Suicide Attempts and Threats on One College Campus: Policy and Practice

Abstract

Because of a university policy requiring a mental health evaluation of every student who is cause for worry with respect to his or her own safety, the counseling center at the College of William and Mary has been able to examine almost all situations in which students are suicidal or thought to be suicidal. Over the course of 1 calendar year, counseling center clinicians recorded data on every case of students who attempted or threatened suicide or were otherwise of concern to residence life staff or faculty or administrators because of a perceived potential for suicidality. Sixty such situations, including 11 suicide attempts and 14 threats, arose. No completed suicides were recorded. The rate of suicide attempts was 14.5 per 10,000 students, and the rate of suicide threats was 18.4 per 10,000 students, a total of 32.9 cases per 10,000 students. Findings by race, gender, and class are outlined, although low base rates did not yield adequate statistical power to make comparisons practical within these groupings. The most prevalent risk factor found in suicide attempters was work or school failure; for suicide threateners, it was difficulty in a relationship; and for those found to be nonsuicidal, the major problem was social isolation. Follow-up therapy was the most frequently used intervention for attempts and threats, whereas instructions for using the emergency on-call system was the most used option in the otherwise worrisome cases. The majority of the suicide attempts resulted in an inpatient stay at the college infirmary or at a hospital. The utility of a policy mandating evaluation of suicidality is discussed.