A Jury Found Iowa State U. Partially Responsible for a Student’s Suicide. Here’s What That Could Mean for Other Colleges.

A jury last month found Iowa State University partially responsible for the suicide in 2015 of Dane Schussler, a 21-year-old junior, and awarded his family $315,000.

Observers say the case raises questions about the extent of colleges’ responsibility for their students’ well-being, how much liability institutions might incur when their services are slashed, and whether certain common treatment practices should be rethought. What is certain is that the events surrounding Schussler’s treatment and death were complicated and, like every suicide, terribly sad. Schussler was said by friends and family to be a smart, funny young man with a bright future.

Here are some facets of the case that legal and medical scholars say particularly caught their attention:

• Schussler’s therapist was a graduate assistant with a master’s degree, not a licensed psychologist. She was overseen by an unlicensed supervisor. And the center’s licensed psychologist didn’t watch videotaped sessions with Schussler, treat him directly, or ask to speak to his parents. (The university argued that the therapist and her two supervisors were a properly credentialed team.)
• A former director of the counseling center testified that budget reductions caused staffing shortages and warned in 2011 and 2012 about the consequent risks, including possible suicides.
• Expert testimony suggested that despite Schussler’s discussion of suicide, the therapist misdiagnosed a major depressive disorder as a mild one.
• In addition to giving him coping strategies and the number for a crisis hotline, Schussler’s therapist asked him to sign a “contract” stating that he wouldn’t harm himself. The contract, she said, satisfied her that he wouldn’t do injury to himself.

The university, which is considering whether to appeal, argues that the ruling is inconsistent with a previous state Supreme Court decision. In that case, the court “found that, unlike when a patient is hospitalized or is being treated in an institutional setting, a university student is not in the physical custody of the university. Accordingly, preventing the student’s suicide was beyond the university’s control.”

Daniel S. Medwed, a law professor at Northeastern University, said that, ideally, a counseling center will have a range of available treatments appropriate to undergraduates and graduate students with a wide spectrum of needs. Six sessions might be enough to treat some students’ problems. And if a center is known for overreacting, students might be reluctant to use its services. “Sometimes a student just needs a safe space to talk.”

Privacy laws, too, are a matter of balance, he said. If they are too strict, families might not be brought into treatment discussions when they should be. But if they are too loose, students could be afraid of bringing their problems to be discussed.

What’s clear, Medwed said, is that a bare-bones staff at the counseling center of a large public university is a health and legal liability. However, it is up to not only colleges but also state legislatures to consider their priorities, and both should be held accountable.

Victor Schwartz, a clinical associate professor of psychiatry at the New York University School of Medicine and chief medical officer of the Jed Foundation, a nonprofit that aims to prevent teen suicide, said that if colleges commit to treating clinical conditions, they must have the licensed, properly trained personnel to do that work. If a college doesn’t have the resources, it shouldn’t make the promises, he said.

Michael A. Olivas, a higher-education expert and law professor at the University of Houston, says a six-session plan in a case that sent up clear red flags is deeply problematic. The Jed Foundation’s Schwartz said session limits are common. The problem, he said, is deciding such a number at the beginning of a case and sticking to it even if evidence comes to light of more serious illness.

Medwed and Olivas also find disturbing the “contract” the therapist had Schussler sign. They understand that it’s part of a therapeutic regimen, but, as Medwed puts it, it is essentially coerced — a “contract of adhesion” — in return for a service the student needs. Having such a contract, should a case go to court, might also raise in jurors’ minds what a counseling service promised, and didn’t necessarily deliver, in return.

It would be one thing if such contracts made medical sense even if they didn’t make legal sense. But, says Schwartz, “there is no evidence that they have any efficacy. In fact, there are suggestions that they may be counterproductive,” offering therapists a false sense of security. “To depend on them is not a well-founded approach.”

Peter F. Lake, who directs a higher-education law center at Stetson University, said that the Iowa State case, coupled with a 2018 Massachusetts verdict involving the Massachusetts Institute of Technology, suggests a new judicial mood toward suicides. For decades, Lake said, for better or worse, suicides were not considered an institutional responsibility except in rare instances, such as if they resulted from the abuse of a legal process or the misuse of a medication. The prevailing wisdom was that reasonable care will not prevent all suicides.

But that might be changing, Lake said. Juries seem particularly sensitive to cases in which services are inadequate or have been cut back. “This is a time when people need more services than ever,” Lake said. “If you’re retreating on service provision, you have to be really thoughtful about that.”

As rich colleges provide more mental-health services and poorer ones can’t, mental health becomes one more arena of inequity, he said.

Regardless of how well-resourced they are, colleges can do more to educate students, said Kathryn Schussler, Dane Schussler’s mother. If they can require students to watch videos about the hazards of drinking and sexual assault, she said, they should also require them to watch videos about mental illness and warning signs for students and their classmates.

She also said that federal laws that prevent colleges from communicating students’ dire straits with parents, during crises and even after a suicide, urgently need reform. “It’s a failing system,” she said, because colleges can’t handle the problem of suicide by themselves. “I think they need to get the parents themselves involved.”

In her son’s case, she said, he probably should have gone on medical leave.

Whatever the limits of a college’s services might be, they should be up front about them, she urges. If colleges can’t communicate with parents, if they can’t offer appropriately intensive intervention, warn students and their families about that, she said. “Make them aware of what they’re sending their children into. Be honest with families.”

She wrote in an op-ed: “It’s no wonder college suicide rates have soared. … The universities have marketed the idea that they are ‘taking care of our children,’ but when something goes wrong, they are not responsible because there is no ‘special relationship.’

“University policy is to not call the parents if a student expresses suicidal ideation. They still do not call the parents when a student unsuccessfully attempts suicide. They only call us to pick up the dead bodies of our dead children and then they cover up the details of their deaths.”

Alexander C. Kafka is a Chronicle senior editor. Follow him on Twitter @AlexanderKafka, or email him at alexander.kafka@chronicle.com.