When a student's in trouble, should
parents know?
US privacy laws prevent counselors from informing parents of danger
signs. But many say they should know if their young adult children – or
their roommates – need help.
By Amanda Paulson | Staff writer of The
Christian Science Monitor
April 27, 2007
CHICAGO
For many parents, the issue is what their children might call a
no-brainer: If their offspring has stalked a peer or stayed in a
mental-health clinic or been watched for suicidal inclinations at
college, they want to know. Immediately.
Yet parents may be among the last people to be told of any concerns.
Because of strict confidentiality laws, such problems cannot be
reported to parents – or roommates or others close to a young adult in
trouble.
The laws, say counselors and mental-health experts, are there for good
reason. Without them, few students would seek help, and a trusting
relationship could be impossible.
But such legal constraints – particularly in the wake of the killing of
33 students and staff at Virginia Tech – are deeply distressing to many
parents who harbor a sense of love as well as responsibility for
children they may see as not yet fully adult. Add to that their role in
providing financial support, and parents can find it tough to be barred
from learning about a child's mental health – or that of a child's
roommate – without the appropriate consent.
"Parents who care about their children want them to become adults with
their own rights, but we don't want them to have any more hardships
than necessary when stepping out into the world," says Elizabeth Root,
a parent with one child at the University of Illinois and another who
will head there next year. She recalls an incident last year when her
college-age son ended up in the emergency room; she wouldn't have been
told had he not called her himself. "We pay for the tuition and the
health insurance," she says, "but we can't be informed unless he dies,
I guess."
Medical professionals are sympathetic, but say the assurance of
confidentiality – except in dire circumstances – allows them to do
their job. "The students trust us. They come and tell us things they
might not have told anyone ever before," says Maggie Gartner, chief of
student counseling at Texas A&M University and president of the
Association for University and College Counseling Center Directors.
She explains to every student who comes in what confidentiality means,
and when – if the student seems to pose a danger – she might breach it.
That decision to break confidentiality or to commit someone to
involuntary care can be one of the toughest a counselor or psychiatrist
has to face, says Dr. Gartner, especially since it may mean the loss of
any relationship. Still, she's done it several times.
"It's an art and a science," she says, noting that she'll assess how
much of a plan students seem to have, whether they can harm themselves
or others, and how stable they appear. "We continually seek the place
where we can go home at night and go to sleep, she adds."
No assessment is perfect, Gartner notes, and schools – like Virginia
Tech – are often blamed if things go awry.
In one highly publicized case, the parents of Elizabeth Shin sued the
Massachusetts Institute of Technology after she committed suicide by
setting fire to herself in her dorm room in 2000, arguing that the
school hadn't done enough to prevent it. The case was eventually
settled out of court. In another case, George Washington University,
saying that he posed a danger, barred sophomore Jordan Nott from campus
after the sophomore checked himself into a mental-health facility with
suicidal thoughts. Mr. Nott sued, and the case was settled last year.
Virginia Tech has faced considerable criticism for its lack of early
action on the day student Cho Seung-Hui went on his deadly rampage. But
some experts say there weren't enough signs to warrant an involuntary
commitment or to breach confidentiality. In 1995, many commentators
were equally critical of Harvard for its decision to rescind admission
to Gina Grant once it came out that the student had bludgeoned her
abusive mother to death when she was 14.
For parents, the concerns center less on liability than the welfare of
their child. "I understand privacy issues, but 18 years old is way too
young to have no parental guidance or awareness or involvement," says
one mother, whose daughter experienced serious depression her freshman
year. Her other daughter tipped her off, and she instantly went to the
school to help. But, she says, it was excruciating to go to the
psychiatrist and find she couldn't learn the smallest detail about her
daughter's condition. "As a mother, it rips you up inside."
Root, the Illinois parent, says she would want to know if her child's
roommate had serious mental-health issues – and says it might be a good
safety measure.
But sharing that information with roommates or parents is often not
just illegal but counterproductive, say experts. "A counseling center
couldn't operate if there wasn't some guarantee that what the student
said in that setting was confidential. It's a cornerstone of the whole
therapeutic process," says Robert Gallagher, who annually surveys
university counseling center directors and ran the University of
Pittsburgh's center for 25 years. He says he often asks students'
permission to contact family.
In last year's survey, 92 percent of directors said they have seen a
growing trend in the number of students attending with severe
psychological problems.
It's unlikely privacy laws will change soon, though Dr. Gallagher and
others say some clarification of exceptions that give counselors more
flexibility might help.
But the Virginia Tech incident has made parents and students more aware
of what they don't know. "Colleges should do more to make sure
everybody is fit to be around other students," says Ashley Brown, a
marketing major at Radford University in Virginia. If they can't inform
roommates about medical issues, they could still do more background
checks and perhaps determine that some students need solo living
situations, she suggests.
"You never had to think about who your roommate was before," Ms. Brown
says. "Now you want to know who that person really is."
Patrick Jonsson contributed to this report.