Falling through the Cracks - VT and the Restructuring of College Mental Health Services

The following is more related to health care delivery than directly to PT...

I recently read an interesting article about the tragedy at Virginia Tech (VT) that occurred earlier this year and the state of college mental health services. The author begins by presenting the accounts of the young man who gunned down 27 students and 5 faculty members. She presents a number of situations that show his disturbed nature in his interactions with his peers and with a professor. He had a few incidents that led him to be admitted to a psychiatric hospital but it remains unclear if there was any follow up after this. What appears clear is "there was no clear way to screen [Cho] for reentry to VT" after his release from the psychiatric hospital.

This extreme case highlights what the author found to be recurring themes through a number of interviews with campus mental health experts from a number of universities: a lack of communication within the campus mental health system and a lack of understanding of privacy laws. "Experts differ about whether and when HIPAA applies" and the The Family Educational Rights and Privacy Act seems to often be misinterpreted to be more restricting than is intended. Hopefully, this unfortunate incident can serve as a catalyst to improve what is presented as a very broken system and help save lives in the future.

The article is a perspective piece that serves to point out a problem that needs to be fixed. Some suggestions are presented to avoid allowing students to "slip through the cracks" but it there are few current systems shown to be very effective. One such effective suicide prevention program was designed for the U.S. Air Force. Some of its success can be attributed to being championed by top generals which helps to overcome the possible stigma associated with mental health.

No matter which system is implemented at universities around the country it is clear communication needs to be more defined. One person should be responsible for each patient in the system, more staff is necessary to handle the magnitude of issues, and the privacy laws have to be made clearer. These gaps in the campus mental health system seem to reflect what is described by many as a broken medical system in the U.S. Personally, I believe there is no excuse for such a poor system and based on the research presented in this one article the politics need to be thrown out of the window to help create a system that works because it seems to be right at our fingertips.

Shuchman, M. (2007). Falling through the cracks - Virgina tech and the restructuring of college mental health services. The New England Journal of Medicine, 357 (2), 105-108.