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"What Killed the Duke Co-ed?" So screamed the newspaper headline following the unexpected death of junior Chris Sanders in his dorm room April 3.

We may never have all the answers in that case, and it may be nobody's business. But the question strikes at the heart of what is suddenly one of the hottest topics in higher education today.

As the Virginia Tech tragedy proved, there is still the potential for serious lapses in the mental health treatment systems available on college campuses. Many media outlets and experts have speculated that more proactive information sharing by Tech administrators could have averted the tragedy or at least flagged the shooter as a potential risk.

The issue has grabbed the attention of officials far beyond the collegiate community. In a report to President George W. Bush by three members of his cabinet following the shootings, the federal government made it clear that changes must be made in the way schools approach mental health emergencies.

Duke officials say they have safeguards in place to prevent anything so severe from happening on our campus. Still, if Sanders' death has taught us anything, it's that tragedy can strike even the most picture-perfect lives.

University statistics back up the notion that mental health is a rising concern on campus. Last year, more than one in 10 undergraduates visited Counseling and Psychological Services, up 24 percent from 2000-01.

Ten percent of those have expressed suicidal thoughts, according to CAPS Director Kathy Hollingsworth. Add up the numbers, and you'll find that one percent of undergraduates have at least considered killing themselves.

That's not some hypothetical theory from some study performed halfway across the country. These are raw numbers, the bitter truth.

"These aren't things that we talk about very widely," Hollingsworth says. "The stereotype is that as your IQ goes up and you become more gifted, somehow you don't have mental health issues."

CAPS has a well-publicized wait to see its therapists that can be up to 2 1/2 weeks at certain points of the year-though Hollingsworth says emergency consultations can be arranged within minutes.

In Sanders' case, the University won't talk specifics, citing family wishes. Hollingsworth declined to comment on whether he visited CAPS at any point. But Bob Thompson, dean of Trinity College and a former child psychologist, says containing the fallout was a top concern in the weeks afterward.

"The trauma to the friends whenever a suicide takes place is really disruptive, so we will work to help professors know there are students in their class. who are having something difficult to cope with," Thompson says.

At Virginia Tech, exams were made optional for all students. Friends of Chris Sanders had the option of working with their academic deans on specialized plans for their schoolwork during the grieving process.

Hypothetically, anyone could have taken an incomplete as a semester plan and made up the work within the first five weeks of fall semester, Thompson says.

And as Duke attempts to learn from Tech's mistakes, there remains a "dynamic tension", in Thompson's words, between ensuring a student's individual privacy and protecting the safety of the community-at-large.

Certainly, no one would claim that all mentally ill students should be suspended until they recover.

"Just because someone is depressed doesn't mean they can't be a part of the academic community," Thompson says. "It's the same as if they have a handicap."

A handicap that can, however, begin to affect those around the afflicted. Thompson concedes that if a student were, for instance, "an active fire setter," they would be removed at once.

Of course, where do you draw the line? And how can anyone measure a student's danger to himself? Clues from the Virginia Tech shootings suggest that dark academic writing could have tipped off administrators there to possible danger.

His assignments "dripped with anger," former professors told CNN. The former chair of Virginia Tech's English department told the network that without an explicit threat, she had few options-so she taught him one-on-one.

"I just felt I was between a rock and a hard place," she said. "It seemed the only alternative was to send him back to the classroom, and I wouldn't do it."

Ian Baucom, chair of Duke's English department, declined to comment on whether he had ever seen dangerous writing from a student at the University. He also declined to say whether his department had ever referred anyone to CAPS for further consultation.

Hollingsworth says she receives referrals from students, staff and professors daily, totaling more than 700 in the past year. Most are casual conversations to ascertain if a student's behavior is only a sign of a bad day or of something far worse.

Those reference calls are highly correlated with severity and urgency, she says.

But Baucom says he believes there is a limit to how far he would expect one of his professors to get involved with a potentially mentally ill student. Although the Virginia Tech shooter was flagged by the English department, Baucom added that he doesn't think his faculty has any further responsibility to keep an eye out than professors of economics or math, for instance.

"What's important for us is to realize what we are competent to do.. Our fundamental responsibility is to teach," he says. In the event of an emergency, an English professor would contact the academic dean, who would liaise with student affairs and counseling services.

It's that sort of circulatory process that the federal report seems to criticize. The report notes that many professors are unaware of the crucial warning signs of dangerous behavior and are unable to get in touch with mental health experts fast enough.

In a June issue of The Chronicle of Higher Education, Peter Lake of Stetson University College of Law writes that universities need to end their resistance to change, and stop trying to "deflect responsibility."

"Higher education. frequently operates in ways reminiscent of its feudal past: Our institutions were designed to preserve and protect knowledge, not students," Lake writes. "Virginia Tech will remind us that a college is a unitary organism, and that it cannot afford to have any student who is seriously withdrawn and isolated or a total loner."

Administrators interviewed for this article rejected the argument that Duke's process moves too slowly. Hollingsworth says she has moved "in minutes" to help suicidal students in the past.

The first line of defense remains the resident assistants in the dormitories, although only to a point. RAs are not allowed to refer a student directly for counseling, even in the most pressing emergency.

The Academic Resource Council has recently taken on a full-time psychologist-previously split between the ARC and CAPS-to sort out whether distressed students are suffering from academic or emotional issues.

And those students with the biggest success stories, students who have successfully overcome mental health issues with the help of CAPS, are not inclined to speak to the campus media about their healing process, Hollingsworth adds. On the other side of the spectrum, those in the most peril are sometimes the hardest to reach out to.

"How do you talk to a friend who's always smiling and doesn't seem like they have any problems?" Hollingsworth says.

It doesn't help that even some school-sponsored programs about mental health approach the issues in a joking manner. Think Party Boy Chad during "The Real Deal, "poking fun at alcohol abuse, date rape and depression.

"One of the things we're undertaking is a campaign to bring many more discussion groups and dialogues that don't involve a costume or alcohol," Hollingsworth says.

As for the University's most recent tragedy, those with the answers aren't talking. No one is saying whether or not his death was preventable, only that it did not involve foul play. But Dean of Students Sue Wasiolek says conversations are underway out of the public eye.

"Anytime there is a death on campus, it absolutely demands us to review the situation and try to figure out if there's something we could have done or did do differently," Wasiolek says.

No word yet on whether the answer to that question is "yes" or "no."

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