When a student's in trouble, should parents know?

For many parents, the issue is what their children might call a no-brainer: If their offspring has stalked a peer or stayed in a mental-health clinic or been watched for suicidal inclinations at college, they want to know. Immediately.

Yet parents may be among the last people to be told of any concerns. Because of strict confidentiality laws, such problems cannot be reported to parents – or roommates or others close to a young adult in trouble.

The laws, say counselors and mental-health experts, are there for good reason. Without them, few students would seek help, and a trusting relationship could be impossible.

But such legal constraints – particularly in the wake of the killing of 33 students and staff at Virginia Tech – are deeply distressing to many parents who harbor a sense of love as well as responsibility for children they may see as not yet fully adult. Add to that their role in providing financial support, and parents can find it tough to be barred from learning about a child's mental health – or that of a child's roommate – without the appropriate consent.

"Parents who care about their children want them to become adults with their own rights, but we don't want them to have any more hardships than necessary when stepping out into the world," says Elizabeth Root, a parent with one child at the University of Illinois and another who will head there next year. She recalls an incident last year when her college-age son ended up in the emergency room; she wouldn't have been told had he not called her himself. "We pay for the tuition and the health insurance," she says, "but we can't be informed unless he dies, I guess."

Medical professionals are sympathetic, but say the assurance of confidentiality – except in dire circumstances – allows them to do their job. "The students trust us. They come and tell us things they might not have told anyone ever before," says Maggie Gartner, chief of student counseling at Texas A&M University and president of the Association for University and College Counseling Center Directors.

She explains to every student who comes in what confidentiality means, and when – if the student seems to pose a danger – she might breach it.

That decision to break confidentiality or to commit someone to involuntary care can be one of the toughest a counselor or psychiatrist has to face, says Dr. Gartner, especially since it may mean the loss of any relationship. Still, she's done it several times.

"It's an art and a science," she says, noting that she'll assess how much of a plan students seem to have, whether they can harm themselves or others, and how stable they appear. "We continually seek the place where we can go home at night and go to sleep, she adds."

No assessment is perfect, Gartner notes, and schools – like Virginia Tech – are often blamed if things go awry.

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