Estaban Yanez/Mustang News Students reveal what comes to mind when they think of suicide, a cause of death that is largely overlooked.

Hannah Croft

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Most Cal Poly students can tell you the story of Carson Starkey. They’ll tell you he was a Cal Poly student lost to alcohol poisoning in 2008. His story is retold every year in hopes of raising awareness about alcohol poisoning and looking out for fellow students.

Starkey’s story is one of many alcohol-related deaths used to educate students on the dangers of alcohol poisoning. His story is somewhat public, as are many stories involving underage binge drinking.

Suicide, on the other hand, is a quiet, private matter. The stories often never get told, despite the fact that suicide claims more college student deaths than alcohol.

In a study conducted at the University of Virginia surveying 254 deaths of university students ages 18-24, 55 of them were alcohol-related. Seventy of them were suicides.

According to the Center for Disease Control, suicide is the second-leading killer of college-aged students, behind traffic accidents.

In just two years, Cal Poly has been shaken by two student suicides; the most recent was on September 25, when Luke Powers shot himself in his Hathway Avenue home. In March 2012, Osvaldo Ponce was found in his car after asphyxiating on a lethal mix of chemicals.

While the past two years have brought their share of tragedy to campus, Cal Poly is in line with national statistics surrounding suicides. Nationally speaking, 8.27 percent of college-aged students have thought about suicide. Approximately 2 percent have made a plan. In Spring 2013’s Healthy Minds Study done by Health and Counseling Services, 7.45 percent (approximately 1,400 students) reported serious thoughts of suicide, 2.43 percent (approximately 460 students) had made a plan for suicide and 0.26 percent (approximately 50 students) had made an attempt within the past year.

Counselor Hannah Roberts said that while Cal Poly’s statistics are “the norm,” sometimes reporting suicide statistics isn’t easy.

“Suicides happen in a lot of different places,” she said. “We don’t always know about student suicides, and we don’t always know if they are suicides, so that’s where things get a little tricky.”

If the statistics are nuanced, then Cal Poly’s policies surrounding suicide are just as so.

“It’s a case-by-case thing,” Roberts said. “And we don’t always hear about it.”

Unlike sexual assaults on campus, which fall under Title IX, there isn’t a chain of command for suicidal students. No one is required to know about a student’s suicidal thoughts or attempts.

Health and Counseling Services doesn’t go out looking for suicidal students, Roberts said, but when they do come into contact with them, there’s a relatively straightforward protocol in place.

“If a student is suicidal and they have a plan, and that plan is imminent, we call (University Police Department),” Roberts said. “They’ll likely be taken to the hospital. But after that, we don’t necessarily know if they’ve been released. And we don’t go trying to find them.”

Usually students aren’t released from the hospital until they have an “exit plan,” Roberts said, which often involves visiting counseling services, but it’s never mandated. There’s a chance Roberts and the rest of the counseling services won’t hear from the student again.

“Suicide is a medical thing,” Roberts said. “So it’s protected by (the Health Insurance Portability and Accountability Act). We don’t get that information shared with us, and we can’t share that information with anyone.”

Though a suicidal student’s medical records won’t be released, Dean of Students Jean Decosta said suicide is one case in which she can break the confidentiality promised to students by the Family Educational Rights and Privacy Act (FERPA), because it falls under the “health and safety” category.

“If a student suicide or suicide attempt came to my attention, I would likely get in touch with the parents,” she said.

While students whose situations are considered “imminent” are treated with a sense of urgency, students whose ideation isn’t quite as urgent are handled slightly differently.

Roberts said that when prompted, most students don’t have trouble disclosing their suicidal thoughts to a counselor.

“Statistically, 90 percent of people who commit suicide communicate intent,” she said. “We’ve found that when asked openly, students are usually quite comfortable talking. So asking them directly, ‘Are you feeling suicidal?’ is usually pretty effective.”

Once a counselor has an understanding of a student’s suicidal thoughts, they follow a series of questions to determine severity.

“Next we ask, ‘How serious are you? Do you have a plan? Do you want to talk about that plan?’” she said. “And is the plan that they’re going to do something right now, or is it that they’re thinking of doing something in the far future?”

After evaluating the situation, counselors will give students options. Those range from setting up regular appointments with an on-campus counselor to a one-time intervention.

“At that point, it’s really up to them,” Roberts said.

Usually, though, students who come into Counseling Services feeling suicidal are receptive to help, Roberts said, especially because they are often uncomfortable with their thoughts.

“Our goal is to meet every student’s needs on an individual level,” Roberts said. But no student is looked at as a higher priority than another. However, Counseling Services has time set aside for emergency students.

“If a student is in crisis, there will always be someone available,” she said. “There will always be a mental health clinician on the line.”

Oftentimes, students use Counseling Services as a last resort. That was the case with aerospace engineering junior Peter Hernandez, who turned to Counseling Services last winter.

“After a couple of months of trying to work it out on my own, I realized that I wasn’t getting anywhere and I decided to look into counseling services at the Health Center,” he said. “Even just the screening and introductory sessions helped me start dealing with my issues just by talking about them with someone who had experience with that sort of thing.”

But according to Roberts, Counseling Services can’t reach every student in need.

“Obviously we don’t have enough counseling staff for all of our students, which is a major issue,” Roberts said. “We still don’t meet the (International Association of Counseling Services) recommendation.”

In order to receive IACS accreditation, the student-to-counselor ratio must be 1500:1, according to CSU executive order 1053. In research conducted for Mustang Daily in March 2012, Counseling Services’ ratio was 1800:1.

Various resources outside Counseling Services can help to offset the lack of counselors on campus.

“Anyone can go through trainings we offer,” Roberts said.

Often departments will decide to participate in a training, like mental health first aid, which teaches appropriate responses to mental health issues, so they can help students in times of crisis.

Despite a thinly-spread counseling staff, Roberts said resources like the trainings can help “our campus become more resourced and more healthy.”

One frequently-used resource on campus is University Housing. Students often rely on their resident advisers (RA), coordinators of student development (CSD) and other University Housing representatives in times of crisis. In a survey of 65 Cal Poly students, 27 said they had called on their RA, CSD or other members of housing for mental health help.

RAs are trained by Counseling Services in mental health first aid, but former RA and mechanical engineering senior Eric Taylor said his training focused more on preventative measures for the moment and less on follow-up.

“We’re always trained to keep an eye on the student,” Taylor said. “And if something happens, we work to take our relationship with them beyond the superficial. Invite them to dinner, to study with you; let them know they’re included.”

If a student discloses suicidal thoughts or makes a suicide attempt in the residence hall, the first step is to call the CSD, Associate Director of Housing Carole Schaffer said.

“We have an emergency response and crisis manual,” she said. “Every CSD has a copy in their office.”

Schaffer said University Housing works closely with UPD, the Dean of Students and Counseling Services, as well as a county-crisis team, to make sure students are safe and supported. Schaffer and the housing staff work with a liaison in Counseling Services to make sure the needs of students are met. But, she said, they won’t force a student to seek help.

“We work to put together a support plan,” Schaffer said. “We can strongly recommend it, but we can’t force it.”

While there are plenty of administrators who can help Cal Poly students in crisis, students can help each other.

Most students are equipped with a toolkit for helping students in unsafe situations involving alcohol and drugs, but those skills extend to mental health, as well.

In a survey of 65 Cal Poly students, 43 said they had helped a friend during a mental health crisis. But 35 students said they didn’t feel confident in their ability to help a friend in crisis.

When it comes to helping friends and loved ones, Roberts highlighted the importance of knowing the warning signs of suicidal ideation and broke them down into four categories.

The first is direct verbal clues.

“That’s literally ‘I’m going to kill myself,’” Roberts said.

More common are indirect verbal clues, along the lines of “I just want it to be over,” or “I wish my life would end.”

Behavioral clues can range from obtaining a means to giving away belongings to saying long, permanent-sounding goodbyes.

“If someone is stocking up on pills, or recently obtained a gun, that might be a warning sign,” Roberts said.

Lastly, environmental clues are sudden changes that may prompt students to think about suicide.

“Usually, these are trauma or loss,” Roberts said. “A death in the family, a really rough breakup, sexual assault, all can cause people to start experiencing suicidal ideation.”

But suicide isn’t necessarily easy to talk about.

Biomedical engineering senior Chris Grieves stressed the importance of normalizing the issue of mental health. In 2011, Grieves worked to create a mental health awareness video for the Week of Welcome (WOW) and noticed that students only talk about it when prompted.

“There’s not a specific time that you’re allowed to talk about mental health,” he said. “It doesn’t have to be a huge deal every time it comes up.”

Grieves, whose involvement in Orientation Programs often exposed him to long discussions about mental health, urged students to understand that mental health isn’t very different from physical health.

“When you have the flu, you need rest, you need medicine and you need support,” he said. “Mental health is the same thing. If you’re feeling depressed, you need rest, sometimes you need medicine and you need support. The support is just a little different.”

For Hernandez, the most important part of his healing process was being able to talk it out.

“(Talking it out) starts making you feel like you’re in control of how you will handle the situation and grow from it,” he said.

Grieves stressed that if a student is in crisis, “It’s more important to help, even if they may not realize they need it.”

“While their reaction in the short-term may not be what you want, they’re going to appreciate it in the long run,” he said.

The responsibility is on students to break down the stigmas surrounding mental health, Grieves said. It has to be a change in the campus culture and that doesn’t come from administration.

“That has to come from the students,” Grieves said. “Students have to stand up and say, ‘This isn’t a sign of weakness; asking for help is a sign of strength.’”

To students who are struggling, or whose friends may be struggling, Grieves stressed that no one is alone on this campus.

“If someone says they’ve never felt anxious or stressed or depressed during their college career, I’d say they were lying,” Grieves said. “It’s OK to feel all of those things. We can work through them together.”

Students in crisis have a large network of students, faculty and staff to fall back on. Decosta urged students not to be afraid to reach out to each other and to those resources.

“We all have a dark moment,” she said. “Students can come together and share those, so maybe we can understand that this too shall pass.”