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BOSTON - Nearly half of the largest U.S. public universities do not track suicides among their students, despite making investments in prevention at a time of surging demand for mental health services.
Tabulating student suicides comes with its own set of challenges and problems. But without that data, prevention advocates say, schools have no way to measure their success and can overlook trends that could offer insight to help them save lives.
"If you don't collect the data, you're doing half the job," said Gordon Smith, a former U.S. senator from Oregon who became a prevention advocate after his son, Garrett, took his life in 2003 while attending college. "We need information in mental health if we're actually going to be able to better tailor health and healing."
The Associated Press asked the 100 largest U.S. public universities for annual suicide statistics and found 46 now track suicides, including the University of Tennessee at Knoxville. Of the 54 remaining schools, 43 said they don't track suicides, nine could provide only limited data and didn't answer questions about how consistently they tracked suicides, and two didn't provide statistics.
In a statement Tuesday, a UT spokesperson said: "UT's Division of Student Life gathers what information it can about all student deaths as part of its overall effort to inform policy and educational programming."
The University of Alabama and the University of Georgia are among the schools that either don't have statistics or don't consistently collect them.
Other schools that don't track suicides include some of the nation's largest, including Arizona State University and the University of Wisconsin, which have both dealt with student suicides in the recent past, according to news reports. There were at least two suicides at Arizona State in 2017. Health officials at Wisconsin said they're finalizing a database to track the causes of student deaths.
"We will create a formal model to accurately document all student deaths at UW-Madison," Dr. Agustina Marconi, an epidemiologist at the university, said in a statement. "Our findings and the standards we create will benefit other universities moving forward."
The issue has come to the fore as some schools report today's students are arriving on campus less prepared for the rigors of college. Many schools have increased spending on mental health services to counter what the American Psychological Association and other groups have called a mental health crisis on campuses.
Surveys have found increasing rates of anxiety and depression among college students, but some experts say the problem only appears to be worsening because students who might have stayed silent in the past are taking advantage of the increasing availability of help.
"It's unfortunate that people are characterizing this outcome as a crisis," said Ben Locke, who runs a national mental-health network for colleges and leads the counseling center at Penn State. "It's counterproductive because it's criticizing the exact people we've encouraged to come forward."
Adding to the skepticism is that young adults in college have been found to have lower suicide rates than their peers. But they are also at an age when disorders including schizophrenia and bipolar depression often start to develop.
Federal health officials have sought to encourage data collection as part of a grant program named after Smith's son that has awarded $76 million to more than 230 colleges since 2005. Schools have separately spent millions on their own, often adding programs that teach basic life skills, and training staff across campus to identify students in need.
The U.S. Department of Education asks colleges to collect data on student deaths but not suicides specifically, and a variety of factors can discourage schools from tracking it.
Often it's difficult to confirm the cause of death, and medical examiners don't always notify universities when a cause is determined. There are concerns about legal liability. Some families prefer to keep it private. Even schools that collect data differ on whether they count suicides that occur away from campus or during breaks.
And if the statistics become public, some schools fear it could damage their reputations.
"No school wants to be known as a school with multiple suicides. It's not good for business," said Nance Roy, chief clinical officer for the Jed Foundation, a nonprofit organization that works with colleges and high schools on prevention.
Advocates in at least three states have pushed to require universities to collect suicide data - in New Jersey, Pennsylvania and Washington - but without success so far.
After the 2014 suicide of freshman track star Madison Holleran at the University of Pennsylvania, one of her former teachers in her hometown of Allendale, N.J., was surprised to learn many universities don't report suicide statistics. He pushed for a law that would have required the state's public universities to collect and publicize annual numbers, but it never made it to a vote amid pushback from schools.
"He felt that it was something that the public had every right to know," said Pam Philipp, a New Jersey mental-health advocate who lobbied for the legislation along with Holleran's former teacher, Ed Modica, who died in 2017 at age 66.
A similar proposal by a state task force in Washington was sidelined amid budget woes last year, while lawmakers in Pennsylvania have yet to vote on recommendations to improve data collection.
National studies have found that suicide rates are on the rise in the United States, reaching 13 per 100,000 among all Americans and 12.5 among those ages 15 to 24. Much of the data on suicide comes from the U.S. Centers for Disease Control and Prevention, which does not specifically track college suicides.
The gap in information led Dr. James Turner to seek funding for a national reporting system for student deaths in 2009 when he was president of the American College Health Association, but the National Institutes of Health didn't see the value, he said, and it never happened.
"I became puzzled, because we as a society are so interested in the health of college students," said Turner, who is now retired from the University of Virginia. "Why is it we don't have a comprehensive way of approaching this?"
The National Institutes of Health declined to comment for this article.
A total of 27 schools provided statistics to the AP that they say were consistently tracked from 2007 through 2016, amounting to an overall suicide rate of about 4 per 100,000, although numbers from some universities were so low that experts including Roy at the Jed Foundation questioned their accuracy. The University of Arizona, for example, averaged more than 40,000 students per year over the decade but reported just three suicides, a rate of 0.7 per 100,000.
Earlier studies have found average rates between 6.5 and 7.5 per 100,000 among college students. Schools that provided data to the AP had rates ranging from 0.27 to 8. Because of the inconsistency in responses, The Associated Press is not publishing figures for colleges that provided data.
Schools that do track suicides, however, often use their data to refine prevention efforts.
After Clemson University started gathering more data in 2015, campus officials noticed an increased suicide rate among transfer students. The school is now redoubling efforts to connect those students with campus services.
Data at other universities have led officials to secure access to certain rooftops.
Among the oldest examples is at the University of Texas at Austin, where officials in the 1990s installed iron barriers atop a clock tower that had previously been closed after several student suicides. The 10-year rate on that campus is in line with averages found in earlier studies, its data show, and has decreased in the second half of the past decade, even as national rates increase.
But Chris Brownson, the counseling center director who analyzes the university's suicides, said it's hard to celebrate success when every new case brings so much pain.
"One death is one death too many," he said, "and that's why we come to work every day - to do the things that we do here to try to prevent any of those from happening."
Close to half of the nation's largest public universities do not track suicide deaths among their students, according to documents obtained by The Associated Press. Through public records requests, the AP asked the 100 largest public universities in the U.S. for annual student suicide statistics over the past decade. Suicide rates for those that provided data ranged from 0.27 suicides per 100,000 students to 8 per 100,000, but because of the inconsistency in responses, the AP is not publishing figures for colleges that provided data.
Here is a look at the schools for which data were requested. Unless a branch campus is named, the line refers to a school system's main campus:
SCHOOLS THAT DON'T HAVE STATISTICS OR DON'T CONSISTENTLY COLLECT THEM
Arizona State University-Tempe
California Polytechnic State University-San Luis Obispo
California State Polytechnic University-Pomona
California State University-Fullerton
California State University-Fresno
California State University-Los Angeles
California State University-Long Beach
California State University-Northridge
California State University-Sacramento
Central Michigan University
East Carolina University
Indiana University-Bloomington
Indiana University Purdue University Indianapolis
Iowa State University
Metropolitan State University of Denver
Middle Tennessee State University
Oklahoma State University
Old Dominion University
Purdue University
Rutgers University-New Brunswick
San Diego State University
San Jose State University
Texas A&M University
Texas Tech University
University of Alabama
University of Texas-San Antonio
University of Arkansas
University of Central Florida
University of Cincinnati
University of Colorado-Boulder
University of Georgia
University of Kentucky
University of Maryland-University College
University of Massachusetts-Amherst
University of Missouri-Columbia
University of Nevada-Las Vegas
University of New Mexico
University of Oklahoma-Norman
University of Oregon
University of South Florida
University of Wisconsin-Madison
University of Wisconsin-Milwaukee
Weber State University
SCHOOLS THAT DID NOT PROVIDE STATISTICS
North Carolina State University at Raleigh
Temple University
SCHOOLS THAT PROVIDED LIMITED DATA BUT DID NOT ANSWER QUESTIONS ABOUT THE CONSISTENCY OF THEIR TRACKING
University of Utah
Florida Atlantic University
Florida International University
Kennesaw State University
Portland State University
University at Buffalo
Washington State University
San Francisco State University
The University of Texas at Arlington
SCHOOLS THAT NOW KEEP STATISTICS ON STUDENT SUICIDES
Auburn University
Colorado State University-Fort Collins
Florida State University
George Mason University
Georgia State University
Grand Valley State University
James Madison University
Kansas State University
Kent State University
Louisiana State University and Agricultural & Mechanical College
Michigan State University
Northern Arizona University
Ohio State University
Ohio University
Oregon State University
Pennsylvania State University
Texas State University
The University of Tennessee-Knoxville
The University of Texas at El Paso
University of Arizona
University of California-Berkeley
University of California-Davis
University of California-Irvine
University of California-Los Angeles
University of California-San Diego
University of California-Santa Barbara
University of Florida
University of Houston
University of Illinois at Urbana-Champaign
University of Iowa
University of Kansas
University of Maryland-College Park
University of Michigan-Ann Arbor
University of Minnesota-Twin Cities
University of Nebraska-Lincoln
University of North Carolina at Charlotte
University of North Texas
University of South Carolina-Columbia
University of Texas at Austin
The University of Texas Rio Grande Valley
University of Washington-Seattle Campus
Utah State University
Utah Valley University
Virginia Commonwealth University
Virginia Tech University
West Virginia University
Source: The Associated Press