Vol. 23, No. 3, Aug. 7, 2003
Mandatory counseling appears to reduce suicide rate by half
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Ill. — Suicide is said to be a "cry for help," but the evidence
suggests the contrary. Most college students who threaten or attempt to kill
themselves will adamantly, even defiantly, resist any counseling that’s
So the suicide-prevention program at the University of Illinois at Urbana-Champaign makes counseling assessment sessions mandatory. And almost two decades of data suggest that doing so has helped reduce the rate of student suicide by more than half – while the national rate has remained roughly constant. (About 1,110 college students kill themselves each year, according to a 1997 study of suicide on Midwestern university campuses.)
A student at Illinois must attend four sessions with a counselor following a reported suicide threat or attempt, or the student may be forced to leave school. Without this policy, only about 5 percent of these students would ever complete the four sessions, and most would not make it to the first, says Paul Joffe, director of the suicide-prevention program at Illinois and a counselor in the Counseling Center.
With the policy, paired with an aggressive effort to contact students, the response rate has been in the high 90s, and this past year was 100 percent. (One student has had to leave school as a result of the policy, but later returned and graduated.)
Based on common wisdom, it doesn’t make sense that it should work, but it does, Joffe said. Students threatening to end it all still care about staying in school.
More important, the policy and program appear to have saved lives. During the first 19 years of the program, none of the students involved in 1,670 reported suicide threats or attempts has later committed suicide while enrolled as a student, Joffe said. All of the suicides during that time came from "out of the blue," Joffe said, with no previous report of suicidal behavior by those students.
During the eight academic years prior to the program, from 1975 to 1983, 19 students committed suicide within Champaign County. During the 19 years since, through the past spring semester, there were 20 suicides within and outside the county. That meant the average annual rate dropped from 6.91 deaths per 100,000 enrolled students during the first period to 2.90 during the second, a reduction of 58 percent.
The suicide-prevention program grew out of a study by Joffe, with help from the county coroner’s office, in which Joffe looked at the 19 suicides between 1975 and 1983. He found that 12 of the 19 had shown suicidal intent, in the form of a public threat or attempt, and just one had seen a campus counselor.
What Joffe and some colleagues discovered early in the program, and since, is the extent to which many of these students are engaged in a "suicide career." The students see suicide as a means of gaining power and control over their own lives, often feeling unable to relieve their distress in less dramatic ways, he said. Ironically, they often feel little distress about the idea of suicide itself.
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