Suicide protocol sparks debate in U.S.

Simon Husted

Mental health issues could lead to deregistration

When a George Washington University student sought help for depression and suicidal thoughts at his university’s hospital, he was barred from campus the following day and threatened with expulsion and other disciplinary charges unless he withdrew from the university to receive treatment.

When a George Washington University student sought help for depression and suicidal thoughts at his university’s hospital, he was barred from campus the following day and threatened with expulsion and other disciplinary charges unless he withdrew from the university to receive treatment.

The student received a letter from administrators stating that he engaged in “endangering behavior” the day of his mental breakdown in 2004. The student withdrew and filed a lawsuit claiming GWU officials infringed against his rights provided in the American Disabilities Act, the Rehabilitation Act, and the D.C. Human Rights Act. The case was later settled out of court in 2006 for an undisclosed amount of money.

This incident at a private university in Washington D.C. ignited a controversy for all universities that enforce mandatory dismissal because of mental health issues. The policies raise concerns over patient privacy and the resulting mental effects of deregistration.

Kent State University has a policy of its own that gives the Vice President of Enrollment Management and Student Affairs the authority, under the advisement of a licensed psychologist, to deregister a student if he or she is deemed to be a threat to him or herself.

However, Greg Jarvie, interim vice president of Enrollment Management and Student Affairs, said the policy is rarely acted on. When it is used, he said it’s carefully done so as not to harm the troubled student.

“I really do believe we do everything we can and try every type of intervention prior to implementing this policy,” Jarvie said.

The policy is not aimed at all students who experience thoughts of suicide or exhibit suicidal behavior, Jarvie said. Many students may admit to a psychologist they have had suicidal thoughts in the past, which is not what this policy targets at all, he said. But when a student says he or she is having thoughts of killing himself or herself now, serious action needs to be taken.

“What does that mean?” he said. “I’m going to kill myself after this session?”

Jarvie said the university has a responsibility to act in this situation, whether that means getting the student help or in the more rare, serious cases, deregistering a student.

“Does it happen very often?” Jarvie said. “No, it doesn’t. But it can happen, and we would be remorseful if we did not take action for that.”

No record exists of the number of students involuntarily deregistered by Kent State, Jarvie said, but he recollects between two or three students involuntarily deregistered in the 10 years he has worked for Enrollment Management and Student Affairs.

Similar policies limited by law in Virginia

One state in particular has passed strong protections for suicidal students so that the GWU incident does not repeat itself there.

In 2007, Virginia was the first state and is still the only state to pass a bill restricting a public university’s policymaking to “ensure that no student is penalized or expelled solely for attempting to commit suicide, or seeking mental health treatment for suicidal thoughts or behaviors.”

House Bill 3064 passed without a single vote against it in either chamber, said Kirsten Nelson, director of communications and government relations at the State Council for Higher Education.

“It was a very popular bill,” Nelson said.

The law requires public universities in Virginia to write policies addressing the different types of suicidal behavior, said Nelson.

“The policies have to have many, many layers,” she said.

Since February, the Student Press Law Center has filed public record requests at seven public universities in Virginia. Out of the four that responded back: University of Virginia, Virginia Commonwealth University, William and Mary University and Virginia Tech; none said their institution held any policy giving administrators power to mandate the deregistration of a student for suicidal behavior.

Student’s rights to confidentiality and HIPAA

The decision of whether a student is healthy enough to stay at school rests with two parties: Jarvie and one or more licensed psychologist.

When a student is not dangerously violent or hospitalized off campus, the second party is typically a psychologist from Psychological Services, said Pamela Farer-Singleton, the chief psychologist at Psychological Services.

Although the university administrator and the student’s psychologist must communicate in the decision-making process, Farer-Singleton said no medical information is shared, including anything that would infringe on the Health Information Privacy and Accountability Act (HIPAA). The only information offered by a psychologist at Psychological Services is a recommendation of whether a student is healthy enough to stay at school, she said.

Nevertheless, Karen Bower, senior attorney at the Washington, D.C.-based Bazelon Center for Mental Health Law, said any discussion about a patient’s mental health without his or her permission is a breach of professional ethics.

A mental health professional is only required by law to inform an authority of a client’s mental health status is if that professional has reason to believe his or her patient intends to harm someone else, Bower said, citing the duty to protect law in Ohio and other states.

Bower said she was most troubled by the first sentence in Kent State University’s policy where it reads: “When in the professional judgment of a licensed psychologist, withdrawal from the university is necessary and in the best interest of the student and the university, a discussion shall occur…to examine alternatives to the situation.”

Bower said no psychologist should include the interests of a university before making his or her decision on the well-being of a student.

“It seems to me that the psychologist has a conflict of interest looking at the interests of the student and the university,” she said.

Follow-up after student is deregistered

Aside from contacting parents and family of the deregistered student, Jarvie said he makes an effort to recommend a student to a health facility. Whether or not the student goes is up to him or her.

Kent State does not keep any records or statistics of any students after they are deregistered, Jarvie said.

If Kent State began keeping tabs on students who were involuntarily deregistered for mental health reasons, Jarvie said it might lead Kent State to be required to do the same for other former students, such as ones forced to leave for poor academic performance.

“I don’t think it’s appropriate, and I don’t see any reason for it to be honest,” he said.

Senior attorney Karen Bower said there are many risks involved when a mentally ill student is deregistered from a university. Not only can a student lose a support network of classmates, faculty and staff, but Bower said a student’s health insurance could be in jeopardy if he or she is forced to leave school.

She isn’t familiar with any student deregistered at Kent State, but Bower said she’s represented and talked to numerous students who fell under mandatory leave, including the student at GWU. Many of the students told her they felt betrayed by their school.

“The schools said they cared about them but no one followed up on them,” Bower said.

The only time Kent State enters back into the student’s life is when the student asks to return, Jarvie said.

Unlike expulsion, involuntary deregistration allows the student to ask the vice president of enrollment management and student affairs to re-register. The student must submit a letter and be given an OK from a licensed psychologist, which would be reviewed by someone from Psychological Services.

“Our expectation is to bring them back,” Jarvie said. “We’re not looking to exclude the student from the university.”

Contact safety reporter Simon Husted at [email protected].