壓力大的康乃爾

Wall street journal昨天的新聞
基本上是說我們學校學生壓力大 從前自殺率高
現在採取有效的方式 所以自殺率降低很多
形容我們學校為什麼 學生壓力大自殺率高
主要是因為
「我們學校地理位置孤立 然後在山丘多的地方
因為這樣特殊的地形
所以學生比較容易 跳下峽谷自殺....」
The university was named the most stressful of 15 top schools in a 2000 book that surveyed students. Adding to its reputation was the campus's physical isolation in the rolling hills of central New York state, and its unusual local geography. Over the years, some students and others took their lives by flinging themselves off one of Ithaca's steep gorges. Stressed-out students have sometimes joked about wanting to "gorge out."
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聯合報的節譯
康乃爾防學生自殺 隱私權放一邊
【聯合報╱本報訊】
2007.12.30 03:23 am
華爾街日報報導，許多大學宣稱隱私法規，使校方即使發現學生有情緒問題，仍無法主動給予協助。美國康乃爾大學卻反其道而行，為所有工作人員提供訓練，教導他們如何察覺有心理問題的學生，以協助防止學生自殺。

學校注意學生的作為，並與家長保持聯繫，似乎是理所當然，可是許多大學拒絕在內部或與外人互通有關學生的資料，宣稱聯邦法使他們必須嚴密保護學生隱私，以免惹上官司。他們也宣稱大學生已經是成年人，必須支持他們獨立自主。

維吉尼亞理工學院一個有心理問題的學生，今年在校園大開殺戒，造成32人喪生，讓人擔心學校是否過度強調學生的隱私，以至於危害他們的健康和安全。

康乃爾素有學業要求嚴格，但卻有學生自殺率很高的惡名。2000年對15所頂尖名學進行的調查，康乃爾更被列為壓力最大的學校。

為了加強保護學生，康乃爾在2002年開始施行新政策，為從圖書館員到維修工等所有工作人員提供訓練，學習辨認危險行為。由行政人員、校警和輔導員組成的「警報小組」，每周開會討論他們發現的學生情緒問題跡象。

如果沒有學生書面同意，許多學校拒絕提供任何資料。大多數學校也很少引用「家庭教育權利和隱私法」的豁免條款。這種條款規定學生如未滿21歲，卻違規使用毒品或喝酒，或出現緊急的健康或安全情況，學校可以通知家長。

這種豁免條款只保護教育紀錄，通常不延伸到觀察學生行為。康乃爾今年卻開始擴大使用這種條款，在發現學生有問題時，不經當事人同意，即通知他們的父母。例如，住宿生如不再註冊上課，校方會主動通知父母。學校表示父母通常很感激接到這種通知，並把孩子帶回家。

2002年之前的六年，康乃爾共有11名學生自殺，2002年開始施行新政策六年來，只有五名學生自殺。
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以下為原文

SAFETY SCHOOL
Bucking Privacy Concerns,
Cornell Acts as Watchdog

Staff Trained to Spot
Students in Distress;
Campus Suicides Drop

By ELIZABETH BERNSTEIN
December 28, 2007; Page A1

ITHACA, N.Y. -- For 19 years as a custodian at Cornell University, Sue Welch has been taking out the garbage and mopping the floors of residence halls. Recently, she added a new responsibility: trying to prevent student suicide.

Ms. Welch noticed during a recent semester that she was repeatedly having to clean up after a particular student's apparent bouts of nausea, and told her supervisor she feared the young woman had an eating disorder. The supervisor told the residence-hall director, who encouraged the student to go to the university health center. Counselors there arranged for her to get treatment for bulimia nervosa. Ms. Welch credits the training sessions that she and other custodians attended on how to spot students with mental-health problems.

"These kids are looking to us to provide care," she says. "But they don't see administrators every day, they see me."

Ms. Welch's dual role puts Cornell at the center of a debate over the privacy rights of American college students. After years in which many colleges have said privacy rules prevent them from interceding with troubled students, Cornell is taking the opposite tack.

Its "alert team" of administrators, campus police and counselors meets weekly to compare notes on signs of student emotional problems. People across campus, from librarians to handymen, are trained to recognize potentially dangerous behavior. And starting this year, Cornell is taking advantage of a rarely used legal exception to student-privacy rights: It is assuming students are dependents of their parents, allowing the school to inform parents of concerns without students' permission.

The Virginia Tech massacre earlier this year, in which a student with a known history of troubling behavior shot and killed 32 people, set off alarms about whether schools were overemphasizing the privacy of students at the expense of their health and safety. Watching over students and keeping parents in the loop may seem like obvious approaches, but many schools decline to share information about their students either internally or externally. Schools say they fervently guard students' privacy because a federal law requires them to, and because they are afraid of getting sued. They also say college students are adults who need to be supported in their growing independence.

Many schools refuse to release information without a student's written permission, and most rarely invoke exceptions allowed in the law, known as the Family Educational Rights and Privacy Act, or Ferpa. Some colleges have paid out settlements when families sued for wrongful death of students and alleged that officials should have raised flags. But other schools have won their cases. A jury last year decided that Allegheny College, in Meadville, Pa., was justified in not alerting the parents of Chuck Mahoney to his distress before his suicide, despite warning signs and discussions among officials worried he might pose a danger to himself or others.

Ferpa allows privacy to be breached if a student is under 21 and has a drug or alcohol violation, or if there is a health or safety emergency. The law only protects educational records, and doesn't generally apply to observations about student behavior. Schools are allowed to share information with parents if students are their financial dependents, as Cornell is now doing. This fall, Cornell used the new policy to inform parents that a student living in a residence hall was no longer enrolled in classes; the university says the parents were grateful for the call and took the student home.

"When parents send their sons and daughters off to college, there's an expectation -- and I think it's understandable -- that there will be people looking out for them," says Timothy Marchell, an associate director of health services at Cornell who holds an unusual additional title, director of mental-health initiatives.

In the last six years since Cornell took it first new steps in 2002, the school has had five student suicides, it says. In the previous six years, there were 11.

Dr. Marchell, 47 years old, is a Cornell alumnus who grew up in Ithaca, the son of a guidance counselor and a nurse-teacher in the local school district. He has been at the center of Cornell's recent collaborative mental-health approach. Until a few years ago, Cornell interpreted privacy law as narrowly as other schools. Even counselors and medical doctors in the health center were reluctant to share information.

But Cornell was battling a reputation as an intense school with a high suicide rate. The university was named the most stressful of 15 top schools in a 2000 book that surveyed students. Adding to its reputation was the campus's physical isolation in the rolling hills of central New York state, and its unusual local geography. Over the years, some students and others took their lives by flinging themselves off one of Ithaca's steep gorges. Stressed-out students have sometimes joked about wanting to "gorge out." Cornell administrators say the reputation is unfounded, and that the school averages one to two suicides a year, consistent with the national average for colleges. Still, they believed that some suicides might be preventable.

Dr. Marchell, who volunteered at a local suicide hotline when he was a Cornell senior, had gone on to earn a master's degree in public health and a doctorate in psychology. In 1998, Cornell hired him with a mandate: Tackle the school's problems with student drinking.

The flash point was a campus tradition called Slope Day. On the last day of classes each May, students would converge on a steep lawn in the middle of campus to drink themselves silly. Decades ago, the university itself supplied beer trucks and barbecues. That stopped when the legal drinking age was raised to 21 in the mid-1980s, but thousands of students started toting their own alcohol to the slope. Ambulances lined up at the edge, and students suffering alcohol poisoning or injuries from fights filled the health center and the local emergency room.

Dr. Marchell urged changes such as arranging appearances by well-known bands to make regulating alcohol more palatable. The school eventually enclosed the event with a long fence, inside which it sold beer but denied it to students under 21. Underage drinking dropped sharply and alcohol poisonings began a steady decline.

By 2002, the executive director of Cornell's health center, Janet Corson-Rikert, began making mental health a communitywide responsibility. The 1999 shootings at Columbine High School had shocked educators into recognizing the danger of failing to spot troubled students. Like most colleges, Cornell was starting to see more students enrolled with severe mental-health problems, as reduced stigma and improved medications allowed more of them to reach college. The counseling center was often overwhelmed with demand for appointments.

Dr. Corson-Rikert asked Dr. Marchell and others to build a network to train people to notice problems and give them ways to report them, while still respecting student privacy. An advisory council on mental-health strategies made up of Cornell staff, faculty and student leaders had its first meeting in early 2004, and members had a realization: In school post-mortems after tragedies, "each person knew pieces of the story but no one saw the whole picture," says Dr. Marchell. "If they had shared the information, maybe we could have intervened."

Dr. Marchell spoke with several suicide-prevention organizations, who pointed the school to a surprising model: the Air Force.

In the 1990s, the service decided to try to reduce suicides by airmen and studied each case for warning signs. They learned to look at behavior changes, discipline problems and poor performance ratings as possible indicators of depression. Four-star generals began to talk publicly about mental illness and encourage all service members to watch for warning signs. Each member of the Air Force is now given training in detecting depression and other mental disorders. The Air Force's protocol is one of few suicide-prevention programs proven effective: The average annual suicide rate dropped by a third, from 13.5 per 100,000 people to 9.9.

Cornell adapted parts of the program. Dr. Corson-Rikert enlisted the university's president, David J. Skorton, to use his speeches and articles to encourage everyone on campus to watch out for each other's mental health. Counselors began seminars to teach the signs of emotional problems or addiction. Last spring, Cornell's health center began screening students who come in for any reason for signs of depression, asking them about trouble sleeping, poor appetite, difficulties concentrating or thoughts of self-harm.

In September, Meredith Shepard, a 20-year-old freshman, went to the health center with a sinus infection. On her questionnaire, she scored high for depression and was referred to a counselor, who saw her the same day. Miss Shepard told her counselor she was feeling overwhelmed with stress from roommate problems and some "deeper struggles," she says. When she was 13, she had experienced depression and anorexia, triggered by suffering she had seen on a family trip to Nepal. Now, after volunteering last year with genocide survivors in Rwanda, she was finding the transition to college difficult. She'd begun over-exercising and under-eating. The counselor referred Miss Shepard to another therapist, who also referred her to a nutritionist, a psychiatrist and a medical doctor. "It's easy to feel lost, uncared for and alone," she says, but her "team" makes her feel "constantly aware of having a safety net."

Cornell therapists also make a form of house calls: They hold free, no-appointment consulting hours in 10 locations across campus. About halfway through each semester, professors in some of Cornell's seven undergraduate colleges are asked to report students who have bad grades, seem disconnected or are failing to come to class. "That kind of checking out is a very serious thing," says Alan Mathios, interim dean of the College of Human Ecology. "So, waiting for the end of the semester to come is often too late." Two psychologists work full-time just consulting with professors and staff when they have concerns about students.

Last August, a review panel on the Virginia Tech massacre recommended that colleges do more to share information about troubled students. About half the colleges in the country had teams of administrators aimed at doing so, and as many as a quarter more have quickly added them, according to a risk-management firm that specializes in colleges' insurance.

Dr. Corson-Rikert and Dr. Marchell had started their own multidisciplinary "alert team" in 2005. It includes the director of counseling, an associate dean of students, the campus police captain, the university's judicial administrator, therapists and sometimes other administrators. The team typically has several students on its agenda each week.

Sometimes administrators are worried that a student has stopped going to class or, as happened recently, is attending classes despite having been suspended. Often the police report a student who has been arrested for excessive drinking or drugs. Therapists are legally required to keep their own patients' information confidential, so they say they don't share that. But they can receive information from other team members and follow up, and can give general professional advice.

Recently, campus police responded to 911 calls about an alarmingly disheveled and agitated young man in a campus building. They took him to the local hospital, where doctors diagnosed him as psychotic and admitted him. The next day, members of the Alert Team planned travel arrangements for the student's parents and set up a medical leave so the student wouldn't fail classes.

"We were trying to put a system in place so that when a problem gets to this level, it doesn't get worse," says Gregory Eells, the school's director of counseling and psychological services.

Protests haven't arisen over the university's interventionist approach, but administrators say many of the mental-health initiatives work privately and students know little about them. Some students say, however, that the university may spend so much time caring for the most emotionally vulnerable students that it has fewer resources left for those who are merely stressed out. Dr. Marchell admits that's a potential problem with the school's approach.

Erin Geld was disappointed by Cornell's services last year after a good friend became seriously ill. Miss Geld says she fell behind in classes, suffered mood swings, felt depressed and slept constantly. But when she called the counseling center, after a triage interview she was told she had to wait three weeks to see a school therapist, and was offered referral to a community health resource for faster help if she wished. Miss Geld says she felt the off-campus therapy was ineffective and soon quit.

"Despite stepping to the plate and asking for help, I did not really get the support I needed from Cornell," the 23-year-old from São Paulo, Brazil, who graduated in May, wrote in an editorial last March in the Cornell Daily Sun, the student newspaper. Dr. Corson-Rikert notes Ms. Geld had the choice of waiting for a school counselor appointment; she says the counseling center schedules many appointments within hours or days based on their urgency, and tries to schedule others within two weeks but doesn't always manage.

Catherine Savage had a better counseling experience. The 24-year-old, whose father committed suicide when she was seven, has seen a therapist and taken antidepressants since she was in middle school. At Cornell, Miss Savage struggled with depression. She saw a therapist at the counseling center on and off. One night during her junior year, Miss Savage called the health center crying, and said she didn't want to live. The nurse on the line told Miss Savage to go to the hospital. She was admitted for 11 days.

Some schools have been sued for requiring suicidal students to leave dorms or campuses. Miss Savage got a call from her Cornell counselor, and one of her teachers visited her. At Miss Savage's request, the counselor arranged extensions in her classes and a voluntary medical leave, and found her a treatment program in her hometown. Miss Savage went home to Madison, Wis., and attended the University of Wisconsin. Her Cornell adviser helped her pick classes that would earn Cornell credit. A year and a half later, in the fall of 2005, she came back to Cornell.

She enjoyed her classes, rejoined the Cornell University Chorus and continued to see her therapist at the health center. "All parts of the school made it clear that my mental health had to be among my priorities if I wanted to have a happy life and do all the things I came to Cornell to do," says Miss Savage, who graduated in May 2006 and works as a hospital dietician in Salt Lake City. "And they gave me the support."