The tragic truth of suicides among college students is that family or friends often don’t understand how much their loved one is hurting.

“(Henry) was the person who’s always looking after everyone. … He was always made sure everyone was OK,” said Christophe Armero, whose son, Henry Armero, died while a sophomore at Carnegie Mellon University. “Sometimes I wonder whether these people just want others to do for them what they do for others.”

Suicide is the second leading cause of death among college students, who often face financial, social and academic pressure that can lead to feelings of overwhelm and shame. Suicide is always a result of multiple, complicated factors that can be hard to disentangle.

“When you add in perhaps a mental health condition, add in access to lethal means, impulsivity, you could see suicide,” said Steve Moore, who has been an active suicide prevention advocate since his 19-year-old son Paul died by suicide in 2006. “These are all things that could be the final straw that breaks the camel’s back.”

Yet there are concrete steps colleges, teachers and fellow students can take to reduce the risk. After Henry Armero’s death, students began to talk more openly about stress and mental illness, resulting in the university publishing an investigative report. And while the pandemic has exacerbated mental illness symptoms, experts say, people are also more open to being honest about it. 

Eliminating opportunity

Research shows that there is often just 5 to 10 minutes between a person deciding and then attempting to die by suicide. Data shows when schools reduce access to lethal means, those precious extra minutes can give someone the time needed to reconsider. 

For example, Cornell University made bridges inaccessible after three students died within a month in 2010. Still, university advisors and Ithaca city officials said it was one step of a comprehensive mental health plan.

“One of the phrases we use: Suicide is a permanent solution to a temporary problem,” Moore said, who is also a member of the American Foundation for Suicide Prevention’s national Public Policy Council. “If there’s no firearm laying around, or if it takes (the student) 10 minutes to get the firearm, get the ammunition … they can change their mind during that 10 minutes.”

Other efforts include installing signs and telephones near these areas to encourage someone considering suicide to reach out for help, according to a report by the Centers for Disease Control and Prevention.

Culture change

When working to prevent suicide on campus, you can’t just look at the individual, says Beth Morrison, Director of Wellness and Health Promotion Services at Southern Illinois University, Carbondale.

“We have to look at their environment,” she said. “And are these policies fair for students? Are they contributing to their mental health positively or negatively? And what can we put into place that will help these students be successful?”

At SIU Carbondale, they train resident assistants, professors, coaches and academic counselors in mental health first aid, a quick approach to keep one safe until they can access professional help.

One national study of a program implementing this “gatekeeper” training found it may have prevented more than 79,000 suicide attempts among 16- to 23-year-olds between 2007 and 2010.

These efforts are particularly effective when students are trained to recognize risk factors. A study of a similar program in 18 American high schools found students were more likely to refer a suicidal friend to an adult.

The school has also created sensory calming rooms for students to decompress, as well as freshman orientation events targeted specifically toward suicide awareness. They’ve also made counseling affordable; it tends to cost about $10 a session, Morrison said.

A plan for what happens next

When a young person on campus dies, it’s essential that campus workers take action, experts say. This includes accidental or overdose deaths — but is especially important when a person dies by suicide. 

“The dynamic is, all this pain that the person who killed themselves (had), the suffering essentially gets dumped on their loved ones,” said Armero, who runs a support group for survivors of suicide with his wife. “And so all that pain becomes grief.”

A plan needs to be made in advance to reduce the risk of copycats, according to the Higher Education Mental Health Alliance. That includes a team that understands best practices in communicating what happened and resources available to the student body, over social media and to the family.

But it also requires empowering all people within a campus to understand what they can do to prevent a tragedy — whether that’s therapists offering grief groups to classmates and staff, or a student checking in on their friends.

“Don’t be afraid of asking someone if they are thinking of hurting themselves,” Armero said. “If you’ve been thinking about (suicide) in your head and somebody asks you … the act of actually having to say it out loud transforms (the words) for them.”