A Cry for Help:

The statistics come down hard: an average of one person every 17.3 minutes commits suicide in America. Suicide is more common than homicide. Suicide claims 13 percent of all deaths in the 15 to 24 age group, second only to car accidents.

According to a 1983 Newsweek poll, one out of eight college students has seriously contemplated killing herself or himself as a way of dealing with stress, burnout, depression or anxiety.

At Harvard, approximately 20 students have taken their own lives in the last two decades. The most recent confirmed case was in 1990, when a graduate student committed suicide.

After a cluster of suicides at Harvard in the 1970s, the number has varied from none to two each year, Director of Mental Health Services Randolph Catlin says.

Most Harvard students who have committed suicide in the recent past did so by overdosing on pills, says Douglas H. Powell, a psychologist at University Health Services (UHS). These students also tended to leave notes, he says.

One student, however, left life tumbling from the Mather House high rise during reading period. Another jumped from a window in Stillman Infirmary. Another hung himself in a dorm stairwell over Christmas break.

Harvard matches other Ivies in suicide rates over the past decade, according to the schools' mental health departments. Cornell University averages about one suicide a year. Yale University averages about one every two years. Princeton University's slate is clear of suicides over the past couple of years. Brown University had four students take their own lives in the last two years.

"An important point to make about statistics is that the story is not complete," says Margaret O'Neil, who for eight years has served as director of the Boston Samaritans, a 24-hour suicide prevention center located on Boylston St. O'Neil says student deaths, no matter how suspect, are usually not earmarked as suicides unless there is a note. Moreover, Powell estimates that for every completed suicide there are anywhere between 20 and 100 attempts, many of them unreported.

Last year, Mental Health Services admitted just under 600 undergraduates--9 percent of the College; Room 13, Harvard's all-purpose peer counseling and outreach service, received about 1300 calls and drop-ins; and the Bureau of Study Counsel counseled about 700 students.

Not all, of course, were suicidal or clinically depressed. "Most students who come in have problems that are well short of the typical psychiatric diagnosis," Powell says. Mitchell C. Bailin '92, co-director of Room 13, says some callers are suicidal, but most are not. "There's a whole range of people who feel down in the dumps, who feel the blues," Bailin says.

"I think almost everybody at Harvard goes through periods where they feel depressed," Bailin adds.

Of the students who seek help at Mental Health Services, women outnumber men, two to one. At the Bureau of Study Council, the ratio is three to two. And over the years slightly more women than men have used Room 13. Catlin attributes the discrepancy to differences in the way men and women tend to address personal problems.

"Women are usually more in touch with their feelings, more willing to talk, and more concerned about issues of relationships," Catlin says. "It's usually more difficult for men to come and talk about their problems."

O'Neil agreed, saying, "It's more acceptable for a woman to ask for help than a man."

According to the 1990 National Center for Health Statistics report, women attempt suicide three times more often than men, whereas men complete four times more suicides than women, often more violently.

Research also shows that the suicide rate remains highest among elderly people and next highest among those under 25. The 1990 report states that the elderly, who constitute 12 percent of the population, committed 21 percent of all suicides, while the young, 15 percent of the population, committed 16 percent.

Although a comprehensive ethnic analysis of suicide and depression is not yet available, more men and women who are white kill themselves than those who are not white, according to a 1983 article in Harvard Magazine. Two-thirds of all suicides in America are committed by white males.

At Harvard, studies that track how students from different ethnic groups use various university services have just gotten underway, and so far they have yielded little consistent data. Approximately one out of 14 Asian undergraduates and one out of eight Black students--compared to about one out of six white students--sought help at Mental Health Services last year. But at the Bureau of Study Counsel, those percentages did not hold, and research into this area continues.

"It has a great deal to do with cultural expectations," says Dr. Charles P. Ducey, director of the Bureau of Study Counsel, of the relatively large number of Asian-Americans who seek advice at the Bureau. That Asian parents often emphasize achievement may be a significant factor in depression among Asian-American students, he says.

Women at Harvard have to cope with the particular pressures of being a sexual minority, says Nadja B. Gould, a clinical social worker at Mental Health Services and supervisor for a number of counseling and outreach services available at Harvard.

The Lonely and the Heartbroken

The clinicians and counselors interviewed for this article all agreed that loneliness is one of the most common triggers for depression among Harvard students, especially after the breakup of an intimate relationship.

"The most common general category of issues surrounds relationships--boyfriends, girlfriends, roommates," Bailin says. And Powell says he diagnoses many students as having reactive depressions, caused usually by the breakup of "a significant romantic relationship" and "the sense that your life will never be the same without a loved one."

Ducey says he sees a whole group of students who come in not because of academic problems, but because of recent breakups. "Loss is probably the major immediate precipitant of depression, and I think research has supported that a great deal," Ducey says.

Harvard first-years commonly suffer from a different kind of separation--homesickness. "A lot of the students who come to [Mental Health Services] have had very close, warm relationships with teachers and family and friends back home," Powell says. "And now they're coming to Harvard--which is for some a cold water bath--and suddenly all those things that gave them support are gone. It seems everyone doesn't know their name, nobody smiles at them when they walk across campus."

"College," says O'Neil, "is a time of a lot of confusion and change--of becoming an adult, of becoming independent, of the realization of the loneliness and difficulty of doing that. For many students it's being thrown into a competitive environment, the pressures to do well, to succeed and fit in, and of course the regular family pressures."

The Harvard Factor

Although most of the pressures Harvard students face are typical of any college, some are unique to Harvard, Ducey says. "Because of the name, families may expect a lot of reflected glory," he says. "Parents may be more demanding. They think because this is Harvard, this is the best."

Many Harvard students become depressed because they lose confidence from the outset. "A lot of students might say, 'My God, this guy's a math whiz, and I can't measure up," says Ducey. He warns that such an outlook often turns into a self-fulfilling prophecy, with the student turning exaggerated self-perceptions of inadequacy into real failures.

"Most students can see a distinction between their performance and their feeling of adequacy," Catlin says. "A particularly difficult situation is when a person bases his or her self-esteem in a very narrow area of performance--like, say, ice skating--especially if they've been told that they were the best in high school."

Admitting the Problem

All the experts interviewed agreed that one of the strengths of Harvard is its extensive counseling and outreach network. The only catch is to use it. Most of the suicides at Harvard in the past two decades have been committed by students unknown to Harvard's therapists and counselors. "It takes a tremendous amount of courage for somebody who's feeling depressed or suicidal to come down here [to Room 13]," Bailin says.

Sometimes the pressure to look Harvardian even though you don't feel Harvardian can cause serious problems. "Harvard is a place where people feel a real need to act like they're okay, to put on a happy face," says Bailin. "Often that makes it more difficult for people to reach out and get help."

At a recent panel discussion on Harvard's counseling services, a few students said they were discouraged from turning to Mental Health Services or other counseling groups because they didn't want others to think them "abnormal" or "weak."

"It was a blow to my ego," said one student who went to the Bureau of Study Counsel for help.

Several students of color at the same meeting said they preferred to have counselors of their gender or ethnic background and complained about the lack of minority staff at Harvard's counseling services. "There are some things about being Black that a person who isn't Black would not understand," said one Black student.

Others said they felt more comfortable talking to peers than counselors, accounting perhaps for the large volume of calls received by Room 13 last year. But there are still people who need help yet don't ask. "For every person that uses [Room 13], I think that there's many, many more who could," Bailin says.

"Generally speaking, suicide is not wanting to die. It's wanting life to be better, wanting a change, the attempt is a cry for help," says O'Neil. Eighty percent of potential suicides show signs before they kill themselves, she says. They give away prized possessions. They seemed depressed. They either can't sleep or can't get out of bed. They are often apathetic, withdrawn, irritable, indecisive. In any case, it is better to ask if they need help than to leave them alone, O'Neil says.

"The worst thing that can happen is that someone gets mad at you," O'Neil adds.

If you or someone you know seems depressed or suicidal, Bailin suggests using Room 13 first. "We're sort of what we like to think of as the front line," Bailin says, pointing to a board on the wall listing phone numbers of everything from Mental Health Services and professional suicide hotlines to local pizza deliverers. "If somebody's in crisis and needs to talk, if somebody needs a referral to a place where they can get long- term counseling, that's how Room 13 is best used," he says.

Catlin, whose office shelves are lined with books with titles like Existence and Solitude, The Meaning of Anxiety, and Theory of Suicide, recalled a favorite anecdote with which to close his interview. "Bertrand Russell," he said, "while he was an undergraduate at Cambridge, described how he felt so despairing that he would go to a secluded spot and think about suicide, but as he thought more about it, he realized how interested he was in mathematics and decided to live on." It is these kinds of stories that Catlin hopes students will remember.