Colleges look for lessons in troubled case

Even before Cho was identified as the shooter at Virginia Tech, many experts and psychologists detailed a general profile that he came to fit almost perfectly. Among other characteristics, mass school shooters tend to be men with psychological wounds from an abusive or troubled past. They are loners whose final outburst is often triggered by a rejection, real or perceived.

Investigators had trouble finding information about Cho because of his extreme social alienation. In both of his plays published online, adult male authority figures are described as having sexually molested or raped teenage boys. Accusations that Cho stalked women may indicate that he felt slighted by a woman.

Patient confidentiality laws make it hard for mental-health workers to speak out, even if they see troubling signs.

"There's an inherent conflict in that, for a dean of students to know which students are most at risk, they need as much information as possible," says Christopher Overtree, director of the Psychological Services Center at the University of Massachusetts, Amherst. "But for individual students to have their rights to medical- and mental-health privacy protected, that information needs to be kept from the deans. So you have this tricky loop."

A few schools have been trying innovative programs to get around that difficulty.

Cornell University in Ithaca, N.Y., decided to offer informal counseling sessions from an office in the engineering department – an option that led to a sharp increase in the number of students taking advantage of counseling, particularly those who had avoided more traditional psychological services. Cornell psychologists also began assisting students with practical concerns, such as visa issues.

"A lot of people at risk of suicide or even violence are people who are under an acute stressor, a family stress or some other kind of environmental or contextual stressor," says Greg Eells, the university's director of counseling and psychological services. "Sometimes it's really about those very practical advocacy things.… If a few key steps can be taken by somebody who knows the system, it gets the student out of that place of hopelessness."

Other universities have focused on educating students about the options available to them – the sort McFarlane says he wished he'd known about.

The University of California at Berkeley is in the midst of a three-year training effort to teach faculty and students how to confront a problem student and direct him or her to services. George Washington University's Hamilton Fish Institute on School and Community Violence has conducted training for resident advisers in dorms on how to deal with violent or potentially violent students.

Few challenge the importance of a communal effort, but some wonder if offering counseling is enough.

"There is a chance that a troubled person might go to a counselor instead of picking up a gun, but the history suggests that rage shooters are probably not going to," says Mike Males, senior researcher for the Center on Juvenile Criminal Justice in San Francisco.

The Chicago Tribune reported that Cho was taking antidepressants, which would indicate that he'd had some psychological treatment. "Even when they've been treated and medicated, they have still gone out and committed horrific crimes," adds Mr. Males.

Meanwhile, statistics show that the likelihood of such an incident recurring is negligible. From 2003 to 2005, the US Department of Education's Office of Postsecondary Education reported only 27 homicides out of a population of 14.4 million undergraduates at four-year colleges across the nation.

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