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"The very effectiveness of modern treatment means that a lot of people who never would have made it into college are stable enough to go to universities," says Kay Redfield Jamison, a psychiatry professor at Johns Hopkins. "[Colleges] are dealing with a lot of kids who are very sick."
Campus counseling centers are, as a result, more overburdened than ever before. Designed primarily for short-term care, many of the centers, understaffed to begin with, are then hobbled with more patients than they can accommodate in already-slim time slots. "You have maybe 10 to 15 minutes per student, and it's very frustrating," says Nancy Schulte, a social worker at Virginia's George Mason University. "You barely have time to ask basic questions." Many students are referred off campus for treatment, and the college's counselors may lack the time--or the right--to check on them.
That was apparently the case with Daniel Shuster, a Brown University freshman who became depressed after his roommate died in a car accident. When Shuster sought help on campus, a Brown therapist gave him the names of four off-campus counseling providers, and Shuster chose a psychologist whose specialty was eating disorders. Two years later, Shuster fatally shot himself in the bathtub in his apartment. His mother, Susan Klein, sued Brown in 1993 for making a negligent referral. Last summer a Rhode Island Superior Court jury cleared Brown of any wrongdoing, saying its actions were not the direct cause of death. Klein is appealing that decision.
Some students blame not only inadequate counseling but also unsupportive campus environments for undergraduate mental-health problems. At Columbia, students complain about days-long waits for counseling appointments. One sophomore, who saw a fellow student, Andrea Melendez, fall eight stories to her death last month, was unable to do homework afterward. Yet he was denied an extension for a major paper due the next day. "I was told I'd had two weeks to work on it," he told TIME. In a recent editorial, the Columbia Daily Spectator demanded greater sensitivity for students' needs. "Students receive psychological support from a system that seems visible only after the death of a classmate," it said. "We need to look at whether there is enough counseling available before the tragedy to deal with the normal rigors of a Columbia day."
Some schools are taking these concerns to heart. In 1999, Harvard commissioned a broad study of its counseling services, which resulted in a larger budget, shorter waiting times for appointments and an information campaign aimed at helping faculty members spot troubled pupils. Dartmouth College, where the number of students admitting to psychiatric problems rose tenfold in the past three years, recently held a symposium on psychiatric health. And Columbia University officials, while declining to comment on any specific incidents, citing privacy laws, say counseling services and residence-life programs intended to support undergraduates have been substantially upgraded in the past five years.