When Holly Duvall started working for Counseling and Psychological Services at Oregon State University, she had no way of knowing how personal the job would become.
Then a close friend took her own life.
That was two years ago, and Duvall, now 22, still struggles with feelings of self-doubt.
“There’s no easy way to get over it,” she said. “You have this slight sense of guilt all the time, even though you know it wasn’t your fault.”
Now Duvall tries to channel those feelings into her work as part of the mental health promotion team for CAPS, which provides an array of services for OSU students facing mental health challenges, including thoughts of suicide.
“It doesn’t just affect one person. It affects everyone in that circle,” she said. “It’s one of the worst things that can ever happen, and I just can’t bear to see people having to deal with it.”
Confronting the problem
Suicide is on the rise across the United States, including Oregon, which consistently outpaces the national average.
It’s also the second-leading cause of death among young people between the ages of 10 and 34, according to the Centers for Disease Control and Prevention — and that makes it a serious concern on college campuses, including OSU.
On average, Oregon State loses three to five students annually to suicide, administrators say. The last two years were particularly brutal, with a total of 10 students taking their own lives.
The university’s leaders are taking notice — and taking action.
In his State of the University address in February, President Ed Ray called suicide “a national health crisis” and cited alarming statistics that showed 11 percent of OSU’s student body had considered suicide, 4 percent had a suicide plan and 1 percent had tried to kill themselves.
He raised the issue again this month at a meeting of the university’s Board of Trustees.
“This is a crisis that touches every one of us,” Ray told the board, “and we simply need to work more effectively going forward.”
In fact, OSU is already taking a number of steps to address the issue and has significantly ramped up its efforts in the last several years.
• Starting in 2013, the university contracted for a 24-hour crisis line so students in distress can reach a licensed counselor at any time of the day or night.
• Since 2015, Student Health Services has increased its investment in psychiatric services by 40 percent.
• Since 2016, all incoming students are given an online screening assessment and are referred for counseling if they show signs of being at risk for suicide.
• Counseling and Psychological Services has two full-time mental health promotion professionals on staff, and in the past five years it has received funding to increase its counseling staff by two full-time positions.
• In the past two years, the Dean of Students Office has upped its staffing by two full-time-equivalent positions to provide support services for students experiencing challenges.
The price tag for these expanded services comes to a little over $600,000 a year, according to figures provided by the Provost’s Office.
And more help is on the way.
The university has budgeted $30,000 to acquire an online program called Kognito to train faculty, staff and students in ways to have conversations regarding mental health issues and refer people to resources.
That program will be available this fall, along with a new peer-support initiative for students called Beavers Belong.
“It is important to realize that, nationally, 80 percent of college students who die by suicide have never visited a counseling center,” said Dan Larson, OSU’s interim vice provost for student affairs.
“We believe that any prevention effort must involve training of the entire campus community to be able to recognize warning signs and provide the opportunity for helpful intervention.”
From prevention to intervention
Located on the fifth floor of Snell Hall, Counseling and Psychological Services is perhaps the most important resource on campus for students experiencing a mental health crisis.
“Most of the work we do here at CAPS is suicide prevention,” said counselor and suicide prevention coordinator Jim Gouveia. “That’s kind of all we do.”
With about 20 counselors and eight to 10 student trainees on staff, CAPS has a number of ways to help students deal with mental health challenges.
Students can make appointments for ongoing counseling sessions or for a new single-session clinic, a one-time, 45-minute visit that results in an action plan.
For more urgent situations, CAPS offers walk-in visits from 9 a.m. to 4 p.m. Monday-Friday, and students in crisis can call the office at 541-737-2131 anytime — if it’s after hours, the call will switch over to a 24-hour crisis line that will connect them with a licensed counselor at any time of the day or night.
As with other mental health programs on campus, students are not billed for these services — the cost of care is covered by tuition and student fees.
The trick is just getting them to come in and take advantage of the services when they need them.
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All the counselors at CAPS are trained to use a care model called Collaborative Assessment and Management of Suicidality, which involves patient and counselor working together to create an agreed-upon treatment plan.
Gouveia believes the approach is effective, in part because it gives struggling students a chance to talk about their problems with a trained professional who can help them realize they have a positive alternative to suicide.
“People who are suicidal tend to think they don’t have a reason to live, that they’re a burden to other folks and that the world would be better off without them,” he said.
“But most people who want to die also want to live. So what you’re trying to investigate is what do you want to live for and what do you want to die for?”
There’s no doubt that the need for mental health services is growing at OSU, said Ian Kellems, director of Counseling and Psychological Services.
“We’ve seen the number of students coming in go up by 58 percent over the last five years and 138 percent over the last 10 years, and that far outpaces the growth of enrollment,” he said.
The reasons for that aren’t entirely clear, but Kellems notes that going to college can present a number of challenges.
For many young people, it means being away from home for the first time in their lives, leading them to feel cut off from their support network. Classes can be stressful, and the cost of attending school can add to the pressure.
And the current crop of students faces a whole new kind of challenge — the sense of alienation that comes with the increasing use of social media and a decrease in face-to-face human interactions.
“It’s an anxiety-provoking world we live in,” Kellems said.
“This generation is the most connected and the least connected ever, and trying to get them more connected with others is one of the most important ways we’re trying to reduce the risk of suicide.”
In an effort to connect with as many students as possible, CAPS is turning its attention outward to the rest of the university.
Gouveia has led hundreds of “gatekeeper” training sessions for faculty, staff and student groups, an approach that focuses on recognizing the warning signs, understanding what resources are available and making sure a potentially suicidal student gets connected with services.
The Office of Student Life distributes information packets on working with distressed and disruptive students to faculty and staff members. The emphasis is on getting students the help they need, even if that means personally escorting them to the CAPS office.
The office has a Student Care division that provides case management-type services for students experiencing a crisis. That division also steps in after a suicide to do a “postvention” aimed at helping friends and family of the deceased and minimizing the possibility that others will take their own lives.
“What we are trying to focus on is creating a culture of caring on campus — getting as many people involved as possible,” Kellems said.
“Counseling service is part of the solution, but part of our responsibility is to engage people across the campus so that nobody falls through the cracks.”
In some cases, students are taking the cause of suicide prevention into their own hands.
Last year OSU soccer player Nathan Braaten and former OSU gymnast Taylor Ricci, after losing teammates to suicide, started a public awareness campaign called Dam Worth It aimed at breaking down the stigma surrounding mental health — especially among athletes, who can be perceived as weak if they ask for help (see accompanying story beginning on A1).
The effort — which has its own hashtag, #DamWorthIt, on social media — has attracted national attention and prompted the Pac-12 to provide funding to extend the campaign to every university in the conference.
Steve Clark, OSU’s vice president for university relations and marketing, thinks Braaten and Ricci are providing a valuable service on the Corvallis campus and beyond.
“They basically said, ‘Enough is enough — we have to start talking about this,’” Clark said.
“I thought what Nathan and Taylor did a year ago is take the covers off what has been a dirty, dark secret in this country.”
Making a difference
Holly Duvall still thinks about the friend she lost to suicide on an almost daily basis. Time has helped her to move on with her own life, but she still feels the ache of loss, the nagging sense that maybe she could have done something more to help. Something that might have made a difference.
She knows she can’t turn back the clock to help her friend, but she believes that, through the work she does at CAPS, she might be able to help someone else.
“My passion and my care for what I do deepened because of that,” she said.
As a member of the mental health promotion team, Duvall has lots of opportunities to help her fellow students.
She’s done presentations on a whole range of issues — not just suicide prevention but also stress relief, nutrition, eating disorders and the importance of self-care.
Part of the job is making sure students are aware of the full suite of services available to them on campus. And part of it is just trying to break down the stigma surrounding mental health issues, spreading the message that it’s OK to ask for help when you need it.
Some days it’s just a job. But there are other days when she feels like she’s getting through to people.
“Every now and then I’ll get someone who comes up to me and says, ‘Thank you for doing this,’” Duvall said.
That’s when she knows she’s made a difference, that she’s made a connection with someone who might need help.
“It’s those tiny little victories,” she said, “that make you really appreciate what you’re doing.”