When his beeper chirped at 2 a.m., Larry Tucker knew that a college student needed his help.
One phone call confirmed it: A student at the College of William and Mary in Williamsburg, Va., had muttered about taking her own life. Her friends told a dormitory counselor.
Dr. Tucker and the college's support team swung into gear, following a well-oiled plan. The dean of students, a psychologist, a physician, and others were also on their way. The team decided the student was indeed suicidal. Her parents were phoned and she went home for treatment. Just six months later the student returned, eventually graduating.
Such happy endings are often overshadowed by the more rare but often well-publicized failures to detect and treat these cases.
Three Massachusetts students who died during one week last month were listed as possible suicides. The deaths at Harvard University and the Massachusetts Institute of Technology in Cambridge, and the University of Massachusetts at Amherst renewed debate over what can be done to lessen college suicides.
Particularly troubling to college officials is the rapid rise in the number of students using counseling services on campus. To the officials, it indicates students are more troubled by relationship, debt, and academic pressures than students in the past.
Uncertainty is another reason for caution, they say. Studies document college suicides only up to 1990, leaving it unclear whether rates are stable or rising.
Alarm rose in the 1980s when studies revealed that suicides among 15- to 24-year-olds grew rapidly between 1955 and 1980. Suicide rates among graduate students are higher than for undergrads and the general population, one recent study indicates.
Researchers found, however, that college-student suicides in the 1980s were only half the rate in the general population - about 7.5 to 10 suicides per 100,000 students compared with 15 suicides per 100,000 overall.
Even with such evidence, officials cite many reasons to try to bring rates down more. Suicides cause shock waves on campuses that may cause other students to contemplate doing the same. There is also potential legal liability for the college if it bungles a rescue.
The profusion of counseling services on campus can help students, some officials say. But even the best programs have difficulty identifying at-risk students because they rely on friends to report threats.
William and Mary officials credit their strong policy - which requires students who threaten to kill themselves to be evaluated - with keeping the suicide rate there to about one-fifth the national rate.
W. Samuel Sadler, vice president for student affairs, says their team approach, which involves many departments, is little changed since it started in the mid-1970s. He says it may be the most assertive in the country, but he makes no apologies. Students making suicide threats want "something strong to happen" in response, he says. If it does not, their efforts may escalate.
They must get evaluated, he says. "That's our message, that we take it seriously."
Dr. Sadler has handed out his school's procedures to at least 50 colleges that have asked. Other schools, too, continue their search for better ways to help. Cornell University in Ithaca, N.Y., which has struggled with suicides in recent years, is beefing up its student counseling, says Philip Meilman, director of counseling.
Skeptics question such efforts. "No suicide-prevention measure sponsored by government or privately has ever been shown to be effective," says Allan Schwartz, associate professor of psychiatry at the University of Rochester in New York.
While he says such programs can be helpful and acknowledges they may stop some suicides, Dr. Schwartz says there is no statistical proof showing these efforts reduce suicide rates.
Ironically, the one proven way to lessen suicides among 15- to 24-year-olds is to "send them to college," he says. The reason: Guns are not permitted on most campuses. This removes the main mode of suicide, and the vulnerability of students to impulsively taking their lives is reduced, he says. Still, he notes that alcohol is another big factor in student suicides and seems undiminished on campus.
Despite the lack of statistical proof linking William and Mary's plan with its low suicide rate, Tucker, the former assistant director of its counseling center, says he only knows what he has seen.
"That student and her family wrote us a wonderful letter," he says. "They were quite clear that our intervention saved her life."
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