Suicide on Campus

Two long months have passed and the door to the room where Paul Wilfong lived at the N.C. School of the Arts remains locked, the shades closed.

On Thanksgiving night, Wilfong, 22, a fourth-year student in modern dance, turned down dinner invitations from friends, cleaned his room, made one last try at calling his mother on her cellular phone, and, in the silence of the deserted campus, hanged himself in his room.

On the small NCSA campus, the painful, ultimately unanswerable, question persists: Why didn’t we see?

No one, it seems, recognized the extent of the turmoil that Wilfong apparently kept locked inside his mind. Classmates and teachers knew him as a handsome dancer who relentlessly pursued the perfection of his form. Intensely private, he kept even his friends at arm’s length.

Now, in the aftermath of his death, they have been left to second-guess their own relationships with him, to read new meaning into the offhand comment he made here or the isolated incident there – and finally, to try to make peace with his death.

“We spent countless hours together, and that’s what makes it all the more confusing,” said Trish Casey, one of Wilfong’s dance instructors. “How could we not have seen? That’s the biggest question, and the one that’s hardest to hold in our minds.”

Though the school offers counseling services, Wilfong never attempted to take advantage of them, officials say. Nothing known about his life signaled him as someone at risk for suicide.

“We never got a chance to help him,” said Chris Burris, the director of counseling at NCSA.

Suicide is the second-leading cause of death among traditional-age college students, behind auto accidents. The estimated number, 1,100 a year nationwide, is relatively low. But in an era when more people with identified psychological problems go to college – and more parents with grievances go to court – schools are paying increased attention to the issue.

They are committing additional resources to psychological services, but in doing so confront the question of how much responsibility they can, or should, take for their students’ lives. Moreover, there’s the hard reality that even well-designed programs or highly trained staff don’t always stop a suicide.

“One of the things that has yet to be well-defined is what kinds of initiatives are going to be effective for the prevention of suicide,” said Allan J. Schwartz, an associate professor at the University of Rochester who researches college suicide.

“We’ve got to do something – or at least we’ve got to find out if we can do something about it. Let’s not sit here and say, ‘Oh well, it’s always been that way,’” he said.

Rate is below general population
The suicide rate among college students is about half that of the general population, according to several long-term studies. It has been stable since the late 1970s, when it peaked.

“No data indicates that rates are getting any better, either … and that’s reason enough we should do something about it,” Schwartz said. The rate is lower among students than in the general population, he said, because guns are banned on most college campuses.

Campus counseling centers have, nonetheless, seen an upturn in the number of students wanting services, said Michelle Pruett-Nostheide, a spokeswoman for the National Mental Health Association.

“It’s a huge problem before you even get to the (serious) mental-health disorders,” she said. “We’re definitely seeing more people having trouble.”

About 80 percent of college counselors responding to a national survey in 2000 reported seeing more students with severe psychological problems. A new study at Kansas State University found a doubling of the number of students seen for depression and a tripling of students expressing suicidal thoughts between 1989 and 2001.

The availability of anti-depressants and other psychiatric treatment has enabled more students diagnosed with mental illnesses to attend college. The Americans with Disabilities Act requires that schools admit them if they meet admissions standards and give them “reasonable accommodation” to make academic progress.

Some say that suicide prevention requires no less than a cultural shift on campus, starting with top administrators.

“You can’t just find needles in a haystack, but if you have a culture of prevention, you have a chance to uncover problems,” said Phil Satow, the president of the Jed Foundation, an organization that he founded after his son, Jed, committed suicide at the University of Arizona in 1998.

Suzanne Williams, the director of counseling at Salem College, has a simple way of expressing her approach to breaking the stigma around mental- health issues on campus.

“Talk, talk, talk, talk, talk to students, in every arena you can,” Williams said. “You can set brochures out and do screenings … but I think the relationship and continuing to talk is the most important thing.”

At the same time, overselling the promise to help troubled students could create the impression that schools are responsible for things that are beyond their control, thereby exposing them to legal action.

Schools around the country are awaiting the outcome of a $27 million wrongful-death lawsuit against the Massachusetts Institute of Technology filed by the parents of Elizabeth Shin, who set herself on fire in her MIT dorm room in 2000. Shin had had contact with the university’s counseling services and was known to have been suicidal. The family alleges that MIT was negligent and failed to follow its own policies.

“A return to in loco parentis is taking root with a pretty substantial litigiousness on the part of parents,” Schwartz said, referring to the philosophy that colleges assume a parent’s place in the student’s life. “If you’re a parent, a child’s well-being is your No. 1 concern. The more the institution agrees that it’s going to take on the parental role, the more untenable it’s going to be.”

But Satow said that previous case law indicates that colleges are liable only if they caused the suicide or were willfully negligent.

“If they have an active program to prevent suicide and use a variety of interventions, case law said they wouldn’t be considered liable,” he said.

Student confidentiality is also an issue, he said. Many students fear that asking for help will jeopardize their academic careers or social standing. Sometimes, they avoid the counseling office for fear that the school will notify their parents. Administrators are sometimes reluctant to tell parents of a suicide attempt, fearing that it may violate a student’s right to privacy under the federal Family Educational Rights and Privacy Act. But in the case of a suicide threat or suicidal behaviors, the law says that confidentiality must go out the window, Williams said.

“You’re walking the line between student privacy and informed family members. It’s a very hard thing to do. But I always have to weigh as a mental- health professional, what can I live with?’ she said.

Strategies to prevent suicide
Just three weeks before Wilfong’s suicide, Bill Donohue, the vice chancellor of student life, sat down with his staff to go through a checklist of strategies for preventing suicide on campus.

The checklist was part of a study published by the Jed Foundation. It advised schools to implement screening programs that catch students whose behavior might indicate depression, and create educational programs for students, faculty and advisers. It also recommended that schools have stress-reduction programs, emergency services and an emergency plan for dealing with the aftermath of a student suicide.

On paper, it seemed that the arts school was doing everything right.

Donohue tries to emphasize that everyone on campus, from the cafeteria workers to the instructors, is responsible for spotting students who might be in trouble. By its very nature, Donohue said, an arts education subjects students to a very stressful schedule and criticism from teachers.

“We hold them close – real close, and there are some things we invade. I’m going to guess that – and I’m only projecting – that we’ll listen more carefully when people tell us things … we’ll respond more personally when we feel disengagement. I’m guessing that any family or community would do that naturally.”

Teachers are often the first ones to notice when a student’s performance is slipping because of emotional problems, and they are supposed to refer them to counseling, said Susan McCullough, the dean of the school of dance.

But, she said, “Paul wouldn’t have been in that category.”

“A” student with self-discipline
Even among his driven peers in the dance program, Wilfong’s self-discipline and persistence stood out. An A student, he was often the last one to leave the studio or the first one to get to the gym in the morning. But he was also often the first to criticize his performance and ability.

“When he got here, he hadn’t had a lot of previous dance training. This place cultivated all that – that the place could shape his body as a dancer,” said Kashanna Brown, a third-year dance student and one of Wilfong’s closest friends at the school.< "You would give him compliments, he would say, 'Thank you.' I don't think he believed it. He was a beautiful mover, a beautiful dancer," Brown said. Four days before his death, Wilfong had finished performing two lead roles in the fall dance recital. He was working on his senior projects and talking of graduate school. On the outside, everything seemed to be going his way. "We saw his potential. He would have seen it eventually. He was at the brink of a major breakthrough - he was there," Brown said. Wilfong was guarded about his personal life and feelings, she said. No one among his group of friends apparently thought he was at risk for suicide. "You just didn't know because the exterior was so beautiful," Brown said. "It's a lot of that not knowing - that's what hurts - of what was really wrong," she said. "If he'd come to any one of us, we would have helped him because he was part of our family. He was our brother." Brown went to Indianapolis, Wilfong's hometown, for the funeral. She keeps a picture of him at her bedside and still wears a loop of red and yellow ribbon that students made for his memorial service. "He's everywhere," she said. "There's not one moment in the day that he doesn't cross my mind. I'll be in dance class and I'll feel his absence." Brown and others who cared about Wilfong are slowly coming to terms with the reality that they may never fully understand what was going on in his mind. On campus, officials say that it is time to heal and to try to move on: They plan to open Wilfong's old room to a new student soon. Wilfong's mother, Kathleen Harman, said that in hindsight, she sees the clues that her son was deeply troubled. When they spoke a few days before Thanksgiving, Wilfong seemed very sad, but Harman attributed it to relationship troubles with his girlfriend, who lives in Taiwan. "He didn't use the word 'depressed,' but I thought he was sad," she said. "If I could have seen his face, I would have known." Harman doesn't think that school officials failed Wilfong. "They had no idea," she said. "The love they gave to my son on that campus - a parent couldn't ask for more. "You pray that they step out and ask for help when they need it instead of hiding it.... The bottom line is that Paul made a choice. It breaks my heart and I don't understand it and I never will." Published February 6, 2003 in the Winston-Salem Journal