Mental Health is Everyone’s Business: Historical Reflections on the Virginia Tech Shootings

A man's college days, collectively, are usually his happiest. Most of mine were not happy. --Clifford Whittingham Beers, A Mind That Found Itself (1908)

Clifford Whittingham Beers’s words came to mind as I followed the news coverage of Cho Seung-Hui’s shooting rampage at Virginia Tech last week. I empathized with the victims and their families and for the community; it was a tragic and terrible loss of life. As the days wore on, I began to have another reaction to the events. Since I am a historian and a client of mental health services, the heated discussions about what to do with “deranged” students like Cho that appeared in various mainstream media seemed all too reminiscent of earlier incidents of discrimination against mentally ill individuals. One especially troubling article  by crime novelist and psychologist Jonathan Kellerman in the Wall Street Journal, placed the blame for the shootings on the anti-psychiatry and deinstitutionalization movement of the 1960s and 1970s. He argued for stricter laws for involuntarily committing students exhibiting disturbing thoughts or behavior, declaring it was better to “err on the side of public safety rather than protect individual liberty at all costs.” This cavalier attitude, combined with the sensationalistic footage of the “madman” on NBC, seemed to me a step backward in a century-long battle to safeguard the civil rights and enhance the public's understanding of mentally ill individuals.

A Mind That Found Itself represented a landmark in this struggle. Likened to Uncle Tom’s Cabin in its vivid description of the horrors of asylum life, the book launched a nationwide movement to reform institutions for the mentally ill. Beers, along with other Progressive Era reformers such as Jane Addams and Julia Lathrop, went on to form the National Committee for Mental Hygiene (NCMH). This organization aimed  to take psychiatry beyond the asylum walls and use the discipline to address problems in homes, workplaces, schools, and other institutions. Like other public health organizations at this time, the NCMH aimed their preventive efforts at youth in schools and colleges, believing intervention was most effective during adolescence when the personality was most malleable.

Supporting the work of the  NCMH were studies of psychiatric problems among soldiers during the Great War. According to Dr. Stewart Paton, a lecturer in neurobiology at Princeton University and a former member of the American Expeditionary Forces Medical Corps, “Peace no less than War produces ‘shell shock.’ ” By the late 1920s, Princeton and at least twenty other private and public colleges and universities had added mental hygiene to their health services on at least a part-time basis.

Establishing counseling services on the college level was not easy, however. Despite the efforts of Beers and the NCMH, mental illnesses, even minor ones, still carried an overwhelming social stigma. Indeed, it was during the 1920s that many states passed laws calling for the involuntary sterilization of “mental defectives.” Another formidable obstacle was opposition from faculty members, who believed that mental hygiene services were simply coddling students who could not meet academic standards. Yet diligence by college mental health experts, as well as a high incidence of psychiatric problems in the military during the Second World War, provided additional justification for counseling programs for the nation’s young people. The 1947 report issued by President Truman’s Commission on Higher Education lent further support, arguing that these institutions should not only train the intellect, but also foster emotional growth and social adjustment. Dana Farnsworth, Director of Harvard University Health Services, argued in 1954 that mental health was not only the responsibility of health care professionals, but was everybody’s business. This included students themselves, whom he believed should play a role in planning and organizing health services.

Farnsworth’s call for a student-centered health service would have unintended consequences in the ensuing decade, as students demanded freedom from “institutionalized paternalism,” which permitted campus health centers to release confidential patient information to other campus officials, parents, and prospective employers. At this time, homosexuality was still considered a mental illness, and grounds for dismissal from many colleges as well as exclusion from the U.S. military and civil service.

Some campus psychiatrists, including Farnsworth, blamed student uprisings on permissive parenting that caused a growing gap between intellectual and emotional maturity in late adolescence. Robert Coles, a research psychiatrist from the Harvard University Health Service, and Joseph Brenner, a physician from the M.I.T. health service, who served as medical staff for the Mississippi Summer Project in 1964, challenged this viewpoint. They found that the student volunteers were far from “immature” or “psychopathic.” Rather, most student volunteers displayed extraordinary bravery in the face of constant danger, serving as exemplars for mental health professionals on how to advance human dignity and freedom. This activism by students and sympathetic professionals contributed to the passage of the Family Educational and Privacy Act of 1974, which was intended to protect students’ rights to privacy.

The passage of the Americans with Disabilities Act (ADA) in 1990 provided further protections for mentally ill students. Earlier this year, Virginia became the first state in the nation to pass legislation prohibiting colleges and universities from expelling or punishing students “solely for attempting to commit suicide, or seeking mental-health treatment for suicidal thoughts or behaviors.” Last week’s tragedy has caused many to consider revoking this law. If accomplished, this measure would be a major setback in the history of mental health services on college campuses. Not only is it impossible to predict which emotionally disturbed students will commit violent acts, the threat of sanction would deter mentally ill students from seeking treatment. It also overlooks larger structural problems, including cutbacks to student counseling services, lack of insurance coverage, and most importantly, persistent cultural myths about mental illness that prevent troubled individuals from obtaining the help they need. The time has come to heed Beers's call, cease stigmatizing the mentally ill, and provide full access to the supportive mental health services that all Americans deserve.

Related Links

HNN Hot Topics: School Shootings