procedure or

treatment that a doctor or healthcare professional prescribes. Legally, a

doctor or healthcare professional is responsible for:

1. Disclosing and explaining to the patient, in language which the

patient can understand, the nature of a proposed procedures

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS! 25

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

or treatment, its potential risks and benefits, and reasonable

alternatives, if any exist.

2. Ensuring that the patient understands what has been explained.

3. Determining whether the patient accepts any risks and consents to

proceed.17

RESOURCES

What types of assistance and supports are available?

Every state has a Protection and Advocacy (P&A) program that

safeguards the rights of people with mental disabilities. When problems

arise, the P&A can pursue legal, administrative and other remedies to

ensure protection of your rights. You can find contact information for the

P&A in your state at http://www.ndrn.org.

You also have a right to file a grievance or a complaint with the

Department of Education’s Office for Civil Rights.18 The OCR resolves

complaints of discrimination based on race, color, national origin, sex, age

or disability. Complaints must be filed within 180 days of the discriminatory

event. You can view some legal decisions and OCR complaints on issues

discussed in this guide on the Students and Mental Health page of the

Bazelon Center website. Complaints based on FERPA may be filed with

department’s Family Policy Compliance Office.19

The National Empowerment Center, http://www.power2u.org, “carry[ing] a

message of recovery, empowerment, hope and healing to people who have

been labeled with mental illness,” has a toll-free information and referral

line and may be able to provide information about support groups in your

area: 1-800-769-3728.

On many campuses there are student-run support groups. Active Minds,

“a peer-to-peer organization dedicated to the mental health of college

students,” is one, with chapters on more than 100 college campuses,

http://www.activemindsoncampus.org. You can also contact local chapters of

Mental Health America, http://www.mentalhealthamerica.net, Mind Freedom

International, http://www.mindfreedom.org, the National Alliance for the Mentally

Ill http://www.nami.org, the Depression and Bipolar Support Alliance, www.

dbsalliance.org, the Suicide Prevention Action Network, http://www.spanusa.org,

or the Suicide Awareness Voice of Education, http://www.save.org.

26 YOUR MIND. YOUR RIGHTS.

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

Where else can I go for help?

There are many other people you can talk to or places you can go.

Your campus may have some of the following resources: support groups,

a resident advisor or resident director, coach, faculty member or advisor,

health center, women’s center, LGBT center, spiritual center or Active Minds

chapter. You can also access local mental health organizations such as

those listed under supports above, many of which have state or communitybased

chapters and offer local resources. Some on-line resources include

the Jed Foundation, http://www.jedfoundation.org, http://www.ulifeline.org, www.

halfofus.com, and the National Institute of Mental Health http://www.nimh.nih.

gov, all of which offer information that you may find helpful.

What are alternative approaches to mental health care?

It is crucial to consult with your physical and mental health care providers

about the approaches you are using to achieve mental wellness. Different

treatments work for different people, and communicating with health care

providers about what does and doesn’t work for you is vital.

There are many alternative approaches about which you can educate

yourself to find something that works for you. A short list includes: selfhelp

groups, diet and nutrition groups, pastoral counseling, animalassistance

therapy, art therapy, dance/movement therapy, music/sound

therapy, acupuncture, ayurveda, yoga/meditation, cuentos, biofeedback,

guided imagery or visualization, massage therapy, telemedicine, telephone

counseling, electronic communications and radio psychiatry. A range of

other alternatives—psychodrama, hypnotherapy, recreational and Outward

Bound-type nature programs—offer opportunities to explore mental wellness.

Before beginning any therapy regimen, learn as much as you can about

it. In addition to talking with your health care practitioner, you may want to

go online or to a book store, health food store or holistic health care clinic

for more information. Also, before receiving services, check to be sure the

provider is properly certified by an appropriate accrediting agency.

CONCLUSION

We hope this guide answered most of your questions and we wish you

the best as you continue to learn more about yourself and take care of your

mental health!

CAMPUS MENTAL HEALTH: KNOW YOUR RIGHTS! 27

LEADERSHIP 21 COMMITTEE of the JUDGE DAVID L. BAZELON CENTER FOR MENTAL HEALTH LAW

NOTES

1 http://www.acha-ncha.org/docs/ACHA-NCHA_Reference_Group_

ExecutiveSummary_Fall2007.pdf

2 For example: R. Szabo & M. Hall, BEHIND HAPPY FACES: Taking Charge of Your

Mental HealthA Guide for Young Adults, Publisher August 2007; E. Saks, The

Center Cannot Hold: My Journey Through Madness, Hyperion, August 2007.

3 “Choosing the Right Mental Health Therapist,” The Substance Abuse and Mental

Health Services Administration, Center for Mental Health Services, http://

mentalhealth.samhsa.gov/publications/allpubs/KEN98-0046/default.asp, visited

Dec. 7, 2006.

4 “If You Are in Crisis and Need Immediate Help,” National Institute of Mental

Health, National Institutes of Health (April 9, 2004), http://www.nimh.nih.gov/

suicideprevention/sui911.cfm, visited Dec. 6, 2006.

5 “Choosing the Right Mental Health Therapist,” Substance Abuse and Mental

Health Services Administration, Center for Mental Health Services, http://

mentalhealth.samhsa.gov/publications/allpubs/KEN98-0046/default.asp, visited

Dec. 7, 2006.

6 Bazelon Center for Mental Health Law’s Model Student Policy http://www.bazelon.

org/pdf/SupportingStudents.pdf. State law and professional ethics govern release

of information by a mental health treatment provider.

7 Family Education Rights and Privacy Act (FERPA), 20 U.S.C.§§ 1232g (a) (1), (b) and

(d). See a guide issued by the Department of Education at http://www.ed.gov/policy/

gen/guid/fpco/doc/ferpa-hippa-guidance.pdf

8 See a summary of the federal privacy regulations under HIPPA, with protections for

consumers, at http://www.bazelon.org/issues/privacy/moreresources/index.htm.

See also the guide listed in note 7: http://www.ed.gov/policy/gen/guid/fpco/doc/

ferpa-hippa-guidance.pdf

9 http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html

10 Reasonable accommodations are modifications to rules, policies or practices that

will enable a student with a disability to meet academic and technical standards.

A school is not required to fundamentally alter the essential nature of its programs

or its core degree requirements. A modification is unreasonable or a fundamental

alteration if it compromises essential academic and technical requirements or

places an undue burden on the school, such as a significant difficulty or expense.

11 See the online complaint form and instructions at http://www.ed.gov/about/

offices/list/ocr/complaintintro.html

12 Bazelon Center for Mental Health Law’s Model Student Policy http://www.bazelon.

org/pdf/SupportingStudents.pdf

13 Ibid.

14 http://http://www.samhsa.gov

15 http://www.bazelon.org/issues/restraintandseclusion/moreresources/

randshandout.html

16 United Nations principles for the treatment of persons with mental illness and

the improvement of mental health care, available at http://www.unhchr.ch/html/

menu3/b/68.htm

17 http://info.med.yale.edu/caim/risk/patient_rights/patient_rights_2.html

18 See the online complaint form and instructions at http://www.ed.gov/about/

offices/list/ocr/complaintintro.html

19 http://www.ed.gov/policy/gen/guid/fpco/index.html

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For Immediate Release: Senate Bringing College Mental Health to Focus

PRESS RELEASE
LEGISLATION SUPPORT ADVISORY

For Immediate Release
June 25, 2018

Contact: Heather Schroeder
(877) 569-MIND(6463)

Support of Bill To Improve Access To Mental Health Services in Higher Education

On June 23, 2018 The Student Mental Health Policy Alliance voted to support a Senate Bill by Bob Casey(D PA) aimed toward improving access to mental health services for students at college campuses across America. The Higher Education Mental Health Commission Act would establish a national commission focused on mental health conditions facing students at colleges and universities across the country.

Between 2010 and 2015, enrollment in colleges and universities increased by only 5 percent, yet the number of students using mental health services increased by 30 to 40 percent. Students seeking help are increasingly likely to have attempted suicide or engaged in self-harm, the same study found. More than 50 percent of students between the ages of 18 and 24 reported having a severe psychological problem or experiencing feelings of hopelessness. This bill would help address the lack of resources to support students with mental health issues.

Highly publicized campus suicides and research showing an alarming prevalence of mental illness on campuses have heightened the sense of urgency. The reality of rampant mental illness on campus shatters the notion of college as a carefree time when the biggest worries are passing finals and finding a date. For many students, dark shadows shroud the sheltered nest of academe.

More than 40 percent of US students become so depressed during their four years in college that they have trouble functioning, while 15 percent suffer clinical depression, according to a 2004 survey of 47,202 students by the American College Health Association. Suicide remains the second-leading cause of death among college students, claiming about 1,100 lives a year.

“Today, campuses are plagued with an unprecedented demand for counseling services,” said Jacob Griffin, a former on-campus advocate—disturbed by campus administrators’ lack of responsiveness in addressing these issues; pivotal to student success and retention. “It is not uncommon for a university counseling center to have a 6 to 8 week wait…with mental health—symptoms intensify quickly,” Griffin continued.
Jacob launched a national non-profit in 2016 strategically focused on helping campus counseling centers address the influx by lobbying campus leaders to increase staffing and budgetary allotments. He has said that budgets in nearly 95% of Public University centers’ in the past 10 years have not changed to match increases in enrollment numbers, let alone the increases in demand. His research has found 7 out of 10 Campus Counseling Center Directors have resigned or retired within the last several years; citing lack of administrative support and over-extension of resources as key factors.

Specialists in the field have long known that the onset of mental illness often comes during adolescence or early adulthood. Living away from home, often for the first time, compounds stress and anxiety. So, too, does pressure to succeed in an increasingly competitive climate on campus.

As the stigma of having a diagnosed mental illness subsides, demand for counseling will presumably continue to rise. Criticizing Millennials as seemingly less resilient is the most popular diatribe, but it shouldn’t be, Griffin emphasized. In fact, it undermines a decade’s worth of work by counselors, psychologists, and student advocates who have strived to not only bring mental health to the forefront of discussion, but to reassure students that there is no shame in struggling—that experiencing mental distress is actually common and not a sign of weakness. “The distinct proof of concept and need,” Griffin said, “is what compels me to continue to advocate: the fact that I’ve had boots-on-the-ground experience…having witnessed and experienced the adversity has led me to continue bringing awareness to these issues” The result of normalizing mental health in higher education is that peers, faculty and bystanders, have intentionally led sufferers to the centers that promise to help them. “There is absolutely,” Griffin, “a lack of follow-through on that commitment.”

About The Student Mental Health Policy Alliance
A subsidiary of the 501c3 charity: Griffin Ambitions Limited, The nations leading voice on increasing campus mental health services too improve the lives of millions of Students affected by mental illness. We are committed to advocating for campus support, while reviewing and improving current trends in college mental health and highlighting promising practices that contribute to student success. We employ various strategic approaches too improve mental wellbeing on campuses. We take an active role in identifying initiatives consistent with our priorities, seeking out Higher Education Institutions’ that can advance these initiatives and work alongside administrators and stakeholders. We aim to effect change at grassroots and systemic levels. Since Founder Jacob Griffin’s mental health advocacy beyond his campus began in 2015, we have distinctly established ourselves through dedication, commitment and an unceasing belief in our mission to strengthen and improve how college Counseling Centers address their influx. Through our united support for education, advocacy and awareness efforts, the Student Mental Health Policy Alliance is at the forefront of increasing campus provisions, and is a distinctly recognized force in urging new ideas and solutions to improve educational outcomes.

###

 

Mental Health in Higher Education Starts With Griffin Ambitions and the Student Mental Health Policy Alliance

 

II

115TH CONGRESS

2D SESSION S. 3106

To authorize the Secretary of Education to establish an Advisory Commission

on Serving and Supporting Students with Mental Health Disabilities

in Institutions of Higher Education, and for other purposes.

IN THE SENATE OF THE UNITED STATES

JUNE 21, 2018

Mr. CASEY (for himself, Mr. KAINE, Mr. NELSON, Ms. HASSAN, Ms. SMITH,

Mr. BLUMENTHAL, and Ms. KLOBUCHAR) introduced the following bill;

which was read twice and referred to the Committee on Health, Education,

Labor, and Pensions

A BILL

To authorize the Secretary of Education to establish an

Advisory Commission on Serving and Supporting Students

with Mental Health Disabilities in Institutions of

Higher Education, and for other purposes.

1 Be it enacted by the Senate and House of Representa2

tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Higher Education

5 Mental Health Act of 2018’’.

6 SEC. 2. FINDINGS AND PURPOSES.

7 (a) FINDINGS.—Congress finds the following:

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S 3106 IS

1 (1) More than 75 percent of mental health con2

ditions begin before the age of 24.

3 (2) More than 25 percent of students between

4 the ages of 18 and 24 reported a mental health con5

cern.

6 (3) More than 50 percent of students between

7 the ages of 18 and 24 reported having a severe psy8

chological problem.

9 (4) More than 50 percent of students between

10 the ages of 18 and 24 reported feelings of hopeless11

ness.

12 (5) Higher education counseling centers are de13

voting more time to rapid-response treatment with

14 more than 25 percent of students who sought help

15 reporting they had intentionally hurt themselves.

16 (6) Over a 5-year period, counseling center uti17

lization increased by an average of 30 to 40 percent,

18 while enrollment increased by only 5 percent, forcing

19 institutions to stretch mental health services to more

20 students without increasing resources.

21 (b) PURPOSES.—The purposes of this Act are the fol22

lowing:

23 (1) To ensure States and institutions of higher

24 education are provided with accurate information on

25 the mental health concerns facing students.

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S 3106 IS

1 (2) To provide detailed recommendations that

2 institutions of higher education, States, and the

3 Federal Government can take to improve the mental

4 health services available to students and properly

5 treat the rising number of students with mental

6 health issues.

7 SEC. 3. ADVISORY COMMISSION ON SERVING AND SUP8

PORTING STUDENTS WITH MENTAL HEALTH

9 DISABILITIES IN INSTITUTIONS OF HIGHER

10 EDUCATION.

11 (a) IN GENERAL.—The Secretary of Education shall

12 establish a commission to be known as the Advisory Com13

mission on Serving and Supporting Students with Mental

14 Health Disabilities in Institutions of Higher Education

15 (referred to in this section as the ‘‘Commission’’).

16 (b) MEMBERSHIP.—

17 (1) TOTAL NUMBER OF MEMBERS.—The Com18

mission shall include not more than 19 members,

19 who shall be appointed by the Secretary of Edu20

cation in accordance with paragraphs (2) and (3).

21 (2) MEMBERS OF THE COMMISSION.—The

22 Commission shall include 1 representative from each

23 of the following:

24 (A) The Office of Postsecondary Education

25 of the Department of Education.

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S 3106 IS

1 (B) The Office of Special Education and

2 Rehabilitation Services of the Department of

3 Education.

4 (C) The Office of Civil Rights of the De5

partment of Education.

6 (D) The Office of Civil Rights of the De7

partment of Justice.

8 (E) The National Council on Disability.

9 (F) A membership association for adminis10

trative and personnel professionals focused on

11 creating an inclusive higher education environ12

ment for individuals with disabilities, as deter13

mined by the Secretary.

14 (G) An organization that represents the

15 Protection and Advocacy for Individuals with

16 Mental Illness program, as determined by the

17 Secretary.

18 (H) An organization operated by and rep19

resenting secondary and postsecondary edu20

cation students with mental health disabilities

21 advocating for mental health services and sui22

cide prevention, as determined by the Secretary.

23 (3) ADDITIONAL MEMBERS OF THE COMMIS24

SION.—In addition to the members included under

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5

S 3106 IS

1 paragraph (2), the Commission shall include the fol2

lowing:

3 (A) Four members from leadership of in4

stitutions of higher education who have dem5

onstrated experience in successfully supporting

6 the retention and graduation of students with

7 mental health disabilities. With respect to such

8 4 members, 1 member shall be a staff member

9 of a 2-year degree-granting institution of higher

10 education, 1 member shall be a staff member

11 from a 4-year degree granting institution of

12 higher education, 1 member shall be a member

13 of campus law enforcement, and 1 member

14 shall serve as a general counsel. Such 4 mem15

bers shall represent institutions of differing

16 sizes.

17 (B) Three members from family members

18 of individuals who are—

19 (i) enrolled in an institution of higher

20 education on the date such family member

21 is appointed to the Commission; or

22 (ii) former students with a mental

23 health disability.

24 (C) Four members from individuals with

25 mental health disabilities, including not less

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S 3106 IS

1 than 2 individuals enrolled in an institution of

2 higher education on the date of appointment to

3 the Commission. Any remaining member shall

4 be an individual with a mental health disability

5 who has attended an institution of higher edu6

cation.

7 (4) TIMING.—The Secretary of Education shall

8 establish the Commission and appoint the members

9 of the Commission not later than 60 days after the

10 date of enactment of this Act.

11 (c) CHAIRPERSON AND VICE CHAIRPERSON.—The

12 Commission shall select a chairperson and vice chair13

person from among the members of the Commission. Ei14

ther the chairperson or the vice chairperson shall be a stu15

dent or former student with a mental health disability.

16 (d) MEETINGS.—

17 (1) IN GENERAL.—The Commission shall meet

18 at the call of the chairperson, but not more often

19 than 8 times.

20 (2) FIRST MEETING.—Not later than 60 days

21 after the appointment of the members of the Com22

mission under subsection (b), the Commission shall

23 hold the Commission’s first meeting.

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S 3106 IS

1 (e) DUTIES.—The Commission shall conduct a study

2 and prepare a report for the Secretary of Education that

3 includes the following:

4 (1) Findings from stakeholders, including

5 through solicitation of public testimony, related to

6 the challenges faced by students with mental health

7 disabilities in institutions of higher education, in8

cluding—

9 (A) the services available to students with

10 mental health disabilities in institutions of high11

er education and their effectiveness in sup12

porting these students;

13 (B) the impact of policies and procedures

14 that help or hinder the goal of providing equal

15 opportunity for students with mental health dis16

abilities, such as reasonable accommodation

17 policies, mandatory and voluntary leave policies,

18 and disciplinary policies;

19 (C) the use of protected health information

20 of students with mental health disabilities by

21 institutions of higher education, including the

22 extent to which campus-based mental health

23 providers share this information with college or

24 university officials without student consent; and

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S 3106 IS

1 (D) the impact of providing mental health

2 services on a student’s academic performance,

3 well-being, and ability to complete college.

4 (2) Conclusions on the major challenges facing

5 students with mental health disabilities in institu6

tions of higher education.

7 (3) Recommendations to improve the overall

8 education, and retention and graduation, of students

9 with mental health disabilities in institutions of

10 higher education, with the goal of helping these stu11

dents access educational opportunities equal to those

12 of their non-disabled peers.

13 (f) COMMISSION PERSONNEL MATTERS.—

14 (1) TRAVEL EXPENSES.—The members of the

15 Commission shall not receive compensation for the

16 performance of services for the Commission, but

17 shall be allowed reasonable travel expenses, including

18 per diem in lieu of subsistence, at rates authorized

19 for employees of agencies under subchapter I of

20 chapter 57 of title 5, United States Code, while

21 away from their homes or regular places of business

22 in the performance of services for the Commission.

23 Notwithstanding section 1342 of title 31, United

24 States Code, the Secretary of Education may accept

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9

S 3106 IS

1 the voluntary and uncompensated services of mem2

bers of the Commission.

3 (2) STAFF.—The Secretary of Education may

4 designate such personnel as may be necessary to en5

able the Commission to perform its duties.

6 (3) DETAIL OF GOVERNMENT EMPLOYEES.—

7 Any Federal Government employee, with the ap8

proval of the head of the appropriate Federal agen9

cy, may be detailed to the Commission without reim10

bursement, and such detail shall be without inter11

ruption of loss of civil service status or privilege.

12 (4) FACILITIES, EQUIPMENT, AND SERVICES.—

13 The Secretary of Education shall make available to

14 the Commission, under such arrangements as may

15 be appropriate, necessary equipment, supplies, and

16 services.

17 (g) REPORTS.—

18 (1) INTERIM AND FINAL REPORTS.—The Com19

mission shall prepare and submit to the Secretary of

20 Education, as well as the Committee on Health,

21 Education, Labor, and Pensions of the Senate and

22 the Committee on Education and the Workforce of

23 the House of Representatives—

24 (A) an interim report that summarizes the

25 progress of the Commission, along with any in-

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S 3106 IS

1 terim findings, conclusions, and recommenda2

tion as described in subsection (e); and

3 (B) a final report that states final find4

ings, conclusions, and recommendations as de5

scribed in subsection (e).

6 (2) PREPARATION AND SUBMISSION.—The re7

ports described in paragraph (1) shall be prepared

8 and submitted—

9 (A) in the case of the interim report, not

10 later than 1 year after the date on which all the

11 members of the Commission are appointed; and

12 (B) in the case of the final report, not

13 later than 2 years after the date on which all

14 the members of the Commission are appointed.

15 (h) TERMINATION.—The Commission shall terminate

16 on the day after the date on which the Commission sub17

mits the final report under subsection (g).

Æ

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Depression and Celebrity Suicide

Celebrity suicide can take a toll on those who are depressed and that happened to me this week with the suicide of Kate Spade and the suspected suicide of Anthony Bourdain, reported just this morning. I can say I was upset by Kate Spade’s suicide (particularly the details, which I won’t discuss here) earlier in the week and then this morning when I learned of Anthony Bourdain’s suicide (not an official ruling at this time), it felt like adding insult to injury. The celebrity suicides of Kate Spade and Anthony Bourdain have actually worsened my depression.

WHY DO THE CELEBRITY SUICIDES OF KATE SPADE AND ANTHONY BOURDAIN MATTER?

Now, truth be told, I don’t much care about celebrities. Their lives are very far removed from mine and for me, they can do whatever they want and it’s almost never relevant to me. So the latest “scandal” is something that others can flip over, I don’t need to.

But celebrity suicide is different. Suicide touches me, of course, and while all suicides touch a huge number of people, when a celebrity dies of suicide, it touches thousands, maybe even millions (Dealing with Depression in the Wake of Robin Williams’ Suicide). And it’s this pervasive and widespread effect that gets me, I think. In fact, sometimes I even feel mad at the celebrity as in, “How could you kill yourself – don’t you know how many people you will hurt?”

(Please understand, anger may not be the most logical of emotions following a person’s death but it is completely normal after a death, especially one of suicide. There are five stages to grief and one can experience any of them [anger being one] at any time.)

And I understand, of course, as someone who has been there, when you’re planning your suicide and taking steps to end your life, you’re not thinking of the others you will hurt, you are just thinking of your own unbearable pain. That pain outweighs everything else. And if you have ever felt it, you understand why. It’s like the pain is stealing all your air. And when you can’t breathe, nothing else matters. It’s also important to note that pain can even make you think everyone else will be better off without you. A very powerful, if very false, feeling.

In the case of Kate Spade’s suicide, I thought of the thousands of people who have her designs (she famously built a handbag brand). I thought it so sad that these cheery designs that must have brought smiles to many were actually tear-stained by Spade.

And I thought of Anthony Bourdain, whose travels and experiences made it appear that he had an amazing life, and how he must have had to hide his pain every day if it was so severe that it drove him to suicide. I know what it is to hide that kind of pain. It’s horrific.

DEPRESSION AND CELEBRITY SUICIDE

And these thoughts of celebrity suicide, particularly one piled on top of another so quickly, has made me feel even more depressed. Somehow, life feels more hopeless, pointless. I suppose this is how suicide can spread – the thought is, if these people, with every resource and everything going for them, can be taken by suicide, then what chance do I have to fight it? How can I possibly win against suicide when Anthony Bourdain and Kate Spade could not?

I do find it odd that a person that I have never met or even felt strongly about can make me feel this way or think this way, but such is the power of celebrity suicide and such is the power of depression.

PUTTING ANTHONY BOURDAIN AND KATE SPADE’S CELEBRITY SUICIDES IN CONTEXT

While celebrity suicides pretty much poke us in the eye with the cold, hard facts about suicide, it’s worth remembering something that never makes it into the news: people fight and win against suicide every day. There is no news to report when someone simply doesn’t die. But countless don’t. Countless aren’t taken by suicide every day. And I’m one of them.

While the news of Kate Spade and Anthony Bourdain’s death has made me feel a sense of hopelessness, this hopelessness needs to be tempered with the knowledge that I am one of those non-newsworthy people who has not died. I have fought suicidal depression. I have fought suicide and won. In fact, I’m doing it right now.

My point is, if celebrity suicide causes you to feel any kind of grief or the worsening of depression, I understand completely. But try to fight against these tragedies by knowing that there are even more miracles of people surviving out there. Yes, suicide statistics are depressing and every news article about these suicides will quote them; but the statistics we don’t have, the ones on surviving and even thriving in the face of suicidal ideation or even suicide attempt, those are worth remembering, too.

I grieve the loss of Spade and Bourdain to suicide. They brought happiness to many and, unfairly, didn’t feel that themselves. But I am also lifted knowing that this is a teaching moment that can encourage people to seek help and remind me of all the wins, including my own personal wins.

If you feel like you may hurt yourself, please reach out. You touch more people than you know and even if suicide is telling you that you don’t matter or the people don’t care about you, know that suicide lies and it is wrong.

Call the National Suicide Prevention Lifeline at 1-800-273-8255.

Also, see the list of suicide helplines and resources on the HealthyPlace website.

Celebrity suicides can feel like dark moments, but there is light too, I promise.

‘Grasping at straws’: Farm advocates concur more resources needed to combat high suicide rates

Psychologist Michael Rosmann said that whenever he is home at his family’s farm in western Iowa he is taking calls or answering emails from farmers asking for help or counseling.

He specializes in behavioral health for farmers and said he has received more requests for assistance in recent months than the last three decades.

“My phone and my email have just been completely filled for the last six months. I work virtually seven days a week if I’m around the phone is always going email is always coming,” he told ABC News.

The calls are part of a critical issue faced by farmers, their profession faces the highest overall rate of suicide in the nation — much higher than the number of suicides in the general population, according to the Centers for Disease Control and Prevention.

PHOTO: Debbie Weingarten and Michael Rosmann during a visit to his farm in Harlan, Iowa, September 2017. Audra Mulkern/Female Farmer Project
Debbie Weingarten and Michael Rosmann during a visit to his farm in Harlan, Iowa, September 2017.

Debbie Weingarten reached out for help four years ago when she was running a vegetable farm in Arizona. She was a first-generation farmer and said that even without the pressure of maintaining a family farm she felt depressed and anxious about the possibility that they would lose money or crops.

“I felt like the risk that farmers undertake to produce food for eaters is not spread out fairly across the food system, so that’s squarely on the backs of farmers,” she told ABC News.

She said couldn’t find anyone to talk to online who understood her situation until she found a program run by Rosmann. The website said it lost funding a few years before but she called anyway.

“I was grasping at straws,” she said.

Rosmann picked up the phone.

Weingarten said she left farming in 2014 but still writes about agriculture. She spent five years researching and reporting a story about the suicide rate among farmers that was published in The Guardian last year.

Farmers in industries that have faced falling commodity prices and international trade disputes have faced additional economic pressure in recent years and farming experts and industry leaders say the uncertainty around the nearly $400 billion dollar Farm Bill adds additional stress for farmers and their families.

“Farmers were going through a very stressful winter weather-wise, a cold and tough winter, and on top of that we are into our fourth year of low milk prices, below the cost of production, and that has been creating a lot of stress,” Robert Wellington, a senior vice president of Agri-Mark Dairy Farmer cooperative, told ABC News on the phone Thursday.

PHOTO: Dairy cows on a Iowa farm are pictured in this undated stock photo.STOCK PHOTO/Getty Images
Dairy cows on a Iowa farm are pictured in this undated stock photo.

On average, Wellington estimated, small and medium dairy farmers have struggled through four years of milk prices that are 10 to 30 percent below the cost of production.

His group sent a letter to members in January forecasting yet another year of low milk prices. In the letter, they included phone numbers for people dealing with financial and emotional stress and a suicide hotline.

The farm bill has traditionally been bipartisan legislation to maintain subsidies, crop insurance programs, and livestock disaster programs but there has been dramatic debate and delays in this year’s bill due to proposals to cut funding from food stamp programs that make up a huge portion of the money allocated by the bill every five years.

This draft of this year’s farm bill in the House would have also provided funding for crisis hotlines and other programs to provide mental health help to farmers.

“Our farmers who feed the world are feeling the weight of the world on their shoulders,” one of the sponsors of that bipartisan provision Rep. Tom Emmer, R-Minn. said on the House floor ahead of the Farm Bill vote.

The House rejected the proposed bill.

In a 2016 report, the Centers for Disease Control found that about 84 out of every 100,000 people in the farming, fishing and forestry industries died by suicide in 2012, the most recent data available. The suicide rate for the general population was about 12 out of every 100,000 people that year, according to CDC data.

PHOTO: A farm in Iowa is pictured in this undated stock photo. STOCK PHOTO/Getty Images
A farm in Iowa is pictured in this undated stock photo.

That study included data from 17 states but did not include data from states like Iowa, Texas, or California where agriculture is a major part of the economy.

The report said that the high rate among farmers could be due to the potential to lose money in the business, as well as social isolation, lack of mental health services, or access to lethal means.

Rosmann is a psychologist and adjunct professor at the University of Iowa who specializes in behavioral health for farmers. He said farming is physically and emotionally stressful but that the current health system does not deal with all of the physical and mental risks for farmers.

“The bigger picture is that we have not attended to the behavioral well being of the agricultural population the way we have to the general population’s need for behavioral health,” Rosmann told ABC News.

He said that farmers have a unique psychology that drives them to work hard but that some factors are out of their control, like policy, weather, or commodity prices, resulting in a very stressful situation, adding that there has been increased economic stress on farmers in recent years and that they think they’re being economically marginalized.

Rosmann said farmers have a strong bond to their land and their farming operation and that on a psychological scale the stress of a life event like losing a family’s farm can be just as traumatic as losing a child.

“It’s almost always because of the loss of livelihood that people do such dramatic things as taking their lives,” he said.

Rosmann said he strongly supports a provision in the farm bill sponsored by Rep. Tom Emmer, R-Minn., to provide more money for states to provide mental health services like crisis hotlines for farmers and ranchers.

He said that some states offer resources like a crisis hotline but they need a stronger network of resources and a national center to help with the problem. In Minnesota the state employs one rural mental health counselor to help roughly 100,000 farmers, according to MinnPost.com.

Earlier in May the president of the National Farmers Union, Roger Johnson, wrote to Agriculture Secretary Sonny Perdue urging him to proactively address what he called “the farmer suicide crisis.”

PHOTO: The U.S. House of Representatives votes down a farm bill, 198-213, on May 18, 2018.C-SPAN
The U.S. House of Representatives votes down a farm bill, 198-213, on May 18, 2018.

“Farming is a high-stress occupation,” Johnson wrote in his letter. “Due to the prolonged downturn in the farm economy, many farmers are facing even greater stress. USDA’s national reach uniquely positions the Department to assist farmers and ranchers during times of crisis. We urge you to leverage your vision for collaboration across USDA and the entire federal government to develop a response to the farm suicide crisis.”

Sen. Tammy Baldwin, D-Wis., and Sen. Joni Ernst, R-Iowa, introduced a bipartisan bill on the issue of farmer suicide that would mandate more spending on mental health resources in rural areas. Rep. Tom Emmer, R-Minn., also introduced a bipartisan bill earlier this year to provide mental health services for farmers and ranchers.

Emmer’s bill was included in the version of the farm bill that was voted down in the House. The Senate’s farm bill has not yet been released.

The current farm bill is set to expire in September the most recent Farm Bill failed 198-213.

The National Suicide Prevention Lifeline provides 24/7 free, confidential support. The organization Farm Aid also offers a hotline for farmers in need of emergency help and a directory of local resources.

Navigating the Student Healthcare Framework

The decision to share confidential student health information among clinicians in the campus health center and counseling center also deserves consideration. Over the past ten years, the US federal government has established integration between primary care and mental health services as a significant priority (learn more here). There are widely varying models for this integration (learn more here).

On college campuses (as in other primary care settings) many students presenting for medical care are experiencing concomitant mental health problems and in many case their mental health difficulties may be their primary presenting problem-whether explicitly or implicitly. On many campuses, some or all of the prescribing of psychiatric medications is done at the health service. As a result, in order to ensure continuity and quality of care, it is helpful for the counseling and health centers to establish a system of carefully bounded communication/collaboration. For some, this occurs through a shared electronic health record and for others it is through a regularly scheduled meeting between health and counseling center staff to discuss shared cases. On a few campuses, the students’ electronic health record is integrated while for others there may be firewalls in place allowing access only to specific information. Often this takes the form of a firewall that prevents health center clinicians from accessing counseling center clinical/therapy notes. Another approach is to keep therapy/counseling notes separate from the electronic health record. In any case, the ability for treating clinicians to be aware of diagnosis and prescribed medications should be carefully considered in informing treatment approaches.

As in the case of sharing information in the event of an emergency, policies for sharing information between health and counseling centers also need to be clear and transparent to students. Some institutions address this in the confidentiality/consent for treatment agreement that the student receives when they present for treatment at the health or counseling centers, while others obtain a release of information from students at the time when information needs to be shared.

JED encourages colleges and universities to develop systems for sharing appropriate clinical information when legally permitted and clinically indicated, whether it be in the case of significant risk or in the service of providing holistic and integrated health care. In both cases, policies for sharing information need to be clear and transparent and easily accessible to students. In all cases, the guiding principle that drives the decision on sharing confidential student health information needs to be what is in the students’ best interest as well as the safety and health of the campus community.

As Ralph Slovenko stated many years ago: “Trust—not absolute confidentiality—is the cornerstone of psychotherapy. Talking about a patient or writing about him without his knowledge or consent would be a breach of trust. But imposing control where self-control breaks down is not a breach of trust when it is not deceptive. And it is not necessary to be deceptive” (Ralph Slovenko, Psychotherapy and Confidentiality, 24 CLEVE. ST. L. REV. 375, 395 (1975))

For further reading on Confidentiality in Campus Counseling Services: Bower, K., Schwartz, V., Legal and Ethical Issues in College Mental Health, in, Kay, J., and Schwartz, V., Mental Health Care in the College Community, Wiley (2010). Pg. 115-23

Read more on integrated care.

JED is grateful to the following individuals who generously took the time to share their insights and experience in reviewing and contributing to this document:

• Louise Douce, Ph.D., Assistant Vice President for Student Life and Director Counseling and Consultation Service, retired; Adjunct Assistant Professor, Department of Psychology, The Ohio State University.

• Greg Eells, Ph.D., Director of Counseling and Psychological Services, Cornell University.

• Peter F. Lake, J.D., Charles A. Dana Chair and Director, Center for Excellence in Higher Education Law and Policy, Stetson University School of Law.

College Students Deserve Mental Wellness

Nineteen-year-old Sophie described her state of mind when asked about what prompted her to seek therapy at her university’s on-campus counseling center in the spring semester of her freshman year: “I was feeling really depressed adjusting to college: the alcohol consumption, relationships, living really close to people for the first time after being an only child who was used to a lot of personal space and privacy — basically, the mess of freshman year.”

Sophie, who asked that her last name not be used, had been in therapy before. A lot of it. From age seven through 18 she had seen the same therapist back home in Los Angeles to treat her ongoing anxiety. The transition to college found her, for the first time in a long time, without a therapist to unburden herself and help her cope.

As a seasoned client she carefully unpacked for her campus counselor all the issues afflicting her and asserted a need to have someone to talk with who might really understand her. But, the counselor seemed more interested in cataloguing Sophie’s symptoms than truly listening to her painful life predicaments. Sophie’s distress was palpable as she recalled how the counselor responded.

“Being clear about what I needed felt like I was doing something wrong,” Sophie said. “The counselor knew what she wanted me to be. She wanted me to be a problem she could fix or put a band-aid on. I believe that therapy is a long-term process and the counselor was not interested in that. I only went to one appointment. It felt like I was with a graduate student getting practice doing therapy.”

After the first session, I was given a date a month later to see a different therapist,” she continued. “I’m sure the counselor had some order of immediacy, somebody who posed harm to themselves or others. I felt like I really needed help at that time but I didn’t fit their model. I wasn’t a priority.”

Adding insult to injury was the fact that Sophie had partially chosen her college over other choices because its well-advertised counseling services were a drawing point for her. Without her regular therapist and insurance coverage that would allow her to see a therapist in the nearby city, Sophie was counting on campus-based therapy. “I wish they had been more honest about what people could expect from the service,” she said. “I thought there would be more counselors. They really underestimated the number of students who prioritized their mental health.”

Sophie’s story is fairly typical of what all-too-commonly occurs on college campuses nationwide: students with complex mental health problems, and a rather sophisticated understanding of psychotherapy based on previous experience, relying on college counseling centers for quality treatment, dropping out prematurely when they encounter inexperienced clinicians who only offer crisis-intervention or a quick-fix approach.

Let’s start with findings that substantiate the complex mental health needs of the new generation of college students. Trends among college students serviced in college counseling centers tracked in the 2016 Center for Collegiate Mental Health (CCMH) annual report show 33 percent having “seriously considered attempting suicide,” compared with 24 percent in 2010-2011. The majority of the 518 counseling center directors polled in the 2014 National Survey of College Counseling Centers (NSCC) pointed out significant increases in the number of students presenting with anxiety disorders, clinical depression, self-injurious behavior, sexual abuse and eating disorders, over the previous five years. More students are showing up on campus with thornier mental health issues, as well as a prior history of receiving therapy. The 2016 CCMH survey estimates that one in two students seeking services on campus has been in therapy before. So we have a cohort of students who are savvy about therapy and in need of quality interventions.

Zach (not his real name) is one such informed psychotherapy consumer. His susceptibility to panic attacks had become aggravated by the dawning sense that his choice of college — a small liberal arts college in New England — might have been an incorrect one. He badly wanted a therapist to act as an objective sounding board so he could pick apart whether there was merit to his dissatisfaction with this particular college, or whether transitioning to any college would have been distressing. “He wanted to talk about my mental health and I wanted to talk about practical things,” said Zach. “But that’s not how therapy works necessarily. It’s like a lot of very practical talk, then you get moments of deeper understanding.”

Other disclosures reflect Zach’s finessed understanding of quality psychotherapy and his disappointment over not receiving it. “He asked about childhood trauma very quickly,” he said. “In fact, the questions he asked were not in sync with what I was talking about. I’m sure it’s good to understand how somebody thinks and you need to do that eventually. But I was flustered. No one at school seemed to listen and meanwhile he wasn’t listening. That was pretty alienating. I was so done after the first visit.”

Sadly, Zach’s final remark reflects an alarming trend in the delivery of care on college campuses — premature drop out. Various studies conducted by University of North Texas professor of psychology Jennifer Callahan reveal that premature termination of psychotherapy in college counseling centers approaches 80 percent, while similar rates in private practice and community clinics fall between 40 and 60 percent. Cognizant of this alarming trend, the authors of the 2016 CCMH report assert that “the management of client drop-out should receive greater attention during treatment and clinician training.”

Is it possible that the inordinately high therapy drop-out rates at campus clinics reflects inexperience on the part of many practitioners and the quality of care offered? We know from the latest annual survey of the Association for University and College Counseling Center Directors, spearheaded by David Reetz, the director of counseling and psychological services at Rochester Institute of Technology, that there is about a one in four chance that a student walking into a college counseling center for services will be treated by an unlicensed trainee mental health professional. However, this data set may underestimate the actual chances a student ends up receiving therapy from a trainee. Several years ago, sleuth work by staff at The Flat Hat, the College of William and Mary student newspaper, discovered that students who sought services at the campus counseling center had a 58 percent chance of being treated by an unlicensed or trainee mental health professional. Depending on where you turn for information, there is probably a one in two to one in four chance that students’ therapy needs are met by trainees on college campuses.

In fairness to trainees, they are often left to “learn as they go,” because supervisors’ time is spread thin and decisions have to be made between reviewing trainees’ work with clients during supervision time and attending to trainees’ professional development and conduct. A study led by Chris Brown at the University of Missouri-Kansas City found that a majority of training directors at college counseling centers were ethically troubled by their struggle to find time to adequately focus on the quality of treatment trainees were providing to clients on the one hand, and addressing issues of professional development and conduct (e.g., discussing child abuse reporting laws, covering laws and ethics pertaining to treatment notes, dressing appropriately, treating other staff members as colleagues/coworkers rather than friends), on the other.

Trainees often aren’t afforded the opportunity to observe their supervisors perform psychotherapy, nor get observed doing psychotherapy themselves. A recent investigation of over 1200 trainee psychologists overseen by Gerardo Rodriguez-Menendez, former dean of the College of Psychology at John F. Kennedy University in Florida, found that 62 percent of trainees had never been observed by a supervisor performing psychotherapy during their internships. Beginning therapists are often left to somehow transpose what they have learned from textbooks and scientific studies into actions that are therapeutically useful.

Matthew Liebman, a psychologist in training at the Montefiore Medical Center in the Bronx, captures the dilemma no-doubt shared by his counterparts in college counseling centers.

“In graduate school it is easy to forget that everything you learn has to do with people,” said Liebman. “None of the theory is any good unless it can be applied to helping people in need. And when that person is sitting in a chair across from you, looking at you with a bizarre mix of depression and hope as if the next thing out of your mouth could potentially have the power to make it all better, the pressure may be enough to shake loose every bit of information you’ve learned in the past several years all at once, creating a flood in your psyche. Alternatively, everything you’ve learned thus far may simply disappear.”

Not only is there a high chance of being treated by a relatively inexperienced trainee when students seek campus-based services, the therapy offered is likely to be of the short-term, solution-focused, crisis-management variety, with sessions spaced weeks apart. On the Health and Counseling Services website at Northeastern University in Boston, students are quickly schooled on the type of therapy offered:

. . . we focus on identifying issues or major concerns, problem-solving, and we provide support to help you develop strategies to address your personal goals. Some problems can be addressed in one or two sessions, while others need a number of sessions spaced over a period of time. We do not automatically see students on a weekly basis.

The emphasis is often on risk-assessment and risk-management, rather than giving clients ample time and space to talk at length about their angst-ridden concerns and delve deeply into the sources of their anxiety and depression. Along these lines, Ben Locke, who directs counseling services at Pennsylvania State University, recently told a STAT news reporter, “You’re making sure people are safe in the moment. But you’re not treating the depression or the panic attacks or the eating disorders.”

According to a trusted source who has been on staff at a variety of top-tier university counseling centers in Southern California, “I’m listening for risk more than listening for things that would result in me making a real connection with a client. I’m listening for any words that I need to jump on because they indicate a suicidal potential. Then I go into overdrive getting consent forms signed, alerting resident assistants, parents, anybody who can keep an eye on the client. My clinical decisions are so governed by fear and anxiety, rather than what the client really needs, which is a connection to a trained professional to talk about distressing problems.”

This source also informed me that at one site he was required to have his laptop open at all intake sessions with clients asking numerous symptom-oriented questions and clicking off boxes accordingly.

This medical-model, symptom-governed, solution-focused, crisis management approach to psychotherapy might quell the anxiety of beginning clinicians, making them feel they are being productive and safety-conscious. It may also satisfy the aspirations of college administrators worried about any added liability associated with increased numbers of students on campus admitting to suicidal ideation. However, paradoxically, a therapy approach where the practitioner functions more like a medical provider and dictates the agenda in terms of symptoms, goals and solutions, can undercut clients being genuinely engaged, encountered and listened to in their moments of dire need. In fact, suicide-prevention experts, like David Jobes at Catholic University of America in Washington, D.C., would proffer that any effective suicide-prevention counseling is predicated on hearing in great detail suicidal clients’ agonizing reasons for having reached such emotional lows in their life; really settling in to thoroughly understanding their existential struggles; really entering the painful narrative they tell and struggling with them to restore hope and meaning in their life.

And, to effectively treat the depression that accounts for clients’ suicidality, short-term therapy comes up short. In one of the most well-regarded studies of its kind, Jeffrey Vittengl, psychology department chair at Truman State University, along with several colleagues, found that crisis intervention, symptom-reduction, solution-focused therapy is insufficient to treat many clients’ depression. Within a year, almost 30 percent of clients offered this approach relapse, as do 54 percent within two years.

If college counseling centers are to accomplish their mission of maximizing the mental health of struggling students to enable them to be “ready to learn,” they need to heed this message from Louise Douce, former assistant vice president of student life at Ohio State University, in the influential publication A Strategic Primer of College Student Mental Health:

Fundamentally, we need a web of caring services that makes it more likely that students who experience symptoms or consequences of a behavior or mental health problem, whether those symptoms are personal, social, or academic in nature — will “stick” somewhere and find their way to one of the entry points for mental and behavioral health care.

Presumably, “stick” means not just improving access to needed psychotherapy, but ensuring it is of quality — relationship based, humanistically-informed and of adequate duration. That way any emotionally troubled student will have a reasonable shot at having contact with the same, well-trained, caring psychotherapist over time. A system heavily staffed by trainees who typically have a year-long stay counteracts the continuity of care from the same trusted provider a recurringly depressed student may intermittently need throughout the four or more years it takes him or her to graduate.

When more than 240 experienced psychotherapists were asked in a 2003 study by the Emory University psychology professor Drew Westen about the number of psychotherapy sessions the average anxious and depressed client needed to achieve meaningful and lasting change the number ranged from 50 to 75. That falls far short of the 4.66 average number of attended therapy sessions per student at campus counseling centers cited in the 2016 CCMH study.

Effectively engaging and keeping college students in the therapy they need to enduringly overcome the psychological problems interfering with their readiness to learn will require a more relationship-based, humanistic type of therapy. College administrators may need to turn back the clock and get reacquainted with the original client-centered philosophy of treatment fostered at the flagship counseling center at the University of Chicago, founded in 1945 by one of the pioneers of humanistic psychology, Carl Rogers: Sustained active listening and empathic understanding, nonjudgmental acceptance and recognition of clients’ feelings, and genuine regard for and dedication to students as they struggle to acquire personal agency, meaning and purpose in their lives.

Mental health in universities …still lethargic

mental-health-in-higher-educationI work in a university – the same university where I studied my undergraduate and postgraduate degrees. The same university where I was first diagnosed with mental illness, and the same university which has supported me ever since my diagnosis. I am incredibly grateful to work where I do, and to work with such incredible individuals. While I was a student the support I received through the Student Services mental health and wellbeing team was fantastic – the Mental Health Adviser within Student Services was able to organise practical support that enabled me to manage my mental health around my studies, as well as contact my GP and Community Mental Health Team (CMHT) when I was in crisis. Most importantly I had a space to express my concerns about dealing with mental health while at university – something which I never realised I needed, and something that I am whole-heartedly grateful for.

Now I work full-time at my university and I have been overwhelmed by the number of students that contacted me in relation to mental health. Having used the university’s counselling and mental health team myself I have been able to guide students in the direction of support, as well as signposting them to charities and organisations such as Student MindsStudents Against Depression and Vital Time by Griffin Ambitions LTD. While my job role doesn’t directly focus on mental health I certainly spend a great amount of time supporting students – or working on mental health projects. I do however know my limits, and I know when and where to go if I feel unable to support a student – Student Services and our Students’ Union are fantastic in working alongside me to ensure that we offer the best possible support for students. However, I do wonder how this works in other institutions – recently The Guardian published a series of articles focusing on the ‘mental health crisis’ currently encompassing higher education – which considers the mental health of both students and academics.

Having dealt with ongoing mental illness both as a student and now as a member of staff within my institution I feel comfortable and confident in the support I have received. And I feel comfortable and confident in encouraging students to use our support services – I have access to my own support networks – but I wonder, does more need to be done to protect the mental health of staff within higher education? And I don’t just mean academics, I mean support staff. Not all staff are like me – I have a fantastic support network, and most importantly – I feel comfortable and able to speak openly and honestly about my mental health, but for others this may not be the case.

Potentially Preventable Tragedies involving Mental Illness in Ohio

The purpose of assembling these is not to demonize persons with mental illness. The people involved in these incidents
are our children, siblings and parents. But because they (i) have serious mental illness, (ii) often do not recognize their
need for treatment, and (iii) are ‘protected’ by HIPAA, we can not help them get treatment until after they become danger
to self or others. Rather than preventing violence, the law requires it. Congress can help by (i) eliminating or reforming
SAMHSA which supports policies that prevent our relatives from getting care (ii) implementing demonstration projects of
Assisted Outpatient Treatment, (iii) instituting HIPAA reforms so we can get info needed to care for our relatives; (iv)
require agencies to prioritize mental “illness” rather than mental “health”, and (iv) end the IMD Exclusion in Medicaid.
Roselawn, Hamilton, OH
On October 22, 2009, James House III, a man with paranoid
schizophrenia, fatally stabbed 93-year-old Ida Martin. House had
been released four months ago from court monitoring after serving
10 years in a mental health facility for stabbing a woman in 1998.
Cincinnati Enquirer, 10/23/09; WKRC, 10/23/09; WLWT.com,
10/22/09
Columbus, Franklin, OH
On October 17, 2009, Daniel James Neeley fatally shot his mother
and wounded his sister. In 911 emergency calls, Neeley’s sister,
Bethany Lafountain, told dispatchers that her brother is a paranoid
schizophrenic. Prior History: On August 5, 2000, Calvin Neely
attacked his father Calvin Neeley who told officers his son has
mental health issues and was not taking his prescribed medicine.
Dayton Daily News, 10/26/2009; Springfield News Sun, 10/28/09;
WHIO, 4/28/10; The Columbus Dispatch, 4/28/10
Columbus, Franklin, OH
On May 2, 2009, Anthony Tilley, a prison parolee with schizophrenia,
knocked on the door of his next-door neighbor at 3:30 a.m. and
stabbed Undra Amos to death. Columbus Dispatch, 11/25/09
Hamilton, Butler, OH
On March 23, 2008, Vincent Blanda killed his 5-month-old daughter,
Brooklynn Blanda, by shaking her. At the time of Brooklynn’s death,
Blanda was not taking his medication for mental illness.Hamilton
Journal-News, 1/13/10
Columbus, Franklin, OH
On October 3, 2011, 40-year-old mentally ill Alesia Sheppard fatally
stabbed her boyfriend, 62-year-old Larry Edwards. Her symptoms
include “auditory hallucinations, delusional beliefs, paranoia and
erratic and impulsive behaviors.” She was ordered held in a secure
psychiatric unit at Twin Valley Behavioral Healthcare until she could
be restored to competency. The Columbus Dispatch, 10/4/11, 3/5/12
South Euclid, Cuyahoga, OH
On March 11, 2012, 30-year-old Quentin Diggs killed his 61-year-old
father Oliver Diggs and attacked his 58-year-old mother Brenda with
a brick. Diggs had a long history of mental illness, and his parents
had always tried to help him. He had a history of domestic violence
against his parents. Witnesses said Quentin Diggs attacked his
mother, and then his father tried to protect her. Fox 8, 3/11/12
Canton, Stark, OH
On January 26, 2011, 60-year-old Alana Monroe fatally shot her
husband, 54-year-old James Monroe, before overdosing on pills. A
judge ruled that Alana Monroe was legally insane when she fatally
shot her husband and had paranoid schizophrenia. Newsnet5.com,
1/27/11; Canton Rep, 7/28/11, 9/7/11

Copley, Summit, OH
On August 7, 2011, 51-year-old Michael Hance killed seven people
during a shooting rampage before he was killed by police. Hance
shot his girlfriend Rebecca Dieter at their home and then moved to

an adjacent house where he shot 51-year-old Craig Dieter, 67-year-
old Russell Johnson, 64-year-old Gudrun Johnson, 16-year-old

Autumn Johnson, and 16-year-old Amelia Shambaugh. Hance then
pursued 44-year-old Bryan Johnson and 11-year-old Scott Dieter
through neighboring backyards and shot both. Polixw asked Hance
to drop his weapon, but shot him when he refused. Hance’s family
believed he had untreated mental illness, though the disagreed on
the diagnosis. He had “delusional beliefs” that airplanes were
polluting the area and the proof was on the stained roof shingles atop
homes. According to the final investigative report Hance was a
depressed, sometimes paranoid. ABCNews.com, 8/8/11; Plain
Dealer, 8/9/11; Beacon Journal, 10/8/11
Bono, Lucas, OH
On October 31, 2010, 24-year-old William ‘B.J.’ Liske, killed his 53-
year-old father, William Liske, Jr., his wife 46-year-old Susan, and
her son 23-year-old Derrick L. Griffin inside their home. There was
“blood everywhere in the house.” A relative said B.J. was dangerous
and had threatened Susie before. Police said that he suffered from
Schizophrenia and at one time had been off his medications. Liske
had repeated encounters with law enforcement that resulted in jail
time and mental health treatment. Five months before his death,
William E. Liske, Jr., called the Ottawa County Sheriff’s Office to
report that his 24-year-old son had walked off after yelling at him and
pushing him during a confrontation at his pole barn. The elder Liske
said he had brought his son home for a weekend visit from the
Sandusky group home where he lived. He said his son was
schizophrenic and apparently wasn’t taking his medication. “He is
angry and uncontrollable,” the elder Mr. Liske wrote in a June 4
statement for the sheriff’s office. “I do not want to press charges, but
he needs to do his meds like most mentally ill individuals.”
ToledoOnTheMove.com, 11/1/10; ToledoBlade.com, 11/1/10,
11/2/10, 9/15/11; CBSNews.com, 11/2/10;
MansfieldNewsJournal.com, 3/22/11; Las Vegas Sun, 9/15/11
Dover, Tuscarawas, OH
On September 5, 2010, Jason Lee Gordon fatally beat his girlfriend,
33 year old Gina Harper. Gordon suffers from bipolar disorder and
schizoaffective disorder and had been admitted to mental institutions
both as a juvenile and an adult. NewsNet5.com, 9/5/10;
19ActionNews.com, 9/6/10; The Times-Reporter, 1/3/11
Enon Beach, Clark, OH
On January 1, 2011, 57-year-old Michael L. Ferryman fatally shot 40-
year-old Clark County Deputy Suzanne Waughtel Hopper before he
died in a shoot out with police in a trailor park. Previously, Ferryman
was found not guilty by reason of insanity in 2001, after a shootout

with authorities in Morgan County. Ferryman stayed at various state
facilities for over three years due to his mental illness.
DaytonDaileyNews.com, 1/3/11, 6/28/11; Columbus Dispatch, 1/4/11
Mansfield, Richland, OH
On April 3, 2010, Mansfield Dan Redman, 27, fatally shot John D.
Williamson, 61, in the back of the head while he was sleeping.
Redman, who had been staying with Williamson, said he couldn’t
control his actions. “It was like I was in control of my eyes, but
nothing else. I didn’t want to do it,” said Redman. Redman’s mother
said her son was diagnosed with bipolar disorder and schizophrenia
when he was 16, and couldn’t afford to stay on medication. Mansfield
News Journal, 4/7/10
Southington, Trumbull, OH
On July 31, 2012, 60-year-old Royce C. Honaker fatally shot his wife,
58-year-old Donna Honaker and called 911 to tell dispatchers he had
just killed his wife. Family members said that Royce Honaker
suffered from paranoid schizophrenia, and his condition had
worsened in the last six months. He believed, among other things,
his wife was poisoning his food. Family said she moved out of the
house but returned frequently to care for him and make sure he was
safe. Donna Honaker had taken her husband to Trumbull Memorial
Hospital’s psychiatric care center to be evaluated, but he checked
himself out three days later against doctor’s advice. Tribune
Chronicle, 8/3/12
Newport, Washington, OH
On August 1, 2012, 48-year-old Mark Stevens shot his neighbor,
Patrick Arnold. Neighbors said that Stevens, who had a history of
mental illness, behaved erratically and made people uncomfortable.
In 1985, he had been found incompetent to stand trial on an
attempted murder charge.Marietta Times, 8/3/12; TheNewsCenter.tv,
8/4/12
Lakemore, Summit, OH
On January 8, 2009, Daniel Tice fatally shot his estranged wife,
Brandi Tice, 28 with a single gunshot wound to the head. After
keeping SWAT officers at bay with Noah, his 4-year-old son by his
side, Daniel Tice was shot by police. Daniel Tice suffers from bipolar
disorder. Family and police said Tice stopped taking his medication.
Akron Beacon Journal, 1/10/09
Colerain Township, Hamilton, OH
On January 24, 2009, Timothy “Timmy” Sturgel shot his adopted
father Jerry Sturgel, 51, Mary Sturgel, 40, and Mary’s daughter,
Emily Hurst, 13 and set the home on fire. Timmy was diagnosed with
bipolar disorder and reportedly heard voices. Sometimes the voice
told him to do bad things. Hamilton County court documents show
Timmy had been ordered to undergo psychiatric care and treatment
at least four times since he was 20. Colerain Township police had
been called to the house previously for a psychiatric emergency as
recently as May 2008, according to records. Cincinnati Enquirer,
1/24/09, 1/25/09, 1/26/09
Dayton, Montgomery, OH
Eric Tyrone Moorer, a mental patient on a weekend pass from the
Dayton Mental Health Center, walked into a bar near the Center and
shot two men to death there. Dayton, Ohio News (Dayton
Metropolitan Area), November 17,
Marietta, Washington, OH

On August 19, 2002 Faran L. Sebring, 43, shoved Hames Lupardus,
42, of Marietta, into oncoming traffic while the two men were walking
together at night. The state’s report indicates Sebring was hearing
voices around the time of the incident and that he feared Lupardus
was trying to kill him. Psychologists determined Sebring was
suffering from paranoid schizophrenia and bipolar disorder. The
Marietta Times (OH), February 26,
Noble, OH
In March 2004, Fred Mundt, a 29-year-old man from Lebanon OH,
beat, raped and murdered his girlfriend’s 7-year-old daughter,
Brittany Hendrickson. Mundt’s mother, Sara Mundt, said her son has
depression and a bi-polar disorder. WTAP News, March 16, 2004
Marietta Times (OH), March 16, 2004 Akron Beacon Journal, 12/8
Cleveland, Cuyahoga, OH
Timothy Ward, 20, of Cleveland, pled guilty to strangling 19-year-old
La’Erica Patterson to death on their first date. Police later found her
body in a toy chest in Ward’s room. Ward said that the “devil made
me do it” and was diagnosed by a court psychiatrist as a paranoid
schizophrenic. Ward had a history of killing family pets and had once
attacked a former girlfriend but had no prior troubles with the law.
Plain Dealer (Ohio), October 1,
Lucas, OH
Stephen Everett, 19, raped, robbed, and murdered Rhonda Douglas
on March 29, 2002 in her Lucas County home about six weeks after
he was released from the Lucas County Youth Treatment Center.
Everett was diagnosed with bipolar disorder and depression at age
13. He stopped taking medication before the murder, and drinking
and drugs exacerbated the illnesses’ effects. Toledo Blade,
November 21,
Alliance, Stark, OH
Felicia Jennings, 35, was charged with involuntary manslaughter,
child endangering and abuse of a corpse for disposing of her
newborn twin sons in a plastic bag for trash pickup. Jennings has
been diagnosed with schizophrenia and borderline personality
disorder and twice was committed for mental health care. She was
apparently not taking her medication at the time she gave birth to the
twins at home. Akron Beacon Journal, November 22, 2002 The
Repository (Ohio), March 13,
Cleveland, Cuyahoga, OH
Jay D. Scott was given the death penalty for murdering 74-year-old
Vinney Prince, a Cleveland delicatessen owner, during a robbery in
May 1983. Prison doctors say Scott has schizophrenia and suffers
from a “history of psychosis characterized by delusional thought
process, paranoia and bizarre behavior.” He hears voices, set his
cell on fire several times, screams incoherently and bangs his head
on the wall Scott was executed on June 14, 2001. The Columbus
Dispatch, April 15,
Columbus, Franklin, OH
Gregory A. Pack stabbed social services caseworker, Nancy
Fitzgivens, to death on October 16, 2001 at his home in Columbus,
OH, after she told him that Child Protective Services would be taking
custody of his children. Pack had a history of bipolar disorder.
Columbus Dispatch, April 27,
London, Madison, OH

Veniamin Linnik, 43, a Ukrainian immigrant with paranoid
schizophrenia, beat his father to death after a night of drinking on
December 14, 2003 inside the London, OH apartment. Columbus
Dispatch (Ohio) May 22,
Akron, Summit, OH
Paul Michael Fassnacht, 32, stabbed and killed his stepmother on
September 10, 2006, in her home. Prior History: According to
records, police and paramedics have been called to Fassnacht’s
home seven times since December 2003 for incidents stemming from
mental illness. The most recent call came in January. In an October
2005 incident, Fassnacht was described as schizophrenic and said
he heard voices and a tapping sound on his windows. In an August
2004 incident, he was said to be yelling obscenities to himself and
punching himself hard enough to fall to the ground. Barbara Lenc, a
neighbor, said she noticed Fassnacht behaving strangely on several
occasions. He would pace alongside the house, wring his hands, talk
to himself and stomp, Lenc said. Akron Beacon Journal, September
12, 2006, November 2,
Alliance, Stark, OH
On February 18, 2007, Morgan Ellis, 53used a gun to fatally wound
his wife, Debra, 44, shortly before shooting himself. Family
members and relatives described Morgan Ellis as a man struggling
with mental illness. Aaron Ellis, 23, who shared the home with his
parents said “He had a problem, he had a serious problem. In his
mind, he thought the world was against him. He took everything out
on her.” Aaron Ellis said one reason he lived with his parents was to
help safeguard his mother. “I had been worrying about my sister for
years,” Jeffrey Carter, Debra Ellis’ brother, said. “He had some
serious issues. I didn’t think he would go this far.”Canton Repository,
2/19/07
East Palestine, Columbiana, OH
Ernest B. Robinson, 21, formerly of East Palestine, OH, pleaded
guilty to causing the death of his 5-month old daughter on August 14,
2002. Robinson had been treated for bipolar disorder and had taken
medication for the illness, though he hadn’t taken medication for the
past five years. Morning Journal News (Ohio), August 25,
Columbus, Franklin, OH
Police say Robert Villalon, 46, attacked his mother Lucia Villalon, 75,
on December 11, 2002 in their home in Columbus, OH. Both the
defense and the prosecuting attorneys agree that he should be
permanently committed. Columbus Dispatch (OH), October 14,
Cleveland, Cuyahoga, OH
Eroge Thomas, a 45-year-old man with paranoid schizophrenia,
stabbed and killed his boss in a downtown Cleveland, OH hotel
restaurant on July 28, 2003. Thomas attacked 29-year-old head cook
Amy Brin in the restaurant’s kitchen and stabbed her 13 times with a
large chef’s knife in front of their co-workers. Thomas, who court
records show was diagnosed with paranoid schizophrenia in 1981,
was on parole after serving 20 years in prison for another murder. In
1980, he robbed and fatally shot Charles Nixon, 23, of Cleveland.
Cleveland Plain Dealer, August 1, 2003; 218/04; 1/23
Huber Heights, Montgomery, OH
On July 22, 2004, Duane Allen Short, 36, shot and killed his wife,
Rhonda Michelle Short, 31, and her friend, Donnie Ray Sweeney, 32
in Huber Heights. Short had recently been diagnosed with bipolar

disorder and depression, but had flushed medication down the toilet.
The Dayton Daily News, September 21,
Miami Township, Clermont, OH

Christina Miracle, 25, a woman with mental illness, killed her 6-year-
old son on February 6, 2004 after she stopped taking her psychiatric

medication. Miracle thought she was bringing her dead brother back
to life and baptizing her son. Prior History: In March 2003, Miracle
began acting irrationally and expressing paranoid fears that
somebody had poisoned her water, family members said. Miracle
was admitted to a psychiatric ward for two days and then released. In
the following days Miracle was re-admitted to the hospital and stayed
for a week. Hospital officials told Miracle’s family she suffered from
major depression and sent her home with medication and orders to
see a counselor. Miracle never sought additional treatment and
discontinued her medications. Cincinnati Enquirer, September 23,
2004;Cincinnati Enquirer, October 13, 2004; Cincinnati Enquirer,
March 1, 2005; Cincinnati Enquirer, March 9, 2005.
Canton, Stark, OH
On July 3, 2004, Sherah N. Bennett, a woman with bipolar disorder,
rammed her car into a delivery truck in Canton, OH, killing the driver,
retired Canton police officer Sheldon Gotschall. Bennett’s attorney
Timothy C. Ivey told the judge that his client is very “functional”
when she is properly medicated. But when her medication is altered
or she fails to take it, Ivey said, problems can arise. Three weeks
before the July 3 crash, Bennett was involved in another crash when
she hit a parked tractor-trailer in a rest area on Interstate 71. After
that incident, according to police records, Bennett told a state trooper
that she was “bipolar and not taking her medication”.
Akron Beacon Journal, September 30, 2004 Akron Beacon Journal,
October 5 & 27, 2004 NewsNet5.com, OH, November 4,
!!!!!Springfield Township, , OH
On August 24, 2004, Paul Thomas Faith, 25 entered a K-Mart store
in Springfield Township, OH, shot and killed one man and wounded
another, then shot and killed himself after leading police on a short
car chase. Faith’s mother said he was diagnosed with paranoid
schizophrenia in 1999. He often heard voices and didn’t take his
medications, she said. “I am angry that the system failed my son,”
Linda Faith said, adding that Faith often wanted to stay in the
hospital but was released because he wasn’t deemed ill enough.
Prior History: Hamilton County court records show that Faith was
twice declared mentally ill and was hospitalized four times between
1999 and 2003.Cincinnati Inquirer, October 6,
College Hill, Hamilton, OH
Michael Meridy, a 20-year-old man with mental illness, stabbed and
beat his grandfather to death at the elderly man’s College Hill, OH
home in November 2003. Meridy told detectives that God and the
devil made him kill Pillow. Meridy suffers from schizophrenia and was
not in his right mind during the killing. Prior History: A month before
the murder, Meridy was taken by family to a psychiatric ward, after
he walked around the house asking if others could hear the voices he
was hearing. Cincinnati Enquirer, October 14, 2004 Cincinnati Post,
October 14, & November 2,
Westlake, Cuyahoga, OH
Daniel Jung, a 22-year-old man with a history of mental illness, killed
his 68-year-old father and injured his mother with the family car in the
driveway of their Westlake, OH home. On October 18, 2004, a judge
ruled that Jung was mentally incompetent to stand trial. Court

psychiatrists who evaluated Jung and reviewed records of past
psychiatric treatment diagnosed him as schizophrenic. Plain Dealer
(Cleveland), October 19,
Columbus, Franklin, OH
On December 8, 2004, 25-year-old Nathan Gale entered a
Columbus, OH nightclub and shot and killed four people, including a
well-known heavy metal guitarist who was up on stage. Gale, who
had taken a hostage after shooting the last victim, was then shot and
killed by a police officer at the scene. Gale’s mother, Mary Clark, said
her son was diagnosed with paranoid schizophrenia in 2003, when
he was sent home from the Marine Corps on an early medical
discharge. “He came home with his medications, and I don’t know if
he took them or not,” Clark said. MSNBC.com, December 15, 2004;
Cincinnati Enquirer, April 14, 2005; Cincinnati Enquirer, May 12,
Hyde Park, Hamilton, OH
On May 31, 2005, Andrew Warrington, a 16-year-old boy with mental
illness, killed his brother Johnny Warrington, 17, in their Hyde Park,
OH home by beating him to death with a baseball bat because he
thought Johnny, was trying to poison him. Warrington suffers from
paranoid schizophrenia and was refusing to take a prescription
antipsychotic medication. Cincinnati Enquirer, 6/16/05, 11/30/05,

12/2/05, 6/12/08, 12/5/08; ChannelCincinnati.com, 11/30/05; WLWT-
TV, 12/16/05; Middleton Journal, 12/17/05; Cincinnati WCPO.com

Cincinnati, Hamilton, OH
William Ushry, a 23-year-old man with mental illness, stabbed a
woman to death after burglarizing her apartment in Cincinnati, OH on
April 25, 2004. Ushry accused his parents of trying to poison him,
took a knife out of his father’s drawer, and left the house. When
Ushry returned, he told his parents he “might have hurt someone,”
said his father. Prior History: After returning from the Army, Ushry
told his parents that the government was reading his mind, that he
was getting messages from the television, and that he could see
spirits. Ushry later lost a job with the Cincinnati Public Schools
because of his mental health problems, his father said. Ushry’s
parents took him to University Hospital, where he was diagnosed
with paranoid schizophrenia. The Kentucky Post, August 12, 2005;
Cincinnati Post, August 19, 2005; Cincinnati Post, September 23,
Middletown, Butler, OH
On September 3, 2005, 25-year-old Michael Carreiro fatally stabbed
his mother, 56-year-old Christine Minnix in his apartment. Carreiro
told detectives he killed his mother as part of a prophecy he received
from a higher power. Carreiro’s stepfather said he suffered from
paranoid schizophrenia. He said Carreiro stopped taking his
medication when he turned 18 and had spent four years in outpatient
mental health care, which was initiated in November 2000 through a
civil commitment proceeding, before he was released on December
7, 2004. Middletown Journal, 9/7/05, 11/8/05, 9/5/06, 11/21/06,
12/12/06, 11/28/06, 12/11/06, 8/10/11, 11/28/11; Cincinnati Enquirer,
9/5/05, 9/7/05; Dayton Daily News, 9/14/05; Journal-News, 10/19/05;
Cincinnati.com, 6/15/11, 12/1/11; Dayton Daily News, 6/21/11
Canton, Stark, OH
Henry A. Sunderman, 32, is accused of raping and killing his infant
niece on March 10, 2006, when Sunderman was baby-sitting 7-
month-old Zoey Sunderman, her two sisters and a brother. Ward
has bipolar disorder and has been on disability for at least five years.
Canton Repository, March 14,

Toledo, Lucas, OH
On March 10, 2006, Sharon John Hawkins, 62, allegedly beat his 77-
year-old roommate, Norbert Konwin, to death at the Foundation Park
Alzheimer’s Care Center. Hawkins has schizophrenia. Toledo
WUPW, 3/29/06; Toledo Blade, 8/8/07
Middleton, , OH
On January 1, 2006, Dean Geldrich killed his roommate, Miranda
Lint, 29, in their Malvern Street home after he bound Lint’s limbs with
duct tape and brutalized her for hours. The judges said they spared
Geldrich’s life because his mental illness — a bipolar disorder with
psychotic features — was an overwhelming mitigating factor against
the death sentence Middletown Journal, 8/9/06, 9/6/06, 9/18/06,
6/5/08; Journal News, 9/27/06; Cincinnati Enquirer, 9/26/06
Youngstown, Mahoning, OH
On March 11, 2007, James R. DiCioccio, 49, choked and killed
Stephen A. Lawson, 34. Lawson died at St. Elizabeth Health Center
shortly after a fight at Illinois Manor, a group home for mentally ill
men. In February 2006, staff wanted him removed to the psych ward
of a hospital, saying he was becoming too violent. Youngstown
Vindicator, 3/20/07
Cleveland Heights, Cuyahoga, OH
On May 26, 2007, Timothy Halton Jr., 27, shot officer Jason West,
who later died at Huron Hospital.
• Nineteen days before, Timothy showed up for a psychiatry
appointment at the downtown offices of Mental Health Service

for Homeless Persons Inc. He had skipped his monthly anti-
psychotic injections recently.. The psychiatrist asked Halton to

stick around for the shot. But Halton left, and the staff never saw
him again. As with Halton’s mother, who struggled to get her
son help, there was nothing the agency could do to compel
treatment.
• On October 4, 2003, Halton’s mother, Jeanette Tiggs, called
police to report Halton’s threats to relatives. Halton says that he
wants “a bullet in his head” and that he is going to “kill a police
officer.” Halton is stopped by police, smashes a patrol car with a
brick and punches Patrolman Mark Merims in the face. He was
sentenced to probation and ordered to take antipsychotic
medication. His probation ended in June 2006, according to
court records.
• On May 24, 2001, Halton’s mother, Jeanette Tiggs, called police
to say her son was threatening to “go kill” President Bush, who
is visiting Greater Cleveland.
• On July 8, 2000, Timothy Halton Jr. punched and kicked a 60-
year-old man who walked past his home. Police get a call from
Halton’s screaming sister, who has locked her brother out of the
home telling them he is bipolar and “violent when not properly
medicated.” Cleveland Plain Dealer, 5/26/07, 5/30/07, 5/31/07,
10/30/09; The Morning Journal, 6/2/07; Plain Dealer, 6/2/07,
6/3/07; Cleveland Free Times, 6/6/07; WKYC.com, 10/30/09
Mansfield, Richland, OH
On May 7, 2007, Preston Fenderson bludgeoned Larry Gutshall at
his apartment in Dalton Place, a 12-room apartment building for
people recovering from mental illness. Fenderson was a diagnosed
paranoid schizophrenic. Police said they believed Fenderson had
been off his medication. Bacyrus Telegraph (CA), 6/13/07; Mansfield
New Journal, 3/19/09, 3/27/09, 4/1/09, 4/2/09
Canton, Stark, OH

On July 9, 2006, Brian C. Aduddell who has a history of mental
illness, admitted using a cane and a carving knife to murder Charles
W. Evans Sr., 81, and Evelyn C. Evans, 80, inside their home.
Aduddell told police that God told him to kill his grandparents in order
to save the world. Aduddell, whose his grandparents basically raised
him since he was 5 years old, had moved in with the couple the day
before. He suffered from severe mental illness. For at least two years
before the killings, Aduddell’s behavior was erratic. He believed in
UFOs and spent his days writing his bizarre thoughts. His relatives
have said he claimed to chase flying saucers and preach the Bible to
aliens. At one point, Aduddell was hospitalized for mental illness; a
month before the murders he sought treatment at a crisis center in
Wayne County, Stafford said. Aduddell’s mother had schizophrenia
and committed suicide when he was young. That Aduddell wasn’t
treated for mental illness frustrates his cousin, John Gardiner.
Aduddell lacked insurance and when he went to the crisis center and
was told nothing was wrong even though his family knew better,
Gardiner said. Canton Repository, 8/7/07
South Euclid, Cuyahoga, OH
On March 22, 2008, Walter D. Spencer Jr. critically wounded his
mother and killed his father in their South Euclid home. Walter D.
Spencer Jr. suffers from paranoid schizophrenia and may not have
been taking his medication. Cleveland Plain Dealer, 3/24/08
Waynesburg, Stark, OH
During the week of August 17, 2008, 22-year-old Joseph P. Grossi of
Waynesburg killed his former roommate, Bruce Bai, 38, after walking
17 miles to Bai’s apartment by stabbing him once in the lower back.
His mother Catherine Grossi said her son bipolar disorder, and
needs medication. Canton Repository, 8/26/08, 1/5/09, 1/13/09
Mansfield, Richland, OH
On December 26, 2007, Larry Evans Jr., fatally shot his brother
Officer Brian Evans, and a neighbor, 44-year-old Robert Houseman
and held police officers at bay for several hours before surrendering.
Evans was off his psychotropic medication at the time. The defense
team, court and prosecution team each hired an expert and they all
agreed Evans, had bipolar disorder and psychosis. WMFD
Mansfield, 9/2/08; Mansfield News Journal, 4/6/10, 4/24/12;
IndeOnline, 6/6/12
Zanesville, Muskingum, OH
On August 29, 2008, John Matthew Hughes, 32, killed Eugene David
Durben. Wendy Pritchard, Hughes’ sister, of Mississippi, said while
she is shocked her brother had anything to do with Hughes’ death,
she wants the Hughes family to know her family is extremely sorry.
Pritchard said her brother has suffered from mental illness for years.
“He’s been diagnosed as a bipolar, paranoid schizophrenic and has
never really gotten any help with his problems,” Pritchard said. “We
aren’t excusing him we’re just hurting ourselves.” Pritchard said the
justice system has never addressed any of Hughes’ problems. “They
just keep putting him in prison and not allowing him to have his

medication,” Pritchard said. “We’ve asked and asked that they keep
him locked up and get him help, but nothing seems to work.”
Zanesville Times Recorder, 9/10/08, 1/23/09
Toledo, Lucas, OH
On July 18, 2010, 24-year-old Lawrence Fitzgerald James was

charged in the fatal stabbing of University of Toledo student 22-year-
old Casey Bucher. James had a history of not taking the anti-
psychotic prescriptions he needed for Schizophrenia and Bipolar

Disorder. Prior History: James was diagnosed with Schizophrenia
and Bipolar Disorder as a teenager, and attempted to claim he was
incompetent to stand trial during a similar case two years ago. He
was released from the Lebanon Correctional Institution near
Cincinnati June 6 after serving time for a 2008 attack in which he
stabbed a gas station attendant who did not comply when he asked
for 70 cents. In both cases, his brother, Lawrence E. James, said he
was not taking the anti-psychotic prescriptions he needed for
Schizophrenia and Bipolar Disorder When he left the prison in
Lebanon last month, he did not refill his four prescriptions for
psychiatric drugs, according to his brother. Toledoblade.com,
7/21/10; ToledoontheMove.com, 7/19/10, 7/21/10; ABC 13, 7/21/10
Harrsville, Butler, OH
On July 28, 2010, 49-year-old Thomas Smith fatally shot his former
brother-in-law, 56-year-old Clifford Stevenson. A relative said that
Stevenson was providing Smith with food and a place to live.
Stevenson’s sister said Smith was being treated for Paranoid
Schizophrenia and was off his medication. KDKA, 8/01/10; Pittsburg
Tribune-Review, 8/2/10; Allied News, 7/12/11
Dayton, Montgomery, OH
On March 17, 2011, 47-year-old Michelle Walker was shot in the
head. The next day, her son, 27-year-old Glenn Walker was taken
into custody and charged with murder several days later. According
to a family member, Glenn Walker suffers from mental illness.Dayton
Daily News, 3/21/11, 3/23/11; WHIOTV.com, 3/17/11
Colerain Township, Hamilton, OH
On July 12, 2011, 24-year-old Lanny Stoinoff violently shook his
infant niece killing her. Stoinoff asked to hold 1-month-old Roslyn
Stoinoff, then shook her while his mother and sister, the baby’s
mother, tried to get him to stop. Officers arrested Stoinoff, who was
staying at this parents’ home, where he been since being released
from a psychiatric hospitalization a few weeks before. “He had some
mental issues and he was committed like for seven days, and they
released him. Prior History: On June 27, 2011, Stoinoff was taken
from his home by police to University Hospital’s psychiatric unit.
Stoinoff told a nurse at the hospital that he had killed his dog
“because it had demons in it” A deputy called Stoinoff’s father, who
said his son was paranoid schizophrenic and off his medicine .
Cincinnati.com, 7/14/11, 11/26/12; Fox19.com, 7/22/11; WLWT News
5, 7/14/11, 8/10/11