Cornell President Promises Holistic Review of Student Mental Health

Cornell University President Martha E. Pollack says that Cornell will be conducting a “comprehensive review” of student mental health, possibly beginning in early 2019. She says the “team” at Cornell Health had advocated for the review “to provide an opportunity to look holistically at mental health on our campus.”

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Cornell University campus

Pollack’s statement came in a letter dated September 20 to Scott MacLeod and Susan Hack, the co-founders of The Sophie Fund. In a letter dated August 23, they had called on Pollack to “appoint without further delay an independent, external-led task force to review and assess the mental health challenges for Cornell students, and the university’s policies, practices, and programs to address them; and to make recommendations to the Cornell President to ensure that the university is implementing current best practices.”

MacLeod and Hack published their letter to Pollack in a blog post on September 8 headlined, “Time for a Mental Health Task Force at Cornell.”

In her reply to the MacLeod/Hack letter, Pollack said: “We will be conducting a comprehensive review of student mental health at Cornell… The team at Cornell Health—those in both clinical and educational roles—have advocated for this review to provide an opportunity to look holistically at mental health on our campus.”

Pollack said that Cornell Health “will work with the campus community” beginning this semester “to determine the appropriate scope for this review, which could potentially begin in early 2019.”

Pollack thanked MacLeod and Hack “for your advocacy for providing the best possible environment to support the mental health of Cornell students.”

Pollack’s letter did not respond directly to MacLeod/Hack’s request for an “independent, external-led” review. In their letter, they wrote: “The independent task force should be led by a recognized public health expert with a strong background in mental health and without any current or previous ties to Cornell or to organizations and professional associations focused on collegiate mental health.”

In a September 18 email to Cornell students reported by the Cornell Daily Sun, Vice President Ryan Lombardi announced plans for “a comprehensive review of student mental health” that will bring together “internal and external partners.”

In a September 18 email to the Sun, Lombardi said: “While for many years the university has engaged in regular assessment of student mental health needs and evaluation of services and programs, the decision to pursue an additional comprehensive review of student mental health reflects the University’s commitment to promoting health and well-being as a foundation for academic and personal success.”

In a statement to the Graduate and Professional Student Assembly (GPSA) on September 24 reported by the Sun, Lombardi said he “can’t speak … to exactly who” will be conducting the review but that the administration does “envision it being external audiences.”

“I think part of the first step is to understand what we want to look at, and then I think that will really inform that broader question about who’s best to come in,” he said. “Obviously I think we’re going to want people to have expertise in mental health. I don’t want that just to be Cornell folks.”

In her letter to MacLeod and Hack, Pollack noted that the intention to conduct a comprehensive review was cited in an update about “diversity and inclusion” initiatives posted on the Office of the President’s website, apparently in early September, and announced in Lombardi’s email to students on September 18. The reference read as follows:

Conduct a comprehensive review of student mental health.

Cornell Health will work with the campus community during the fall 2018 semester to determine the appropriate scope for a comprehensive review of student mental health at Cornell, anticipating that such a review could potentially begin in early 2019.

MacLeod and Hack, whose daughter Sophie (’14) died by suicide while on a health leave of absence in 2016, initially wrote to Pollack on April 19, 2017 detailing their concerns about “systemic failure” in Cornell’s institutional handling of mental health matters, and calling on her to launch an independent task force review. However, in a letter to MacLeod and Hack on January 11, 2018, Pollack declined their request, citing an “external assessment” conducted by The JED Foundation, JED’s on-site visit to the Cornell campus in the summer of 2017, and Cornell’s “ongoing engagement with the foundation to ensure we are providing holistic support.”

MacLeod and Hack said that they wrote to Pollack in August asking her to reverse her decision after studying the JED review and finding it “plainly insufficient.” They said a glaring omission was the lack of any reference in findings or recommendations regarding the capacity of the Counseling and Psychological Services staff to meet the demands of students for services. Another omission, they said, was the lack of any reference to the capacity of community mental health providers to address the needs of Cornell students referred to those off-campus services by CAPS. They said that the JED-review documents reported no findings and recommendations in areas such as academic workloads and faculty and academic staff handling of students in distress, and appeared to lack a comprehensive assessment of Cornell’s suicide prevention policies and practices.

MacLeod and Hack also questioned the independence of the review, pointing out that institutions of higher education pay The JED Foundation a fee to become what JED calls “partners” in the JED Campus program. They also said that the JED review entailed only one on-site campus visit by a JED External Contributor, one that lasted merely three hours and did not include meetings with any of the community providers who receive many CAPS referrals. They also said it appeared that Cornell had not released all relevant documents pertaining to the JED review.

In response to Pollack’s September 20 letter, MacLeod and Hack said in a statement:

“We welcome President Pollack’s personal engagement and specifically her commitment to conducting a comprehensive review of student mental health at Cornell. We commend Cornell Health for advocating for this review “to provide an opportunity to look holistically at mental health on our campus,” as President Pollack said. Lastly, we are encouraged to know that the Cornell administration will consult with students and other members of the community as the review proceeds.

“There is a mounting mental health crisis facing our young people today, and the goal of the comprehensive review should be not merely to tinker with the existing system but to create a gold standard for supporting student mental health in the years to come. As one of the world’s leading research institutions, Cornell should expect no less of itself.

“We continue to stress the importance of a truly independent, robust, and transparent review, led by an external expert—a recognized public health authority with a strong background in mental health and without any current or previous ties to Cornell. This is vital, both to ensure the best possible outcome and to win the confidence of Cornell students and the wider campus and Ithaca communities that the university administration is doing its utmost to support student mental health.”

The full September 20, 2018 letter from President Pollack:

Dear Ms. Hack and Mr. MacLeod,

Thank you for your letter dated august 23, 2018, and for your care and concern for the mental health and well-being of Cornell students.

As you may have seen in our recently announced diversity and inclusion initiatives (https://president.cornell.edu/diversity-and-inclusion-initiatives/), we will be conducting a comprehensive review of student mental health at Cornell. Beginning this semester, Cornell Health will work with the campus community to determine the appropriate scope for this review, which could potentially begin in early 2019. Vice president Lombardi also shared this news with our students in a message sent on September 18, along with other updates and investments in mental health support services.

The team at Cornell Health—those in both clinical and educational roles—have advocated for this review to provide an opportunity to look holistically at mental health on our campus. We also continue to engage with and support mental health resources in the larger community.

Thank you again for reaching out to me and for your advocacy for providing the best possible environment to support the mental health of Cornell students.

Sincerely,

Martha E. Pollack

Time for a Mental Health Task Force at Cornell

We have written a letter to President Martha E. Pollack stating that the recent review of Cornell University’s mental health practices by The Jed Foundation is “plainly insufficient” and calling on her to appoint an external-led task force to perform an “independent, transparent, and robust review.”

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Statue of Andrew Dickson White, Cornell’s first president, in the Arts Quad

Our daughter, Sophie Hack MacLeod ’14, died by suicide at age 23 in Ithaca while on a Health Leave of Absence from Cornell, where she was enrolled in the College of Architecture, Art, and Planning. In setting up The Sophie Fund in her memory to advocate for mental health initiatives aiding young people in the greater Ithaca community, we became very concerned about the mental health policies, programs, and practices for supporting Cornell students.

We initially wrote to President Pollack on April 19, 2017, just after she assumed office as Cornell’s 14th president, detailing our concerns about “systemic failure” in Cornell’s institutional handling of mental health matters, and called on her to establish an independent task force to report on Cornell’s mental health policies, practices, and programs and to make recommendations on needed improvements.

In a January 11, 2018 email to us, President Pollack declined our request. She cited an “external assessment” conducted by The JED Foundation, JED’s on-site visit to the Cornell campus in the summer of 2017, and Cornell’s “ongoing engagement with the foundation to ensure we are providing holistic support.” She also cited the JED review in subsequent remarks to Cornell’s Graduate and Professional Student Assembly (GPSA) and the Cornell Daily Sun.

In a letter last month, dated August 23, we informed President Pollack that we have examined what Cornell has made public about JED’s “external assessment” and concluded that it is plainly insufficient. It is not the independent, transparent, and robust review that we sought and that we believe Cornell’s students deserve. And it does not adequately address many of the concerns we raised in our original 2017 letter—about practical issues such as campus and off-campus mental health services and the high incidence of sexual assault and hazing misconduct, as well as policy concerns such as a defensive mindset that appears to prioritize Cornell’s public image over the welfare of students struggling with mental disorders.

We pointed out that, despite her promise to release the JED report, to date Cornell has chosen to publish—on the Cornell Health website—only two documents related to the review.

A glaring and troubling omission in the two posted documents is any reference in findings or recommendations regarding the capacity of the Counseling and Psychological Services staff to meet the demands of students for services. Another omission is any reference to the capacity of community mental health providers to address the needs of Cornell students referred to those off-campus services by CAPS. The documents report no findings and make no recommendations in areas such as academic workloads and faculty and academic staff handling of students in distress.

We explained to President Pollack that it does not appear that the JED review included a comprehensive assessment of Cornell’s suicide prevention policies and practices. However, we commended Cornell Health Executive Director Kent Bullis for recently announcing provisional support for the Zero Suicide Model initiative within the framework of the Tompkins County Suicide Prevention Coalition.

As we wrote in our letter to President Pollack, we do not believe that the JED review can be considered an independent external assessment because institutions of higher education pay The JED Foundation a $22,000 fee to become what JED calls “partners” in the JED Campus program. Furthermore, the director of Cornell’s Counseling and Psychological Services has a longstanding professional relationship with JED and is a member of its Advisory Board. The JED External Contributor who conducted JED’s on-site visit to the Cornell campus is a professional colleague of the CAPS director.

Neither of the two posted documents contain any JED findings; rather, in the first document JED merely makes brief comments on Cornell’s self-reported survey responses, and in the second document JED makes recommendations without reference to any findings they are presumably based on.

We understand that the review entailed only one on-site campus visit by a JED External Contributor, and the visit lasted merely three hours. We also understand that the External Contributor’s visit did not include meetings with any of the community providers who receive many CAPS referrals.

According to the JED Campus program, its partnerships with participating colleges’ mental health programs include the following five elements, which Cornell has not released: a Strategic Plan “complete with detailed objectives and action steps for implementation”; a Fourth-Year Post-Assessment “evaluating systems change”; a Healthy Minds Study, which JED describes as “an in-depth assessment of students’ attitudes, behaviors and awareness of mental health issues”; a Feedback Report on the JED Campus and Healthy Minds Study findings; and a Summary Report containing data analysis for the JED Campus assessment and the Healthy Minds Study. JED declined to release its Cornell report to us, citing a confidentiality agreement with Cornell.

We believe that the JED review is clearly inadequate for a comprehensive assessment of the serious mental health challenges faced by a large university campus today, especially one located in a small upstate community. As we reminded President Pollack, the 2017 Cornell PULSE Survey of 5,001 undergraduates reported that 71.6 percent of respondents often or very often felt “overwhelmed,” and 42.9 percent said that they had been unable to function academically for at least a week on one or more occasions due to depression, stress, or anxiety. Nearly 10 percent of respondents reported being unable to function during a week-long period on five or more occasions. Nine percent of the respondents—about 450 students—reported “having seriously considered suicide at least once during the last year,” and about 85 students reported having actually attempted suicide at least once in the last year.

We have often heard the view that Cornell’s mental health policies are better than those of many universities, and that Cornell’s mental health statistics are no worse. We find such a complacent view to be surprising and disappointing, especially coming from a world-renowned research institution. In fact, these escalating mental health challenges require a relentless approach in response from everyone in a position to act. We truly hope that President Pollack—and Cornell—will lead the way.

—By Scott MacLeod and Susan Hack

Scott MacLeod and Susan Hack are the co-founders of The Sophie Fund, a nonprofit organization advocating mental health initiatives aiding young people in the greater Ithaca community. The organization is named in memory of their daughter Sophie Hack MacLeod, a Cornell fine arts student who took her own life in Ithaca in 2016.

UPDATE 9/7/18:

Lee Swain, director of JED Campus, sent the following comment to The Sophie Fund:

I do see one inaccuracy I’d like to correct related to this paragraph:

“According to the JED Campus program, its partnerships with participating colleges’ mental health programs include the following five elements, which Cornell has not released: a Strategic Plan “complete with detailed objectives and action steps for implementation”; a Fourth-Year Post-Assessment “evaluating systems change”; a Healthy Minds Study, which JED describes as “an in-depth assessment of students’ attitudes, behaviors and awareness of mental health issues”; a Feedback Report on the JED Campus and Healthy Minds Study findings; and a Summary Report containing data analysis for the JED Campus assessment and the Healthy Minds Study. JED declined to release its Cornell report to us, citing a confidentiality agreement with Cornell.”

The elements you describe are part of our current program. I believe Erica explained to you how the program has changed. When Cornell joined, the program was designed slightly differently than is currently described on our website. For instance, we did not have a partnership with or include the Healthy Minds Study at that time. So, Cornell did not participate in that data collection. Also, Cornell is not completely through the four year program yet, which is why they have not posted or shared the “fourth year post assessment” as it has not yet been completed. It should also be noted that because Cornell joined an earlier version of the program than what is described on the website, they also only paid $1,950, the cost of the program at that time, not the $22,000 that schools currently pay which includes the Healthy Minds Study, a day long visit (sometimes a bit more) and policy and protocol review (both at the beginning of the program and throughout as policies are changed/adapted). We also collect more data on counseling center utilization, crisis incidents, and staffing patterns in the current version of the program than in the original version.

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.

 

Cornell Says “No” to Independent Review of Mental Health Policies

Cornell University President Martha E. Pollack this week rejected a request to establish an independent task force to review the mental health challenges facing Cornell students as well as the university’s policies, programs, and practices to address them.

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Cornell University President Martha E. Pollack

The request was made 10 months ago by Scott MacLeod and Susan Hack, the parents of Sophie Hack MacLeod (’14), a Cornell fine arts student in the School of Architecture, Art, and Planning who died by suicide in Ithaca at age 23 on March 26, 2016 while on a health leave of absence taken in her senior year.

The request was originally sent in a letter to Interim President Hunter R. Rawlings III and then forwarded to Pollack after she took up her post as Cornell’s 14th president in April 2017. The letter was also cc’d to Cornell Board of Trustees Chairman Robert S. Harrison.

In the detailed 13-page letter dated March 27, 2017, MacLeod and Hack said that in their experience as the parents of a Cornell student who took her own life they observed “systemic failure” in Cornell’s mental health policy and practice affecting areas such as suicide prevention, mental health counseling, and sexual violence.

This, they wrote, included a failure to “fully and openly recognize the magnitude of the mental health challenges facing Cornell, and to address them with best practices backed by human and financial resources commensurate to the scale.”

MacLeod and Hack said they observed “an institutional mindset reflecting complacency and defensiveness that appears to prioritize Cornell’s public image over the welfare of students struggling with mental disorders.”

Describing the mental health crisis confronting today’s college students, MacLeod and Hack cited several studies including the 2016 annual report of the Center for Collegiate Mental Health. The report said that collected data from 139 college counseling centers showed that 33.2 percent of 150,483 college students seeking counseling in the 2015-16 academic year had “seriously considered attempting suicide.” That was a marked increase from 23.8 percent in the 2010-11 academic year. The data also showed that 9.3 percent of the students seeking counseling had reported actually making a suicide attempt.

The letter went on:

“In a constructive spirit, we call on you to establish an independent, external-led task force on student mental health without delay to review and assess the mental health challenges for Cornell students and the university’s policies, programs, and practices to address them; and to make recommendations to the Cornell President to ensure that the university is adopting and implementing current best practices.”

In her initial response on May 3, 2017, Pollack did not address the request for an independent review but thanked MacLeod and Hack for “voicing your broader concerns about Cornell’s policies and programs regarding student mental health.” She added, “We strive to always be open to how we can do better.”

In an email on January 11, Pollack turned down the request for a task force. She also declined a November 28 follow up request from MacLeod and Hack for a meeting to discuss the request for an independent review with the Cornell president in person.

Pollack’s email said in part:

“Please know that we share your commitment to ensuring that we provide the best support possible for our students. …

“We have been thoroughly reviewing our operating standards and capacity at Cornell Health this fall, including institutional and board-level conversations about the operational and strategic direction of the center. On a related note, we reviewed our most recent external assessment provided by the JED Foundation along with their subsequent visit to our campus this past summer. We will continue ongoing engagement with the foundation to ensure we are providing holistic support.

“While I acknowledge your request that we establish an additional independent review of the Cornell Health operation, it is not our intent to do so. We appreciate your support and look forward to our continued collaboration in the future.”

MacLeod and Hack established The Sophie Fund in their daughter’s memory in 2016 to advocate for mental health initiatives aiding young people in Ithaca and Tompkins County.

Commenting on Pollack’s decisions, MacLeod and Hack said in a statement:

“We have done our best to responsibly bring our concerns to the attention of the university’s senior leadership. President Pollack’s decisions don’t improve our confidence that Cornell has grasped the magnitude of its mental health challenges or fully stepped up to meet them. We hope the internal review she speaks of will be comprehensive and not limited to Cornell Health, and that its findings will be transparently released to the Cornell and Ithaca communities.”

According to Cornell’s website, it ranks 14th among the world’s universities in the 2018 QS World University Rankings, with an enrollment of about 22,000 students.

Starting the Conversation

Talk to each other… it may save a life…

“Starting the Conversation” is an excellent new guide helping students (and parents) to learn about mental health conditions and signs that need serious attention—and how to talk about them. One in five students will experience a mental health condition in college.

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The guide explains why it is so important to have conversations and create awareness—including among students and their parents.

“Conversations allow you to plan for the unexpected; to know what to do if you develop emotional distress, a mental health condition or if an existing condition worsens. Talking about mental health is important even if you don’t experience a mental health condition because a friend may need help. Students often prefer to confide in a friend before confiding in anyone else—or you may notice that a peer is struggling and you may be able to assist. By learning more, you’ll be better equipped to know what to do if you or a friend is in distress.”

Click here to download “Starting the Conversation.” It was released yesterday for the start of National Suicide Prevention Awareness Month 2016 by the National Alliance on Mental Health (NAMI) and The Jed Foundation.

Here’s a sample:

STRESSORS THAT MAY AFFECT MENTAL HEALTH

Relationship breakups

Academic pressures

Poor grades

Financial stress

Social status pressures

Feeling alone or homesick

Feeling marginalized, misunderstood or like you don’t fit in

Concern or worry about your family members at home

Loss of day-to-day family or community support

Drug and alcohol use

Inadequate sleep

Feeling overwhelmed

Grief

Gender and sexuality questioning

Friendship challenges

Sports team losses

Unmet expectations

Read TIME magazine’s report this week on the “Starting the Conversation” guide.

Active Minds is a student organization with branches on college campuses throughout the USA and Canada devoted to “changing the conversation about mental health.” Active Minds is promoting awareness activities this month: click here to read their guide for getting involved.

For parents, a good video to watch is Not My Kid: What Every Parent Should Know. The video was produced by the Society for the Prevention of Teen Suicide.