Hormazd Kanga (CAS ‘04) was driving back to campus from Dupont Circle on Saturday night, when he first noticed that something was wrong. When he got to Reservoir Road, as he was turning into the Georgetown hospital entrance, he was passed by five police cars, speeding past him with their sirens on.
Kanga, who is a resident assistant on the 2nd floor of Village C East, parked his car in Lot T and walked quickly towards the Village C patio. When he arrived, he saw police officers running from Dahlgren towards the Village C West door, which had already been propped open.
Kanga walked into Village C West and saw that the student guard was in visible shock. The guard simply said, “there’s a guy hanging down there,” and pointed.
Kanga ran down to another RA’s room on the third floor and called the hall director and RA on duty. “After that, all the senior Residence Life staff came to Village C and took over,” he said.
When first-year student Jeremy Dorfman (CAS ‘06) took his own life on January 11, it was the first suicide that Georgetown University had seen on-campus in almost eighteen years. Six years ago, another student who had been caught cheating committed suicide while at home during spring break, according to Associate Director of Counseling and Psychiatric Services (CAPS) Dr. Paul Steinberg.
Research shows that suicide is the third most common cause of death among the 15 to 24 age group, making it a more common cause of death than car accidents. According to a Boston Globe 2001 survey, about seven undergraduates per 100,000 commit suicide. For the nationwide 17 to 22 age group, which includes those not enrolled in a college or university, the suicide rate is much higher at 13.5 per 100,000.
Georgetown’s incidence of suicide, in comparison, is much lower than the national average. With approximately ten percent of Georgetown students seeking counseling at CAPS and others seeking outside professional help, it is clear that Georgetown does not lack its share of students experiencing depression and other mental health issues. Dorfman, for instance, had very serious mental health problems, according to Steinberg, and had been receiving counseling services at the University prior to his death.
University administrators credit Georgetown’s low suicide rate to a proactive web of resources, which involves administrators and RAs like Kanga, called “Safety Net.” In the most serious cases, the University may recommend a student to take a leave of absence, but for less serious situations, CAPS or another on-campus resource will be used if possible. Whether or not this system works is up for debate. Some Georgetown students who have dealt with depression have felt isolated from the community and did not feel as if the University adequately dealt with their cases.
In a period of a year and a half at Georgetown, Olga Pierce (SFS ‘04) was hospitalized for depression three times. Her transcript became littered with withdrawals and incompletes and her depression showed no signs of improving.
She tried to talk to her roommates about her problems, but felt like nobody around her really understood her situation. “I think that because by definition most people [at Georgetown] are successful, it makes it a hard place to be if you’ve hit kind of a bump,” Pierce said, who started as a first-year at Georgetown in fall 1997. “I think it’s hard for people whose lives are more or less together to understand what’s going on when somebody is in another sort of situation,” she said.
During her final stay in the hospital, Pierce’s doctors recommended strongly that she should take a leave of absence from Georgetown. “They essentially said, ‘we don’t want to let you out of the hospital unless you go home to your parents’,” Pierce said. CAPS echoed this recommendation.
Pierce resisted going home because many of her problems stemmed from issues with her family. She did not, however, see any other option. “If there’s any sense in where the system failed me, it was that there was no third option,” Pierce said. “The key thing was really struggling to avoid going home to my family, and the only other viable option was being here and going to school, which also was bad.” Underlying all of this, Pierce no longer had the financial means to stay at Georgetown while not taking classes.
Pierce returned this January to Georgetown, after a year and half leave. During her time off, she returned to her hometown of Lincoln, Neb., but decided not to live with her parents. “For me, it turned out really well … I took courses in things I was interested in, and I had chances to ask myself questions about who I am and what I want to do,” Pierce said.
The Safety Net
The “Safety Net” program is a combined effort between the Office of Student Affairs, Health Education Services and CAPS to educate staff and faculty members about various issues such as stress, depression and alcohol abuse. Twenty-two chaplains-in-residence, hall directors and 60 RAs undergo the Safety Net training each year. Participants in the program are trained to recognize changes in students’ behavior that may signal depression or suicidal tendencies.
Vice President for Student Affairs Juan Gonzalez also attributed much of Georgetown’s low incidence of suicide to the Safety Net program. “The Safety Net program is about training and having a network that is extensive and proactive,” Gonzalez said. “There’s a feeling here that you can’t be passive when you come to depression and suicide attempts … you have to reach out.”
Gonzalez said that his office, in coordination with Health Education Services, steps up their mental health awareness campaign every February, which he referred to as “slump month.” During this month, in which there is generally a higher rate of depression, Gonzalez said that the Student Affairs and Health Education staff ensure that flyers about depression and a mental health self-diagnosis website are visible on-campus.
At the beginning of each semester, resident assistants also receive extensive training through lectures and role-play exercises on handling situations in which one of their residents shows signs of depression or suicidal tendencies. Step-by-step guidelines are also included in the RA manuel to instruct Residence Life staff what they should do to intervene with a suicidal student.
“In this one area of training, I think it was excellent,” said Kanga, who said that his training prepared him to know how to best deal with the situation when he first arrived at the scene and afterwards when comforting his residents. “The issue of copycats popped into every RA’s head immediately,” Kanga said. “So for a couple of days afterwards, we were all very vigilant about watching out for it.”
After any incident of suicide, there is typically about a 50-day window where staff and counselors are put on high alert because of the risk of copycat suicides. Research has shown that students of the college-age group are at a greater risk of committing suicide in the two to four week period following a suicide because of reasons such as desire for similar attention. Residence Life staff are cautioned to be particularly proactive during this time.
No copycat suicide attempts were made following Dorfman’s death, according to Steinberg. Approximately 20 to 40 students are hospitalized per year for mental health reasons, he said, primarily for suicide attempts.
The day after Dorfman’s death, the Office of Student Affairs sent out a campus-wide e-mail notifying students and faculty of the incident and providing information on the counseling services available.
Leaving Georgetown
Katie Seitz (CAS ‘03), who has struggled with serious depression while at Georgetown, initially reacted to Dorfman’s death with a mixture of sadness and relief. “As sad as I was about the whole thing, my first reaction was, finally, the administration can’t cover this up,” she said. “I was not surprised at all. Actually, I was more surprised that this was the first suicide that Georgetown had had since I’ve been here,” she said. “Jeremy Dorfman was not an isolated incident.”
Seitz believes that it is necessary for the University to take a stronger stance on mental health issues-particularly, to take the sense of shame surrounding it. “I really feel like the University tried to hush things up [around Dorfman’s death]. The school has a responsibility to foster a sense of community.” Gonzalez firmly denies that the University attempts to hush up incidents of suicide or suicide attempts on campus. Referring to Dorfman’s death, Gonzalez said, “We have a belief that this was a person who had an illness, fought the illness and lost. Giving it widespread attention or a spotlight is inappropriate.”
Dr. Alan Siegel, Chief of Mental Health Service at the Massachusetts Institute of Technology, a university that has a high incidence of suicide, disagreed, saying that a public discussion of these incidents is useful for the community’s healing process. “I can understand [Georgetown University]’s apprehension; they just want it to go away, but I don’t know if there’s any data to suggest that if you put the information to people that it will affect them in a negative way,” Siegel said. “Essentially, you have to be very active about open discussion about the effects of the suicide, whether it be through an large number of articles, providing counselors for students, or helping people identify if they are also at risk.”
Pierce believes that the Safety Net program is only useful for short-term resolutions. “I think it would be helpful if [a student] is suicidal and someone needs to intervene in a short-term way,” she said. “But if you’re depressed, it’s usually long-term, and I don’t think that general faculty and administrator awareness would really help.”
If the Safety Net identifies a student in distress, or if the student realizes a problem exists, CAPS usually enters the scene.
The most important thing to find out once a student informs a CAPS counselor of suicidal thoughts is to find out whether the student has a detailed plan of action, said Steinberg. Students who articulate a concrete plan for carrying out the suicide are considered to be at much higher risk, he said.
When determining the best plan for treatment, Steinberg said, “The most crucial question to ask is ‘What’s keeping someone alive?’ We want to grab onto that life force.”
He said that because suicide rates are more associated with hospitalizations and drop-out rates, CAPS tries its best to make sending students home to combat their mental illnesses the last viable option. “We recognize that and do everything we can to keep people out of hospitals and dropping out,” he said.
Steinberg explained that the decision for a student to go into the hospital is usually made when they realize that it is necessary for the student to be under constant monitoring. “We ask the question of who the person would call if he or she was really desperate. If someone says that they wouldn’t call anybody, we realize that we need to get someone to watch over them 24/7,” he said.
Steinberg said that sending a student away from Georgetown to deal with their mental illness is the last option for CAPS. “We try our best to keep people here at the University and sit through the problems,” he said.
Holes in the net?
“I was told that if I didn’t request a leave of absence, the University would do it on my behalf,” said Chris Trott (SFS ‘03) of his experience with the administration during the spring semester of his first year at Georgetown.
Trott, a Voice staff member, told his CAPS counselor in the second semester of his freshman year that he was thinking of committing suicide. As his depression intensified, Trott’s counselors recommended that he check himself into Georgetown Medical Center so that he could be monitored continuously. While in the hospital, Trott experienced a severe depressive episode, signaling to those around Trott that his situation was much more serious than they had previously assessed.
After being in the hospital for three days, a group of doctors, a social worker, Trott’s mother and Residence Life staff members convened in Trott’s hospital room to discuss his situation. No
representatives from CAPS were present at this meeting. It was during this meeting that former Assistant Residence Life Director Chuck Van Sant told Trott that his mental illness was interfering too much in his life for him to continue successfully as a student.
“He told me that there was no way to do both, and I needed to get better before I could continue,” Trott said. “The [group at the meeting] told me that I should go home and focus on getting better.”
Trott explained to Van Sant and his doctors that he did not think it would be best for him to take a leave of absence because many of his problems were catalyzed by familial issues. “Home was part of the contributing factors to my condition,” he said. “I really felt going home would make things worse for me. I had no support system at home, no friends and no one who was experienced with depression. It almost felt like a death sentence.”
Trott was so opposed to taking a leave of absence that he threatened to kill himself at home if forced to go. The response he received, however, was unanimous in telling him that going home was what he needed to do. “I saw it as my only option,” Trott said.
When Trott went to School of Foreign Service Dean Andrew Steigman to submit his request for a leave of absence, the office had already been contacted by Residence Life. After getting approval for his leave, Trott and his mother went back to his New South dorm room and packed up his things to leave.
Since coming back to Georgetown in Fall 2000, after a 6-month leave, Trott still does not believe that going home was the best option for him. “No, I didn’t commit suicide while I was at home, but my getting better would have happened anyway. I had the same or worse thoughts of suicide while I was at home.”
Steinberg was shocked to hear about Trott’s situation. “I really feel like we do everything in our power to keep a student here on campus if that is their choice,” he said.
Trott said that he did not believe that Georgetown’s lower than national average suicide rate is because of anything that the University is actively doing. “I think it’s because we’re lucky that the people it would happen to aren’t here because they choose to leave or not come here. I don’t think it’s because of something that the University is doing to prevent it.”
There is a lot of awareness of mental health and depression issues within the Student Affairs staff, Trott said, but this does not translate into a wider awareness amongst the wider campus
community. “There’s not enough outreach to let people know what services are available,” he said, “so the people who are able to hide it from administrators, professors and deans are the ones who get lost in the shuffle.”
But not all decisions to leave Georgetown are made by the administration. Several of the students interviewed came to their own decisions to take a leave of absence from Georgetown and were granted their requests.
When a student decides to leave the University because of medical reasons, he or she must first submit a letter of request to the appropriate deans’ office, outlining the reasons for the leave and the length of the leave. The Council on Studies, a collective review committee composed of deans which meets weekly, then reviews the request and gives its approval or disapproval. During this review, the deans’ office will take into account any recommendations made by CAPS, according to Associate Dean Anne Sullivan of the College.
If approved, the student’s transcript will denote only a leave of absence, with no specifics. Sullivan said that the only time that a leave of absence is specified as being for medical reasons is if the deans’ office is requested to verify medical leave for an insurance company, at the student’s request.
If the reasons for the leave are because of a mental health illness, the University will set conditions on the student upon his or her return. Before the student is allowed to return, he or she must first submit a letter approving the return from his or her home doctor to the deans’ office. The student must also make an appointment with CAPS before his or her return. The CAPS director will also review the letter from the home doctor and make a final recommendation to the deans’ office, Sullivan said. If the return request is approved, the student must then work with the deans’ office and CAPS to set conditions for his or her return, such as the continuation of regular counseling upon re-enrollment.
“Going away was probably the easiest thing I’ve ever done at Georgetown,” said Seitz, who began as a first year in the 1998 fall semester. Seitz was experiencing bouts of depression and doing poorly academically during her sophomore year at Georgetown. She had gone to CAPS to try to improve her mental health, but was disappointed with the treatment she received there. Instead of feeling like her counselors wanted to help her get better, she felt even more isolated.
Seitz, who took a leave of absence from spring 2000 to fall 2000, said that she decided to leave Georgetown because she was dissatisfied with her experience at CAPS. “I really resent the approach that CAPS took towards my case. They made no efforts to create a sense of community or improve my mental health issues,” Seitz said. “I really resent the fact that I had to go away, [but] going away seemed so much easier than staying.”
After she decided to request a leave of absence, Seitz did not discuss the matter with CAPS because she did not feel comfortable talking to them further about her situation. Instead, she went straight to the College Dean’s office and requested a leave. “As soon as [the Dean’s office] heard I wanted to leave because of personal reasons, they were OK with it,” Seitz said.
After a year working abroad, Seitz returned to Georgetown and decided to begin seeing another counselor at CAPS because of its on-campus convenience. Although she has continued experiencing depression since she has been back, she speaks very positively of a relationship that she developed with her new counselor at CAPS. This counselor, however, has now left Georgetown, forcing Seitz to once again look for a new doctor.
Efforts nationwide
According to the Boston Globe study, MIT has the highest incidence of suicides when compared to other schools of its caliber. Since 1990, 11 MIT students have taken their own lives, ten of them undergraduates. MIT has an undergraduate population of approximately 4,400.
Following the rash of suicides, the MIT administration decided to take radical action. In a combined initiative between the Chancellor, the Undergraduate Association and MIT Mental Health Service, the Mental Health Task Force was developed to perform an in-depth review of the school’s mental health services.
The task force found that 74 percent of MIT students surveyed reported having had an emotional problem that interfered with their daily functioning while at MIT. What they were more shocked to discover though was that only 28 percent of these students had actually sought help at MIT Mental Health Service.
In November 2001, the Task Force issued a report outlining several recommendations for improving services. Recommendations included an extension of Mental Health Service’s hours, including evening walk-in hours, an increase in outreach training for students and student advisors and the creation of a new Clinical Director of Campus Life position, who now acts as a liaison between the medical and campus communities. MIT has also since built more dormitories for its students, as well as a new sports center in the hopes of creating more activities for students to be involved in on-campus.
“MIT is very committed to dealing with the emotional life of its students,” said Siegel, who came to MIT this past September. “I think after the incidents from a couple of years ago, there was an awareness here that something was wrong.”
Since the report came out, he said that the University has seen improvements. “I think the impression that people have is that the services are more accessible now,” he said. “You can never really do enough to ensure that you do not have any more of these [incidents], but you need to create more opportunities for people to find help.”
Cornell University, another school reputed to have a high incidence of suicide, also underwent a series of improvements in an attempt to increase suicide and crisis prevention. From 1990 to 2000, nine Cornell students killed themselves, and the campus newspaper reported the discovery of the body of a student who had been missing for nine months. In a Cornell Daily Sun article, the College of Engineering Dean John E. Hopcroft said that the college had expanded its student services to work with University Health Services on identifying suicidal students and to “try to make them feel more connected.”
But if feeling connected and accessibility to mental health services are hallmarks of successful suicide prevention, not all students’ experiences at Georgetown have shown this to be true. While the Georgetown administrators believe that they are being proactive, they may not be far enough.
When Pierce heard about Dorfman’s death, she saw reflections of her own life. “To a certain extent I was thankful that I came through that period of my life and didn’t get written about in the newspaper like [Dorfman],” she said. “Everybody had such positive things to say about him. It made me wonder why someone so liked would feel so disconnected from the community and have no one notice.”
Pierce returned to Georgetown after a year and a half because, in the back of her mind, she always wanted to come back. Not only did she know that it was necessary for her future aspirations to attain her college degree, but she also felt the sense of wanting to finish what she had started.
Pierce encourages people to actively address the problems in their lives. “If you’re very unhappy, you don’t have to wait and continue being unhappy,” she said. “Sometimes it takes something dramatic like leaving for a year or seeking out treatment if it’s your happiness that’s at stake.”
