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
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.