At Virginia Tech, Cho's parents were never told he was judged by a psychiatrist to be mentally ill (and ordered in a court hearing to outpatient treatment, which he never received). Now many colleges, including Virginia Tech, according to spokesman Larry Hincker, say they're making sure they follow through on troubled students asked to get psychological help.
Most legal scholars agree that colleges have the right to expect students to get mental health evaluations and treatments if there is cause, to contact parents and to ask students to withdraw if there is a documented concern about safety, says Bonnie, the University of Virginia law professor.
Medications have improved, allowing people who have bipolar disorder (manic depression) and even some with schizophrenia to get an education.
"Before, they would have stayed home," says John Greden of the Depression Center at the University of Michigan.
It can be a rough transition.
"They leave home, lose their support systems. If they had therapy at home, it's gone. Their workload increases, sleep is erratic, and they may be exposed to lots of alcohol."
Depression and bipolar disorder often surface for the first time during college, Greden says.
Students who feel they have nobody to confide in are most vulnerable to mental health problems, suggests a new study by University of Michigan researcher Daniel Eisenberg. Men are more at risk than women, though fewer men come to counseling centers, and minorities tend to be more isolated, his study shows.
Competition has turned ferocious for college-bound kids of every race, and that also is triggering mental health problems, suggests Susan Lipkins, a psychologist practicing in Port Washington, N.Y.
"They burn themselves out through high school trying to have a résumé much more impressive than adults have," Lipkins says. "It's become a culture of winner vs. loser, reflected in the reality shows. There's just more acceptance of demeaning, humiliating behavior if you're a loser."
Lipkins says the reported rates of students on psychiatric medicine, high as they are, are underestimated. "Most don't even tell the schools they're on meds," she says.
Susan Putnins, a senior at Harvard, came to college on medication for bipolar disorder and didn't tell anyone at the school.
"The transition was really hard. The biggest difference was, I had a fantastic support system of friends in high school. At Harvard I didn't." She has gradually made friends and learned to curb stress during exams.
In new surveys, students say they're most likely to share their anxieties and depression with other students. Efforts to raise students' awareness of mental health problems and the value of treatment are underway.
For example, cable channel mtvU has teamed with the Jed Foundation to run more than 8,000 public service announcements on the widely watched college network, says Courtney Knowles of the foundation.
They're also airing videos of popular musicians, such as Mary J. Bilge, talking about their mental health at halfofus.com. Troubled students can find links to counseling centers at a site created by Jed Foundation, ulifeline.org.
Active Minds, Inc. (activeminds.org) is a student group that sponsors activities to inform students about mental disorders and decrease stigma. Executive director Alison Malmon, 26, who founded the first chapter in 2001, says chapters are on 119 campuses.