For Parents and Schools: 13 Reasons Why, Season 2

Netflix launched Season 2 of its smash hit series 13 Reasons Why on May 18. With the “gravity” of issues featured in the series that debuted in 2017—suicide, bullying, sexual assault, substance abuse, and school shootings—a coalition of mental health organizations issued a statement of concern to parents, educators, and professionals “in an effort to help reduce the risk of a tragedy.”

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Suicide Voices of Education (SAVE), which issued the statement, also announced the launch of a website containing information, resources, and toolkits for youth/peers, parents, educators and clinicians/professionals to address the specific topics raised in the episodes. Click here to access the website.

Netflix itself, following the intense criticism it received from mental health experts after the launch of Season 1 in March 2017, has created a website including a warning video, discussion guide, and other resources. The page includes the warning: “This show is rated MA for mature audiences, it covers many issues including depression, sexual assault and suicide. If you are struggling, this series may not be right for you or you may want to watch it with a trusted adult.” Click here to access the Netflix 13 Reasons Why information website.

The Sophie Fund created a web page with links to information and resources about 13 Reasons Why. The page contains expert studies and commentaries discussing how the series creates risks for suicide ideation and contagion among young people by romanticizing suicide, downplaying the reality of mental health struggles, and undermining the roles of parents and school counselors in supporting young people in distress. Click here to access The Sophie Fund web page for 13 Reasons Why resources.

Here are the recommendations released by the coalition of mental health organizations in its statement of concern:

1. For vulnerable and at-risk youth (for example those living with depression or an anxiety disorder) we encourage families to make a thoughtful decision about whether or not to watch 13 Reasons Why because of the triggering impact it might have on them. We recommend using the show’s TV rating as a source of guidance about the intensity of the content. Some of the story lines could be quite upsetting and result in them needing additional monitoring, support and/or treatment.

2. If your teens do watch the series, make an effort to watch with them. This will allow you the opportunity to monitor the impact the show has on your child. It also affords you the chance to talk after each episode and ensure that they are comfortable enough to continue watching.

3. If you are not able to watch together, talk with your teens about their thoughts, reactions and their feelings about the content. Check in with them multiple times as it can take a few days to process the content and they will likely continue to talk about the show with their peers. Let them know that they can come to you with questions or worries about themselves or their friends and that you will be there to listen and help guide them.

4. Reassure youth that fiction and reality are not the same thing. Even though some might believe that what they have seen on television is or feels like reality, it is critical that you help them understand it is not and that the outcomes from the series do not have to be their outcomes.

5. Learn what resources are available in your local community where you can find help if needed. These might include: a local public health agency, a mental health professional, the counselors in your child’s school, or a crisis phone service in your area. Knowing who you can reach out to for support is a good prevention strategy.

The release of 13 Reasons Why Season 2 coincided with another deadly school shooting on May 18, this time in Sante Fe, Texas, where 10 people—eight students and two teachers—were killed by a 17-year-old student who reportedly confessed to the violent rampage. (Early reports indicated that the suspect had been bullied in school and was suicidal.)

The Jed Foundation, a national mental health and suicide prevention organization, added this statement to its concerns about 13 Reasons Why Season 2:

In light of the gun violence depicted in 13 Reasons Why and the devastating school shootings on Friday, we want to remind you how to be safe if you are involved in an active shooting, urge media to follow guidelines for safe reporting on these incidents, and provide tips for discussing and coping with these terrible events.
What to do if you find yourself in an active shooting:
—RUN and escape, if possible. Call 911 once you’re in a safe place.

—HIDE, if escape is not possible. Once you feel safe, try to reach out for help silently (i.e. text, social media, email, put a sign up in the window).

—FIGHT as an absolute last resort. The first response is never to confront an active shooter.

 

“Art, Wine, and Wood”

“Art, Wine, and Wood” is an exhibition featuring work by local artists Kristina M. Baier and Lisa M. Narloch, at Leidenfrost Vineyards in Hector through May and June. The artists are generously donating proceeds from the exhibition to The Sophie Fund in honor of their friend Jason Seymour.

Baier is a photographer and painter who works in abstract photography, mixed media, and other modes of expression. Narloch, who operates Wood Owl Original Designs, creates art from rescued wood.

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“Harvest Moon,” painting by Kristina M. Baier

 

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Lisa M. Narloch, at the May 11 opening of “Art, Wine, and Wood,” Leidenfrost Vineyards, in Hector, NY

 

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Wood designs, by Lisa M. Narloch

 

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Wood boxes, by Lisa M. Narloch

 

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Hearts, by Lisa M. Narloch

 

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“Waves & Ripples,” multimedia by Kristina M. Baier

 

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“Night Vision,” multimedia by Kristina M. Baier

 

Photos by Michayla Savitt/The Sophie Fund

Cornell’s Hazing Problem Redux

George Desdunes, son of a single-mom Haitian immigrant, joined the Sigma Alpha Epsilon chapter at Cornell University in part because he thought fraternity connections would help him find a good job after graduation. He never made it to that proud day. In the early hours of Friday February 25, 2011, the 19-year-old sophomore died in a hazing incident at SAE’s house on McGraw Place.

Kidnapped, blindfolded, wrists and ankles bound with duct tape, Desdunes drank a shot of vodka for every incorrect answer to a trivia question until he passed out. Fraternity pledges hoisted him onto a leather sofa, where custodians found him motionless a few hours later and called 911. Marie Andre wailed when she saw the corpse of her son in the morgue.

When President Martha E. Pollack announced frat-house reforms last week, it was but the latest effort by successive Cornell administrations since the senseless death of George Desdunes to put an end to the hazing scourge that, as Pollack puts it, “threatens the health and safety of our students and casts a shadow over our community of scholars.” Pollack set ambitious goals for her administration: not only to “eradicate hazing,” but to “present an example for other universities to follow.”

It remains to be seen if Pollack’s announced changes—banning hard liquor, stiffer penalties for hazing violations, mandatory educational programs, tighter house supervision—will have any greater impact than the ballyhooed initiative “to end pledging as we know it” put forth in 2011 by David J. Skorton, who was Cornell’s president at the time of the tragedy on McGraw Place.

An illustrious Cornell figure, Skorton, a cardiologist, is currently head of the Smithsonian Institution; his name and words are engraved in stone on an edifice on the Ithaca campus—the Skorton Center for Health Initiatives (“Bring your strength and spirit and heart to develop a caring community everywhere there is the name Cornell”). Yet Skorton’s own ambitious effort to stamp out hazing—which he heralded in a forceful Op-Ed in the New York Times—seems to have been a total failure. By Cornell’s own reckoning, at least 28 of the university’s fraternities—nearly half of them—have been sanctioned for hazing since Desdunes’s death.

Cornell disbanded the SAE chapter for a minimum five-year period after George Desdunes died. A judge found the fraternity guilty on state hazing charges and imposed a $12,000 fine. Three SAE pledges were acquitted of hazing charges. Desdunes’s mother brought a $25 million wrongful death suit against the national fraternity, and eventually reached a multi-million dollar out of court settlement.

Pollack’s initiative, which omitted any reference to Skorton’s “comprehensive strategy,” appears to be driven by another spate of cases and allegations this academic year—her first full year at Cornell—including the three-year suspension on hazing charges of the Gamma Theta chapter of Sigma Nu fraternity last Friday as Pollack was making her announcement in an email to the Cornell community. The hazing allegations against Sigma Nu cited by the Cornell Daily Sun included phrases like “I want this to stop,” and “makes me want to kill myself.”

A Cornell hazing incident made national headlines in February when the university’s Zeta Beta Tau was put on probation over a fat-shaming contest. Called the “pig roast,” new fraternity brothers were awarded points for having sex with overweight women.

Pollack announced changes to be enacted in four phases.

Effective immediately:

—Substantiated acts of hazing will result in a chapter’s suspension and loss of recognition. A minimum of three years will be applied for those cases that include coerced alcohol or other drug consumption, sexual and related misconduct, or other forms of violence or mentally abusive behavior that poses a threat to health “and safety…

—Hard alcohol (more than 30 percent alcohol by volume) is not permitted in a residential chapter house at any time.

Effective Fall Semester 2018:

—Each Greek letter chapter must submit a new member education plan prior to participating in new member recruitment. Chapter leadership will assume accountability for adhering to the approved plan.

—Prospective and current members must participate in mandatory educational programming (including, but not limited to, university expectations, hazing awareness, and policies on alcohol, drug use, and sexual and related misconduct) in order to be eligible to participate in the new-member recruitment and intake processes.

—A systemwide, online scorecard will be published and updated annually to include, among other things, the full judicial history of each chapter. This website will be publicized to the campus community and to the parents of all students.

—A comprehensive review of event management guidelines will be conducted and submitted for my approval. The review will include, but not be limited to, the training required for sober monitors, the use of independent bystander intervention services, the distribution of beer and wine for large events, and the number of large events permitted.

Effective Spring Semester 2019:

—Leadership positions in residential Greek letter organizations must be held by junior or senior students who reside in the chapter house.

—A comprehensive review of the Chapter Review Board process that governs recognition for fraternities and sororities will be conducted and submitted for my approval. The review will include, but not be limited to, structure, procedures, process, membership and community expectations.

Effective Fall Semester 2021:

—All residential fraternities and sororities must have a full-time, live-in adviser with clearly stated objectives and expectations for the role.

Said Pollack:

“The behavior in question goes well beyond innocent fun. It includes extremely coercive, demeaning, sexually inappropriate and physically dangerous activities that jeopardize students’ health and lives. The danger of such reckless actions cannot be ignored. Such activities are not tolerated in society and must stop in our Greek letter organizations… I do not take these steps lightly.”

Six and a half years ago, Skorton expressed similar determination in his Times Op-Ed:

“This tragedy convinced me that it was time—long past time—to remedy practices of the fraternity system that continue to foster hazing, Yesterday, I directed student leaders of Cornell’s Greek chapters to develop a system of member recruitment and initiation that does not involve ‘pledging’—the performance of demeaning or dangerous acts as a condition of membership. While fraternity and sorority chapters will be invited to suggest alternatives for inducting new members, I will not approve proposals that directly or indirectly encourage hazing and other risky behavior. National fraternities and sororities should end pledging across all campuses; Cornell students can help lead the way.”

In a November 28, 2012 memo titled “Plan to Meet President Skorton’s Challenge ‘To End Pledging as We Know It,’” Susan Murphy, vice president for Student and Academic Services, announced that Shorton had approved a “comprehensive strategy” for eradicating hazing.

Based on the recommendations of a special task force, the Fraternity and Sorority Advisory Council, and university administrators, staff, and alumni, the comprehensive strategy, as outlined by the Cornell Chronicle, included the following phases:

Effective immediately, fraternities and sororities must:

—Remove the “power differential” between members and initiates, which often leads to coercive behavior, and construct a model that treats all members, prospective or current, as equals;

—Transition from a pledge model to a membership development model that focuses on the organization’s core principles and extends through graduation;

—Secure approval for orientation events, by Cornell and such partners as the national organization, before they occur;

—Shorten new membership orientation to six weeks in 2012-13 and to four weeks thereafter;

—Communicate transparently, including online postings, about all infractions;

—Increase alumni involvement.

Effective Spring Semester 2013:

—The start of formal decision-making about live-in advisers in chapter houses and other issues.

Effective Fall Semester 2014:

—Training will be coordinated and standardized for live-in, chapter and alumni advisers, and consistent academic standards will be established for the Greek system.

“I applaud the work of students, staff and alumni to design a new membership approach for the Greek community,” Skorton said afterwards. “It is clear that progress has been made through this collaborative process. It is equally clear that we are not yet where we need to be.”

The Greek community is the heart of much of the social life at Cornell. About one-third of the university’s 15,000 undergraduates belong to one of 64 recognized fraternities and sororities. Neither Pollack nor Skorton proposed an indefinite alcohol ban on the Greek system—though most undergrads and virtually all pledges are under the New York State drinking age of 21—and both vigorously defended fraternities as part of a proud Cornell tradition.

“Greek letter organizations have a long history at Cornell University and have been a prominent feature of the undergraduate experience since 1868,” said Pollack last week. “The Greek system is part of our university’s history and culture, and we should maintain it because at its best, it can foster friendship, community service and leadership,” said Skorton in 2011.

In its editorial after Pollack’s announcement last week, the Cornell Daily Sun called the new changes “a good first step” but voiced skepticism about their ultimate effectiveness. The Sun said many of the ideas had been tried before, and speculated that Pollack’s alcohol ban would be unenforceable or ignored. “We have a new president, but a very old university, and old habits have an old habit of dying hard,” the Sun said.

It’s Mental Health Awareness Month!

“Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, daily functioning, and ability to relate to others. Mental illness doesn’t develop because of a person’s character or intelligence. Just as diabetes is a disorder of the pancreas, a mental illness is a disorder of the brain that can make it difficult to cope with the ordinary demands of life. No one is to blame—not the person, and not the family.”

So begins “Navigating a Mental Health Crisis,” a new resource guide for to help those experiencing a mental health emergency, published just in time for Mental Health Awareness Month.

Click here to download the guide

The guide includes sections explaining:

—How to understand mental health crises

—How to prepare for a crisis

—What to do during a crisis

—What to do following a crisis

—How to create a crisis plan

The guide is published by the National Alliance on Mental Illness. As NAMI explains:

When mental illness is present, the potential for crisis is never far from mind. Crisis episodes related to mental illness can feel incredibly overwhelming. There’s the initial shock, followed by a flood of questions—the most prominent of which is: “What can we do?”

People experiencing mental illness—and the people who care for them—need information. However, that information is not always readily available and the search for answers may require more energy and persistence than possible in times of crisis.

“Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” provides important, potentially life-saving information for people experiencing mental health crises and their loved ones. This guide outlines what can contribute to a crisis, warning signs that a crisis is emerging, strategies to help de-escalate a crisis, available resources and so much more.

Like any other health crisis, it’s important to address a mental health emergency quickly and effectively. With mental health conditions, crises can be difficult to predict because, often, there are no warning signs. Crises can occur even when treatment plans have been followed and mental health professionals are involved. Unfortunately, unpredictability is the nature of mental illness.

Unlike other health emergencies, people experiencing mental health crises often don’t receive instructions or materials on what to expect after the crisis. That is why we created this guide, so people experiencing mental health emergencies and their loved ones can have the answers and information they need when they need it.

Click here to find more information about NAMI

Click here to connect with NAMI-Finger Lakes chapter

Family & Children’s Service of Ithaca is hosting two special events during Mental Health Awareness Month.

On Thursday May 17 at 7:30 a.m. the organization will hold its annual breakfast celebration at the Country Club of Ithaca, 189 Pleasant Grove Road. The event will honor Lynette Scofield, Claudia Brenner, Sandy True, and the Cayuga at Twilight Committee. Tickets are available for $25 via Eventbrite. Support a great local mental health organization.

On Thursday May 31, F&CS hosts a community screening of The Mask You Live In, a film directed by Jennifer Siebel Newsom that follows a diverse group of boys and young men as they struggle to stay true to themselves while negotiating America’s narrow definition of masculinity. The screening to be followed by a panel discussion takes place at Cinemapolis, 120 East Green Street, from 6-9 p.m. Reserve seats at the Cinempolis website.

Watch the trailer!

Suicide on the Campus: A Task Force, a Death, and a Lawsuit

Legal counsel, risk managers, counseling centers, and student mental health advocates at colleges in Ithaca and across the nation will be monitoring a new lawsuit that asserts that the University of Pennsylvania’s failure to provide “any meaningful help, support and safety net” led to the suicide of 21-year-old business school student Ao “Olivia” Kong. The lawsuit seeks to hold Penn’s trustees accountable for “reckless disregard” in failing to follow best practices for suicide prevention, contending that the university “had a duty to ensure her safety and wellbeing and protect her from harm.” In asserting the university’s negligence, the lawsuit says “Penn didn’t just fail her, it killed her.”

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Ao “Olivia” Kong (Source: Feldman Shepherd)

In the spring of 2016, according to the lawsuit filed on April 10 in Philadelphia County’s Court of Common Pleas, Kong became despondent while struggling with an academic overload and symptoms of anxiety, depression, insomnia, and anorexia during the second semester of her junior year. The 3.3 GPA student feared that she might fail a course, and jeopardize her financial aid as well as an upcoming paid summer internship with Bank of America, the lawsuit says.

Born in China, Kong had immigrated to the United States at age 9 with her parents and became one of the top students in the Philadelphia public school system. She placed first in national math contests and city science fairs; played violin in the school orchestra; was a member of the drama club, varsity tennis squad, and newspaper editorial board; and volunteered in community service organizations. She won early admission to Penn’s prestigious Wharton School, Class of 2017; Wharton is ranked as the No. 1 undergraduate business school in the United States, with annual tuition and fees of $53,534.

Kong was struck and killed by a SEPTA train in West Philadelphia in the early morning of Monday April 11, 2016. The lawsuit brought by her parents contends that in seeking help amidst a mental health crisis from the university’s Counseling and Psychological Services (CAPS), Student Health Center, and the Wharton School, Kong communicated that she was suicidal to Penn professionals on at least nine occasions between April 7 and April 9.

According to the lawsuit, Kong’s suicidal thoughts were expressed directly or indirectly to a CAPS psychiatrist on four occasions; a CAPS clinician; a CAPS social worker; a Wharton academic advisor; and on a CAPS intake form and a school petition for a course withdrawal.

The four-count lawsuit, which alleges negligence, wanton and willful misconduct, reckless disregard, and includes a wrongful death claim and a survival action, reads as a scathing indictment of Penn’s academic pressures and mental health policies and practices as well as of its institutional mindset. It labels the suicides at Penn a “worsening epidemic,” stating that Kong had been the tenth Penn student to die by suicide in three years, and another four have taken their own lives in the two years since then.

“So long as Penn refuses to adequately address the academic and personal stresses underlying these suicides, and take appropriate measures to protect its students from the harms associated with those stresses, it willfully and recklessly exposes its students to an extraordinarily high risk of suicide,” the lawsuit says.

It goes on: “Similarly, Penn’s abject failure to hire competent and qualified professionals to assist its students in managing their stress and/or enact and implement policies designed to ensure the safety, physical and mental wellbeing of its students, constitutes a reckless disregard and callous indifference to the safety, health and wellbeing of its students.”

The lawsuit alleges Penn’s repeated failures to follow best practices related to suicide prevention, including:

— Failure to provide outreach and support programs and to formulate, implement, and enforce policies, practices, and guidelines that comply with current professional standards and nationally established criteria and/or best practices “to reduce academic stress and the risk of suicide”;

—Failure to formulate, implement, and enforce policies, practices, and guidelines to address the warning signs of suicide in students-in-crisis, including those suffering from academic stress; and to assess and treat students with suicide ideation;

—Failure to hire, retain, and ensure that the persons overseeing, supervising, administering, and providing psychological services are aware of and/or comply with best practices for suicide prevention;

—Failure to waive patient confidentiality to inform parents when a student was in imminent danger of suicide;

—Failure to dedicate sufficient resources to reduce the risk of, and prevent, suicides.

The lawsuit slates Penn for other failures, including:

——Failure to formulate, implement, and enforce policies, practices, and guidelines to assess and treat students-in-crisis, including those suffering from academic stress;

—Failure to ensure that information about Penn’s mental health resources is easily accessible to people providing the services and to its students;

—Failure to hire, retain, and ensure that the persons overseeing, supervising, administering, and providing psychological services are aware of Penn’s programs and resources for students-in-crisis;

—Failure to provide adequate procedures for late withdrawal from courses; taking leaves of absence; reducing unmanageable course loads; managing student distress caused by unmanageable course loads; and receiving tutoring services.

Academic Stress and Anxiety

The lawsuit says that Kong was afraid of failing a course, and was frustrated by hurdles in the way of dropping it and by her inability to get academic tutoring. She first reported academic stress, anxiety, lack of sleep, and inability to concentrate during a visit to the Student Health Center on March 30, according to the lawsuit. The attending physician attributed Kong’s signs and symptoms to an upper respiratory infection and fever, and failed to address her academic stress and anxiety or refer her to any university resources for students experiencing such conditions, the lawsuit says.

A week later, after her physical and mental health deteriorated, the lawsuit goes on, Kong placed a call in a state of distress to the after-hours CAPS number at around 1:30 a.m. on April 7. She reportedly told the on-call psychiatrist that she was anxious and afraid of failing a class, unable to sleep, and had experienced a panic attack, feelings of self-hatred, and suicidal thoughts. The lawsuit alleges that the psychiatrist dismissed Kong’s academic fears as “run of the mill” for undergraduates and discussed how CAPS could assist her in dropping the course during regular business hours.

According to the lawsuit, later that day she went to CAPS and conveyed her academic anxiety and current suicidal thoughts on the intake form as well as to a social worker—with whom she also shared her feelings of depression and shame and idea of taking an overdose of sleeping pills as the method of killing herself. The social worker concluded that Kong had no actual intention or means of taking her own life, the lawsuit says. It adds that the social worker scheduled Kong for a follow-up CAPS appointment four days later at 3 p.m. on April 11—by then, Kong had died as the result of blunt force trauma.

Still later on April 7, Kong met with a Wharton advisor, mentioned her past suicide ideation, and filed a petition for late withdrawal from an upper-level course. She explained that she was “struggling with the class and it is causing me to become depressed. I have not been able to sleep for the past week.” She concluded the petition by stating she has “thoughts of suicide.”

According to the lawsuit, after the Wharton advisor alerted CAPS about her meeting with Kong, the CAPS social worker sent Kong an email reminding her of her CAPS appointment the following Monday afternoon April 11; she also said that in the meantime Kong had the options of visiting or calling CAPS during regular business hours, contacting the CAPS after-hours clinician, or calling a national suicide hotline 24/7.

On Saturday evening April 9, after a Penn graduate assistant alerted CAPS of his concern about Kong, the CAPS psychiatrist reportedly spoke with her again by phone for about an hour. She had gone to spend part of the weekend at home with her parents, who were concerned about her welfare but were unaware of her expressed intention to kill herself.

According to the lawsuit, Kong told the psychiatrist of her frustration and hopelessness with Wharton’s “roadblocks” to dropping a class and exploring a leave of absence. “After telling him that ‘people aren’t listening to me,’” the lawsuit alleges, “Olivia said that she planned to return to campus the next day and kill herself.”

Kong and the psychiatrist also discussed the possibility of an inpatient psychiatric admission, which Kong was told was an option “if no other plan can work,” the lawsuit says. When Kong inquired about the expense of an emergency room visit, the lawsuit alleges, the psychiatrist remarked that “the cost of [an emergency room] is likely less than [the] cost of funeral arrangements.”

According to the lawsuit, the psychiatrist advised Kong to speak with her parents and said he would contact Wharton about her academic situation; and said if she could not make it emotionally until her Monday appointment with CAPS, she had the options of calling CAPS, dialing 911, or to “get herself to the ER.”

The lawsuit faults Penn professionals for failing due to ignorance or incompetence to refer Kong to multiple available mental health services and programs; failing to develop a treatment plan for Kong’s suicide ideation, provide psychotherapy and medication, or refer her to a local hospital or emergency room; failing to notify Kong’s parents that she was at imminent risk of self-harm, or to arrange for somebody to stay with Kong until she obtained medical help; failing to alert the police of her intention to take her own life; failing to relieve Kong of severe academic stress; failing to ensure that she was capable of handling a heavy course load.

“The failure of these multiple professionals,” the lawsuit argues, “to take adequate and proper precautions or preventative measures to adequately treat Olivia and protect her from harm during a period when they knew her articulated suicidal thoughts and plans or in the exercise of due care should have known that she was suicidal and that she was incapable of maintaining proper perspective and making sound decisions regarding her health, safety and wellbeing was the proximate cause of her suicide.”

Standards and Practices

The lawsuit does not specifically identify a source for its reference to professional standards and nationally established best practices. However, one prominent example is the 2012 National Strategy for Suicide Prevention, released by the U.S. Surgeon General, which describes goals to “promote suicide prevention as a core component of healthcare services” and to “promote and implement effective clinical and professional practices for assessing and treating those at risk for suicidal behaviors.” The strategy is meant to guide suicide prevention actions in the United States throughout the decade.

In February 2016, The Joint Commission, a body that accredits healthcare programs in the United States, issued recommendations to improve the treatment of individuals with suicide ideation. The commission urged all healthcare organizations “to develop clinical environment readiness by identifying, developing and integrating comprehensive behavioral health, primary care and community resources to assure continuity of care for individuals at risk for suicide.”

Furthermore, the commission said, “it’s imperative for healthcare providers in all settings to better detect suicide ideation in patients, and to take appropriate steps for their safety and/or refer these patients to an appropriate provider for screening, risk assessment, and treatment.”

Many experts point to the Zero Suicide Model of the Suicide Prevention Resource Center (SPRC) as a prime example of best practices; it holds that “suicide deaths for individuals under care within health and behavioral health systems are preventable.”

The question of whether universities and college counseling centers have a legal “duty of care” to prevent suicide is currently evolving. A strong legal precedent has yet to be established, due in part to the fact that many lawsuits alleging university negligence in suicide cases are settled before they reach court.

Guidance issued by SPRC notes that in successful medical malpractice lawsuits, the plaintiff proves a breach of duty of care by showing that the defendant’s act or omission fell below the standard of care and increased the risk of harm to the plaintiff. The core of a suicide case, SPRC says, is whether the suicide was “foreseeable”—that there was a reasonable anticipation that some harm or injury is likely to result from certain acts or omissions.

The Jed Foundation, with which Penn maintains a mental health review partnership, argues that “ultimately, litigation risk can be substantially reduced by following some simple advice—use good professional judgment; develop a comprehensive suicide/violence prevention program; follow written and/or unwritten policies and protocols; ensure that available mental health services are in keeping with professional codes of ethics and standards of practice.”

The Kong lawsuit also takes Penn administrators to task for the way in which they announced Kong’s death. Initially, the lawsuit says, President Amy Gutmann informed the campus community of a student death without identifying the student or the manner of death. The same day, Penn representatives allegedly told Kong’s parents as well as Wharton undergraduates that her death was an “accident.”

“Responsibility for Their Own Wellbeing”

Kong’s death occurred just a year after a high-profile Penn task force issued a report praising Penn for its “impressive” and “wide array” of mental health resources, peer-education and support groups, and singling out CAPS for providing “excellent services to a wide range of students.” The report said that the “unwavering commitment” of staff and faculty to ensuring mental health support for students was “very impressive” and “clearly evident.”

Rather, the report said, the problem was the pressures engendered by the perception among Penn students that “one has to be perfect” in every academic, co-curricular, and social endeavor. That perception can lead to stress and distress, compounded in some cases by the endemic use or misuse of alcohol or other drugs, lack of sleep, and improper nutrition, the report said.

The report emphasized that “stress is a normal part of life,” that “campuses across the country” face mental health challenges, and that college students are not statistically at a higher risk for suicide. At Penn, the report stated, “students (undergraduate, graduate, and professional) are expected to take responsibility for their own wellbeing.”

The report recognized that “during times of stress or distress, it is challenging to maintain one’s perspective and to make sound decisions about whether and to whom to turn for help.” Therefore, the report explained, “Penn has a strong and committed network of individuals and of offices that can either provide direct assistance or ensure that students are appropriately referred.”

Gutmann and Provost Vincent Price convened the task force in February 2014 shortly after two student suicides, and charged it with examining student mental health challenges; reviewing Penn’s programs, policies, and practices for addressing the challenges; and making recommendations for improvement.

The task force said there were “opportunities to further strengthen the university’s efforts” and made recommendations in four main areas: 1) communicating to students about the importance of mental health and wellbeing to their academic success; 2) making information about Penn’s mental health and wellness resources more accessible; 3) educating and training faculty, staff, students, and parents about mental health and in responding to students who need help; and 4) “optimizing” the resources the university devotes to psychological counseling.

The report cited “the limits” on the resources Penn provides to CAPS and made no recommendation to increase funding; instead, the report said that CAPS should communicate to students—as well as to staff, faculty, and students who refer students to CAPS—that CAPS is only designed to provide short-term care and make referrals to other care providers.

The Kong lawsuit, arguing that Penn failed to provide and/or dedicate sufficient resources to implement and enforce current professional standards and nationally established best practices for reducing academic stress and the risk of suicide, challenges the task force’s claim of funding limitations. “Given Penn’s $12 billion endowment, there were (and are) sufficient resources to address its continued failure to ensure the safety of its students, but for inexplicable reasons, it has failed (and continues) to do so,” the lawsuit says.

The lawsuit takes issue with the task force for “shockingly” placing “the responsibility for its students’ health and wellbeing not on the professionals associated with those offices and programs but on the students themselves” and for concluding “that the problem did not lie with those programs and resources but in persuading students to use them.” The lawsuit says “the ultimate irony” is that Kong “not only sought help from all of the resources available to her, but she also specifically communicated her suicidal thoughts and plans, all to no avail.”

Nevertheless, the lawsuit adds, the task force report established that “Penn was clearly aware that the highly competitive academic stresses it placed upon its students not only increased their risk of developing depression and anxiety but decreased their ability to maintain proper perspective and make sounds decisions about their safety, health and wellbeing thereby increasing their risk of committing suicide.”

The lawsuit blames Penn for failing to ensure that the members of the task force were “qualified” or that its findings and conclusions complied with current professional standards and nationally established best practices to reduce academic stress and the risk of suicide. The lawsuit accuses Penn of failing to ensure that “the entire Penn community” was aware of and complied with the findings, recommendations, and conclusions of the task force.

The lawsuit criticizes Penn for excluding students from the task force reviewing the university’s mental health policies and practices; the 10 task force members were all Penn senior administrators and academic officers, including five vice presidents and vice provosts, and a number of current and former deans and department chairs.

In response to the Kong lawsuit, a university spokesperson told local media that Penn does not comment on pending litigation.

After Kong’s suicide, Penn reconvened the mental health task force in 2016 but did not release a new report. According to the Daily Pennsylvanian, “the University’s task force concluded after Kong’s 2016 death that Penn’s wide array of ongoing mental health initiatives are sufficient to address the issue.” Penn’s student newspaper quoted task force co-chair Rebecca Bushnell, a former dean of arts and sciences, saying: “The task force completed its work at the end of the summer of 2016, so we have nothing new to say.”

[If you or someone you know feels the need to speak with a mental health professional, you can contact the Crisisline (National Suicide Prevention Lifeline) at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]