Kayla Pope, M.D. (top), and Aeva Gaymon-Doomes, M.D.
April marks the one-year anniversary of the killing of 32 people at
Virginia Tech by a single gunman, who reports later showed did not receive
recommended care for psychiatric problems. The incident resulted in the tragic
loss of many lives and also highlighted how college students with unmet mental
health needs can matriculate without provisions for receiving adequate
Since the tragedy there has been an increased focus on mental health care
on college campuses and a long-overdue dialogue on how to improve access to,
identification of, and services for college students with mental health needs.
With the demand for services growing, we encourage residents and early career
psychiatrists to consider working with this population.
In the wake of the Virginia Tech killings, many programs are reorganizing
their mental health services and making improvements on access to services. To
understand how one program is continuing to develop its mental health clinic,
we interviewed staff and toured the health center at the University of
Maryland, College Park.
The university has a separate mental health clinic, which is directed by
psychiatrist Marta Hopkinson, M.D. At that campus, with a student population
of more than 35,000, the mental health clinic sees about 1,600 students a year
for a combination of both psychotherapy and medication management, with
approximately 1,300 additional students receiving care at a separate
The number of students seeking care has increased steadily over recent
years, with the clinic seeing about 200 more patients in the 2006-2007
academic year and having more than 1,000 additional clinic visits than in the
2005-2006 academic year. The clinic employs two full-time and two part-time
psychiatrists, and they are currently seeing as many patients as they can.
Dr. Hopkinson noted that demand quickly meets any increase in the services
available and that the staff is aware that there are students who are not
receiving services but who need them.
She pointed out as well that since the Virginia Tech incident, there has
been an increase in the number of requests for evaluations. What has changed
is that the requests are now being made by family members, roommates, and
faculty, which was rarely the case before. The tragedy in Virginia has helped
the college community overcome its hesitancy to get involved when someone
needs help, and there has been a realization that everyone must play a role in
keeping a campus safe.
Dr. Hopkinson emphasized the need to do more educating about what mental
illness is, how to know when you need help, and how to access care when you
To address these needs, the clinic received funding from the federal
Substance Abuse and Mental Health Services Administration to launch a new
initiative titled Suicide Awareness Health Education Training. This initiative
will provide on-campus training for students and faculty to help them identify
signs of depression and anxiety. The initiative will also involve a
public-health campaign to address mental illness stigma. The campaign's slogan
will be "Seeking help is a sign of strength."
The university is making substantial efforts to encourage students to
identify and refer peers who may need services at the mental health clinic.
This year the clinic staff is attempting to make information sharing more
seamless while still being in compliance with both the Health Insurance
Portability and Accountability Act (HIPAA) and the Family Educational Rights
and Privacy Act (FERPA).
At the clinic the staff is moving toward more of a community mental health
model that is similar to case management. Dr. Hopkinson pointed out that while
the majority of mentally ill individuals do not, of course, become violent,
without appropriate mental health services being offered on campus, students
who need those services and do not pursue them may not be living up to their
full potential. She also noted that the number of students who have to leave
the university for mental health reasons is increasing, and improving their
re-entry process is very important.
While there are frustrations in working to provide the best care possible
for the students at the University of Maryland, Dr. Hopkinson said that she
greatly enjoys her work. College-age students have a lot of potential, and
most of them have good outcomes, she noted.
As for a career in the area of college mental health, she emphasized that
the college setting also provides for lots of therapy experience with
high-functioning patients and presents many opportunities to diagnose patients
at the onset of their illness. She noted as well that it is a great way to
gain considerable experience with adolescents, which most residents do not get
during training. Ultimately, mental health clinics on college campuses are a
rich setting in which to practice psychiatry and should be considered as a
possible career path by more psychiatrists. ▪