Prevention

On September 22, 2010, Rutgers freshman Tyler Clementi left his dorm room, drove his car to the George Washington bridge, and jumped to his death. A victim of cyber-bullying by his roommate, Clementi’s death brought the issue of college suicide into sharp focus nationwide. There are 1,100 suicides on college campuses every year in the U.S., and Duke has seen three since 1997—two graduate students and one undergraduate. In an environment of high stress, suicide prevention remains a priority for the administration.

But in the case of suicide-related outreach, one group is often left behind—the survivors. “Survivors,” in this case, are the friends, relatives and loved ones of a suicide victim. They are the other side of the coin when it comes to suicide prevention, the other group affected by an issue that is the second-leading cause of death among American college students. And in the Triangle, suicide prevention efforts focus on both stopping the creation of new survivors and supporting those who have already experienced such a loss.

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The point program for suicide intervention on Duke’s campus is DukeReach, a collaborative initiative managed by the Dean of Students Office and also incorporating Counseling and Psychological Services (CAPS), Student Health, Sexual Assault Support Services and the Women’s Center, among many others.

Although Duke does not have a crisis hotline, Gary Glass, assistant director for outreach and developmental programming for CAPS, said he believes DukeReach is an even more effective resource for students. Instead of relying on student volunteers and similar personnel, as many hotlines at other universities do, DukeReach can conveniently connect a student requiring assistance or students concerned about one of their peers with a relevant professional—including a 24/7 Residence Coordinator and Dean on call. The RC and Dean each have constant access to CAPS clinicians, Duke Police and the Duke hospital system.

“You don’t just prevent suicide by stopping somebody who is acutely suicidal; you prevent suicide by getting students that are struggling on less life-threatening points on the continuum before they reach that point,” Glass said.

Rather than merely serving as a reflex for students in dire circumstances, DukeReach provides a means of intervening earlier, as it incorporates RAs and others who are trained on how to perceive signs and symptoms and then how to activate the system.

On November 7 the TCSP, working with the American Foundation for Suicide Prevention, held their fifth annual Triangle Out of the Darkness walk. The event raises $25,000 to $30,000 a year for the cause of suicide prevention, and it also provides a forum for survivors to gather, raise awareness and support each other. One of the participants was a senior from the University of North Carolina at Chapel Hill, Kristen Stefureac, who has been highly active in suicide prevention activism at UNC. She and 65 family members marched in honor of her mother, who suffered from bipolar disorder and who Stefureac lost to suicide when she was 16 years old.

Working together with the family of Eric Bryant, a UNC law student who committed suicide in April, Stefureac helped start a campus branch of Active Minds, a national organization promoting awareness of mental health issues among students. The group provides a forum for students to both discuss and share their issues with any form of mental illness, from depression to schizophrenia to bipolarity. She said so far, the group’s reception has been tremendous, and she receives e-mails daily asking how to get involved or inquiring about the organization.

“I think the biggest hurdle is getting [students] to realize that it is okay to go talk to somebody: they’re not going to be judged, people aren’t going to look at them like, ‘Oh, you need counseling,’” Stefureac said. “That’s not just something that exists on college campuses, I think that’s a pretty general idea that people have: if you have to see a psychologist or a counselor or something, there’s something wrong with you. But we’re trying to say that no, that’s not the case: everybody at some point in time needs to talk to somebody. I’m convinced that if everyone had to talk to somebody, the world would be such a better place.”

At the same time, one of Stefureac’s main concerns and goals for the group is to ensure that students are aware of the many resources available to them through Counseling and Wellness Services, UNC’s equivalent to CAPS. For this purpose, she applied for a Kenan-Biddle Grant—a new monetary award made available for collaborative projects between Duke and UNC students—alongside Duke junior Leigh Spivey, who is abroad this semester.

“We want to get a pretty well-known speaker to come and do an open forum with students and faculties and staff,” Stefureac said. “We want to look at the policies on both campuses regarding suicidal ideations and what happens when a student comes in and says they’re suicidal… and then just try and come up with a new policy working with CWS and CAPS to see if there’s a better policy we could have—and we also want to make these policies more transparent for the students.”

To this end, Stefureac and Spivey also want to create a website or easily accessible compendium of all the resources a student has access to at his or her respective school.

For the grant, Stefureac is working with a postdoctoral fellow at UNC, Dr. Nicole Heilbron, who is also a clinical associate with the Duke Child and Family Study Center and helped her start the Active Minds group. Along with Dr. David Goldston, a clinical psychologist and associate professor of medical psychology at Duke, the three have been involved in the TCSP, the Out of the Darkness Walk and Stefureac’s awareness efforts at UNC. Both Goldston and Heilbron specialize in suicide issues among adolescents and young adults.

Discussing the topic of prevention on a campus like Duke’s, Goldston and Heilbron both touched on the topic of gatekeeper training—how one prepares a figure like an RA or an RC, who might be the first person to be contacted by an individual with suicidal feelings, to address such a situation properly.

“It depends on what point you’re going to intervene with, but there are definitely programs out there for training folks who are first-contact individuals,” Goldston said. “Part of their training, in a lot of programs, is to help facilitate steering individuals into the resources that they need.”

Heilbron added that it’s important to keep in mind the ambivalence in the feelings of a depressed or suicidal person, which is part of why helping them confront and address their issues is so important.

“When someone comes to you, it’s not likely that the person is completely set on, ‘This is what I’m going to do,’ and you’re going to have to change their mind,” Heilbron said. “It’s much more that the person is caught with these competing pressures…to act or not to act.”

And this, in the end, is at the heart of what successful suicide prevention entails: avoiding the point where people even consider suicide as an option, or, worse yet, the only option.