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September 28, 2006

Suit over Allegheny College student's suicide exposes issues

In a case watched closely on college campuses, a Crawford County jury ruled Aug. 31 that an Allegheny College counselor and consulting psychologist were not at fault in the suicide of a student under their care.

The civil suit was filed by Deborah and Charles Mahoney III, who alleged the defendants’ negligence contributed to the death of their 20-year-old son Charles Mahoney IV, who hanged himself in his fraternity house in 2002.

Former University Counseling Center director Robert Gallagher, who testified for the defense, said the case is unusual in that it was brought to trial. Most such cases, he said, are settled out of court, leaving the issues being debated out of the public eye.

Two Pitt faculty members were involved in the trial — psychiatry professor Michael Thase, who testified for the defense, and economics professor James Kenkel, who prepared a report for the plaintiffs to show the student’s potential lifetime loss of income.

Among similar cases settled out of court are two suits against employees of Massachusetts Institute of Technology.

One was a $27 million wrongful death suit filed in 2002 by the family of a student who set herself on fire in her dorm room in 2000; the other, settled this month, was filed by the parents of a student who died in 2001 after taking cyanide.

According to published reports, Charles Mahoney had been in counseling with the Allegheny College counselor and had been evaluated by the psychiatrist 10 days before he died. The doctor did not recommend involuntary hospitalization or a call to Mahoney’s parents. The parents contended they should have been notified when their son was judged to be at high risk for suicide and that the counselor and psychiatrist should have recognized warning signs and ensured their son received proper care.

Such cases raise a number of issues: the delicate balance between a student’s right to confidentiality and parents’ concerns for their children’s well-being; the rising numbers of students on medication or with mental health problems, and what is required of mental health care professionals should a student appear to be at risk for harming himself or others.

“I’m glad a case went to court and had a jury trial … to get it out to the university community,” Gallagher said of the Allegheny College case.

Gallagher, who compiles a nationwide annual survey of college counseling center directors, reported in his 2005 survey of directors at 366 schools in the U.S. and Canada that increasing numbers of students already on psychiatric medication are being seen in college counseling centers — 25.1 percent in 2005, up from 20 percent in 2003, 17 percent in 2000 and 9 percent in 1994.

University Counseling Center director James Cox said such figures are an indication of what’s happening in society in general. Additional stress, pressure and medications aren’t simply college phenomena. “It’s in our society. We reflect what goes on outside of here,” he said.

Statistics gathered by the Jed Foundation, a nonprofit group founded in 2000 to reduce suicide among college students, estimated approximately 1,100 students per year commit suicide, the second leading cause of death among college students. Approximately 15 percent of adolescent suicide victims are under treatment at the time, Jed Foundation statistics showed.

Although there have been suicides among Pitt students, none has been a client of the counseling center, said Cox.

At Pitt’s counseling center, all staff are licensed mental health professionals who follow ethical and legal mental health care standards, Cox said. Heeding those requirements not only provides quality care to clients, it minimizes the potential of liability.

Among those standards are confidentiality principles that preclude the center from divulging information on clients 18 or older without their written consent. “That’s the law,” Cox said, noting that confidentiality generally is not an issue. The average age of clients at Pitt’s counseling center is about 24, he said. “We don’t really have to speak to their parents; they’re adults.”

And the center voluntarily submits to accreditation by the International Association of Counseling Services and communicates with the University’s general counsel and risk management personnel periodically on best practices.

Proximity to additional resources such as Western Psychiatric Institute and Clinic and access to Allegheny County’s Allegheny Crisis and Emergency Service (ACES) mobile crisis team works to Pitt’s advantage, Cox said. Both can perform evaluations should concerns for a client’s safety arise.

“We’re not in the middle of nowhere with limited psychiatric services or inpatient services,” Cox said.

He noted that mental health issues are not the sole reason students might visit the center. Some students have relationship issues or developmental concerns they want to discuss with a counselor.

“Each case is different,” he said.

The Allegheny College decision has not caused a huge reaction among college counselors. “Nobody is up in arms, just pleased with the outcome,” Cox said. “The school won; that’s a good thing from the counseling perspective,” he said.

“I can’t blame the parents for [filing the suit],” he added. “Everyone did the best they could to help this young man.”

Dealing with clients who have suicidal thoughts is always a concern for mental health professionals, he said. “There is no 100 percent proof method for keeping someone from killing themselves if they want to kill themselves.

“We take our jobs very seriously. People sometimes don’t appreciate the responsibility a job like this carries,” Cox said.

—Kimberly K. Barlow

Filed under: Feature,Volume 39 Issue 3

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