As more information seeps out about the mental state of Cho Seung-Hui, who shot and killed 32 people at Virginia Tech Monday before turning his gun on himself, university counseling services have become a nationwide issue.
In news conferences Thursday, Virginia Tech officials said Cho did not receive any treatment from the school's counseling center, and the court did not tell the institution when Cho was released from outpatient treatment at a local clinic.
Nonetheless, more and more accounts from classmates of the disturbed student and the intense coverage of the incident have reinforced the crucial role counseling facilities play for many college students.
At Notre Dame, the University Counseling Center (UCC) has a wide variety of options for students who "face any problem or concern that may require professional assistance," according to the UCC's brochure.
In the 2005-06 school year, the UCC saw approximately 950 students for individual counseling, said Susan Steibe-Pasalich, the UCC director and assistant professor in the psychology department. Of those students, 14 percent were freshmen, 21 percent sophomores, 19 percent juniors, 21 percent seniors and 21 percent graduate students, Steibe-Pasalich said. Three percent did not report their academic year.
The UCC has 12 psychologists, eight employees under supervision who either are working toward or have received a Master's degree, one consulting psychiatrist and one consulting nutritionist.
"We do think we have very qualified people here. We have licensed psychologists who are experts in college student development," Steibe-Pasalich said.
Although data on whether students visited these staff members as a result of the Virginia Tech shootings is not available, the UCC has added a links to its Web site for students, faculty and staff to give tips for managing distress in the aftermath of the shootings.
In University President Father John Jenkins' e-mail to students Thursday, he encouraged students, faculty and staff members with a need to discuss the shootings to contact the UCC.
Reasons for visits
While Notre Dame students may visit the UCC for a variety of reasons, 47 percent of students seen last year reported depression, according to Steibe-Pasalich. Twenty-seven percent of students reported anxiety.
"They really are our top two issues," she said.
The UCC asks counselors to report what issues they "work on" with students. Steibe-Pasalich said that 53 percent reported that they worked with students to deal with "interpersonal concerns," which could include relationships with family members, peers, classmates, roommates, or boyfriends and girlfriends.
"I think it's really just not feeling good - feeling down, feeling depressed, feeling anxious - that brings students in, and the reasons for that could be all over the board," she said.
Last year, 19 percent of students who visited the UCC reported academic adjustment as an issue.
While Notre Dame strives to maintain a Catholic identity, something the UCC must take into account, Steibe-Pasalich said students are not counseled in a particular religious direction.
"We certainly are sensitive to a Catholic student body in that they are unique and it behooves us to pay attention to how that uniqueness manifests itself," she said.
And with some students not used to the grey skies of a South Bend winter, seasonal affective disorder seems to impact "students who come from warm and sunny climates," Steibe-Pasalich said. The UCC, which sees slightly more females than males, has a light box to help with this in its Inner Resources Room.
Rules and regulations
Whether for faculty, undergraduate students or graduate students, the UCC upholds the same confidentiality policy.
"Legally, because we are staffed by licensed psychologists, we do, by law, have to maintain students' confidentiality," she said. "Exceptions to that are if a student is suicidal or homicidal. We might need to alert somebody to that fact in order that the student and others are kept safe."
The Virginia Tech slayings have caused many to ask whether or not university counseling centers have the authority to force students to seek counseling.
At Notre Dame's UCC, it is not possible to make a student go to counseling, Steibe-Pasalich said. DuLac, however, does give faculty or Hall Staff permission to mandate an assessment.
"A rector may say [to a student] 'I want you to present yourself to a counselor for psychological assessment in order for you to stay in the hall," she said.
When an assessment is mandated, Steibe-Pasalich said, the UCC can make recommendations for that student, and the student will usually have the UCC let his or her rector know that the student visited.
However, if an assessment indicates that a student may be in or cause harm, the UCC has the authority to hospitalize the student.
Ultimately, students who want to want to make psychological changes must want to receive help.
"The student has to want help, to be motivated," Steibe-Pasalich said.
Off-site referrals from the UCC are not too common and are handled carefully.
"We don't refer out many students," Steibe-Pasalich said. "We are careful when we refer out. We document that. We usually see the student until [he or she] has connected with someone else, unless if medication is the only issue."
Reasons a student may be referred off site include the need for medication, if a student is in so much distress he needs more than once-a-week counseling or if a student wishes to receive long term counseling with the same counselor, which can conflict with the UCC's brief therapy model.
"We would like to see a student decrease their need for counseling," Steibe-Pasalich said, adding that the UCC has an ethical obligation to refer students who do not seem to be "getting better" elsewhere. The UCC may also suggest that students who do not comply with treatment recommendations seek help elsewhere.
The beginning of help
The recently renovated UCC - located on the third floor of Saint Liam Hall - includes group and individual counseling rooms, a conference room and a library. The Inner Resource Room, which was the gift of the Class of 2004, includes a massage chair, biofeedback technology and software games to help control breathing and increase relaxation. White noise machines in the halls keep counseling private and confidential. There are also rooms in which students can fill out intake paperwork.
This intake paperwork - filled out on a student's first visit to the UCC - helps see what a students issue is, Steibe-Pasalich said. It also helps the UCC gather statistics and demographics to "determine who we're not meeting enough with" and to help the UCC tailor services to specific groups of students when necessary.
Once a student has completed intake forms, the UCC's Disposition Team - a group of staff members that meets twice a week - discusses a student's case to determine whether the UCC is the best place for the student to receive help, Steibe-Pasalich said.
Along with regular scheduled counseling appointments, the UCC offers options for students in emergency situations.
"We have a walk-in emergency service. If a student or someone concerned for a student can't wait to come in [for a scheduled appointment]," she said. "[We have] a 24/7 emergency call system. One of us is always available to help a student in distress. ... Our availability is paramount, I think."
Counselors are available by the call system to answer phone calls from students or anybody who may be concerned about a student.
Students who are in distress themselves, have concerns about another distressed student, or are wondering what to do in the event that another student displays violent tendencies are encouraged to call 631-7336 between 9 a.m. and 5 p.m. and request to speak with a "warm line" counselor.
Along with individual and emergency counseling services, the UCC offers group counseling and outreach programs. UCC groups deal with issues such as obsessive-compulsive disorder, depression, stress, alcohol, food and body image, personal growth and relaxation. There is also a group for graduate students.
In addition to helping students, the counseling center also advises faculty and staff on dealing with students.
"We're also consultants to faculty and staff who need advice on handling a distressed student," Steibe-Pasalich said.
