Optimism sweeps the nation in August as tens of thousands of American families send eager students to U.S. colleges and universities. Yet, if statistics hold true, the sobering fact is that nearly 1,100 won't come home.
"Suicide is reality, and it's the one disease that's totally preventable," said Cynthia Mauzerall, director of counseling at the College of Idaho.
The Suicide Prevention Resource Center reports that suicide "is a leading cause of death among college students in the United States" and "suicide and attempted suicide are the tip of the iceberg of a larger mental health and substance abuse problem among college students."
Those problems surface early. According to the Idaho Bureau of Vital Records and Health Statistics, one in seven Idaho high-school students reported seriously considering suicide, and one in 14 made at least one attempt.
Idaho's numbers are consistent with national statistics, said Alison Malmon, founder and executive director of Active Minds, which is preparing to send its provocative exhibit, Send Silence Packing, on a fall tour of American college and university campuses. The display invites passersby to walk among 1,100 backpacks, representing the average number of college students who die by suicide each year. Many of those backpacks were once worn by students who took their own lives.
"Just a few weeks ago, I was standing among the backpacks at the University of Alabama at Birmingham," Malmon said. "A young man walked up to me and said, 'A year ago, one of these backpacks would have been mine.' That same night, we received a Facebook message that said, 'I saw your display. I've been thinking of suicide myself. I'm going to get some help. Can you help me?'"
Malmon's own world turned inside out in 2000, when she was a freshman at the University of Pennsylvania and lost her only brother to suicide.
"He was a top Ivy League student, editor of the paper and made the dean's list. But he kept many of his struggles private," Malmon said. "He thought he was the only one on his campus struggling because there were no conversations about anxiety, depression, suicide, any of these issues."
That's when Malmon began a student organization to get her fellow students talking about mental health. After graduation, she continued to grow Active Minds and today, the Washington, D.C.-based nonprofit includes chapters on more than 400 American campuses. To date, more than 300,000 people on campuses in 85 U.S. cities have experienced Send Silence Packing.
The exhibit even caught the attention of The New York Times, which profiled the organization in an Aug. 2 feature story titled "Campus Suicide and the Pressure of Perfection."
Mauzerall, a counselor since 2007, is now an Active Minds adviser on the campus of the College of Idaho where she's also about to take over as the college's new director of counseling. She said there's a tangible difference between the reasoning and coping skills of college freshmen and seniors.
"We see 18- and 19-year-olds coming to school, very intelligent and very successful. Yes, those are 18- or 19-year-old brains but those frontal lobes haven't fully developed yet," said Mauzerall, referring to the problem-solving section of the brain. "As you get older, you access the brain's frontal lobe more often. That's when you recognize that a feeling of, say, not being good enough is a feeling that is, in fact, temporary. So, that's the importance of counseling or a suicide hotline for young people: To start doing some rational thinking. It can really save lives."
Access to that counseling or hotline has never been more important. In its Aug. 2 report, the Times wrote that "a survey of college counseling centers has found that more than half their clients have severe psychological problems, an increase of 13 percent in just two years."
Mauzerall's C of I colleague, Office of Residence Life Director Jen Nelson, said colleges and universities need to rely on the skills of resident assistants at college dormitories more than ever.
"I'm often asked about the qualities of an ideal R.A., and I must say that when I'm hiring, I'm looking for someone who really likes people in every manifestation—the beautiful and wonderful but also the sad, frustrating, horribly messy things that occur when a lot of people live together in close quarters," said Nelson. "Additionally at the College of Idaho, we have first-year mentors living on each floor where first-year students live. But our biggest advantage is our smaller size. For example, if a student doesn't show up for class a couple times in a row, or even appears down, many faculty members would contact that student or even ask someone to track them down to make sure they're OK."
The student body is considerably larger at Boise State University, where enrollment is around 22,200 compared to C of I's approximate 1,100. Because of that, Boise State officials said ample safety nets take on a special urgency.
"Some of the most significant stressors for our students can come in that first transitional year," said Karla West, director of counseling services at Boise State. "I think we're constantly striving to be better as a culture, but we still have a lot of work to do to destigmatize depression, anxiety and even suicide—and take care of our emotional health as much as our physical health."
In particular, West points to QPR, shorthand for "Question, Persuade and Refer," as a methodology for mental health intervention. Boise State caregivers are hoping QPR becomes as commonplace as CPR for saving lives in their community.
"We initiated QPR training in late 2012," West said. "We've trained 30 other trainers and they, in turn, have trained about 600 faculty and staff. "
Occasionally, a referral might lead to the Idaho Suicide Prevention Hotline, which is now available at all hours.
"We're 24/7 now," said ISPH Director John Reusser, who plugged the Idaho-based hotline back into service in 2012 after six years without funding.
"The hotline has already surpassed 2,200 calls this year and in 2014, we had about 2,800 calls for the entire year," he said.
Nearly a quarter of the callers to the ISPH said they were 24 years old or younger, while 30 percent of all callers didn't report any age.
"Idaho is among some of the highest suicide rates in the nation. We're 44 percent higher than the national average, and that includes a good many young people," said Reusser. "There's a tremendous pressure on kids to succeed."
Reusser stressed how any significant cultural change must begin with education and plenty of conversation, which is why his organization will be taking advantage of the upcoming World Suicide Prevention Day on Thursday, Sept. 10. The Idaho hotline will launch a new chat service, which means someone might access help from work, school or home instead of looking for privacy to make a phone call. Additionally, Reusser said the Idaho hotline will recognize World Suicide Prevention Day through something unique featuring tattoo artists from the Treasure Valley.
"We're going to be offering tattoos—permanent or temporary—of semicolons," said Reusser. "Why a semicolon? Think of it for a moment. In speech, a semicolon represents a place where you're going to stop; but ultimately you continue. You move forward."
If you or someone you know is in emotional distress or suicidal crisis, call 1-800-273-TALK.