Preventing Suicide Among College Students

As the second leading cause of death in college students after car accidents, suicide is a serious problem that can affect teenagers and young adults at an age when serious mental illness first manifests itself and often goes undiagnosed. A psychiatrist and an authority on suicide at Columbia University Medical Center and NewYork-Presbyterian Hospital offers parents and students advice on how to spot and address potentially suicidal behavior.

"College can be a difficult transition, with new independence, responsibilities and expectations arriving just as a student’s previous support system of family and friends are often not readily available. To add to the problem, the late teen years are often when biologically-based illnesses, such as depression and bipolar disorder, begin to manifest themselves. And students, who are new at asserting and managing their independence, can be especially reluctant to seek out help," says Dr. David Kahn, vice chair for clinical affairs for the Department of Psychiatry at NewYork-Presbyterian Hospital/Columbia University Medical Center. He is also clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and a staff member of the New York State Psychiatric Institute.

"While the warning signs of mental illness can be difficult to spot in the context of college where unusual sleeping patterns, experimental ‘phases,’ drug taking and binge drinking are common, there are several behaviors that should indicate that intervention is necessary," adds Dr. Kelly Posner, a leading expert in suicide research who helps the FDA and CDC on suicidality issues. She is an assistant professor of clinical psychiatry in the Division of Child and Adolescent Psychiatry at Columbia University College of Physicians and Surgeons and a child psychologist at NewYork-Presbyterian Hospital. She is also on staff at the New York State Psychiatric Institute.

Warning Signs
• Any signs of depression, such as sad mood, reduced interest and enjoyment in life and a sense of hopelessness.
• Withdrawing from friends and activities.
• Talking about suicide. This may be stated directly - "I’m going to kill myself." Or indirectly - "You would be better off without me," "I wish I were not alive any more," or "Soon you won’t have to worry about me anymore." Eight of 10 suicides verbalize their intention to commit suicide.
• Giving away possessions.
• Abrupt change in personality and behavior - including appearing sad, anxious or hostile most of the time or displaying unusual calmness after a loss or period of depression.
• Sudden drop in school performance.
• Dwelling on an academic or relationship setback or other loss of prestige or physical health.

"Virtually all college students who take their own lives had a diagnosable, treatable mental illness. The issues that lead to suicide are usually temporary - sadly suicide is permanent. If treated, these students will receive the necessary tools to manage their depression and develop coping mechanisms later in adult life," says Dr. Kahn. "When you suspect that someone might be considering suicide, trust your instincts and, as awkward as it might seem, reach out to them and ask them about their intentions. This is an important first step toward getting them the help they need."