While a student, I wrote several articles for Vanderbilt’s campus newspaper, but all of these were lost from the Vanderbilt Hustler website (along with all historic website content) sometime in the summer of 2016. I’m going to try to upload these articles here while I can still find scanned PDFs of the print issues that existed at the time. Unfortunately, the articles’ original links to sources are lost. 

This article did end up prompting a conversation about the tuition insurance policy. Vanderbilt Student Government passed a resolution encouraging a policy change. The Bursar (who was very genial when I met with him about this with the Student Body President) negotiated a new tuition insurance policy that reimburses mental and physical illness equitably, which took effect the following year (2015-2016).

Equality in name only? How Vanderbilt promotes a discriminatory insurance policy

(Published August 27, 2014)

Like many universities, Vanderbilt aspires to promote diversity and inclusion. The university requires its first-year students to discuss racism and the importance of pluralism, and its official policies include a promise to not discriminate in university programs. There is even an Equal Opportunity, Affirmative Action, and Disability Services Department whose “core values include equity, diversity, inclusiveness, accessibility and accommodation.” In light of the university’s seeming commitment to equality, I found it particularly vexing to receive a letter from Vanderbilt, accompanied by a signed note from the bursar, promoting a policy that is patently discriminatory.

Vanderbilt offers a “tuition-insurance” plan issued by A.W.G. Dewar, Inc., which provides reimbursement of education fees should a student withdraw from the university for medical reasons. The plan explicitly specifies that withdrawals caused by “mental health conditions” are given a 60 percent refund while a 100-percent refund is given for “injury and sickness.” The plan also indicates that withdrawals precipitated by addiction or substance abuse receive zero compensation.

On the face of it, the plan suggests either that mental illness is equivalent to three-fifths of a physical illness or that 40 percent of doctor-certified mental illnesses are feigned. Neither of these claims is borne out by any evidence. Rather than aiding a vulnerable student, the plan adds another layer of financial stress to a person likely facing a cascade of problems, possibly impeding his or her return to Vanderbilt.

This practice makes for an incoherent insurance policy, since it provides significantly less coverage for the illnesses most likely to warrant withdrawal. A 2009 study at 10 universities found that having clinical depression was the strongest predictor of withdrawing from college. So giving less coverage for mental illness is rather like having car insurance that provides 40 percent less coverage when your accident involves another car.

Moreover, distinguishing between mental and physical illness to provide unequal service perpetuates stigma against psychiatry and psychiatric illness — the idea that mental illness is “less real” than physical illness, or worse still, that someone is more blameworthy for having a mental illness than a physical one.

The practical implications of this policy are jarring to the point of ineffability. Why should a student suffering from depression because a person raped her receive a 40-percent-reduced reimbursement compared to a per-son struck by the “kissing disease”? Is post-traumatic stress caused by being robbed at gunpoint a less valid reason for withdrawing from college than a football injury?

The policy also violates the spirit, if not the letter, of federal law. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, which requires equal coverage for mental illness, including substance abuse, in health insurance plans. Hence, as The New York Times writes: “This would probably be illegal if tuition refund policies were deemed health insurance, instead of insurance that just happens to be based solely on your health.”

Since 2010, Vermont has required that colleges in the state provide equal coverage for withdrawal due to mental illness. Prompting the change was a complaint by a University of Vermont student named Sherry Williamson, a registered nurse who suffered from depression. “I couldn’t believe that UVM, which tries to promote diversity and be all-encompassing, would take on a policy that was clearly discriminatory,” Williamson said in an interview.

By choosing to contract with A.W.G. Dewar, Inc. under these terms, Vanderbilt University is complicit in unambiguous discrimination against people with mental illness. This is unacceptable for an institution that claims to be forward-looking and antithetical to the welfare of its students. Renegotiating a nondiscriminatory plan is essential if the university’s commitment to equality is more than skin-deep.

While a student, I wrote several articles for Vanderbilt’s campus newspaper, but all of these were lost from the Vanderbilt Hustler website (along with all historic website content) sometime in the summer of 2016. I’m going to try to upload these articles here while I can still find scanned PDFs of the print issues that existed at the time. Unfortunately, the articles’ original links to sources are lost. 

Suicide is not inevitable
A look at how small changes can make all the difference 

(published October 23, 2013)

The decision to commit suicide may be the most important choice a person could ever make. Suicide is unrivaled in its finality, permanence and, of course, tragedy. Death is forever, unknown and unknowable, surely a state a person would want to think about carefully before embracing. And to kill oneself may be the only decision one cannot take back. As a result, it is commonly understood that suicide is a deliberate act, the capstone of years of unrelenting suffering.

But this characterization of suicide is almost always wrong. In the spring 2013 edition of
its seasonal magazine, the Harvard School of Public Health called the notion that suicides
are “long-planned deeds” the “biggest fallacy” about the act. The magazine reports: While “people who attempt suicide often face a cascade of problems,” empirical studies suggest that “they act in a moment of brief but heightened vulnerability.” In 2001, epidemiologists at the Centers for Disease Control and Prevention interviewed 151 people who nearly died while attempting suicide. Shockingly, a quarter of interviewees reported that less than five minutes elapsed between the decision to commit suicide and the attempt itself. Half said less than 20 minutes had passed. Seventy percent said less than one hour, and 86 percent said less than eight hours. Suicide thus tends to be an impulsive reaction to a crisis. Many people kill themselves, for example, on the days they get fired, get divorced or fail a test, and the availability of suicidal means is often the trigger for suicide.

The suicides on the Golden Gate Bridge demonstrate this fact. As described in a recent Slate article, the bridge’s “mythic beauty, easy access, and promise of near-certain death” beckons many to suicide. To jump off the bridge, one need only surmount a 4-foot barrier; suicide notes left on the bridge often ask, “Why did you make it so easy?” More than 2,000 people have leapt off the bridge to their deaths since it opened in 1937. Nevertheless, efforts to erect a barrier on the bridge have not gained traction, largely because of the belief that it wouldn’t prevent suicide. But there is good reason to believe that stopping a person from attempting suicide very often saves his or her life. A famous 1978 study at the University of California Berkeley tracked down 500 people who were restrained just before they leapt off the Golden Gate Bridge between 1937 and 1971. At the time of the study, 94 percent were alive or had died of natural causes.

Furthermore, there is ample evidence that even simple measures can stop suicides. A meta-analysis of the effect of bridge barriers at suicide hotspots around the world found
that, on average, they reduce suicides on that bridge by 85 percent; though in some cases
suicides shifted to nearby bridges, barriers still decreased the number of local suicides by 30 percent. Gun-owning households in the U.S. are at least three times more likely to be the site of a suicide, but simply using gunlocks or securing ammunition can reduce the risk of suicide by two-thirds. As the Harvard School of Public Health reports, whether those who attempt suicide survive “depends in large part on the ready availability of highly lethal means, especially firearms.” (More than half of the 40,000 Americans who kill themselves each year do so with guns.) In the U.K., a 1998 law restricting the pack size of acetaminophen (the active ingredient in Tylenol) reduced the number of suicides by 200 in the first three years alone.

Hence, restricting access to suicidal means is an effective way to prevent suicide. Heeding this fact, as Cornell University did, can save lives. Between 1990 and 2010, 27 people committed suicide by jumping off one of the five bridges on Cornell University’s campus. In 2010, responding to three student suicides in a month, Cornell installed safety nets on campus bridges.

Moreover, the Golden Gate Bridge example shows that suicidal thoughts, even when acted on, are often fleeting. Only 30 people have survived a jump off the Golden Gate Bridge; of those, 27 lived out the rest of their lives without killing themselves, according to the Bridge Rail Foundation. In interviews with The New Yorker, many survivors of attempted suicide reported that they felt regret the moment they jumped. Ken Baldwin, a survivor who later found his calling as a high school teacher, recalled: “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable —
except for having just jumped.” Perhaps many of the thousands who did not survive felt the same way.

These findings echo nationwide studies, which suggest that 90 percent of people who attempt suicide and survive ultimately do not kill themselves. Nevertheless, many people cling to the erroneous idea that suicide is inevitable, an opinion commonly held even by psychiatrists, the people trusted with caring for the mentally ill. How many people must die on the altar of fatalism before that belief fades?