For Tommy Edwards, Things Come Full Circle

by Will Stewart, TechSideline.com
General Manager and Managing Editor
Apr 17, 2008

The events of April 16th, 2007 touched many people. Lives were changed and altered in various ways, from the victims to the survivors to the first responders to the university community. For former Virginia Tech running back Tommy Edwards, the aftermath of the tragedy was a call to action, to return to a place he had left years ago, to try to make a difference.

Hokie fans who have come on board in the last 12 years, since the 1995 Sugar Bowl, may not know who Tommy Edwards is. In nearby Radford, Virginia, Edwards had a storied high school career that saw him amass 57 rushing touchdowns and nearly 4,000 yards in just two years of high school football. A decorated recruit, he followed his father (Kenny Edwards, a VT running back from the early 1970s) to Virginia Tech in 1992.

In the 1993 season, as a redshirt freshman, Edwards scored nine touchdowns, and his future was bright. By 1995, though, he was gone, transferred out to Division 1-AA Boise State, where his college football career ended quickly. It was the pre-Internet age, and the large majority of Hokie fans were in the dark, wondering what had happened to "Touchdown Tommy" Edwards to cause him to flame out so quickly.

Tommy Edwards's story is not the story of a prima donna unhappy over playing time, nor is it the story of a smalltown athlete who wasn't talented enough to make the big time. His story is about mental illness and the effects it can have, how it can derail the most promising of lives and careers. The story of Tommy Edwards not only answers the question, "Whatever happened to Tommy Edwards?" It tells you what the events of April 16th mean to him, and why he is inspired to do what he's doing today.


A Promising Start

As a child, Edwards struggled academically due to dyslexia, but as he matured and started to excel in track and football at Radford High School, athletics helped him gain acceptance. "I always felt like somewhat of an outcast, somewhere outside the circle," he says. "But I began to gain some recognition through track and football, and all of a sudden that opened a lot of doors, socially, for me."

It also opened the way to a football scholarship at Virginia Tech. After a decorated high school career (detailed above), Edwards enrolled at Tech in the fall of 1992 and redshirted.

That's when things started to take a turn for the worse. Edwards was already fragile psychologically when he entered Tech. "Some things happened to me when I was pre-school age, or even pre pre-school age, just some emotional and psychological trauma. I dealt with a number of issues when I was growing up," he says.

While he was redshirting, he was stricken with mononucleosis, which was misdiagnosed at first as strep throat. When the correct diagnosis was finally made, Edwards had to quit practicing and training, and he dropped the weight he had put on. By the time spring football rolled around, though, he was back up to 215 pounds and was ready to practice. Still, the physical illness had taken an unseen toll. "I think during that period of time, my brain chemistry was just really stressed."

Add in a traumatic event towards the end of the year ("I had a girl threaten to commit suicide in my room my freshman year the night before my final biology exam"), and Edwards's mental health started to decline.

"That summer (1993) I was an orientation leader at Tech. I was just starting to deal with depression, and it got pretty bad at different periods that summer. I didn't have the same get up and go that I had had my whole life. I slept a lot more, and I rationalized this as going through the after affects of really pushing my body through the mono and not really giving myself a chance to really heal and get over it. I had a real desire to get back into the weight room early, and the doctors okayed it. I really wanted to get my weight back up to be competitive and try to win a spot."

He was successful, and he wound up third on the depth chart entering the 1993 season, behind Dwayne Thomas and Ranall White. Edwards blew up in the first two games, scoring two touchdowns against Bowling Green (a 33-16 win), and four more against Pittsburgh (a landmark 63-21 victory).

"All of a sudden I was leading the nation in scoring and was in the national headlines and all eyes were on me. That created some added pressures and things that I hadn't anticipated," Edwards remembers.

The world is full of people who would handle that stardom just fine, but Tommy Edwards wasn't one of those people. "I started experiencing some anxiety. I didn't have any idea just how public my life had become at that point, and how scrutinized every move I made would be."

He went on to score 11 touchdowns that season, including Tech's Independence Bowl win, but it was mostly as a goal-line specialist. The limited role wasn't what Edwards nor many people around him wanted.

"There was a lot of outside influence, people just speculating why I wasn't playing, and it just became frustrating. My mental state, my emotional state, at the time was somewhat ... not perfect. Having people speculate and create negative ideas really weighed into my mental health and really caused me to start questioning the loyalty of my coaches, when they were doing the best job that they could.

"Looking back on it, there were just too many influences, and I kind of got swept into it. I've known Frank Beamer and Billy Hite for most of my life, and we've been friends, but I had people drive a wedge between me and the people I put my trust in."

The mounting pressures of college football, sudden stardom, and second-guessers exposed Edwards's emotional frailty, and his mental health started to steadily decline.

"At the end of that year, I got into a fight at a fraternity house. One of my friends got jumped by a bunch of guys. I ended up getting arrested. I had always kind of prided myself on being a pacifist, and I just reacted and tried to help my friend. All those years in the weight room, and all those years on the field learning to react kind of took over, and I kinda banged some heads.

"I was charged with malicious wounding, which was grossly exaggerated. The charges were eventually dropped, and I had to do some community service, but it was just really publicly embarrassing. That really sent me into a spiral that summer, and I started drinking more and more to try to cope with the embarrassment and anxiety. I really started to question who I could trust around me, and I started drinking more, and that contributed to the depression and anxiety. I just became more and more unhappy.


The Last Year at Virginia Tech

"Going into my redshirt sophomore year [1994], things just got worse. My depression got worse, my anxiety got worse, and I was throwing up every day before practice and during practice, like it was uncontrollable, like a gag reflex. I was really embarrassed, because P.J. Preston had gone through basically the same thing and had left the team over it. There was all kinds of speculation as to whether he was on drugs, and I didn't want to be scrutinized in the same way, so I just didn't say anything to anybody."

In addition, the Hokies had a change of offensive coordinators, going from Rickey Bustle, who had orchestrated the high-scoring 1993 Hokie offense, to Gary Tranquill, who disrupted everything from strategy to play calling to team chemistry. Tranquill's regime at Tech was short (one year) and unsuccessful, and according to Edwards, it negatively impacted the players he coached, to say the least.

Edwards, by his own words, became more of a recluse that season, and his depression worsened. He started having suicidal thoughts, and more than one night, he sat on the edge of his bed with a shotgun in his hands.

After finishing as Tech's second-leading rusher in 1994 (115 carries, 396 yards, 3 TDs) for the second season in a row, it call came crashing down. Edwards's aunt intervened, forcing him to get therapy, but he struggled to make the appointments, or to do much of anything else.

"I was incapacitated to the point where all I wanted to do was sleep 24 hours a day and do nothing. I pretty much stopped going to class. I took some incompletes and I failed a couple of classes. My family practitioner prescribed me some anti-depressants, which actually made the situation worse."

Edwards knows now, having been diagnosed years later, that he was bi-polar. His mood swung back and forth from depressed to manic. While manic, "I just acted irrationally. My party antics sort of took on a legendary kind of status. I was 'Touchdown Tommy,' and that in a way took on its own alter-ego.

"I didn't feel like that person inside. I've always been an artist and a very creative person, with intellectual pursuits and interests. But I had become this kind of cartoon character in people's minds. When I was in a public setting, especially when I was manic, I lived that, and I really pushed that to the extreme. I just wasn't right. I was sick.

"I can remember after one game in either my freshman or sophomore year, and a bunch of kids were lined up to get my autograph. I really hadn't done much during the game except play special teams. I didn't even get a snap at tailback. My personal self worth was so diminished at that point that I didn't feel worthy of the attention of these kids. I felt that my life off the field was in such disorder and disarray that I didn't feel like they should respect me, or that they should want my autograph. I just wanted to crawl in a corner and die."

In the spring of 1995, he quit going to practice, and he asked Frank Beamer if he could take some time off to sort things out.

"I was incapacitated to the point where there were times where I just couldn't get out of bed. I tried to explain the best I could what was going on, and I told him I needed some time to try to figure things out. I was told that wasn't an option."

Edwards looked for other ways out, and transferring became his focus. He looked at Boise State, the 1-AA national runners-up in 1994, and decided to go there, aided by the presence of some relatives in Boise. His family and friends were pressuring him to stick with football, and he felt a change of venue would improve things.

It didn't. "The whole summer leading up to my transfer, I went through more depression swings. It was exacerbated by drinking too much and partying.

"I got out there, and we were going through two-a-days, and I had an emotional breakdown after a practice. I was trying to talk to my coach and try and communicate what I was going through, and that I was having an anxiety attack. I thought I was having a heart attack at one point. He didn't know what to do or how to react to somebody just breaking down and crying on the field."

Edwards was prescribed Prozac and sleeping pills. "The Prozac made me feel like a zombie, and the sleeping pills made me feel like I was on speed. When I called to tell them what was going on, they told me to just take two. That didn't work."

Edwards stuck with it, but he suffered a shoulder injury that fall, and by the time spring rolled around, he gave up football forever.


Life After Football

He returned home, but home was a place where he was still "Touchdown Tommy," and where everyone thought he should be playing football. His depression worsened, and he abused drugs and alcohol and had several run-ins with the law.

He finally gave up drug and alcohol abuse in 1999, got married in 2001, and moved to California, so his wife could work toward her doctorate at Pacifica Graduate Institute. The marriage failed, but while in California, Edwards's life blossomed. He developed a skateboard company, Sasquatch Skateboards, and his music career also took off. He opened for high profile artists and performed on television a number of times.

Just as things were taking off for Edwards, he had a serious skateboard accident in 2003 and suffered a brain injury. The injury brought on extreme brain chemistry fluctuations, resulting in hyper-mania, and within six months, he had lost his business, his home, and most of his friends.

In our interview with Edwards, he didn't go into great detail about these events. "I've still had to deal with the chemical fluctuations as an adult, and sometimes they've been more detrimental than others," he sums up. "Especially after my head injury, some things really came to light. I kind of understood myself better, as far as what's good for me and what's not.

"A couple of years ago, I met a retired psychiatrist who became a friend of mine and became my mentor. He basically diagnosed me, and we worked towards non-pharmaceutical treatments through nutrition and activities. It's been an amazing journey. Difficult at times, but it's really helped me understand myself, my life, and what's valuable in my life."


April 16th and The Heart of Virginia

Edwards rebuilt his life in San Diego, and then came the fateful events of April 16th, 2007. He was visiting family back on the East Coast when the shootings at Virginia Tech happened.

"I was visiting in Christiansburg [on April 16]. We had heard the sirens, and we thought maybe there had been an explosion at the [Radford] arsenal or something. I turned on the TV at lunch, and it said '33 dead at VT.' I immediately got sick. I didn't know how to respond.

"I just wanted to help somehow. I just wanted to help ease the pain. I wanted to help raise money in some way, and that's where the idea of a benefit concert came from."

That idea grew into something more, and Edwards founded "The Heart of Virginia Foundation." Edwards was greatly affected by the story of Seung-Hui Cho, and how an obviously mentally ill young man had slipped through the cracks and hadn't found treatment.

From his own life experiences struggling with mental illness, Edwards settled on the mission of The Heart of Virginia: to raise awareness of mental health issues.

"I made the decision to drop what I was doing in San Diego and pack everything and move across the country to start this," he says. "I started calling up all my contacts, and I felt there was enough interest from the entertainment world and the folks that I knew to help me feel like it was a legitimate idea, and that there would be some support behind it."

Edwards's goal is to raise $2 million by April 2009 for his foundation, which will in turn donate the money to mental health services to develop, expand and coordinate programs that promote physical and mental health.

As written on his web site, <a href="http://www.theheartofva.org/">theheartofva.org</a>, Edwards hopes to "create an event that changes the way we, as Americans, deal with the escalation of violence and the deterioration of mental well-being in our country. And to show the world that this senseless tragedy will not pass quietly as one in a string of violent acts, but call for change."

The centerpiece of his efforts, that "event," would be a benefit concert in Lane Stadium. "If Tech doesn&#39;t want it to be in Lane Stadium," Edwards says, "we&#39;re looking at doing it in Scott Stadium at UVa, or Richmond International Speedway or Bristol ... but we&#39;d really like to do it in Blacksburg, because it&#39;s the epicenter of the tragedy."

Edwards wants create something positive and long-lasting from the tragedy, something that is an ongoing force for change. He saw too much negativity from the outside world after the tragedy. "We want to create a positive perspective for the world of what Virginia means to us, especially after the negative aspects and controversy were placed by the national media. That&#39;s a trend in our society that actually contributes to more school shootings and more acts of violence."

Starting The Heart of Virginia Foundation has been an arduous, complicated, exhausting task, from the very beginning. "Initially when we went out and tried to gain support, there was a lot of skepticism in what we were doing. Even moving across the country, my car broke down ten times and cost me something like $6,000, which was $6,000 more than I had planned on. It took me almost five weeks to drive from San Diego to Virginia."

But he believes in what he&#39;s doing, and he relishes the challenge.

"It&#39;s been an amazing process, having to surrender my own timeframe schedule. Sometimes I try to force things to happen, but then I have to stop and take a break, and let it come to me. And it has."

It has been a long, hard road for the former high school star and hotshot recruit, but he has found his calling, and he&#39;s determined to see it through.


This Saturday, April 19th, High Point Coffee in Roanoke will be hosting The Heart Of Virginia fund raising event with former Hokie football player Tommy Edwards. There will be live music from 4-10 pm featuring local talent such as, Kristi Emmons, Ben Hurt, Jess Pillmore, Red Mahna, Brad Archer and Donna Pearson, Randy Walker (of the Aardvarks) and the host, Tommy Edwards. In addition there will be door prizes all day and a silent auction. How can you help? Please stop by and/or spread the word.

For more information, visit <a href="http://www.theheartofva.org/">The Heart Of Virginia</a> web site.

--

Original Source:
<a href="http://www.techsideline.com/news_archive/showArticle-3630.php">http://www.techsideline.com/news_archive/showArticle-3630.php</a>

Will Stewart

2008-05-02

Kacey Beddoes

Will Stewart (will@techsideline.com)

eng

On-campus mental illness issues unique

By Dick Durbin
RRSTAR.COM
Posted Apr 17, 2008 @ 10:59 PM

This week, our nation marked the anniversary of the tragic shootings at Virginia Tech that took 32 lives and wounded 17 other people. Just two months ago, our state was stunned to witness a similar tragic shooting at Northern Illinois University in which 5 students were killed and 17 were wounded.

I cannot imagine the magnitude of heartbreak and pain for friends and families of those killed or the trauma borne by those who survived these tragedies. As we mourn the loss of so many promising young lives, it is important also to learn from these tragedies.

So what are those lessons?

The first is to consider the tortured mind of the shooter. Mental illness is an illness, not a curse. It can and should be treated. Many who receive appropriate counseling and medication lead normal, stable and happy lives. But our laws ignore this reality. We have created legal and financial obstacles to appropriate care. This year, for the first time in a decade, the U.S. Senate has passed a bill to give mental health parity with physical health under the law. The House of Representatives also has passed legislation, and we are negotiating a compromise to fulfill the promise of health parity for millions facing mental health problems.

But the challenge of mental health on our college campuses is unique. Many mental illnesses manifest themselves in this period when young people leave the security of home and regular medical care. The responsibility for the students&#39; well-being shifts many times to colleges and universities struggling with limited resources.

The situation is growing worse. Studies show that 10 percent of college students have contemplated suicide and 45 percent have felt so depressed that it was difficult to function.

Colleges also are encountering students who 10 to 20 years ago would not have been able to attend school because of mental illness, but who can do so today because of advances in treatment of such illness.

To meet the increased need, many schools have tried to increase mental-health education and outreach efforts. But the ratio of students to counselors is growing. Currently, there is only one counselor for every 2,000 students on our college campuses.

NIU and Virginia Tech taught us that mental-health parity and better campus counseling services are not only critical in preventing these tragedies, but in dealing with the aftermath. The victims were not just those who were killed or injured in the shootings. Others have mental scars that are less obvious than bullet wounds but often slower to heal.

The emotional trauma experienced by many students, faculty and families might require years of therapy and counseling.

Finally, when the unthinkable does happen, as it did at Virginia Tech and NIU, we need to respond quickly and effectively to the immediate and long-term needs of the affected college community.

Our colleges and law-enforcement agencies have made great strides in preparing for and responding to active-shooter situations, progress reflected in the admirable response to the NIU shootings.

But we also need to view these violent tragedies on our campuses for what they are — catastrophes, like natural disasters, that require a sustained and coordinated recovery effort in the months that follow.

We have a federal agency to deal with hurricanes, earthquakes and floods. But there is no central federal resource to help guide college communities through the recovery process. In the days and weeks after the shootings in DeKalb, NIU officials found themselves being led in circles through the bureaucracies at the federal departments of Education, Justice, and Health and Human Services, not to mention numerous state agencies. These entities, all of whom were well-meaning, often didn&#39;t talk to one another, forcing school officials and victims&#39; families to navigate a red-tape maze to find answers to even their simplest questions.

Just as we expect a coordinated emergency response to a flood or tornado, we need to ensure that victims, their families and college communities are able to receive similar assistance in the wake of these personal disasters.

Reflecting on the loss of his own son, the well-known minister the Rev. William Sloan Coffin once said, "When parents die, they take with them a portion of the past. But when children die, they take away the future as well." As we mourn those lost at Virginia Tech, NIU and other schools across the country, we must learn from these incidents, work to avoid them and improve our response when they do occur.

Dick Durbin, a Democrat, is a U.S. senator from Illinois.


Licensed under Creative Commons
<a href="http://creativecommons.org/licenses/by-nc-nd/2.5/">Attribution-Noncommercial-No Derivative Works 2.5 Generic</a>

--

Original Source:
<a href="http://www.rrstar.com/opinions/x1498098116">http://www.rrstar.com/opinions/x1498098116</a>

Dick Durbin

2008-04-19

Kacey Beddoes

eng

Anniversary Reactions to a Traumatic Event

Date: Mon, 14 Apr 2008 22:00:00 -0400
From: Unirel@vt.edu
To: Multiple recipients <LISTSERV@LISTSERV.VT.EDU>
Subject: Anniversary Reactions to a Traumatic Event

Here is some information from the university&#39;s Cook Counseling Center and the university Employee Relations Office.

Source: National Mental Health Information Center of the U.S. Dept. of Health and Human Services


Anniversary Reactions to a Traumatic Event:

The Recovery Process Continues

As the anniversary of a disaster or traumatic event approaches, many survivors report a return of restlessness and fear. Psychological literature calls it the anniversary reaction and defines it as an individual&#39;s response to unresolved grief resulting from significant losses. The anniversary reaction can involve several days or even weeks of anxiety, anger, nightmares, flashbacks, depression, or fear. On a more positive note, the anniversary of a disaster or traumatic event also can provide an opportunity for emotional healing. Individuals can make significant progress in working through the natural grieving process by recognizing, acknowledging, and paying attention to the feelings and issues that surface during their anniversary reaction. These feelings and issues can help individuals develop perspective on the event and figure out where it fits in their hearts, minds, and lives.

It is important to note that not all survivors of a disaster or traumatic event experience an anniversary reaction. Those who do, however, may be troubled because they did not expect and do not understand their reaction. For these individuals, knowing what to expect in advance may be helpful.

Common anniversary reactions among survivors of a disaster or traumatic event include:

Memories, Dreams, Thoughts, and Feelings: Individuals may replay memories, thoughts, and feelings about the event, which they can&#39;t turn off. They may see repeated images and scenes associated with the trauma or relive the event over and over. They may have recurring dreams or nightmares. These reactions may be as vivid on the anniversary as they were at the actual time of the disaster or traumatic event.

Grief and Sadness: Individuals may experience grief and sadness related to the loss of income, employment, a home, or a loved one. Even people who have moved to new homes often feel a sense of loss on the anniversary. Those who were forced to relocate to another community may experience intense homesickness for their old neighborhoods.

Fear and Anxiety: Fear and anxiety may resurface around the time of the
anniversary, leading to jumpiness, startled responses, and vigilance about safety. These feelings may be particularly strong for individuals who are still working through the grieving process.

Frustration, Anger, and Guilt: The anniversary may reawaken frustration and anger about the disaster or traumatic event. Survivors may be reminded of the possessions, homes, or loved ones they lost; the time taken away from their lives; the frustrations with bureaucratic aspects of the recovery process; and the slow process of rebuilding and healing. Individuals may also experience guilt about survival. These feelings may be particularly strong for individuals who are not fully recovered financially and emotionally. Avoidance: Some survivors try to protect themselves from experiencing an anniversary reaction by avoiding reminders of the event and attempting to treat the anniversary as just an ordinary day. Even for these people, it can be helpful to learn about common reactions that they or their loved ones may encounter, so they are not surprised if reactions occur.

Remembrance: Many survivors welcome the cleansing tears, commemoration, and fellowship that the anniversary of the event offers. They see it as a time to honor the memory of what they have lost. They might light a candle, share favorite memories and stories, or attend a worship service.

Reflection: The reflection brought about by the anniversary of a disaster or traumatic event is often a turning point in the recovery process. It is an opportunity for people to look back over the past year, recognize how far they have come, and give themselves credit for the challenges they surmounted. It is a time for survivors to look inward and to recognize and appreciate the courage, stamina, endurance, and resourcefulness that they and their loved ones showed during the recovery process. It is a time for people to look around and pause to appreciate the family members, friends, and others who supported them through the healing process. It is also a time when most people can look forward with a renewed sense of hope and purpose. Although these thoughts, feelings, and reactions can be very upsetting, it helps to understand that it is normal to have strong reactions to a disaster or
traumatic event and its devastation many months later. Recovery from a disaster or traumatic event takes time, and it requires rebuilding on many levels - physically, emotionally, and spiritually. However, with patience, understanding, and support from family members and friends, you can emerge from a disaster or traumatic event stronger than before.

If you are still having trouble coping, ask for help. Consult a counselor or mental health professional.

At Virginia Tech, students should contact the Cook Counseling Center at 231-6557. Faculty and staff can contact the Employee Assistance Center at 866-725-0602 or Employee Relations at 231-9331.


- end -

University Relations (unirel@vt.edu)

2008-04-14

Brent Jesiek

eng

Reflections on a Mass Homicide (Commentary)

<p>(PDF, 30KB; Full text below.)

Commentary

<b>Reflections on a Mass Homicide</b>

Jimmy Lee,¹ MBBS, MMed (Psych), Tih-Shih Lee,^1,2 MD, PhD, FRCP (C), Beng-Yeong Ng,¹ MBBS, MMed (Psych), FAMS

¹ Department of Psychiatry, Singapore General Hospital, Singapore² Duke-NUS Graduate Medical School, Singapore

Address for Correspondence: Dr Tih-Shih Lee, Department of Psychiatry, Singapore General Hospital, Singapore, Outram Road, Singapore 169608. Email: tihshih.lee@gms.edu.sg

<b>Introduction</b>

The names "Virginia Tech" and "Cho" will be associated forever with the tragic mass homicide of 32 persons <i>cum</i> suicide by Seung-Hui Cho on 16 April 2007. In the aftermath, many questions have been posed: "What happened and why?", "Was he crazy?", "Could it have been prevented?", "Could it happen here?" This was the third mass killing in a US campus, with the largest number of fatalities. The first was in 1966 in the University of Texas with 16 dead and 31 wounded, then the Columbine High School shooting in 1999, in which 13 students were killed. We do not profess to know more about what happened in Blacksburg, Virginia, or Cho&#39;s neuropsychiatric condition than whatever is published in the popular press.¹ But through a series of questions, we reflect on this tragedy, attempt to place it into a human and psychiatric perspective, and offer insights into if, and how, it can be averted in the future.

<b>Question 1: Was Cho insane?</b>

Cho was described as a shy and quiet child, who was good in mathematics, but struggled with English. There were allegations of him being taunted and bullied in school since young. Both his pastor and relatives had suspected he might be autistic and suggested professional assistance. There was no record of him being involved in overt violence except that he had harassed 2 female classmates, one of whom called in the campus police.

He expressed suicidal ideation and was involuntarily committed by a judge in a mental health facility briefly for assessment. A psychiatrist wrote in his chart, "Affect is flat and mood is depressed" and "Insight and judgment are normal," and released him. He was supposed to have been on some treatment regimen but may not have adhered to it. In English Literature classes he wrote on haunting themes of violence and death. Moreover, from the rantings of his final macabre video, it can be inferred that he had grandiose and persecutory thoughts.

One could conceivably argue that anybody who murders <i>en masse</i> and then commit suicide must be insane. But insanity is an imprecise term that is no longer in the psychiatric lexicon. So we ask if he met criteria for a diagnosis based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) or International Classification of Disease-10 (ICD-10)? Or was he of a criminal antisocial or psychopathic mind? Unfortunately without having interviewed him or having access to his records, we cannot say for sure. We could speculate that he was depressed with delusional thoughts, and perhaps had undiagnosed Asperger&#39;s disorder (a mild variant of autism), or was taking illicit substances. But we do not have enough evidence to be certain of a definitive psychiatric condition that could account for his extremely violent behaviour.

<b>Question 2: Was it due to psychosocial developmental difficulties?</b>

Cho emigrated at the age of 8 years from South Korea and had difficulty speaking English. He was reportedly ostra-cised by his classmates and was isolated. The effects of migration on mental health are well described in the litera-ture. In the US, alienation is a problem for many Asians. Among Southeast Asians, the Hmong feel the most alien-ated, followed by Cambodians, Laotians, and Vietnamese.² Many symptoms could be due to acculturative difficulties, racism, and overwork. A migrant faces difficulties with 3 main areas; changes in social environment, changes in interpersonal relations, and cultural differences.³ Reports from those who knew Cho strongly supported the roles of these 3 factors in his maladjustment to the new country. From his video and writings, it is evident that he had tremendous envy and rage projected onto better-adjusted and well-to-do American kids.

Southeast Asian refugees have higher rates of brief reactive psychosis and paranoid psychosis compared to other Americans.^4,5 Sometimes paranoia develops among Southeast Asians when they are dealing with a new environment and experiencing "varying degrees of miscommunication, fear of rejection, and feeling mistreated, slighted or discriminated against".⁶ Psychosis among Southeast Asians can take the form found in many ethnic groups, e.g. "Aliens&#39; paranoid psychosis", a syndrome characterised by a usually short-lived xenophobia and by feelings of persecution because one belongs to an ethnic minority group.⁷

On the other hand, the overwhelming majority of immigrants and minorities are well-adjusted and functioning, despite having endured many of the same stressors that Cho endured. In particular, his sister, who shares much of his genetic substrate and environmental milieu, had apparently been doing very well. Many immigrants may have coping difficulties, but they do not usually resort to violence. The other 2 campus mass murderers were neither immigrants nor from minority groups. So, whereas difficulties relating to migration probably played a part in his violence, it would be simplistic to attribute it to primarily these stressors. Instead it would be a disservice to the large immigrant and ethnic minority communities.

<b>Question 3: What factors may have precipitated Cho&#39;s sudden outburst?</b>

There is a small literature considering situational factors and triggers that have consistently been found to be important in initiating a homicidal episode. Triggers for murder in Ressler et al&#39;s study⁸ included financial, legal, employment, marital and other conflicts. Emotional states such as frustration, anger, hostile moods, and feeling agitated and excited were reported at a lower frequency. Levin⁹ has offered a four-factor model of sudden indiscriminate mass killing. First, the potential offender has led a "life of frustration"; second, he has access to, and the ability to use, firearms; thirdly, there is a significant destabilising experience of a loss of "social controls", such as moving to a new area or the loss of an important relationship; fourth, there must be a precipitating event such as unemployment or divorce. Gresswell and Hollin¹⁰ have suggested that a more useful way of conceptualising the "firearms" component would be to consider that a fascination with weapons indicates a style of coping with stress, frustration, and low self-esteem that includes violent fantasies involving weapons. In such cases, the nature of such fantasies may be the best predictor of a homicidal response to a stressful event.

<b>Questions 4: Is there a neurological basis for aggression?</b>

Aggression refers to behaviour that is intended to cause harm, and is the behavioural manifestation of disturbances in the brain or mind. We now have some, though incomplete, appreciation of various neuroanatomical structures that may be involved in aggression. These structures include the prefrontal cortex, amygdala, hypothalamus, and temporal lobe. In particular, some evidence suggests frontal lobe dysfunction in violent and criminal behaviour, especially in the presence of focal orbitofrontal lobe injuries.¹¹ Brower and Price¹¹ proposed that clinically significant focal frontal lobe dysfunction is associated with aggressive dyscontrol. Orbitofrontal syndrome is associated with behavioural excesses, impulsivity, disinhibition and mood lability. Outbursts of rage and violent behaviour occur after damage to the inferior orbital surface.¹²

Abnormal brain concentrations of the neurotransmitters serotonin, dopamine and gamma-aminobutyric acid are implicated in impulsivity and aggression.¹³ Pharmaco-therapy with selective serotonergic reuptake antagonists, antipsychotics as well as mood stabilisers have all been used in treatment, with mixed results.

Studies of aggression in patients with brain injury suggest that their aggression tends to be (1) reactive, i.e., triggered by modest stimuli; (2) non-reflective, i.e., not premeditated or planned; (3) non-purposeful, i.e., does not serve long-term goals; (4) explosive; (5) periodic; and (6) ego-dystonic.¹² Some of these features describe Cho&#39;s aggression. But we do not know, and may never know, if a definable lesion was present in Cho&#39;s brain, or if present, whether that was severe enough to account for the violent behaviour.

With the evolving science on aggression, a discussion about "nature versus nurture" often arises, i.e. whether murderers are born or bred. Research has now demonstrated that genetic aberration per se is not the sole reason leading to violence; environmental factors such as childhood adversities play a significant part in the development of violent behaviour.¹⁴ Gene expression is influenced by environmental factors, and brain circuits are affected by life experiences.

<b>Question 5: How is dangerousness assessed?</b>

Psychiatrists are often called upon to determine how much a threat someone will pose to others and society, also known as dangerousness. Dangerousness is a subjective assessment of the element of danger attributed to a particular person and is qualitative in nature. Predicting dangerousness, particularly in an extreme form such as mass homicide, has been an elusive goal for those investigators who have attempted it. It is often said that "Hindsight is 20/20". When a person is exposed to be a murderer, we tend to focus on those warning signs in his character and biography that were previously ignored. For a category of violence such as mass homicide, however, the low base rate and consequent likelihood of finding false-positive results are overwhelming.¹⁵

Just as in Cho&#39;s instance, numerous questions were raised about the concerns of his teachers and the psychiatric assessment in November 2005. It must be emphasised that the assessment of dangerousness is not an exact science, and cannot yield a black-and-white result of "dangerous" versus "not dangerous". In our psychiatric assessments, we weigh various factors such as past history of violence, history of mental illness, personality, social background, context and state of mind in which dangerous behaviours manifest.

Past behavioural patterns provide the best insight into future behaviours. However, the accuracy of dangerousness assessments quoted in the literature is as low as 0.33.¹⁶ Mossman¹⁷ in 1994 extracted 58 datasets from 44 published studies, and revealed that mental health professionals&#39; violence predictions were better than chance. Current risk assessment tools such as the Historical/Clinical/Risk Management 20-item (HCR-20)¹⁸ and Psychopathy Checklist (revised) (PCL-R)¹⁹ offer a structured and more systematic approach to violence prediction, but none could tell with consistent (surely not 100%) accuracy that a person would re-offend.

Homicide is clearly the most serious of all crimes. Approximately two-thirds of homicides involve the killing of a victim by a partner, relative, friend or acquaintance. This may partly explain why the clear-up rate for these crimes is particularly high - the police do not need to look very far in order to solve the majority of murders.²⁰

The relation between mental illness and dangerous behaviours has been overemphasised, especially in the eyes of the public. There is a tendency to believe that murderers are mentally ill. However, a recent study among homicides in Singapore showed that 57% of murderers have no mental illness. Out of the 110 charged with murder, depressive disorders accounted for 9.1% and schizophrenia, 6.4%.²¹

The proportion of foreigners (defined here as non-citizens and non-permanent residents) who committed murder in Singapore was significantly higher compared with locals, which supports the earlier point about the stressors of migration. Also, foreigners tend to suffer from more serious psychiatric disorders, are less likely to have a known history of violence, and are more likely to be new to psychiatric services.²² This implies that the first violent outburst is usually the first presentation to psychiatric services. Cho did not have a history of overt violence prior to April 16.

<b>Question 6: What about the psychological trauma to family and friends of the victims?</b>

For those who saw their friends getting shot and killed, those who were injured and those who survived unharmed, the families and friends of the victims, it would be very difficult to collectively summarise the ordeal they went and are still going through, as each will have their own individual experience of it. Some may be at high risk of posttraumatic stress disorder (PTSD), but others will cope fairly well with milder symptoms. But it is safe to say that life will never be the same again. And we must not forget the hapless and unfortunate family of Cho, whose suffering cannot be fathomed.

There were positive measures taken by the school and public authorities in the aftermath that are worth learning. The measures included leave from school, time and ceremony to grief, and the provision of counsellors to all students of the school. School events such as examinations and convocation ceremonies continued as usual in an attempt to restore normalcy.

The telecast of Cho&#39;s video on national TV was highly controversial. Many others around the world later saw Cho&#39;s nefarious video and images of the "massacre". The national broadcast potentially traumatised viewers and re-traumatised survivors. In addition, it helped Cho achieved his aim of broadcasting his views, possibly achieving "martyrdom", and it may inadvertently encourage copycat murderers, as if a race were on to increase the body count. We would strongly urge that TV network companies and their regulating agencies revisit the guidelines and regulations on such telecasts.

<b>Question 7: Can it happen to us?</b>

Mass murder in a US school or college is a relatively rare event - three times in 40 years, despite the widespread availability of firearms and the large numbers of disenfranchised youths. Hence, it can be described as a low-probability, catastrophic-outcome event, like an earthquake occurring on a given day. The probability of its happening is very low, but once it hits, the results may be catastrophic. For countries with strict firearm and explosive control laws, the risk of a mass murder on the same scale is much lower.

With the benefit of hindsight, to discuss what the psychiatrist or the judge should have diagnosed or done is moot now. There was and always will be a balance between protection for society and infringement of the individual&#39;s civil liberties. This dilemma is all the more difficult if the assessment is made before a crime is actually committed. It would be virtually impossible for a psychiatrist to predict which of the patients would commit violence, least of all mass murder. If the decision is to commit the patients as a preventive measure, how long should the internment last, and who would set him free?

Nevertheless, for psychiatrists and all doctors, this is a timely reminder to be thorough and diligent in the assessment for dangerousness, and to acknowledge that we are far from perfect in our assessments. Under Section 34 of the Mental Disorders and Treatment Act (1973, revised in 1985), any registered physician in Singapore may refer a patient suspected to be of unsound mind or requiring psychiatric treatment to the Institute of Mental Health (IMH) for evaluation and treatment. IMH is the only gazetted mental hospital that has the statutory authority to hold patients involuntarily, should the person be deemed to be suffering from a mental illness, and detention serves the person&#39;s best interests and those of other persons.

For the majority of patients who are deemed not to need involuntary hospitalisation, there is little we can do to enforce treatment, other than relying on the family to supervise medications and appointments. If we suspect that a patient may pose a specific threat to another person, we may face an ethical dilemma with regard to confidentiality. This issue brings us back to the landmark Tarasoff case where the Californian courts found the therapist negligent for not warning the intended victim of a threat.²³ Kok et al²⁴ discussing this case with regard to the applicability of the Tarasoff ruling in Singapore, concluded that in the absence of local case law, a psychiatrist caught in this situation should consult the Singapore Medical Council prior to breaching doctor-patient confidentiality.

The Cho case also brings to mind the problems of troubled youths in Singapore - a combination of disengagement from society, low self-esteem, poor coping with rising expectations, and academic pressures. These forces predispose them to seek alternative forms of release and validation, such as using illicit substances and joining street gangs. Therefore, parents and school authorities should always be on the lookout for troubled or poorly adjusted youths. If need be, they should be referred to mental health professionals for evaluation and treatment. Another lesson in the local context would be for us, as a society, to be more tolerant and empathic to those who are less well-adjusted and successful, especially foreigners and migrants, so as to minimise resentment and wrath.

<b>Conclusion</b>

In summary, as we try to make sense of this apparently senseless violence, we find ourselves in the recurring debate of nature versus nurture. We probably will never know what Cho was really thinking when he pulled the trigger repeatedly, or nor can we be sure if he had a psychiatric condition that fulfilled DSM IV or ICD-10 criteria. Our hypothesis is that he had an underlying neurobiological or genetic vulnerability; he endured developmental psychosocial stressors in a chronic invalidating environment; and that finally some yet unknown "third-hit" triggered his rampage. Nevertheless, we highlight the need for thorough assessments of dangerousness by mental health professionals despite the limitations of our tools; the need for a system to attend to the psychological anguish of the survivors and loved ones of the victims; and the need for us collectively to adopt a more empathic stance towards our less fortunate brethren.

We also remember the 33 lives extinguished and countless more traumatised on that Spring day in 2007.

<b>REFERENCES</b>
<ol><li>Thomas E. Special Report: Making of a Massacre. Newsweek April 30, 2007:18-30.</li><li>Nicassio P. Psychosocial correlates of alienation: study of a sample of Indochinese refugees. J Cross-cultural Psychol 1983;14:337-51.</li><li>Moilanen I, Myhrman A, Ebeling H, Penninkilampi V, Vuorenkoski L. Long-term outcome of migration in childhood and adolescence. Int J Circumpolar Health 1998;57:180-7.</li><li>Nicassio P. The psychosocial adjustment of the Southeast Asian refugee: an overview of empirical findings and theoretical models. J Cross-Cultural Psychol 1985;16:153-73.</li><li>Westermeyer J. Paranoid symptoms and disorders among 100 Hmong refugees: a longitudinal study. Acta Psychiatr Scand 1989;80:47-59.</li><li>Lin KM. Psychopathology and social disruption in refugees. In: Williams C, Westermeyer J, editors. Refugee Mental Health in Resettlement Countries. Washington, DC: Hemisphere Publishing, 1986.</li><li>Tung TM. Psychiatric care for Southeast Asians: How different is different? In: Owan T, editor. Southeast Asian Mental Health: Treatment, Prevention, Services, Training, and Research. Washington, DC: US Department of Health and Human Services, 1985:5-40.</li><li>Ressler PK, Burgess AW, Douglas JE. Sexual homicide: patterns and motives. Lexington, MA: Lexington Books, 1988.</li><li>Levin J. Why his last shot blew the truth away. The Sunday Times, London 1987, August 23, p23.</li><li>Gresswell DM, Hollin CR. Multiple murder: a review. Br J Criminology 1994;34:1-14.</li><li>Brower MC, Price BH. Neuropsychiatry of frontal lobe dysfunction in violent and criminal behaviour: a critical review. J Neurol Neurosurg Psychiatry 2001;71:720-6.</li><li>Silver JM, Yudofsky SC, Anderson KA. Aggression. In: Silver JM, McAllister TW, Yudofsky SC, editors. Textbook of Traumatic Brain Injury. Washington, DC: American Pychiatric Publishing, 2005.</li><li>Swann AC. Neuroreceptor mechanisms of aggression and its treatment. J Clin Psychiatry 2003;64 Suppl 4:25-35.</li><li>Reif A, Rosler M, Freitag CM, Schneider M, Eujen A, Kissling C, et al. Nature and nurture predispose to violent behaviours: serotonergic genes and adverse childhood environment. Neuropsychopharmacology 2007.</li><li>Fox JA, Levin J. Serial murder: myths and realities. In: Smith MD, Zahn MA, editors. Studying and Preventing Homicide: Issues and Challenges. California: Sage Publications, 1999.</li><li>Monahan J. The prediction of violent behaviour: Toward a second generation of theory and policy. Am J Psychiatry 1984;141:10-5.</li><li>Mossman D. Assessing predictions of violence: Being accurate about accuracy. J Consult Clin Psychol 1994;62:783-92.</li><li>Webster CD, Douglas KS, Eaves D, Hart SD. HCR-20: Assessing risk for violence (version 2). Burnaby, BC: Mental Health Law and Policy Institute, Simon Fraser University, 1997.</li><li>Hare RD. The Psychopathy Checklist-Revised. 2nd ed. Toronto, Canada:
Multi-Health Systems, 2003.</li><li>Ainsworth PB. Psychology and Crime: Myths and Reality. Edinburgh: Pearson Education Ltd, 2000.</li><li>Koh KG, Gwee KP, Chan YH. Psychiatric aspects of homicide in Singapore: a five-year review (1997-2001). Singapore Med J 2006;47:297-304.</li><li>Koh KG, Peng GK, Huak CY, Koh BK. Migration psychosis and homicide in Singapore: a five year study. Med Sci Law 2006;46:248-54.</li><li>Tarasoff v Regents of University of California. California Report 1976;118:129.</li><li>Kok LP, Yap HL, Cheang M. Mental disorders and public safety of the community at large - does the Tarasoff principle apply in Singapore. Ann Acad Med Singapore 2002;31:535-6.</li></ol></p><p -d="nq">--

Archived with permission of the editor.

Original Source: Annals, Academy of Medicine, Singapore, June 2007, Vol. 36 No. 6
<a href="http://annals.edu.sg/PDF/36VolNo6Jun2007/V36N6p444.pdf">http://annals.edu.sg/PDF/36VolNo6Jun2007/V36N6p444.pdf</a></p>

Jimmy Lee, Tih-Shih Lee, and Beng-Yeong Ng

2007-08-26

Brent Jesiek

Kirat Kaur (Ms)
Editorial Executive
Annals, Academy of Medicine, Singapore
annals@academyofmedicine.edu.sg

eng

What We Can Learn From Virginia Tech

By Dr. Thomas Parham

In the wake of the tragic events that occurred at Virginia Tech University, many in our community will be forced to wrestle with and confront some tough questions and concerns. Our hearts and prayers go out to the victims and families, as well as the broader campus community. No amount of planning and preparation can ever truly prepare one for the events that unfolded on April 16, and yet our thoughts cannot resist the tendency to delve into spaces that invite critical reflection and analysis about our own vulnerability to such a tragedy within the borders of this campus.


Times like these challenge our individual and collective sensibilities as we seek to desperately cling to notions of life that are far more predictable, less scary and less unsettling. Our designs for living and patterns for interpreting reality have been shaken by this single act of horrific proportion, which dislodges us from our comfortable spaces of intellectual, emotional, behavioral and even spiritual comfort.


As people struggle to cope with this horrific tragedy, it is likely that some will experience a broad range of emotional reactions, including anxiety, confusion, depression, insecurity, anger, resentment, sadness, vulnerability and fear. Some may experience difficulty sleeping, eating or concentrating on their studies. These feelings are normal and reasonable, and consistent with what mental health professionals predict. Over time, these feelings will diminish for most people.


We want each member of our community to know that we are here for you in ways that ensure, to the best of our ability, your safety, as well as address your emotional and psychological well-being in this time of extreme distress.


In recalling the incidents of last week, I want to invite each of you to resist the temptation to espouse what could or should have been done. Hindsight is always 20/20, and none of us really knows what it was like in the moments surrounding the tragedy. What I do want to encourage and provide is an invitation to explore the implications of this tragedy for our own UC Irvine campus and the psychological resources that are available to assist us, should some incident darken our door.


First, no one can predict with absolute certainty if or when such a tragedy might occur or when individuals, whether reacting to normal life stressors or challenged to cope with some level of mental illness, are likely to erupt. We have little, if any, control over these events that so impact our lives. Fortunately, incidents like Virginia Tech or Columbine are relatively infrequent and it is important to remind ourselves that order is much more frequent than disorder and tragedy, and our blessings in life far outweigh our trials and tribulations.


What we do control is how we manage our own spaces, and how we access and/or refer individuals to the resources that can help them better cope with personal or life challenges, particularly in times of moderate or severe distress. The UCI campus is blessed with a full array of mental and physical health and wellness services. The Counseling Center provides a broad range of mental health treatment that can deliver individual and group counseling and therapy, walk-in and triage coverage, consultation, psycho-educational workshops and training, and crisis intervention. Our Student Health Mental Health Clinic, in addition to the psychological interventions listed below, also delivers psychiatric assessment, pharmacotherapy and consultation. Our campus also boasts a Health Education Center that provides important information on healthy lifestyle support that can be useful in managing or coping with a tragic circumstance. Please encourage students to take advantage of these services.


If you experience any of these symptoms or would just like someone to talk to, we invite you to contact the Counseling Center at (949) 824-6457 or the Student Health Mental Health Clinic at (949) 824-1835. For staff or faculty, we invite you to contact the Faculty Staff Counseling Center at (949) 824-8355.


Do not be reticent about discussing emergency planning and personal-safety scenarios with your family, roommates and friends. Determine how you will communicate and plan for how you will physically reconnect. Having these plans will provide a focus for stepping through tragic circumstances and help to lessen our concerns about the unknown. UCI&#39;s Environmental Health and Safety Web site can walk you through this type of planning.


We also control how we interact with colleagues and friends, and our ability to leave those interactions having helped create a positive space where people feel comfortable, cared about and affirmed for having been with us. A smile, or an encouraging word, goes a long way toward making someone&#39;s day.


In addition to the tone of the conversation, we also control the quality of the interaction. How many times a day, in our interactions with friends and colleagues, do we fail to engage people in more genuine and authentic conversations? People respond to our queries about how they are doing with canned, almost robotic answers that suggest they are "fine." And yet, behind many of their replies is a staff, faculty colleague or student friend whose smile masks a deeper pain or hurt, or maybe just a hint of discomfort. You can make a difference in their lives by simply slowing down the questioning enough to get an honest and legitimate answer. If they are experiencing any distress, please refer them to a professional for help and assistance.


Central to our campus values articulated so well by Chancellor Michael Drake is the value of empathy. Let us use this occasion to empathize with the victims, families, students and colleagues in Virginia and pray that their healing will be swift. Let us also allow these circumstances to remind us to engage each person in this UCI campus community with a level of compassion and caring that illustrates their importance to our university family.


Thomas A. Parham is the assistant vice chancellor of counseling and health services and the director of the Counseling Center.

Thomas A. Parham

New University

2007-08-19

Sara Hood

Zachary Gale <newueic@gmail.com>

eng

UC Irvine&#39;s Counseling and Health Services Are Under-Funded

By Emilie Doolittle
Staff Writer

Three weeks ago, before midnight, a student was found with a gunshot wound to the head in the Social Science Building at UC Irvine. He had committed suicide. Two weeks ago was the Virginia Tech massacre. In the aftermath of recent tragic events, students at UCI wonder how safe our campus is and how psychologically healthy the students are. Is the Counseling and Health Center doing enough to make our campus psychologically healthy? What provisions are they making?


If the Health Center gets a distress call, where someone is either a danger to themselves, a danger to others or gravely disabled, then they can send a psychologist to mentally evaluate the person. However, psychologists do not have the capacity to attend distress calls beyond the working week hours of 8 a.m. to 5 p.m. For after-hour coverage, it is up to the on-campus police to handle distress calls. If the police officer feels that a mental health professional needs to be involved, they will call California&#39;s Welfare and Institutions Code 5150, which mandates that the distressed person be sent to a clinician. Generally, the person would be sent to the UCI Medical Center where they can have psychiatric help at any time.


Students who are not sent to psychiatric help by law enforcement, may be in need of psychological support. How can they get support when the Counseling Center is closed? Currently UCI has no psychological counseling hotlines such as suicide prevention or sexual assault victim counseling. Students have to seek psychological support from sources outside of UCI.


For any student to find psychological assistance, they have to look up a service, generally via the Internet, or have someone else look it up for them. This may cause a problem for someone who is already in a vegetative state of depression and has no one around to notice that they are in dire need of psychological help. If a student was severely depressed and did not have a friend to help them get counseling it might be helpful if they were to see a poster for a counseling service phone number, or a sticker for a suicide prevention hotline.


At Pembroke College, in the University of Cambridge, England, as well as the University of Scotland, bathroom stalls have stickers and posters that list psychological assistance hotlines for students to call. Hotlines for students who are victims of sexual assault, for students who feel overanxious and depressed and even for female students that may be in need of birth control are on the bathroom stall walls. A bathroom stall is an intimate place for student to find information on how they can get help.


While the bathroom stalls at UCI often have notes posted for students who are looking for a roommate or are trying to sell their books, from personal observation there rarely are mental health awareness flyers or stickers. Why is this?


The apparent reason is that, like most college campuses in the United States, the Counseling and Health Services at UCI are under funded. Dr. Thomas Parham, the Assistant Vice Chancellor of the UCI Counseling and Health Services would fully support more marketing for psychological health awareness, including signs in bathrooms, if there were more funding. The Counseling and Health Services do not have the resources to afford more flyers and mental-health awareness signs.


It is hard enough for them to afford to pay for psychologists. The Counseling Center is understaffed with mental health professionals and its psychologists are overloaded with students. On average, each of the UCI psychologists has 609 more students than they are recommended to counsel according to the International Association of Counseling Services. However, according to the OC Register UCI is in the process of looking for two new counselors.


Unfortunately, students are only allowed a maximum of seven free one-on-one counseling sessions. This may not be enough for students who are in need of more sessions.


Fourth-year sociology major Cassandra Rush was a victim of sexual assault during her second year at UCI. Although she received assistance from the Counseling Center afterward, she said, "Seven sessions wasn&#39;t enough. I felt kind of betrayed because I spilled my soul out to one psychologist and then they switched me over to another psychologist. I was already at a point where I didn&#39;t trust anyone."


Luckily for Rush, she could afford to see a professional psychologist outside of UC Irvine. However, some students in need of mental professional help are not so fortunate. Various health insurance companies do not cover psychological counseling and some students do not have the personal funding to afford it. Like Rush&#39;s case, one of the most common reasons why students enter the counseling center is for cases of sexual assault. While there is a group for victims of sexual assault that meets throughout the school year which Rush recommends, group counseling is not always as helpful as a one-on-one.


More students are seeking counseling at UCI than in the past. The no. 1 reason students seek counseling is because of stress, including intense emotions and mood changes.


In Dr. Parham&#39;s words, students live in an almost pathologically competitive society. Unlike students of previous generations that went through time periods of struggle, such as the Great Depression and the Cold War, where they were taught that hardship was a part of life, "Now we create this illusion that everything is OK. Students are not used to struggling," said Parham.


Not only has the number of suicides increased at college campuses nationally, but so has the number of suicides at UCI in the last decade. The two students who committed suicide within the last two years did not seek counseling or psychiactric help from UCI&#39;s health services.


With the influx of students and the already lacking amount of resources, Counseling and Health Services is in dire need of funding.


Despite a lack of funding, the Health Education Center has worked hard to obtain grants from the Substance Abuse and Mental Health Services Administration, which provide small grants for campuses to provide for suicide prevention groups. UCI was one of the 22 campuses in the nation to win a grant.


With the grant, the Health Education Center is promoting student health through "Project Courage." The project is designed to bring awareness to incidences of mental health and let people know what their resources are. Also, it is a social marketing campaign to help suicidal people think a second time before erasing their future.


The Web site for Project Courage, www.donteraseyourfuture.org, lists difficulties famous people such as Martin Luther King Jr., William Shakespeare and Marie Curie went through, with the message that the world would not be the same without them.


If a student is feeling anxious, depressed or violated, and is in need of psychological counseling they can call 949-824-6457 and set up an appointment with the UCI Counseling Center. If a student is feeling severely depressed and in need of psychological counseling outside of the available hours they can call 1-800-273-TALK (8255).
--

Original Source:<a href=http://www.newuniversity.org/showArticle.php?id=5763>New University - April 30, 2007</a>

Emilie Doolittle

2007-08-19

Sara Hood

Zachary Gale <newueic@gmail.com>

eng

Enlightened

My youngest son, Travis Miller graduated from Virginia Tech in 2006, and my experiences goe back gto my early teens. As a woman, a Mom, and a researcher, the events of April 16, 2007, grabbed my full attention, and still do.

You see, since 1993, I have been treated for a condition, called Bipolar/Manic Depression. My losses have been many, and severe, as in those 14 years, due to the disease, I had no judgment, no sense of reality. I have all my charts, and I now know I was very over medicated by my EX Dr of some 12 years. Life altering changes occured, for myself, and my 3 sons [who were not educated, nor had therapy] which resulted in Dad walking away, after 5 years. Treating mental illness, as something one chooses, or can "snap out of" is extreamly uneducated.

The past 3 years, I have dedicated myself to research, and to understanding the past, as to understand the present, and hopefuly simplifly the future. Including my sons somewhat in the exploration, led to estrangement, and Family Protective Orders. I was not included in my son&#39;s graduation of 2006. Isolation, since 1993, continues from my family, but I now have a better understanding, throught my faith, Buddhism. I accept my part, and thankfully, injoy a full remission, which requires no prescriptive medication at present. But there is still fall out, and I am fighting the good fight, to bring awareness to Virginia, the Nation on the subject of Mental Health.

Trying to understand April 16, 2007, I did know perhaps better that most, how Cho might have acted out his terror, his emense anger, at his perceived rejection, his isolation. I think he fell through the many "cracks" as it were, and that as a state with a D- rating by Nami, [mental health ass.] we have the chance for change. I wrote a Letter to the Roanoke times, on a bill before Congress, up in September for vote, on teaching K-12, good mental health. Yes, we need the tools, we need the education, to demistify, what is baseicaly a "chemical imbalnce", widely unreported, and over or undermedicated, and yes, ignored by too many.

It is up to each of us to know, and to be aware of the very real symtoms, of mental illness.

And I personaly want to do all I can to help, as I council freely in my hometown, happily 2 friends have also seen the "root&#39; of their depression, and no longer take prescription medication, and are doing great. It is a process, and that is called life.

Dona Wheeler

2007-08-19

Dona Wheeler

eng

Counseling and Support Information for Students and Employees

Date: Fri, 17 Aug 2007 13:34:30 -0400
From: Virginia.Tech.news@vt.edu
To: Multiple recipients <LISTSERV@LISTSERV.VT.EDU>
Subject: Counseling and Support Information for Students and Employees

August 17, 2007

Counselors from Cook Counseling Center and ValueOptions will provide drop in counseling services from two locations, a tent on the Drillfield and in Squires Student Center: Sunday, August 19 from 10 a.m. to 6 p.m., Monday, August 20 and Tuesday, August 21 from 8 a.m. to 9 p.m.

Cook Counseling Center, McComas Hall, will also be open Sunday, August 19 from 10 a.m. to 6 p.m., Monday, August 20 through Thursday, August 23 from 8 a.m. to 9 p.m., Friday, August 24 from 8 a.m. to 5 p.m.

For additional counseling support for students please contact Cook Counseling Center at 231-6557 or 231-6444 after hours. For additional counseling support for faculty or staff, please contact Employee Relations at 231-7772.

Counseling and Support Resources for Faculty and Staff

Tom Brown, Dean of Students, and Christopher Flynn, Director of Cook Counseling Center, will be offering a series of seminars on "Identifying and Referring the Distressed Student" tentatively scheduled for Wednesday, Sept. 5 from 4 to 6 p.m., Thursday, Sept. 6 from 6 to 7:30 p.m., and Monday, Sept. 10 from 7:30 to 9 a.m. Registration is not required. Participation is open to everyone the Virginia Tech community. Locations to be announced.

The Center for Excellence in Undergraduate Teaching is sponsoring a workshop on Thursday, August 30 on "Pathways to Resilience - From Surviving to Thriving". The workshop will be led by two clinical psychologists from James Madison University. Sessions will be held from 9 a.m. to noon and from 2 to 5 p.m. at The Inn at Virginia Tech and Skelton Conference Center. To register, visit www.ceut.vt.edu. Registration is open to faculty and staff.

Faculty, staff, and dependents covered by Virginia Tech health insurance always have full access to counseling referral through ValueOptions, our EAP provider. Call 866-725-0602 anytime, 24 hours a day, 7 days a week. Callers will be referred to a local counselor for an appointment.

Counselors are available to meet with departments and workgroups at their offices or other convenient locations by appointment - contact 231-7772 to request this service.

Counseling Resources for Students

Cook Counseling Center, McComas Hall (231-6557): There is no charge for counseling services for graduate and undergraduate students. Individual and group psychotherapy services are available. Groups are forming for students coping with trauma; call for information. The after hours emergency number is 231-6444.

Web Resources

Additional resources and information for the university community are available at <a href="http://www.virginiatech.healthandperformancesolutions.net/ ">http://www.virginiatech.healthandperformancesolutions.net/</a> and www.hr.vt.edu/supportresources. Additional resources and information for students are available at www.ucc.vt.edu.

Other Counseling Resources

Mental Health Association of the New River Valley (540-951-4990) provides referrals to local counselors (no student services). New River Valley Community Services Board (540-961-8421, no student services). Psychological Services, Department of Psychology (540-231-6914) provided non-emergency counseling/therapy to students and to faculty, staff and/or family members (there is a fee for service). Family Therapy Center, Human Development Department (540-231-7201) provides non-emergency services to students, faculty, and staff (there is a fee for service).

Upcoming Events for Employees

The annual CommonHealth and Benefit Fair will be held Wednesday, October 31 from 10 a.m. to 2 p.m. at Squires Student Center in the Commonwealth Ballroom. In addition to vendor&#39;s booths, there will be wellness and stress management seminars. Watch for information coming in early fall.

For more information contact Human Resources and Benefits(231-9331 or www.hr.vt.edu); Employee Relations (231-7772); Work/Life Resources (231-3213 or www.worklife.vt.edu); ADA Services (231-4638); Cook Counseling Center (231-6557 or 231-6444 after hours); Dean of Students Office (231-3787); Office of Recovery and Support (231-0062); Virginia Tech Police Tip Line (231-6411).

Virginia.Tech.news@vt.edu

2007-08-17

Brent Jesiek

eng

Universities mull privacy

BLACKSBURG, Va. - The revelation that Virginia Tech shooter Cho Seung-Hui had a documented history of psychological problems is likely to intensify an already heated debate about how campuses handle troubled students.

A number of high-profile court cases in recent years have centered on the constraints and responsibilities university officials confront in deciding whether to take pre-emptive action on behalf of at-risk students.

Christopher Flynn, director of the Cook Counseling Center at Virginia Tech, alluded to that difficulty in discussing Cho&#39;s history of strange behavior.

"There are lots of issues that are present on a college campus," Flynn said during a Wednesday press conference. "The extent to which we can make a judgment about whether someone is a danger is a separate issue."

For universities, it is an issue fraught with moral and legal complications. Officials have to balance concern for campus safety with an obligation to protect individual privacy, often with vague guidelines.

"Schools walk a real fine line," said Johnne Armentrout, assistant director of counseling services at Wake Forest University. "The tricky thing is that they face lawsuits on both sides, either from not doing enough or from violating their students&#39; privacy rights."

Federal law prohibits universities from revealing a student&#39;s psychological problems, even to parents, unless they have a signed waiver or believe the student poses an imminent danger to himself or others.

Deciding when to break that confidentiality is difficult, but universities typically have erred on the side of protecting student privacy.

In recent cases, universities have prevailed in court against parents arguing that they should have been better informed about their children&#39;s psychological problems.

"When in doubt, my decision is to respect the student&#39;s right to privacy," said David McCord, head of the psychology department at Western Carolina University. "The students&#39; right to privacy is mandatory training for all faculty."

But in the wake of Monday&#39;s tragedy at Virginia Tech, there already are calls for revisiting the circumstances when counselors can disclose potential threats. Flynn and other campus officials faced tough questions Wednesday about why Cho was not forced to seek more help when professors complained about his behavior.

"We certainly are always sensitive to the potential for violence," Flynn said. "That&#39;s a very difficult thing to predict clearly."

That uncertainty is what puts counselors in such a challenging position, said Robert Murphy, executive director of the Center for Child and Family Health, a joint venture between UNC-Chapel Hill, Duke and N.C. Central universities. He said universities are likely to review their policies in the aftermath of Monday&#39;s shooting.

"Legally, our society has come down more on the side of the individual client or patient rights," Murphy said. "There are hundreds of thousands, if not millions, of people in this country who might present with similar warning signs but never go on to commit an act like this, and that&#39;s the really tricky part."

--

Original Source:<a href=http://media.www.dailytarheel.com/media/storage/paper885/news/2007/04/19/StateNational/Universities.Mull.Privacy-2851714.shtml>Daily Tar Heel - April 19, 2007</a>

Erin France and Eric Johnson

Daily Tar Heel

2007-07-27

Sara Hood

Kevin Schwartz <kschwartz@unc.edu>

eng

Thoughts About Media Coverage of the Virginia Tech Tragedy

posted 5.01.07

<a href="http://www.miwatch.org/about.htm#Wahl">Otto Wahl, Ph.D.</a>, University of Hartford

The tragic death of 33 students at Virginia Tech has shocked and saddened us all. Given the mental health aspects of the situation, it is not surprising that there has been much in the coverage about mental illnesses and their treatment. Unfortunately, the articles and editorials that followed the shootings have often been troubling in what they convey to the public about mental illnesses and mental health interventions.

One troubling aspect of the media coverage has been the frequent vilification and dehumanization of the troubled young man who perpetrated the killings. Appropriately sympathetic descriptions of the background and lives of the "32" victims were widespread, and such descriptions helped us to better appreciate the tragedy on a more personal level. However, descriptions of the 33rd person who died in the tragedy, Cho Seung-Hui, focused almost exclusively on his pathology, his anger, and his menacing manner. Some media sources characterized Cho as motivated by "meanness;" others labeled him as a "fiend," a "psychopath," or "just plain "evil." Such coverage ignored the fact that Cho&#39;s death—and much of his life—was also a tragedy. His alienation, isolation, anger, and ultimate suicide are probably not the life goals he set out for himself. Much of the media coverage did discuss Cho&#39;s mental health, but mostly without notable empathy for his difficulties.

Related is the mistaken implication in coverage of Cho&#39;s actions that mental illness and violence are synonymous. The widespread images of Cho brandishing weapons epitomized the already prevalent public image of the "menacing madman," and that image was underscored further by the fear-inducing labels Cho was given in many media accounts, such as "maniac" and "psycho" and worse. Likewise, the repeated discussions of the need to protect the college community—and the larger community—from such individuals served to reinforce unwarranted public fears of people with mental illnesses. The vast majority of people with mental illnesses, including severe mental illnesses, are neither violent nor criminal. The vast majority of students on campus who are living with mental illnesses are not threatening others, but working and studying to make better lives for themselves. I saw little discussion of this in media coverage.

The events at Virginia Tech were truly horrendous. The media, like the public, searched to make sense of the tragedy and to find clues as to how future tragedies could be prevented. However, there was a tendency to focus on mental illness as the sole or primary explanation for the horrific outcome at Virginia Tech. Many reporters and even mental health professionals seemed to commit what social scientists have dubbed the "fundamental attribution error." This term refers to our tendency to attribute the actions of others, particularly unacceptable actions, to their inner, psychological attributes and to neglect potential situational influences. If we succumb to this error and focus mainly on the possible internal causes of behavior, the mental health of Cho Seung-Hui in this case, we may overlook other potential contributors to the event and, thus, other potential and important avenues for prevention.

Often overlooked, then, were questions about how we engage or do not engage students on our college campuses or how we do or do not integrate diverse students to better create a sense of community, questions about what gaps in understanding and education about cultural differences might have contributed to Cho&#39;s apparent isolation and to the ultimate outcome, and questions about the extent to which stigma and negative attitudes about mental health problems could have contributed to Cho&#39;s apparent reluctance to accept counseling assistance despite the recommendations of Virginia Tech faculty.

Instead of looking at the factors above, many media reports implied—directly or indirectly—that the major preventive solution is the lessening of restrictions on involuntary hospitalization. After horrific events like the Virginia Tech deaths, it is easy to forget that the current criteria for involuntary psychiatric commitment result from a long history of indiscriminate and abusive use of forced hospitalization and from a belated recognition that the individual civil rights of people with mental illnesses need protection. Just as the tragic events of 9/11 should not have allowed us to dismantle the basic civil liberties on which our country is founded, a tragic event like Virginia Tech should not serve as justification for diminishing the hard won civil protections of the millions of people with mental illnesses. But it may, and some of the news coverage is suggesting that it should.

Also, it is not clear that involuntary commitment for Cho would have been the appropriate solution. Coerced treatment may have poorer long term outcomes than voluntary treatment if it creates trauma and fuels antagonism and poorer treatment compliance. For a person like Cho, who already felt persecuted and angry, this may have been likely. So hospitalization might have only postponed the tragic outcome. Outpatient treatment may have had a better chance of succeeding in helping Cho and preventing the lethal outcome. In hindsight, we know it was not successful, but we do not know that involuntary hospitalization would have had more success.

The events at Virginia Tech have led to calls for greater security on campuses and for a better ability of campus authorities to exclude people with serious mental illnesses from the campus. Again, this represents a troubling inclination to further restrict the rights and opportunities of people living with mental illnesses. Easier hospitalization and campus restrictions are not what is needed for preventing tragedies such as the one at Virginia Tech. Instead, we need better training of service providers to deal with individuals who are reluctant to accept treatment, and therapeutic alternatives that are more attractive, less aversive, and better funded. We also need reduced stigma for seeking and accepting treatment, along with greater outreach and prevention efforts.

I do not mean to suggest that there was no sensitive and appropriate media coverage of the events. Many stories were sympathetic to the needs of troubled youth on campuses, urging improvements and cautioning against attempts to exclude students. Former Rosalynn Carter Journalism Fellow, John Head, for example, wrote, in the <i><a href="http://www.ajc.com/search/content/opinion/stories/2007/04/20/edhead0420.html">Atlanta Journal Constitution</a></i>, "A policy that punishes students for enduring emotional and mental disturbances will only discourage them from seeking help." Articles and editorials have called for expanded suicide prevention programs and improvements in culturally competent services, as well. An article in the <i><a href="http://www.washingtonpost.com/wp-dyn/content/article/2007/04/22/AR2007042201190.html">Washington Post</a></i>, by another former Carter Fellow, Shankar Vedantam looked "beyond the shooter," to consider social factors that may have contributed to the fatal outcome. And there did emerge a number a number of pieces that looked more fully and sympathetically at the life of Cho Seung-Hui and at his family&#39;s pain and suffering.

Media coverage also brought to light the archaic and offensive language of the federal statutes for regulation of gun purchases. I am referring to the prohibition against selling guns to "mental defectives,&#39; a category which, for the federal government, apparently includes persons with mental illnesses. I am amazed that such a reference to mental illness—language that was discarded decades ago because of its pejorative nature and its connection to eugenics and Nazi cleansing—could still be the chosen terminology in the laws of our country.I can only hope that the wide exposure of this language in the press may lead to sufficient embarrassment and/or outrage as to generate an appropriate updating.

I am, however, cautiously optimistic. Despite the great deal of stigmatizing coverage that has surrounded the tragic loss of life at Virginia Tech, the discussions that are occurring have the potential to generate important changes. Chief among these are greater understanding of and improved responsiveness to mental health needs on campuses. I do not mean to suggest, as some media coverage has, that these are needed primarily to protect the student body from unstable shooters, but rather that they are needed so that universities can enhance their abilities to support the learning and accomplishment of all students, including the many who experience mental health problems.

--

Archived with permission of the author.

Original Source: MIWatch.org
<a href="http://www.miwatch.org/Wahl.htm">http://www.miwatch.org/Wahl.htm</a>

Otto Wahl

2007-07-17

Brent Jesiek

Otto Wahl (owahl@hartford.edu)

eng