College MH Care

The more things change, the more they stay the same. In the 1960s and'70s there were many college psychiatric services on campuses staffed full time by the likes of psychiatrists Dana Farnsworth, John Wilms, Syd Schroeder, John Curtis, and Dale Svendsen (all M.D.s)—as well as the undersigned. At the time, all of these psychiatrists were widely admired for running effective programs, usually out of their student health services.

Now it would seem from the tone of the article in the July 15 issue that all that is gone, and we must “review scientific data” to justify starting up preventive college mental health programs again—that is, reinvent the wheel.

As a long-time college psychiatrist and observer, it is not news that there is practically an epidemic of mental illness—particularly depression—on college campuses, but also considerable schizophrenia and substance abuse. Some of those afflicted are also dangerous to others as well as to themselves.

The interesting question is, Why did colleges let these services lapse beginning in the late 1970s? I would have our APA committee start by interviewing the deans of student affairs, for example, at the above psychiatrists' universities, namely, Harvard, Purdue, Kansas, Kentucky, Georgia, Ohio State, Indiana, and Louisiana State. In addition, a root-cause analysis of what happened in a notorious malpractice case against a college psychiatrist in North Carolina would be instructive.

One theory is that college psychiatry is now an embarrassment because of a decline in a “state of community” on many campuses, characterized by increasing alienation and isolation of many students. This situation was described in “A Pilot Program of Mental Health Education for Faculty” in the December 1974 Journal of the American College Health Association.

It may also be true that with the current availability of managed care, HMOs, and so on, college health services are no longer considered a necessary expense by cash-strapped institutions.

That journal article also describes the development of an “early warning network” to identify suicidal and homicidal students.