Anne Giedinghagen wanted desperately to stay in school. Having struggled with depression and anorexia since the sixth grade, the rail-thin Cornell junior was meeting regularly with a therapist at the university's counseling center in Ithaca, N.Y. But late last fall, when she told her therapist about her increasingly strong urge to kill herself, Giedinghagen received an ultimatum from the school she loved so much: she had to get better or she would have to leave. So she did what any crafty 20-year-old would do. She tried to carve out a third option--feigning improvement by, as she put it, acting "as normal as I could." When she agreed to spend her winter break at a psychiatric hospital, the university stopped threatening to kick her out. But afterward, says Giedinghagen, "I felt like I had to hide how I was doing from my doctor, my counselor, my nutritionist, so that I could stay."
Giedinghagen is one of thousands of troubled college students who each year are forced to make such stark choices. With two recent court rulings holding that college administrators may be held partly responsible for student suicides--which total some 1,100 a year nationwide, making suicide the second leading cause of death among college students, after motor-vehicle accidents--many universities have hastily adopted mandatory-leave policies in an effort to reduce the risk of self-inflicted, on-campus deaths. But a tragic result, say psychiatrists and student advocates, is that emotionally distressed students may be less willing to come forward and get the professional help they need.
Another unintended consequence: hypervigilant colleges are getting sued by students who allege they are being discriminated against for being mentally unstable. The U.S. Department of Education last year warned at least a handful of schools that receive federal aid that the Americans with Disabilities Act protects people with mental problems. Several students who were suspended after threatening to commit suicide are in the process of suing their schools; others have been offered settlements before their cases reached the courts. In a sign of just how flummoxed the world of higher education has become over the issue of suicide, United Educators, which insures more than 1,100 colleges and secondary schools, issued a bulletin last month noting that when dealing with emotionally distressed students, schools are left "with the quandary of being sued no matter what they do."
That is particularly alarming since the number of students diagnosed as mentally fragile appears to be rising. The 2005 National Survey of Counseling Directors, conducted by the University of Pittsburgh, found that 95% of directors reported an increase in the number of freshmen who arrive on campus already taking psychiatric medicines. "A lot of students who may not have gone to college five years ago are able to attend today because their illness has been recognized earlier and they are on medication," says Joanna Locke, a program officer at the Jed Foundation, a New York City--based college suicide-prevention and outreach program.