New York Times on Penn’s Problems With Suicide and Perfectionism

Feature profiles Penn student who narrowly averted taking her life. Is Penn making strides in helping students in distress?

Terracotta Heraldry on the Duhring Wing.   | Steven Minicola, University of Pennsylvania  Communications.

Terracotta Heraldry on the Duhring Wing. | Steven Minicola, University of Pennsylvania Communications.

Today’s New York Times has an article on campus suicide that features the story of Kathryn DeWitt, a student at the University of Pennsylvania. Like her classmate Madison Holleran, DeWitt was a standout student and athlete in high school, but arrived at Penn to find that plenty of other students were just as remarkable as she was — and many were such high achievers, they made DeWitt feel inferior. In what seemed like countless ways, DeWitt imagined she didn’t measure up, as the TimesJulie Scelfo writes:

Classmates seemed to have it all together. Every morning, the administration sent out an email blast highlighting faculty and student accomplishments. Some women attended class wearing full makeup. Ms. DeWitt had acne. They talked about their fantastic internships. She was still focused on the week’s homework. Friends’ lives, as told through selfies, showed them having more fun, making more friends and going to better parties. Even the meals they posted to Instagram looked more delicious.

DeWitt got depressed and suicidal, as she explained in a blog post from February 2014:

I had been planning my suicide since winter break. Being back at home with some of my greatest friends from high school made me realize how unhappy I was at Penn. …I decided right before Christmas that I was going to kill myself. For my friends, I enjoyed every moment with them to make sure they had a good last memory with me. And I prepared them, saying that I probably wouldn’t be back “for summer” when I really meant ever. Goodbyes were so important to me, but they weren’t perfect. They never are.

Fortunately, DeWitt’s plans were averted by her roommate and some dorm staff, who recognized that she was in trouble and got her help, including a stint in a psychiatric ward. She eventually returned to Penn and is now a leader of Active Minds, a campus advocacy and awareness group.

The Times article notes that the suicide rate for 15- to 24-year-olds has increased in the past few years, as has the number of college students with anxiety and depression. It also points to the growth of social media accounts, which often present happy, shiny images of success even when the reality is quite different. Overall, the point is that striving to reach perfection — or the pressure to do so — can lead students to have mental health problems, and ultimately, to commit suicide.

The same month that DeWitt wrote her blog post about being suicidally unhappy at Penn, the school formed the Task Force on Student Psychological Health and Welfare. Its purpose was to “examine the challenges confronting students that can affect their psychological health and wellbeing, review and assess the efficacy of Penn resources for helping students manage psychological problems, stress, or situational crises; and make recommendations related to programs, policies, and practices designed to improve the quality and safety of student life.”

One year later, the task force released a report with its findings, including some very specific challenges that students face at Penn — one of which is the drive to achieve at a high level. The report notes that the demand for academic excellence, “along with the perception that to be successful one needs to hold leadership roles in multiple realms, contributes to the amount of stress and distress experienced by Penn students.” Task force members found that “students often have trouble coping when they receive anything other than a perfect grade” and were subject to the notion that “there is only one pathway to success which demands a near-perfect academic record and demonstrated leadership in extracurricular activities.”

The report also noted that there were problems getting help. Teachers often didn’t know where to point troubled students for assistance, and the university’s decentralized structure means that “support programs are spread across the University’s 12 schools and its administrative divisions, which makes systematic coordination of these resources difficult.” Once someone did get referred to the right place, long waiting times for an appointment impeded the quality of care.

That last issue was the subject of particular concern after a March 2014 Daily Pennsylvanian report outlined the claims of a former psychiatrist at Penn’s Counseling and Psychological Services [CAPS], Nick Garg, who provided the DP with documentation to show not only that wait times could stretch beyond three weeks, but how such delays could negatively impact a student’s mental health:

One case Garg pointed to involved an undergraduate who called CAPS in late fall 2011 with mild depressive symptoms, according to Garg’s notes. She was told she had to wait six weeks or take a referral to a therapist in Philadelphia, so she took a referral. However, she didn’t like the outside psychologist, so she called CAPS again. She was told to wait another several weeks. While she waited, she began cutting herself with a kitchen knife. She called one of her parents, asking her parent to make sure she didn’t cut herself deeper or jump out of a window. The student’s parent furiously called CAPS, demanding an appointment. The student was seen immediately.

The Task Force report describes the way that school-related stress can escalate:

When stress is overwhelming it can lead to distress which, in turn, can manifest as demoralization,
alienation, or conditions like anxiety or depression. If untreated, these conditions may lead to serious impairment.

Given that problem, the Task Force issued the following recommendation:

Penn should ensure CAPS continues to deploy its resources effectively to keep wait times for first-time appointments in non-emergency situations to no more than seven days, even during periods when demand is high. When students request a first-time appointment, irrespective of whether they are experiencing stress or distress, they should have prompt access to a CAPS clinician.

The report notes that CAPS relocated to a larger space and added three staff members as of fall of 2014. Peter Moon, director of communications for Active Minds Penn, says the university is making progress. “The wait times at CAPS have been reduced, according to [CAPS director] Bill Alexander, to two to three days,” says Moon. “It’s still a bit of a rigid schedule, which isn’t always ideal for students — mental health issues don’t generally call ahead to figure out when it might be best for them to spark up, and some students may need someone to speak to more urgently than others. But that point is merely to say that things can always be improved. The work CAPS and the University have done to reduce wait times to help students get the mental health care they need more quickly is a move we applaud.”

The Task Force also recommended the development of a web-based wellness application, and I would add that any improvement to the CAPS website would be welcome. It’s utterly unfriendly and lacking in language and features that would encourage a student in distress. In fact, under the Self-Help tab (which a student would presumably click while waiting for an appointment), two sections (“Improving Your Concentration,” Organizing Your Times”) out of four are about being a better student — which sends precisely the wrong message: Feeling stressed? Here are some tips on how to concentrate on your schoolwork! (To see a school that does this kind of website well, check out Temple University’s.) The language on the CAPS site is clinical or third-person distant, and the site’s overall organization would make a dedicated UI expert weep.

The important thing, though, is that students are getting help more quickly, and that Penn has implemented improvements as a result of the Task Force findings. Students are also helping each other, which is equally important. On-campus groups that address mental health issues include Penn Initiative for Minority Mental Health, Penn Benjamins, UPenn Mental Health Helpers (formed by members of the incoming Class of 2019), Beautiful Minds (a blog and mental health magazine project), Consciousness Club (mental wellness and meditative exercises), and many more. Moon says, “When you add in campus resources like CAPS, RAPline, etc., suddenly you see that Penn really does have a large web of support for students that need it.”

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For confidential support if you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Learn about the warning signs of suicide at the American Foundation for Suicide Prevention.