On November 15, Stanford students huddled around copies of “The Stanford Daily,” their eyes glued to the front page account of the pseudonymous “Neil Fisher,” a sophomore who was sent to the locked inpatient ward of Stanford Hospital only weeks earlier.
In “Vaden Doctor Sends Depressed Student to Psychiatric Ward,” Daily Senior Staff Writer Jennie Kim reported on Fisher’s alleged mistreatment during his 72 hour forced stay at the ward.
Fisher’s doctor had acted under California Proposition 5152 which states that a patient can be legally hospitalized for three days against his will if he fulfills a certain specified set of criteria.
Fisher’s story sparked controversy across campus and prompted a flurry of responses to the paper from students and professionals alike, raising questions not just regarding Fisher and 5152 but the serious crisis of mental illness pervading U.S. college campuses.A 2004 study by the National Alliance for the Mentally Ill (NAMI) states that one third of college students report symptoms of mental illness and the College Mental Health Association alleged in spring 2004 that 14.9% of U.S. undergraduates have been diagnosed with depression.
These statistics have been furthered by the specific evidence of five student suicides at New York University since September 2003 and an article in the Harvard Crimson this fall which stated that 80% of the university’s students are experiencing mental health problems.
An August 25 press release issued by NAMI warned parents to be better aware of their children’s mental health problems stating that while “Fifty percent of students rated their mental health as below average, only 25 percent of parents report their student’s mental health to be in this range.”Additionally, only 30 percent of students reported a friend’s mental health to be in that range, according to NAMI.
Dr. Rona Hu, Assistant Professor of Psychiatry and Behavioral Sciences at the Stanford University Medical Center, is fully aware of the gravity of students’ psychological
problems at college today.
“Mental health issues are a big deal on campus,” she said, and cited a variety
of reasons for their sudden onset during this time period, among them the initial separation of students from family members and friends at home.
“We’ve had a lot of cases where a parent will pick up a kid at the airport and drive them straight to the hospital because the person they picked up isn’t the same person they dropped off in the fall,” she said.
Hu concluded that other changes such as increased drug experimentation
and extreme focus on success, especially at an institution such as Stanford, can also play a part in detracting from a student’s well-being.
“Failing grades combined with substance abuses can create
suicidal thoughts,” she said.Additionally, college can also be a time when symptoms of bi-polar disorder begin to appear. The disease, which results from a brain chemical imbalance and produces mood swings, is usually typified by an onset of symptoms
in the years preceding age 20.Studies show that nearly 50 percent of people with untreated bipolar disorder attempt suicide.
Despite the number of issues pertaining to making the transition to college, Hu noted that the representation
of freshmen in the hospital is no greater than any other class. She said that the influx of first-years at the start of school is coupled with an increase in graduate student patients in the spring quarter and an overall upsurge in resident representatives from all classes during finals week.
Due to the gravity of the mental illness epidemic that colleges are facing,
Hu thinks that “people shouldn’t be afraid to ask for help” and is a little wary that because of The Daily’s article (in which she was quoted), Stanford students will be less likely to seek out treatment at the hospital. “The difficulty with the initial article was that I couldn’t [address] specific things,” she said, due to the Hippocratic Oath which protects patients’ privacy. She added that an article like that is “going to be mostly from the point of view of the person who brought it up” (which in this case was that of the patient’s).
Fisher’s main allegations in the article included both being put under a “three-day-hold,” and thereafter spending
a night in solitary confinement, for invalid reasons; receiving medical
disregard for health issues such as high blood pressure and asthma; and suffering from extreme humiliation epitomized by having to leave the facility barefoot, due to the hospital’s temporary displacement of his shoes.
On Friday October 29, Fisher was attending what he thought was a routine appointment with his psychologist, Dr. Karnik, until the doctor invoked 5150 and summoned police members to take Fisher off to the hospital’s locked inpatient facility.
Hu referenced that patients can be indicted under California State Proposition 5150 if and only if they fulfill a specific set of three conditions.Explained Hu: “It would have to be a situation where they’re a danger to others, a danger to themselves or unable to provide for themselves.
”She added: “You can’t be hospitalized
for having crazy thoughts or acting
crazy” and clarified that even someone
who does harbor suicidal thoughts will not necessarily be locked up.5150 and its counterparts in other states were created in the second half of the twentieth century to prevent the type of irrational institutionalization
which occurred in the Soviet Union during the Cold War.“
In the ’50s it was pretty easy to hospitalize a family member,” Hu said. “Now nationally there are people who feel that the pendulum has swung too far in the opposite direction.”Advocacy groups started by family
members devastated by loved ones’ suicides have even sprung up in an effort to create a stronger form of 5150 in order to prevent future deaths.Hu, however, sees some merit to the Proposition as is.“The laws are definitely there for a reason and I don’t think that we’d want to live in a country [where they didn’t exist],” she said. “It’s kind of a big deal to have someone locked up; it’s almost taking away their civil rights.
”Fisher, himself, feels that the law is often invoked too flippantly—
especially in his case.“There exists, I believe, a pernicious
‘vortex of American medical
paranoia,’ ” Fisher wrote in an e-mail from back home in India where he is taking off the rest of thequarter as a result of his experience.
“A vortex, he continued, “into which millions of Americans have been sucked, and, more importantly, a vortex from which many Americans
need urgently to be rescued.
“Dr.Karnik diagnosed me as imminently
likely to commit suicide,” he said. “This was indeed much less of a conclusion than a baseless presumption—a presumption whose factual tenacity [Karnik and another doctor present] failed to recognize, and whose validity they callously failed to doubt, in spite of my many statements unambiguously expressing
a total lack of suicidal intent.”
Stanford students were left with mixed views on the description of Fisher’s stay, especially regarding the incident in which he was placed in solitary confinement during his second night. The solitary confinement
was a result of an argument he had had with a nurse over not being allowed to bring a DVD he had left in the ward lounge back to his room.Senior Neil Chou sympathized
with Fisher’s experience.
“I would almost be discouraged [from sending a friend to the ward] if what this guy had claimed was true,” he said. “I thought the solitary confinement thing was especially was a bit harsh.”Junior Eric Adamson, however,
was more skeptical regarding
the student’s credibility.“
From what I read, it didn’t seem like the student was all too trustworthy,” he said. “While there probably were some mishandlings, it seemed to me that the largest mistake made was the student’s inability to see both sides of the issue. If someone in a psych ward is getting angry over a DVD, a nurse doesn’t really have too much sympathy.
Their job description is set.”
Hu provided psychological
insight into the issue. “With depression it’s hard to maintain insight and view one’s own problems objectively,” she said, noting
nonetheless however, that the H2 locked ward has an 85% approval rating from outgoing patients“A lot of times patients are initially
mad but later realize that [their stay at H2] was helpful,” Hu said.She pointed out that in the meantime though the hospital makes a special effort to provide as comfortable and as just accommodations as possible.
On Mondays, Wednesdays and Fridays, Santa Clara County lawyers and a judge visit the facility and have actual hearings between patients and doctors. Each patient is given the opportunity to have one of these trials.
Hu also described that the hospital is equipped with lounge areas, pianos and ping pong tables and offers such activities as artwork and occupational therapy. She also negated Fisher’s description of the room windows as being boarded up, stating instead that they look out onto a private garden and though they do have electronic shades, it is only for safety precautions.She also wished to clarify that the hospital tries to take into account patients’ criticism as much as possible.
“We respond to feedback and we [carry out] feedback on a lot of levels,” she said. “We actively seek it out.”Feedback is something that Fisher has a lot of.
He describes the final incident of his temporarily stolen shoes as epitomizing
the pinnacle of his humiliation: “I was embarrassed and felt completely stripped of my dignity,” he wrote. “All I could do was leave, so I left, and waited for a cab barefoot on the street corner, gravel piercing the soles of my feet.”
Even now, he remains steadfast in his belief of his mistreatment and has the support of several professionals.“I have visited a number of psychiatrists
(most trained in United Kingdom)
and all of them have condemned the treatment rendered upon me at the Vaden center and the Stanford Psychiatric ward. In fact, they claim that my institutionalization has had a deleterious effect of my psychological
state,” he said in an e-mail.
Nevertheless, despite Fisher’s highly publicized account, Hu said that the hospital currently does not plan to implement any changes in procedures or rules.She stated that the ward’s staff and administration would simply continue to do what they always had done: “Strive to have the best possible care for everybody.”