Four Months After the Massacre, Lessons to Be Learned

Steps to Prevent a Tragedy

This state of affairs is dangerous and unacceptable. Therefore I would like to propose the following solutions that would untangle the current maze of legal and ethical issues that prevents colleges from helping students with mental illness get proper treatment.

As a condition for matriculation, require all students to sign a confidentiality waiver in case of any suicidal or violent ideation, as determined by student mental health (the imminent likelihood of danger of violent behavior is impossible to establish with any semblance of certainty).

Institute mandatory teaching and dormitory staff training in recognizing signs and symptoms of the three most common psychiatric illnesses that may lead to suicidal or violent behavior: schizophrenia, bipolar disorder and major depression. Training should include recognition of suicidal ideation and violent intent and should not take more than three to four hours.

Using a business model that mandates an evaluation by employee health for anybody who disrupts the work environment, require college staff to refer students with signs and symptoms of serious mental illness for an evaluation by student mental health services. Cooperation with mental health evaluation should not be optional if the student wishes to remain matriculated.

Allow student mental heath services to contact the families of all students with active suicidal and homicidal thoughts, even those that do not threaten to kill themselves or hurt somebody else in the near future.

With the advent of modern psychopharmacology, many more bright and highly functional students with mental illness will attend college. Therefore the issue of how to deal with mental illness on campus will become ever more important.

The stakes are very high and involve our children's lives.

At first glance the approach I have proposed may seem overprotective and excessively limiting of personal freedoms. But in reality it is less restrictive than those used by most business or nonprofit institutions. If implemented, it will save many student lives and reduce or eliminate the stigma of mental illness in the process.

Dr. Igor Galynker is director of the Bipolar Family Treatment Center and associate chairman for research at the Department of Psychiatry at Beth Israel Medical Center in New York.

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