Suicide is the second leading cause of death among college students and 1,100 college students die by suicide each year. This article reviews some of the top recommendations in the field of college suicide prevention. These objectives can be implemented both on college campuses and in the general community.
"I was contemplating suicide and made my way to the roof of the tallest building on campus," is how the student began our session. My mind immediately flashed to the terrifying image of this student on the roof, 19 stories high. The student went on to describe that the previous year, he had also been depressed and on several occasions he had gone to that rooftop "to think." He reported that he enjoyed being alone on the roof, looking out over New York City. As he sat there, he contemplated suicide. On another occasion, the student went up to the roof, yet this time he found that the roof door was alarmed. Not wanting to trip the alarm and alert security about how he was feeling, he came instead to the counseling center to get help.
This incident, which occurred several years ago, confirmed for me that means restriction, which refers to reducing the availability of means for suicide, saves lives. The previous year, I had successfully lobbied to have all roofs on campus alarmed and properly monitored. This, along with other precautions, was put into place to help keep students safe. Those critical of means restriction efforts point out that if someone is determined to end his or her own life, he or she will find other means to do so. While definitely true, there are countless suicides that happen impulsively, without any real thought or planning, especially among the high school and college-aged populations. These suicides can potentially be prevented with means restriction. Even in pre-planned suicide attempts, if the method chosen is found to be less easily available, a critical window is created for the suicidal urges to diminish or for an attempt to be aborted or interrupted. Placing physical or temporal barriers between any suicidal individual and possible means for suicide, can be life saving. There are also individuals who envision how their suicide will look and when those specific plans are thwarted, they do not pursue other means. This New York Times Magazine article gives several poignant examples of means restriction having saved lives.
In September 2008, the Bulletin of the World Health Organization looked at suicide methods, and concluded that "restricting access to the means of suicide is more urgent and more technically feasible than ever." Means restriction should be a crucial component of any campus suicide prevention effort.
Another initiative that can save lives is gatekeeper training programs. Many students in emotional distress are not likely to seek out their university's counseling services for help; rather they are more likely to speak to a trusted coach, faculty member or resident advisor. When emotional concerns are raised in these non-clinical settings, most lay people are apprehensive about how to properly respond. Many offer false reassurance and others collude with the student's avoidance of seeking professional help. Gatekeeper training teaches university faculty and staff and others how to manage their own anxiety when faced with emotionally charged situations and to best respond to students in distress. This improves the likelihood that the sensitive "referral" conversation takes place and that appropriate referrals are made. The Yeshiva University-Supports Our Students (YU-SOS) gatekeeper training program is modeled after Campus Connect: A Suicide Prevention Training for Gatekeepers which was created by Cory Wallack, Ph.D. of the Syracuse University Counseling Center. It is listed on the Suicide Prevention Resource Center's (SPRC) Best Practices Registry for Suicide Prevention programs. Since 90 percent of people who take their own lives had exhibited some warning signs prior to their suicide, we need to guide others in our university communities to recognize these warning signs and properly respond when they encounter them.
In addition to the above initiatives, there are other strategies that help reduce suicide risk. Behavioral Intervention Teams and Students At-Risk committees identify vulnerable students, monitor their well-being and attempt to get them into treatment when appropriate. Advancing positive psychology concepts, along with promoting social networks and helping students develop better coping and life skills can also help prevent suicide. Active Minds on Campus is another impressive resource as a student run mental health awareness program, whose goals include decreasing stigma of mental illness and increasing student access to mental health care. At Yeshiva University, the Counseling Center and the YU chapter of Active Minds on Campus work closely on many events, which serve to educate the student body about mental health issues and to guide those in need for treatment.
While it is self evident that campus counseling centers should play a significant role in suicide prevention on campus, they cannot do it alone. Rather, successful suicide prevention requires the close collaboration and shared responsibility of many divisions of the university.
The Jed Foundation, the American Association for Suicidology and the Suicide Prevention Resource Center all have excellent information available on their websites to further guide those committed to suicide prevention.