Yesterday’s New York Times featured an article about a young man from
Hamilton College who took his own life. The story is very moving and at the
same time points out the flaws in our system of care. The article raises
broad issues inherent in the mental health system including concerns
regarding privacy and the lack of a systemic response to mental health
issues on college campuses. Much like we have found with schools through
our mental health education initiative, there are undoubtedly colleges
doing laudable work with mental health services and there are others that
barely have staff dedicated to these complex issues.

There is certainly greater awareness on college campuses and
organizations like The Jed Foundation and Active Minds have done an
incredible job with limited resources. There are several MHAs in New York
and other organizations that also do great work on college campuses. All
that said, much like New York is doing regarding mental health in schools,
a similar public policy need is necessary to address mental health
issues on college campuses. 

The article is attached.

His College Knew of His Despair. His Parents Didn’t, Until It Was Too Late.

By Anemona Hartocollis
– The New York Times

May 12, 2018


CLINTON, N.Y. — In the days after her son Graham hanged himself in his dormitory room at Hamilton College, Gina Burton went about settling his affairs in a blur of efficiency, her grief tinged with a nagging sense that something did not add up.

She fielded requests and sympathy notes from the college, promising the dean of students a copy of his obituary “so you can see how special Hamilton was to him.” This was why his suicide “makes no sense,” she added in a puzzled aside. The next day, Ms. Burton accepted condolences from the college president, and assured him “how right a choice Hamilton was” for her son.

But two weeks later, she read her son’s journal and everything changed. Mr. Burton, a sophomore, wrote that he was flunking three of his four classes and called himself a “failure with no life prospects.” He had struggled to sleep, missed classes, turned in assignments late. The college had known of his difficulty, he wrote, but had been slow to offer help and understanding.

“Would you care to shed some light on this?” Ms. Burton asked in an angry email sent at 2:53 a.m. to the academic dean, with copies to the president and the dean of students. “If this is what drove Graham, I don’t think I’ll be able to cope.”

Every year, parents send their children to college, trusting that they will be well, or that word will come if they are not. Ms. Burton had lived every parent’s nightmare: a child flunking out, sinking into despair, his parents the last to know. Her discovery set off a wave of pain and soul-searching but also a campaign to strip away some of the veils of confidentiality that colleges say protect the privacy and autonomy of students who are learning to be adults.

Suicide is the second-leading cause of death, after accidents, for college-age adults in the United States. The number of college students seeking treatment for anxiety and depression has risen sharply over the past few years, and schools have in turn stepped up their efforts in mental health research and intervention. Even so, families have continued to put pressure on them to take greater responsibility for students’ well-being.

In a case that was closely watched across the country, Massachusetts’s highest court ruled on Monday that M.I.T. could not be held responsible for the 2009 suicide of a graduate student. But the court ruled that a university might be liable under limited circumstances, such as when a student expressly tells college staff members of plans to commit suicide.

“I think everybody should be on notice that schools can’t hide their head in the sand,” a mental health lawyer, Carolyn Reinach Wolf, said. “They can’t say, ‘Students are on loan to us.’”

Professors at Hamilton College, in upstate New York, had expressed concerns about Mr. Burton for much of the fall term and knew he was in deep distress, according to a report on his death that was shown to The New York Times. More than a month before his death, his adviser, Maurice Isserman, wrote the academic dean the strongest of many warnings: “Obviously what’s happening here is a complete crash and burn. I don’t know what the procedures/rules are for contacting parents but if this was my kid, I’d want to know.”

Professor Isserman struck at the heart of what mattered to the Burtons: whether the college had a responsibility to tell them what it knew.

College officials say they are constrained by the Family Educational Rights and Privacy Act, or Ferpa, a federal law governing student privacy, in reaching out to parents. A Hamilton official cited it at a recent student assembly meeting, when students asked about the Burtons’ contention that they had not been told of their son’s troubles. The law views students as adults and bars parents from even the most basic student records, like a transcript, without their child’s consent.

There are exceptions: Colleges can release any student record to parents if the student signs a consent, if the college knows that a parent claims the child as a dependent on tax forms, or in a health or safety emergency. Even so, federal law allows colleges to use their discretion. They are allowed, but not required, to release the records or let a family member know if a student is suicidal.

Graham Burton was among the Hamilton College students who have died in recent years and are remembered on a wall on campus.

Colleges use the law not only to protect students’ privacy but also to shield the college from conflict with parents and other forces in society, said Brett Sokolow, a risk management consultant to universities.

“There is an ethos of maintaining privacy and confidentiality — which sometimes is very beneficial,” Mr. Sokolow said. “But when somebody’s dead, do you wish you’d worked to maintain their privacy, or do you wish you’d worked to keep them alive?”

As colleges contend with how involved to be in students’ lives, parents, too, often struggle with their responsibility to recognize when their children need help. Some Hamilton administrators said that they did not want to encourage helicopter parenting, and that parents were sometimes part of the problem.

“There’s a concern that if the school has too low a threshold for contacting family or suggesting a student take a leave of absence, it will actually discourage kids from coming forward for help,” said Dr. Victor Schwartz, the chief medical officer at the Jed Foundation, an advocacy group for student mental health. “So you’re basically walking a tightrope.”

Warning Signs

No matter how close parents are to their children, there is so much, especially of their internal lives, that they may not know about them.

Many parents are astonished to realize that they may never see a transcript of their child’s grades. If they are lucky, the college might send home a congratulatory note, to be tacked onto the refrigerator, about the child making the dean’s list. But parents, often referred to as “authorized payers” on tuition bills, are not likely to get a similar notification if a child is flunking, or seeking help for distress.

Even when the suicide threat is explicit, colleges have been reluctant to bring in parents.

In the spring of 2016, Olivia Kong, a junior at the University of Pennsylvania, had been barely sleeping, worried about not being able to drop a class she thought she would fail.

Ms. Kong called the university counseling center on April 7 and told the on-call psychiatrist that she was thinking of killing herself, according to a lawsuit filed by her parents last month against Penn, where 14 students have committed suicide since 2013. Later that day, she filed an electronic petition for late withdrawal from her class, writing: “I have had thoughts of suicide.”

That weekend, she went home to her parents, who live nearby in Philadelphia, and spoke to the same on-call psychiatrist. In his report, the psychiatrist wrote, “I offered that the cost of E.R. visit is likely less than cost of funeral arrangements.” He added, “Said that she had actually planned to return to campus Sunday and kill self.”

Ms. Kong did return to campus, and her parents went to check on her at about midnight Sunday, meeting her outside her dorm. Her mother felt her daughter’s forehead for fever and gave her some dumplings she had cooked for her.

The next morning, April 11, Ms. Kong walked into the dark tunnel of a commuter rail station and lay down on the tracks. The conductor could not stop in time.

“We still feel shocked,” her mother said last month in their lawyer’s office in Philadelphia. “The university, they know everything, but they didn’t tell us anything.” A spokesman for the university, Ron Ozio, declined to comment.

The warning signs in Mr. Burton’s case were murkier, all the more reason, Ms. Wolf, the mental health lawyer, said, that colleges should have a clear protocol for responding.

Xianguo Kong and Zhao Lin, the parents of a University of Pennsylvania student who committed suicide in 2016. They said they were not told that their daughter, Olivia Kong, had talked to counselors about wanting to kill herself.

Mr. Burton’s father, Stewart, an investment banker, and mother, Gina, who stayed home to raise their two boys and did volunteer work, had taken him to Hamilton with high hopes his freshman year, making the five-hour drive from their home in Toronto.

His nickname was Savage, and friends gravitated toward his humor and nonconformist style. He embraced his Canadian origin by wearing a plaid jacket and a red maple-leaf cap. In his last weeks, one friend recalled, he brought down the house at a student cafe with a hilariously dreadful rendition of the indie rock song “In the Aeroplane Over the Sea.”

He spent hours playing guitar and talking about life with his close friend, Max Phillipps, who lived across the hall their sophomore year. Mr. Phillipps recalled that Mr. Burton seemed extraordinarily creative at the time, writing plays and short stories and filling journals. But he also wore the same clothes every day and had erratic sleeping habits. “His expression was pretty melancholy,” Mr. Phillipps said. “I had to work to make him laugh.”

In hindsight, Mr. Phillipps added, “There were definitely signs.”

Some professors thought so, too. The report on Mr. Burton’s death showed that three of his four professors, his adviser and the academic dean had exchanged emails about his frequent absences from classes. The three professors submitted four academic warnings. Mr. Burton sometimes replied to their emails, opening with a polite “Hello,” always sounding distracted.

The youngest, Anne Feltovich, a Latin teacher in her 30s, was the most persistent and appeared the most empathetic. “Dear Graham,” she emailed him on Oct. 24, “You’ve dropped off the radar. How are you doing?” Later, she offered to give him an incomplete and to tutor him in Ovid and Livy by Skype over break. “Sending you support and strength from afar,” she wrote.

His adviser, Professor Isserman, at first dismissed Mr. Burton’s inattention to his studies as “his M.O., I’m afraid.” But he soon escalated his warnings.

On Nov. 2, Professor Isserman wrote to the academic dean, Vivyan Adair, that he had not been able to reach Mr. Burton, who he said was going through “a complete crash and burn.” About two weeks later, Mr. Burton wrote to Professor Feltovich that he had been meeting with the dean.

Asked about Mr. Burton this past week, Professor Adair said in an email that she had urged him “to speak to his parents about his academic issues and to seek help from the counseling center if he felt depressed.”

But she said that when she met with him, he appeared engaged in college, in his writing and in his social life. “My job was to work with him to resolve his academic issues, which I did,” Professor Adair said. “If I had perceived that he was at risk, I certainly would have taken additional steps.”

The report said there was no policy or practice that prevented staff from contacting the parents. But it said, “The pervasive impression of faculty and staff is that the college’s overall philosophy is to treat students as adults and allow them to take ownership of any issues they are facing.”

At about 1:30 a.m. on a day during finals week, Mr. Phillipps came back to his dorm from studying and found Mr. Burton wanting to talk. But Mr. Phillipps had a final exam in the morning and asked if it could wait.

When he returned from his final, at about 11 a.m. on Dec. 14, he opened Mr. Burton’s door and found him hanged by his belt, his feet inches from the floor.

“Every day of my life I think about it,” said Mr. Phillipps, who was given Mr. Burton’s guitar. “I do feel guilt at not being there at 1:30 a.m., maybe keeping him alive for another day.”

Ian Lunn, who is doing an independent study of suicide on campus, said he thought the wall of privacy between the administration and parents was too rigid.

Four business cards were found on Mr. Burton’s desk: one for someone at the counseling center; two from the academic dean, with the names of psychiatrists written on them; and one from a peer counselor.

He had never been placed on the college’s list of “Students of Concern,” the report said. “He was not on anyone’s radar, including the counseling center, other than through academic warnings, and had never been brought to the weekly S.O.C. meeting for discussion.”

A Wall of Privacy

The Burtons said they deserved at least the chance to try to save their son. “I can assure you that I would have been far more aggressive in getting Graham the help he needed,” Ms. Burton wrote to Hamilton’s president, David Wippman, after reading her son’s diary.

The Burtons were not totally unaware. In her emails to the college after his death, Ms. Burton said that she had made doctor’s appointments to look into his insomnia and that she had been talking to him about visiting the Amen Clinics, a psychiatric center, for brain scans. But she said he had talked about his classes and was looking forward to the future: going on a family ski trip, buying a used Subaru, getting a summer job.

Still grieving more than a year after their son’s death, the Burtons wrote an open letter to the Hamilton College community in March. Noting a second suicide nine months after their son’s, they said, “We do not believe the college has done enough in the wake of our son’s death to safeguard other students.”

Students shared the letter via email. One, Ian Lunn, said he thought the wall between the administration and parents was too rigid. “A lot of people feel, sure, tell my parents, I just don’t want to die,” said Mr. Lunn, who is doing an independent study of suicide on campus.

Drew McArthur, a classmate and friend of Mr. Burton’s, said he would resist signing a blanket waiver of his privacy. But, he added, “I would sign something that said, ‘In the event that people are worried about you.’ That may be subjective, but I would trust the college with that.”

The report recommended that the college adopt a more centralized case management system for students in distress. It also recommended “workshops on empathy.”

College officials declined to comment on Mr. Burton’s death, but said they had taken steps recommended by the report. They created a position, the associate dean of student support, filled by someone with mental health credentials. Faculty members are being trained to help recognize students in distress, with a separate committee following up with students of concern. The college also formed a coalition of faculty, staff and students, led by the associate dean, to try to reduce stress at the college.

Despite the changes, faculty members still are expected to contact a dean, not parents directly, when they are concerned about students, Terry Martinez, the dean of students, said.

In their open letter to the college, the Burtons asked for a mandatory process to notify parents “in circumstances where a professor, coach, adviser or other community member has concerns about a student’s well-being.”

They could not get over not knowing what the college had known. “The question that will haunt us forever is why didn’t she call us?” Ms. Burton wrote in an email to the college president, invoking the academic dean who had met with their son.

Hamilton was just a five-hour drive away, she wrote. They would have gone the same day, reassured him. They would have taken him home.

Susan Beachy contributed research.

A version of this article appears in print on May 13, 2018, on Page A1 of the New York edition with the headline: His College Saw Despair. His Parents Didn’t, Until It Was Too Late.

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