Tuesday, 11 December 2012

Donning a Mask: Suicide at Harvard

Part I of a three-part series on mental health at Harvard. Parts II and III will appear on Dec. 12 and 14.

“I felt that it was better to take my life than to accept failure,” Christine says plainly.

Christine, now a senior, is direct and open as she reflects on her first of two suicide attempts during her sophomore year. Shaking her head, she says that she thought college would allow her to escape the depression and anxiety that plagued her in high school.

“I came to Harvard thinking Harvard would fix it,” she reflects wryly. “I thought, ‘I can build my own life from scratch and build something wonderful.’”

But during her second year of college, news from home triggered overwhelming emotions.
Over a phone call in early December, Christine learned that one of her close family members was found homeless on the streets. That news flooded her mind with memories and emotions from her own experience at home.

“The only way I felt I could respond and make a statement was to commit suicide,” she says. “The ultimate statement of rebellion and expression of pain was to hurt myself.”

Christine became calculating and rational as she prepared for death. She withdrew all of the money from her bank account and placed it in an envelope for her roommate.

“I figured I should probably utilize my resources effectively,” she says. “At least if I die someone could use my money.”

However, when Christine made it back to her dorm room, she became emotionally overwhelmed. Channeling her anger and pain toward her possessions, she pitched objects across the room. A suitemate who happened to be in at the time heard the shattering of glass and called 9-1-1.

“I was numb; it was surreal,” Christine says. “I felt like an 80-year-old woman. I felt I had experienced way too many things to fit into my 20-year-old body.”

Though her memories from the attempt are hazy, she laughs now when she recalls the ambulance driver asking her if she would like the siren on. Christine—whose name has been changed, like the other students in this series, all of whom have attempted suicide—attributes her mental illness to her abusive home. However, like nearly every student interviewed for this series, she also faults Harvard’s health system and high-pressure culture with contributing to mental illness.

The email, titled “Sad News,” has been sent out three times so far this year. Each time it opens with a similar line: “It is with very great sorrow that I write to inform you of the death of a member of the Harvard College community.”

Though the names, biographies, and location of death differ in each of the emails, Dean of Harvard College Evelynn M. Hammonds’ message remains the same.

By the third “Sad News” email of 2012, Christine began to wonder how an achievement-driven environment like Harvard might aggravate mental illness—and, for some, ultimately lead to suicide. One of those emails stated that the student had taken his own life; within days of another, The Boston Globe and other media reported that the death was a suicide.

Paul J. Barreira, then the director of behavioral health and academic counseling for University Health Services, told The Crimson in October 2011 that the suicide rate among Harvard students was fewer than 5 per year for 100,000 students.

That rate would place Harvard well below the national average of 12 per 100,000, last reported by the Center for Disease Control in 2009, and below the average for college students, listed at 6.18 per 100,000 in a 2009-10 nationwide study conducted by a University of Virginia researcher.

Harvard’s relatively low rate, which was calculated before this year’s three deaths, counted enrolled students over a 10-year time frame at all of the University’s schools, according to University Health Services spokesperson Lindsey Baker, and excluded students on leave, following the convention of other universities nationwide.

Using a 5-year time frame focused solely on the undergraduate population, The Crimson found a significantly higher suicide rate.

Counting only enrolled undergraduates who committed suicide either on or off campus, the College’s suicide rate is 18.18 per 100,000. When students who committed suicide while taking a leave of absence are included, that rate increases to 24.24 per 100,000.

Even the most conservative calculation, made using only enrolled college students who committed suicide on campus, yields a rate of 12.12 per 100,000—over twice the rate provided by UHS last year, and nearly twice the national average for college students.

Whether examining the numbers or listening to individual survivors’ stories, the problem is painfully evident. This three-part series tracks the ways struggling students say University Health Services could serve them better, the efforts of a few University officials and student activists to change the numbers, and the difficult paths that mentally ill students currently navigate once they enter Harvard Yard.

Martin has attempted suicide twice while a student at Harvard.

“We put on a mask,” he says. “We put on a perfect face that just isn’t us. All of us are struggling and flawed in some way, but by putting on the mask we all end up magnifying the individual insecurities of the students who are here.”

Martin worries that a lack of open discourse makes it difficult for individuals to express their need for mental health care. Mental illness is stigmatized at Harvard, he says, and the seemingly successful student body is a large part of the problem.

“You come back from summer break, and everyone tells about their amazing summer. They tell perfect, unflawed stories. You begin feeling that everything we do is supposed to be successful; everyone is supposed to be so happy. It leads to a culture that amplifies feelings of inadequacy,” he says.

Christine came to Harvard thinking friends, leadership positions, and academic performance would liberate her mind from the past, but she soon found herself crying every day of her freshman year. She resisted the urge to tell someone about her depression because she thought she was the only one struggling.

“I came here and everyone was a National [Merit] Scholar; everyone was really smart,” she says. “It didn’t feel like any of the things I had accomplished in the past twenty years mattered because everyone had it—and more.”

For thirty years, Kyle M. Carney ’73, a licensed independent clinical social worker, has worked with Harvard students at the Mount Auburn Counseling Center in Harvard Square.
Harvard students do not suffer from mental illnesses like schizophrenia and bipolar disorder at a rate higher than the general population, according to Carney, but a “high prevalence” of anxiety and depression is linked to achievement.

“All of a sudden when they arrive at Harvard, they are no longer ‘a big fish in a small pond’ and it can be very stressful and difficult to cope. That, combined with moving away from home, sometimes halfway across the country, leaving friends and family, can be quite difficult,” says Carney.

Undergraduates are not alone. Carney notes that many of the stresses facing Harvard College students—including adjustment to the competitive atmosphere and anxiety about their next steps after Harvard—are amplified among the many post-docs and tenure-track professors who also seek treatment at the center, which is not affiliated with the University.

According to a year-end survey conducted by UHS last spring, one quarter of Harvard College students reported symptoms of anxiety and 18.7 percent reported symptoms of depression. Three and a half percent of College students admitted to having suicidal thoughts.

“Environments in which students can perform at very high levels academically while also engaging in a broad array of time-consuming extra-curricular pursuits can result in unnecessary stress,” a UHS statement says as a reflection on the numbers. “This is a phenomenon occurring throughout higher education, and Harvard is no exception.”

Mackenzie attempted suicide at home after a difficult sophomore year. Having done well academically in high school, she felt that people would not take her seriously when she said she was having trouble with tests and work at Harvard.

“I was forced to live a lie,” she says. “I was hiding my struggle. I felt that if I can’t finish something, I’m a bad student. I’m a bad person.”

Though she made close friends and enjoyed the fact that freshman year allowed her to explore, Mackenzie’s feelings toward Harvard changed as her academic struggles intensified.
“It got more difficult to answer if you enjoy your time at Harvard,” says the current senior, who took time off after her suicide attempt.

Alexa, who has also attempted suicide and who suffers from bipolar disorder—mostly depressive, which she jokes is “less fun”—feels that it is not Harvard itself that brings out mental illness.

“People like us are often intelligent and creative and also prone to mental illness. If you get thousands of us together, it’s likely that there are going to be issues,” she says. “My friends are all crazy in different ways.”

A fan of the University’s mental health offerings, Alexa is grateful for the medical help she has received. However, she worries that a culture of perfection has for many students made reaching out for help tantamount to surrender.

“The likelihood is that every other person you’re sitting next to is dealing with some of the same issues you are,” she says quietly. “But people don’t necessarily know that or talk about it. There is a culture of keeping going, wearing your battle wounds.”

—Staff writer Quinn D. Hatoff can be reached at quinnhatoff@college.harvard.edu.

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