If you are in crisis and would like to talk to someone, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text “HELLO” to the Crisis Text Line at 741741. Both services are free, confidential, and available 24/7.

This spring, after the third undergraduate student death at Dartmouth College in one academic year, Martha Aguirre began to notice a pattern in the emails the college sent to its grieving campus. They seemed to follow a template:

Name. Date of passing. Class. College and concentration. Achievements.

Frustrated by what she saw as inaction to address a cluster of suicides on campus, Aguirre, a rising senior, felt the emails’ formality was callous.

“What are you even talking about, dude? People are literally killing themselves,” she said of the emails.

The spate of deaths at Dartmouth left students like Aguirre looking for answers and reignited conversations about mental health in higher education. Other campuses have been grappling with similar tragedies during the past year: West Virginia University lost two students to suicide, and Cornell University saw five students die unexpectedly.

Clusters of suicides — multiple deaths in close proximity — have raised concerns of “suicide contagion” on campuses. Research has shown that exposure to suicide can increase suicidal behavior in others, especially those who are already at risk.

“It can happen at small places like Dartmouth [or] big places like the University of Washington,” said Kevin Kruger, president of Naspa: Student Affairs Administrators in Higher Education. “They’re even more tragic when you have a series of deaths like this because it really affects the community. Every institution ought to look at the root causes of this. We know that mental-health issues are a significant challenge.”

Experts say there are ways colleges can improve their suicide prevention and response protocols to help stop the tragic cycle.

“We have to think about overall prevention measures — giving students the skills, tools necessary to address some of the ups and downs of life,” Kruger said.

On November 19, 2020, Beau DuBray, an 18-year-old freshman from South Dakota, died by suicide, sending ripples across the 6,500-student Dartmouth campus.

Aguirre said DuBray’s death marked the first time her peers started talking about mental health.

“When you see 50 people sitting at the library, you think all those people are working. … And then you sit down, and you can’t seem to do your work, and you’re falling behind,” she said. “I think what I realized once the suicide of Beau was reported was that lots of people were faking it.”

Then, in March, another Dartmouth freshman died unexpectedly. Friends of Connor Tiffany, a 19-year-old from Virginia, told the Boston Globe his death was also a suicide.

Two more deaths came in quick succession. In April, Lamees Kareem, a 20-year-old junior from Saudi Arabia, died of a medical condition unrelated to Covid-19. And in May, Elizabeth Reimer, an 18-year-old freshman from New York, died by suicide after the college sent her home against her will following a previous suicide attempt and hospitalization.

Reimer’s death, Aguirre said, was the “breaking point” for the student body, which punctuated the academic year with makeshift vigils and graffiti outside the college president’s house.

In response to the suicides, Dartmouth officials relaxed coronavirus restrictions to allow students to gather; added new counselors, a wellness coordinator, and other staff to the health service; organized a vigil; extended deadlines for students to request courses be marked incomplete or not recorded at all; and partnered with the nonprofit Jed Foundation to develop programs and policies that support campus mental health.

But Aguirre and other students wanted the college to give them a day off to grieve together. The Dartmouth Student Assembly’s request for a day off from classes on the day of the vigil was rejected by the college, to the frustration of students.

Dartmouth College’s Office of Communications declined The Chronicle’s requests for interviews with campus officials.

While the Dartmouth administration’s responses to the suicides were in line with recommendations from mental-health professionals, so was the break students had called for. It can be difficult to strike a balance between allowing students to grieve and helping them move forward.

Experts say there are some critical actions colleges must take after a suicide to reduce the risk of contagion and to help people on the campus heal. One is to acknowledge the death of the person without adulating them or sensationalizing the suicide.

“Sometimes, there’s very public memorializing and a lot of outward expressions,” said Mitchell J. Prinstein, Ph.D., chief science officer at the American Psychological Association. “It tends to raise the person’s status and profile … and then vulnerable individuals who seek to feel that they’re accepted by their peers in the same way … are at risk for engaging in suicidal behavior in order to get the same kind of response.”

The Centers for Disease Control and Prevention advises that a response team pair those who may be at high risk of attempting suicide with a counselor for a screening interview, reduce access to common methods of suicide, and promote suicide crisis centers and hotlines. Dr. Ryan Patel, chair of the mental-health section of the American College Health Association and a senior staff psychiatrist at Ohio State University, said incorporating mental-health breaks into the academic calendar can be helpful.

“This situation of multiple deaths by suicide over a short time period has occurred in many communities and some campuses nationwide over the years, and what we have learned is that it affects the health of the entire student community, faculty, staff, everybody,” Patel said. “It is very devastating for institutions to experience that.”

Preventing suicide, Patel said, requires a great deal of self-reflection.

“We need to address the entire system,” Patel said. “So many campuses have, as a result of this, doubled efforts in creating a culture of care, where everybody is a stakeholder.”

Calculating the reach of a suicide cluster — let alone one person’s death — on a college campus is difficult. But recent data show just how common suicidal behavior and, less frequently, attempts are at colleges.

In a fall 2020 survey of 13,000 college students by the American College Health Association, about one in five screened positive for suicidal behavior. About 2 percent of students indicated they had attempted suicide in the previous year.

The survey also showed that nearly one in four college students had been affected by someone else’s death (from any cause) in the past year. Among those affected, 75 percent said it had caused them moderate or high distress.

With these numbers in mind, many colleges have invested in prevention measures, said Kruger, Naspa’s president.

“A lot of effort has been … around wellness programming and nutrition and sleep and stress-management programs like that, which don’t solve the most serious psychological issues for a student, perhaps, who has suicidal ideation,” he said. “But they do address a wider range of students who are struggling with the kinds of psychological issues you’d expect in early adolescence that crop up — anxiety, depression, those kinds of issues.”

Prinstein said some colleges are not sure how much to delve into the mental-health sphere.

“There’s a lot of ways in which universities give somewhat mixed messages about how much people should be talking about mental health,” he said.

That results, he said, in a lack of training for faculty to discuss mental health with students.

A spring survey of 1,685 faculty members by the Boston University School of Public Health, the Healthy Minds Network, and the Mary Christie Foundation showed that nearly eight out of 10 professors had spoken one-on-one with a student about mental health during the past year. Yet less than 30 percent of faculty members surveyed said they had received training from their colleges to have such conversations.

Nearly 70 percent of professors said they wanted to better understand student mental health and would like more training.

At West Virginia University, the dean of students said faculty interest in training has soared recently as mental health has secured a prominent seat in the national conversation.

The university’s earlier attempts at providing mental-health training had “not had a whole lot of faculty participate because they’re optional,” said G. Corey Farris, the dean. “But I will tell you in the past year or so when we’ve offered them, the interest has skyrocketed. … There’s been a whole lot more participation by those faculty.”

Additionally, Farris said, many faculty, staff, and students have become certified in mentalhealth first aid, which teaches risk factors and warning signs for mental-health and addiction issues, as well as skills for helping people in crisis.

For students, the training can be particularly important for spotting warning signs in their friends and peers. According to Active Minds — a nonprofit organization focused on young people’s mental health — 67 percent of young adults tell a friend they are feeling suicidal before anyone else.

At West Virginia, anger over campus leadership’s response to the suicides of two students in the past year led to protests and social-media uproar.

In July 2020, Eric Domanico, a rising sophomore from South Lyon, Mich., died at home. In April, Benjamin Pravecek, a 20-year-old student from Harpers Ferry, W.Va., fell to his death from a parking garage. A tweet from the official university account read: “You are valued. You are loved. You are needed.” The post listed several mental-health hotlines, and it received a flurry of frustrated replies.

“Before the first death, the problem wasn’t really discussed by students, or the university,” said Logan Riffey, a rising junior and president of WVU’s Active Minds chapter. “And then afterwards it became a hot topic, the main issue for many students.” Enough of an issue, he said, to organize a protest.

Central to WVU students’ complaints were the perceived shortcomings of the university’s Carruth Center, which provides mental-health services. Like most psychological-treatment centers on most campuses, it is intended for short-term care only. Those with more severe mental-health issues, such as suicidal thoughts, often need extended care.

Campus leaders say they’re listening and making changes in a long-term effort to bolster the Morgantown institution’s mental-health services. In the fall, the university will be rolling out Healthy Minds University, a long-term mental-health clinic. Services will include psychiatric care, case management, and therapy, WVU officials said.

The clinic is not affiliated with the Healthy Minds Network, which researches mental health on college campuses and is housed at the University of Michigan.

Dr. T. Anne Hawkins, director of the Carruth Center, said she was aware of only one other institution that had introduced a similar program: the University of Southern California, which in 2019 added a fifth floor to its student-health center and dedicated it to long-term therapy. The WVU program has been in the works for three years, Hawkins said. In early March of last year, E. Gordon Gee, WVU’s president, announced the Carruth Center would receive a budget increase to support the hiring of five new positions, the creation of a crisis text line, and other initiatives.

Treatment costs at the long-term clinic will be billed to students’ insurance, Hawkins said. Care at the Carruth Center is subsidized by a mental-health fee — $12 per student starting next semester.

The goal, she said, is to consolidate students’ care to ensure that what they receive is multidisciplinary.

“What we really wanted to do was to keep them in the WVU family,” she said. “We wanted to be able to provide support in a way so that we could close all loops.”

Prinstein, a professor of psychology and neuroscience at the University of North Carolina at Chapel Hill, said college students want to be understood as a “whole person,” and the multidisciplinary approach can help providers achieve that understanding.

“College students want an adult on campus that knows that knows their name and cares about them,” he said. “Period. Not just someone who they see in classrooms, but someone that has their back, and is not just going to ask them about their grades but understands kids are experiencing that in the context of romantic relationships, breakups, in the context of their parents, roommate struggles, and is interested in them as a whole person.”

In college, he said, there’s a tendency to segment needs to various offices such that students feel like no one understands how the pieces of their humanity coalesce and collide.

“Everyone knows a piece of the student,” he said. “But what college students want is someone that knows the whole them and understands that all these pieces interconnect.”


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