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Colleges target mental health

Campus groups, courses, online services help reduce the stigma of treatment

At the Massachusetts Institute of Technology, trained students staff an all-night hot line that fellow students call to talk about everything from stress to suicidal depression. When Harvard University offered free iPods at a depression screening, about 800 students showed up to fill out mental health surveys. Brandeis University students recently gathered for a movie night focusing on depression on campus. One film's title: ''The Truth About Suicide: Real Stories of Depression in College."

In the Boston area and throughout the country, colleges have expanded efforts to educate students about mental illness and provide treatment. Many schools have increased staffing at counseling centers. Others have developed courses on dealing with stress, added depression screening days, offered students online help, and undertaken an array of efforts to reduce the stigma associated with mental illness.

Highly publicized campus suicides and research showing an alarming prevalence of mental illness on campuses have heightened the sense of urgency. The reality of rampant mental illness on campus shatters the notion of college as a carefree time when the biggest worries are passing finals and finding a date. For many students, dark shadows shroud the sheltered nest of academe.

More than 40 percent of US students become so depressed during their four years in college that they have trouble functioning, while 15 percent suffer clinical depression, according to a 2004 survey of 47,202 students by the American College Health Association. The annual survey found that 1 in 10 college students had seriously considered suicide, the second-leading cause of death among college students, claiming about 1,100 lives a year.

Richard Kadison, Harvard's chief of mental health services, offers a sobering reality check to parents of incoming students: ''I tell them, 'Look at the person next to you. One of your kids is going to get depressed to the point they can't function in college. There's no shame in that. The only shame is if you don't recognize the problem and do something about it.' "

Specialists have long known that the onset of mental illness often comes during adolescence or early adulthood. Living away from home, often for the first time, compounds stress and anxiety. So, too, does pressure to succeed in an increasingly competitive climate on campus.

Because of the use of antidepressants, many youngsters who wouldn't have been able to attend college in the past now do so. That forces schools to deal with more students struggling with more severe mental illness.

Despite the pervasiveness of mental illness on campus, specialists say, one of the toughest challenges remains overcoming stigmas that keep students from seeking treatment. In fact, more than a third of college students who committed suicide had never sought treatment, said Kadison, co-author of ''College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It."

''The most frustrating thing for most of us in the field is trying to get students in the door; that's the hard part," Kadison said. ''When a student is in distress, you have a brief window of opportunity to help them."

Brian Malmon was a student who suffered in silence. At Columbia University, he made the dean's list every semester, wrote and edited for the campus newspaper, and led an a cappella singing group. Friends and relatives remember that others leaned on him when they struggled. He comforted people. He made people laugh.

During his three years at Columbia, nobody knew about the voices that existed only in his mind or about the darkness that enveloped him. He hid his schizophrenia and depression well before he was diagnosed in the fall of his senior year. Then, on March 24, 2000, at his family's home in Maryland, he squeezed the trigger of a handgun and ended his life.

Since then, his sister, Alison Malmon, has made it her mission to help spare others the horrific pain her brother and all those who loved him suffered. Malmon, a 23-year-old graduate of the University of Pennsylvania, founded the nonprofit Active Minds on Campus, which aims to build awareness about mental illness on campus and reduce the stigma associated with it. A fledgling chapter has started at Brandeis in Waltham.

''Brian was just trying his hardest to hide his illness from as many people as he could," she said. ''I think part of him just felt like it was his fault."

Active Minds works hard to dispel such misconceptions. The group reaches students through its chapters and a website,, which includes mental health screening and links to other sites to help those with mental illness.

For its mental health movie night, members of the Brandeis chapter covered the walls of a room on campus with facts about mental illness and quotes from famous people who suffered depression. The group also set up tables on campus and passed out silver ribbons, a symbol of mental illness.

Michelle Schlesinger, the Brandeis freshman who started the chapter, has suffered depression, and she said eliminating the stigma will ease the suffering of others. ''When one person starts talking and breaks the silence," she said, ''it breaks the stigma. And people start to realize anyone can have depression."

Like Active Minds, the Jed Foundation strives to strengthen the safety net for at-risk students. The foundation, the first nonprofit group dedicated solely to reducing suicide on college campuses, grew out of a family's painful loss: Jed Satow, a University of Arizona student, killed himself in 1998 at the age of 20.

Colleges nationwide have tried to help troubled students before they're in crisis.

Harvard hired more therapists within the past five years, and this school year added a new high-level position to oversee and better coordinate disparate mental health services the university had termed fragmented ''fiefdoms."

At MIT, teams of physicians and counselors hang out with students in the dorms. And some of the dorms have been redesigned to foster more interaction and less isolation. ''Having staff available and present goes a long way toward demystifying the whole idea of mental health and psychological problems," said Alan E. Siegel, chief of the Mental Health Service at MIT.

Columbia, Cornell, and New York University station counselors in dorms. Harvard sends to dorms ''wellness-resource tutors" who help students deal with issues from procrastination and stress to depression. Some schools, including MIT, offer stress-reduction and relaxation techniques such as yoga, meditation, and tai chi.

Emory University, the University of North Carolina, and MIT ask students to fill out anonymous mental health questionnaires. A credited course at the University of Maryland helps freshmen deal with stress and time management. Now about two-thirds of the nation's schools offer such courses.

At Tufts University, Jonathan Slavin, director of the counseling center, said the campus has reduced the stigma associated with mental illness to the point that 750 of 6,000 undergraduates have received counseling. ''If you can make a counseling service commonplace and ordinary, and students can just drop by," he said, ''that is the best prevention. That means you made the place something other than this kind of scary, mysterious place you got to be crazy to go to."

But despite progress, specialists say, huge gaps in treatment on campuses remain.

Such concerns have spread from campuses to Capitol Hill. Lawmakers approved $82 million in federal funding last fall for programs to prevent youth suicide, including $15 million in grants for mental health programs at colleges and universities.

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