Starting college is stressful for hundreds of thousands of freshmen each year, not to speak of their families. One concern that should be put to rest immediately is that the choice of college increases the risk of suicide. A succession of colleges have been in the news over the years when they’ve experienced a well-publicized series of suicides.

But the cause of suicide is not Ivy League pressure or the social and academic expectations that distinguish one school from another. Suicide is the third-leading cause of death among young people between 15 and 24 years of age: The college years simply fall within this period.

Brain changes

The brain changes that occur in adolescence—specifically the pruning of gray matter that makes our brains more efficient and capable of complex, intellectual operations—are often responsible for adolescent angst as well as the onset of serious psychiatric disorders. The first peak of depression typically occurs around age 13 to 14, schizophrenia first appears around 18 to 19, and adult-onset bipolar disorder tends to begin suddenly around 19 to 20. Every year for the past 50 years approximately 5,000 young people have committed suicide, and more than 400,000 have made serious attempts that required medical attention.

Colleges across America have recognized that their student populations are vulnerable, and they’ve responded by expanding their mental health services (the fastest growing expense at many institutions), and yet campuses have still seen many tragic and shockingly public student suicides. This poses the question: What more can be done to save student lives?

More students

To answer this question we must first recognize that our population of at-risk college students is larger than in previous decades. That’s not because we, as a nation, have a growing number of depressed adolescents, but because more are going to college. Improvements in the identification, diagnosis, and treatment of psychiatric disorders—coupled with more effective medications and new forms of psychotherapy, specifically cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT)—have enabled high school students with successfully treated psychiatric disorders to apply for and attend American colleges.

During the application process, these students are encouraged to put their best foot forward and keep their psychiatric history private. The problem is that they continue to keep their condition a secret after they’ve been admitted to college and started their freshman year. These teens, overjoyed at the prospect of leaving home “to start over again” in a new community, believe they can remake themselves—ditch all their adolescent high school baggage—when they arrive at college and meet their new peers.

Support is crucial

The truth is that no matter how hard they try they can’t cancel out psychiatric illness, the greatest risk factor for suicide. It’s critical that these kids find the support they need in the college setting, that they don’t discontinue therapy or medication they’ve been taking, and especially, that they not hide their feelings from new friends and mentors in college.

And to parents: Don’t think the Arizona sunshine or the prestige of Harvard will cure your child’s ADHD, depression, or anxiety. Don’t assume he no longer needs your assistance in getting accommodations and services. Your continued attention and help are desperately needed.

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