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LET’S TALK: MENTAL HEALTH

September 25, 2014

University suicide response examined through the years

When walking into the atrium of Bobst Library, the history of NYU’s struggle with student deaths is inescapable. The golden, cage-like panels that cover the interior of the 12-story building were installed in 2012 to prevent students from jumping from the upper floors, and for some they serve as a constant reminder of the ongoing mental health challenges faced by students.

Seven students died during the 2003-04 school year, leaving the university stunned and the administration struggling to deal with a shocked student body. As recently as August of this year, NYU student deaths have continued to make headlines, earning the university a reputation of being a suicide school. With each death, administrators and university officials are left to decide how to address the NYU community.

Depending on the circumstances of the death, students will receive a university wide email regarding the tragedy and reminding them of available counseling services.

NYU spokesman John Beckman said the university does not have definitive policies regarding communications.

“We do not have one set practice that is repeated in every instance; while student deaths share a common aspect of tragedy and sorrow, the specifics and circumstances vary widely, and so we make the decisions carefully and on a case-by-case basis,” Beckman said. “We do not believe there is a ‘one-size-fits-all’ approach that would be successful.”

While a university wide email might not always be sent out, NYU will still notify professors, classmates and others who could be potentially impacted by the student’s death.

Beckman added that the university is mainly concerned with the safety of the entire NYU community. The Werther Effect, commonly referred to as the contagion effect, suggests that when suicides are given a lot of attention, those with suicidal thoughts are more likely to act on their impulses.  For this reason, the university does not allow campus memorials in cases of suicides and attempts to limit university communication.

Victor Schwartz, School of Medicine faculty member and former medical director of the NYU student mental health service, said while it is important to be careful of drawing a lot of attention to student deaths, it is still important to keep the needs of friends and family in mind.

“At the same time, we don’t want to appear cold and uncaring,” Schwartz said.  “I think the challenge is to be able to acknowledge that there is a loss, that there are friends and family that are in pain, while at the same time not over dramatizing or making this death seem appealing.”

School of Medicine professor Claude M. Chemtob said he disagrees with the idea of withholding information about suicides from the student body, saying instead we need to have an open discussion about suicide and mental health.

“Keeping people less than completely aware is a mistake,” Chemtob said. “My view is that when one of these things happens, you have to rally people to recognize we are a community, by informing them of the risks and the issues, and increasing the sense that we’re all responsible for one another.”

Chemtob said he believes the key to suicide prevention is creating a resilient community that provides support and is also educated on the characteristics of suicidal behavior.

He added that, although suicide rarely happens, it intensely impacts communities and it is important to continue to educate students and faculty on how to identify those with suicidal impulses and provide them with the necessary resources.

“We must create a culture for students around mutual taking care of each other,” Chemtob said. “On the other hand you have to actually teach them skills to recognize when they have to reach out to the student, or to adults who can help.”

The need for community is echoed by members of the student body. Steinhardt sophomore Taylor Gese said while living in New York provides unparalleled experiences, the sense of isolation can be hard to escape.

“Living in Greenwich Village at 18 is an experience you’d be crazy to pass up,” Gese said.  “That being said, New York is so lonely for some reason I’ve never been able to pinpoint.”

Tisch junior Aylah Donayre shares the sentiment that going to NYU can be a lonely experience, but she highlighted the support system the university can provide to students in times of need.

“The city environment can be very isolating and is not conducive [to] a community atmosphere,” Donayre said. “If you’re interested in finding that community within NYU all you have to do is be proactive about looking for it. The city is somewhere that I thrive but I know if it ever became too overwhelming all I would have to do is ask for help.”

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Valentina Duque Bojanini at [email protected]

Guide to common mental health conditions

Eating Disorders

What are some identifying signs?

Anorexia, bulimia and binge eating disorders vary in symptoms — restrictive eating; binge eating; self-induced vomiting; abuse of laxatives; weight loss or weight gain; excessive exercise; spending most of the day thinking about food, weight and shape; guilt about eating; not experiencing normal hunger or fullness; avoiding eating situations with other people; and bloodshot eyes or swollen cheeks from purging. The spectrum of eating disorders affects all genders, and there are long-lasting physical and psychological consequences for everyone suffering from one.

What are the usual treatments?

An assessment of medical and psychological status is usually done first, then either an inpatient unit, an intensive outpatient program or weekly outpatient therapy is conducted. Help from a nutritionist and a psychiatrist are sometimes involved. Medication depends on the individual.

What should be done if you notice these signs in a friend?

Sound supportive without sounding accusatory. “Use ‘I’ phrases, [such as] ‘I’m concerned about you,’ or ‘I wonder if I can help you in anyway,’ or ‘I feel like eating may be something that’s hard for you,’ or ‘I worry about you spending so much time at the gym.’ Rather than, ‘you’re spending too much time at the gym,’ ‘you’re doing this,’ ‘you’re doing that.’” — Dr. Diane Klein

What can lead to a recurrence of the condition?

Stress, a new environment where things may be out of one’s control or seasonal depression. During winter one may feel down and during summer one may feel body pressure.

Depression

What are some identifying signs?

Weight gain, weight loss, oversleeping, not sleeping enough, loss of interest, inability to concentrate, consistently discouraged mood lasting more than two weeks, eating too much, not eating, agitation, low self-esteem and suicidal thoughts.

What are the usual treatments?

Antidepressants, cognitive behavioral therapy, psychodynamic therapy, group therapy, mindfulness-based treatments and many other forms of talk therapy.

What should be done if you notice these signs in a friend?

“People [with depression] are typically treatment-seeking, more so than [those with] drug abuse. Approach them out of care, out of worry. Express concern without judgment.” – Dr. Michael Walton

What can lead to a recurrence of the condition?

Although depression is not necessarily linked to anything, it can be triggered by a memory or setback, heavy stress or seasonal depression with lack of light.

Anxiety

What are some identifying signs?

Feeling nervous, being restless, sweating, worrying excessively, constantly projecting negative outcomes, discounting success, shaking and physical upsets such as an upset stomach, headache and insomnia. Stress is often prevalent during exams or tests, but when it starts to affect a person’s performance and ability to drop their worries or rationalize, one should seek help.

What are the usual treatments?

Counseling, antidepressants to regulate serotonin levels, cognitive behavioral therapy, psychodynamic therapy, group therapy, mindfulness-based treatments and many other forms of talk therapy and skills building.

“First, these people must very carefully reduce alcohol and drug use which can inflame [anxiety]. It’s hard to treat the problem when a person is using.”– Dr. Michael Walton

What should be done if you notice these signs in a friend?

Take their concerns seriously. Reach out with support, give your direct observations, listen openly without judgment and patiently remind your friend that you are willing to assist them when they are ready to talk or get help.

What can lead to a recurrence of the condition?

It peaks around times of stress — keep a regular schedule, do not cut out sleep and make sure to exercise.

COURTESY OF Charles Marmar, M.D.; Rebecca Whiting, LCSW; Luis Ramirez, LCSW; Anne McEneaney, PH.D.; Diane Klein, M.D.; Michael Walton, M.D.

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Emily Bell and Hannah Treasure at [email protected]

Common causes of anxiety, tips on how to alleviate them

Approximately 40 million Americans experience anxious feelings, many of whom include college students. In such a fast-paced environment it is unsurprising that students often feel overwhelmed. Here are some common anxiety triggers, as well as methods to help address these problems.

Stress

Though impossible to avoid completely, increases in stress — caused by anything from homework to your personal life — can cause you to experience anxiety, restlessness or even panic attacks. Try to make time for you. Set aside an hour a day to relax and breathe, which will help put external stressors in perspective.

Sleep

Sleep deprivation can do a lot of damage to your body, and can even trigger anxiety. To avoid putting your body on edge, try to stick to a regular sleep schedule, shooting for seven to eight hours a night.

Caffeine

Your daily espresso craving may be causing more than just a buzz. Ingesting caffeine, which increases your heart rate in order to give you that boost of energy, can also be an anxiety trigger. Cut back your daily coffee intake and instead stay hydrated with water.

Medication

Certain prescription meds, such as drugs for asthma, attention deficit disorder and oral contraceptives, have the possible side effect of increased anxiety. If you are taking any form of medication, consult your physician to see if the type of drug can be altered to decrease these symptoms.

Genetics

Sometimes anxiety is part of your genetic makeup — your DNA may make you susceptible to feelings of anxiety. If you have a family member with anxiety and experience feelings of anxiety yourself, a variety of options are available, from therapy to getting a prescription medicine.

For more information on anxiety, visit the Anxiety and Depression Association of America’s website at adaa.org.

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Dana Reszutek at [email protected]

Take a break at local destressing spots

The hustle and bustle of New York City, especially when combined with the pressure of college, can easily be overwhelming. Fortunately, there are many places to take a breather away from the crowds and cabs.

The High Line

The converted railroad track of the High Line is a great spot to catch a view of the city, surround oneself with urban landscaping and find a bench to sit on and think. Check out the new section that just opened, but make sure to avoid it on weekends when it gets most crowded.

The Metropolitan Museum of Art

One of the perks of the Met having a suggested price is an affordable place to instantly be immersed in beauty and stillness. Head to the back rooms of the Met, especially on weekday afternoons, for an unexpected place to get away for a bit.

Caffe Dante

Close to NYU but not as close or as crowded as Caffe Reggio, Caffe Dante is the perfect place to get some leisure reading done. Laptops are not allowed, so ditch the obligations of email and disconnect while enjoying a great cappuccino.

Waverly Diner

While the food is slightly overpriced, the friendliness of the waitstaff and the comfort of the food make this diner an ideal setting to feel at home in the big city. It is usually fairly empty, and people-watching in the booths while eating a grilled cheese is about as relaxing as it gets.

The Strand Underground

The Strand can become pretty zoo-like, but head to the cool lower level to experience a reprieve from Bobst Library while enjoying the smell of old books. Explore each tiny corner and slowly slip away from the craziness of Broadway.

Grand Army Plaza (Manhattan)

For a park where you will not run into anyone from NYU, sit in front of The Plaza Hotel at Grand Army Plaza. At the bottom of Central Park, it feels like old-world New York and will help remind you of the reason you came to the city.

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Emily Bell at [email protected]

Mental illness stigmatization hurts students

The prevalence of mental health problems on American college campuses is alarming. In a national survey conducted by the American College Health Association, 40 percent of male students and 50 percent of female students reported “feeling so depressed that they had difficulty functioning one or more times during the last school year.” College students face a myriad of stressors. We must achieve the perfect balance of dedication to classes, extracurriculars, jobs, internships and friends. We worry about student loans. We worry about careers and post-graduate life. Given the weight of the college experience and the tremendous pressure to not flounder in it, it is not difficult to understand why so many students suffer psychologically. Eradicating this issue will not be an easy feat, but it must begin with a conversation on society’s destructive cultural attitudes toward mental health.

Negative societal perceptions of mental illness are deeply rooted in history. During the Middle Ages, mental illness was associated with witchcraft. It was believed that mentally ill individuals were influenced by the devil, and they were punished rather than treated. While cultural attitudes have thankfully evolved, progress still must be made. Modern society makes a clear distinction between physical and mental illness. Physical conditions are less likely to carry social stigma and thus conversations about treatment and recovery occur more publicly. Mental illness is usually not met with these same affirmations of legitimacy. Government policies reflect this view. During financial crises, mental health care budgets are typically among the first services to be cut. Medicare, which provides unlimited coverage for inpatient treatment at a general hospital, only covers inpatient care at a psychiatric hospital for up to 190 days.

Mental illness is regularly coupled with shame. Speaking openly about depression or anxiety is considered relatively taboo, and this dangerous stigma can discourage people from seeking help. At NYU, students in need of mental health services have several options. Our Student Health Center offers a 24-hour Wellness Exchange hotline, counseling, psychiatric medication services and informative workshops. Despite the availability of these resources, many students may not feel prepared to disclose their personal condition and seek help. A 2012 National Alliance on Mental Illness survey revealed that fear of stigmatization is one of the top reasons students choose not to disclose mental health issues. There are more students quietly suffering instead of utilizing the services available to them.

Raising mental health awareness should be a priority on college campuses. Minimizing the importance of the problem does not help anyone. NYU requires all freshmen to go through an online alcohol education program — creating a similar program for mental health education could foster a greater understanding of these illnesses. We must use education to combat the stigma around mental health, especially on college campuses. Only then will we begin to reach the many students who suffer silently.

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Zahra Haque at [email protected]

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