Depression could be easier to detect on a small campus

The shootings in Blacksburg, Va., on April 16 offered a harsh wake-up call to the Virginia Tech campus staff of potential cracks in its emergency plans.

It also offered a slap in the face as to how colleges and universities do, or don't, work with students who have mental health issues. As student health nurse at Dickinson State University, Carrie Knudson said it may be easier to detect warning signs of depression on a smaller campus.

"Occasionally, people come in and say they're worried about their roommate, saying he or she never leaves the room" Knudson said. "I'll make the trip over."

Knudson evaluates a student she goes to see, or students who come to her office, by offering a depression screening. She said sometimes the results surprise the students.

The results aren't so surprising to Knudson, who said the first signs of depression often come out when people are college-aged.

"Students almost always...are very open and accommodating and say, 'Yes, I don't mind talking to someone,'" Knudson said. "Usually they're really open to going (to counseling)."

Knudson said if students are open to seeking help, they're referred to the Badlands Human Service Center located in Pulver Hall on the DSU campus.

"Ninety-nine percent of the time, (Badlands says) to bring them right in," Knudson said.

The Badlands Human Service Center works with the entire community, not just students, even though it is located on campus. Its services include counseling, psychology, psychiatry, aging, addiction evaluations and treatment and services to those with developmental disabilities, along with referrals.

"(People) can walk in at any time and be seen on an emergency basis," said Tina Pitts, human relations counselor at Badlands. "On an emergency basis, there isn't a fee."

Because DSU doesn't have either a full-time or part-time counselor, it does rely on Badlands' services to help students.

"My worst nightmare is that they hit capacity," said Dr. George McClellan, vice president for student development. "Through their hard work, they offer a tremendous service to the community."

DSU does, however, have a part-time wellness director, along with the part-time student nurse.

A new decade

Although DSU's student mental health policies have been working, the events at Virginia Tech caused McClellan and other staff to re-evaluate its protocols.

McClellan leads the campus Emergency Management Committee. During a regularly scheduled meeting last Wednesday, the group discussed its mental health policy.

"One thing is a lot of it's informal and one-on-one, but it's not cast in writing," McClellan said. "Our thought Wednesday was let's try to codify some of that. Again, keeping it simple."

McClellan already has guidelines in mind in talking with faculty, staff or resident assistants about students' mental health. He said it's important to listen and observe, be self-aware of their counseling limits, communicate those limits to students and help with referrals.

"If you're judging you're not counseling," McClellan said. "It doesn't mean you don't have an opinion, but it's not your job to judge."

McClellan also talked about the limits of confidentiality when it comes to students visiting with staff or resident assistants.

"The most dangerous question a student can ask is 'Can I tell you a secret?'" McClellan said. "The answer is, 'It depends.'"

He said if a student indicates to faculty, staff or RAs he may harm himself or others, they have to share that with a supervisor or law enforcement. McClellan said it is also important for them to take all statements seriously and report them.

McClellan said the university does a good job of raising awareness about drug and alcohol issues, eating disorders, gambling and more common physical health issues. He said there is less awareness on suicide prevention issues.

With the events in Blacksburg, McClellan said depression issues may move more to the forefront.

Knudson said the university does occasionally offer depression screenings on campus; however, they are rarely taken by students, so it's not done annually.

"One of the things to happen in higher education in my time is more people with mental issues can come to college," McClellan said.

He said with better medicines and understanding, more people are able to become and stay enrolled in college across the United States.

Making it mandatory

Knudson said students in most cases aren't forced into counseling. In an emergency, Knudson would rush students to Badlands, but if students' symptoms are milder she'd help them set up an appointment.

If a student did not want to seek counseling, Knudson could refer him/her to a medical doctor for anti-depressants. However, again, she can't ensure the student went.

"Usually, I try to do the whole trusting student relationship," Knudson said. "I call to check in on them and see how things are going."

She said her calling system isn't a written policy, but rather her own method for following through with patients.

Knudson and McClellan said there are some exceptions to voluntary counseling. Usually if a student has done something wrong, such as alcohol or drug activity, McClellan can make counseling a condition of the students' enrollment.

McClellan said in those instances, students sign releases allowing the university to know they've been going to counseling, but does not address the dialogue of the counseling.

Pitts at Badlands said if a client who is a potential harm to others came to the center, the staff would ensure that person is given the services he or she needs.

"This includes assessment as well as potentially calling law enforcement for assistance, or enlisting a friend or family member to help transport the individual to the hospital," Pitts said.

She said services at Badlands are voluntary, and staff can't force anyone to participate.

"If we feel someone could be harmful, we can get other services for them and those could be involuntary, like sending them to a hospital or the state hospital," Pitts said.