By Anne Blythe

Three chairs covered with flowers, sticky notes and other messages of raw emotion were a reminder of the UNC-Chapel Hill students who will no longer be among the throngs on campus making their way to classes and school events.

Kevin Guskiewicz, the UNC-CH chancellor, canceled Tuesday classes after campus police investigated a report of a death by suicide and an attempted suicide in two different residence halls within less than 24 hours of each other over the weekend.

“[W]e are taking a moment to acknowledge and reflect on the seriousness of mental health illness and the challenges we face as we wrestle with the stress and pressures of our world today,” Guskiewicz said in a note posted on Sunday to the Carolina Community

“We are in the middle of a mental health crisis, both on our campus and across our nation, and we are aware that college-aged students carry an increased risk of suicide,” he wrote. “This crisis has directly impacted members of our community – especially with the passing of two students on campus in the past month. As chancellor, a professor and a parent, my heart breaks for all those whose suffering goes unnoticed.”

Suicide is the second leading cause of death in the United States for people between the ages of 10-34 years old, according to the Centers for Disease Control and Prevention. One national survey of young people, including college-age students, found a 10-fold increase in reported thoughts of self-harm and suicide during the pandemic.

The UNC-CH pause of classes on Tuesday coincided with the commemoration of the university’s founding, as well as World Mental Health Day.

In addition to the empty chairs memorial, students and others on the UNC-CH campus used sidewalk chalk to leave messages of inspiration and support on the brick plaza that has long been a central gathering place.

Chalk messages on a brick plaza
UNC-Chapel Hill students leave messages of support and encouragement during a day off from classes to tend to their mental health. Photo credit: Anne Blythe

“You are loved,” someone wrote with a heart drawn beside the words.

“It’s temporary,” someone else wrote with yellow chalk. “The bad will pass for the good to take over.”

“One day at a time,” another said.

Training 10,000 to recognize warning signs

Though the focus this week has been on the Chapel Hill campus, the University of North Carolina system decided earlier this year to invest $1 million from the Governor’s Emergency Education Relief Fund into a new Mental Health First Aid initiative.

The statewide launch of the program aims to train students, faculty and others without a professional mental health background across the 17 UNC system campuses, the entire North Carolina Community College system and 36 North Carolina Independent Colleges and Universities such as Duke, Elon and Davidson to recognize signs and symptoms of mental illness. The ultimate goal is for students and faculty to be able to connect others in need to available mental health resources.

“All of us have a role to play,” UNC President Peter Hans said in August when announcing the multi-campus initiative.

After an inaugural training session in August, more classes opened this month. UNC hopes to train 240 people over the academic year to serve as instructors who can teach 360 first aid classes. By this time next year, up to 10,000 people across the campuses could be trained to recognize warning signs of someone who might be developing a mental health or substance abuse problem, and figure out how to offer initial support.

Those who are trained to be instructors are asked to conduct three first aid courses, which could lead to the training of as many as 90 more people under their wing, creating a Domino effect. That would lead to more people on campuses, and in the communities where they are based, being aware of signs of a mental health crisis in the making and knowing what resources are there for help.

Bethany Meighen, UNC system vice president for Student Affairs, said there is enough funding to keep the program going for two years, but she hopes it will prove to be an initiative that can survive long after that.

It costs far more to train instructors, Meighen said, than offering first aid classes to help people recognize signs and symptoms. Nearly $24,000 was spent on the three-day courses to get the first 16 people trained, she said. The first aid courses cost about $18 to $20 per person, she estimated.

“It’s to help us to create healthy and resilient campus communities,” Meighen said.

Reaching out at an HBCU

Kacey DiGiacinto, a kinesiology professor at Elizabeth City State University, took the training in August and has already put those newly acquired skills to use.

“Having training in mental health first aid is really in my wheelhouse,” said DiGiacinto, who has a master’s degree in school health education as well as a doctorate in kinesiology.

Elizabeth City State is one of the UNC system’s five Historically Black Colleges and Universities, or HBCUs, and working there for more than a decade played into DiGiacinto’s decision to take the training course.

“Statistically, African Americans are at greater risk for having a mental health crisis and not getting help for it,” she said.

The reasons for this are many.

Some are tied to the long-standing disparities in health care access that leads to undiagnosed illness as a whole. Others include stigma still associated with mental health issues, a lack of providers from diverse racial and ethnic backgrounds, as well as cultural experiences in which Black students might not see a family member seeking or getting help in a crisis, according to the National Alliance on Mental Illness.

On all campuses, the pandemic has added another thorny layer to a college experience that can come with lots of stress and anxiety during more routine times.

Some students have had to pick up jobs to help with family expenses if someone in their household lost wages because of COVID cuts. Others are caring for family members who might have health-related issues.

“Students are very stressed out,” DiGiacinto said. “They are overloaded with everything they’re trying to juggle.”

More than 55 percent of young adults between the ages of 18 and 24 reported symptoms of anxiety and depression during the pandemic, higher than any other age group, according to a Kaiser Family Foundation report

Graph courtesy of the Kaiser Family Foundation

Even before the Mental Health First Aid program training, DiGiacinto and some of her fellow faculty members at Elizabeth City State were making a conscious effort to check in more with students.

In the latter part of September, DiGiancinto used her training to help a student who reached out to her after she gave a talk about Title IX, a federal law that prohibits sexual harassment and discrimination in education programs.

The professor was able to connect the student to available resources. Because DiGiancinto is not a licensed mental health care provider, she cannot find out about any treatment unless the student asks that she be informed. DiGicianto is not certain what happened with the student after her talk.

Nonetheless, DiGicianto is an advocate for faculty, students and others to participate in the Mental Health First Aid training.

“I do think it will be helpful in the long run,” she said. “Anything we can do to normalize accessing help is good.”

Recognizing stressors

Ray Palma, a UNC-CH junior and president of the UNC Association of Student Governments with a seat on the system’s Board of Governors, went through the inaugural training session.

“It was a very humbling experience,” Palma said.

As a student seeking a degree in public policy, business administration with a minor in Spanish, Palma juggles many responsibilities.

“I’ve had my share of mental health challenges in the past,” Palma said.

Though he was able to get through those struggles without outside assistance, the experiences gave him an understanding of feeling alone and wondering why no one was reaching out to him.

The mental health training that Palma got in August, he said, has given him a better sense of how to reach out to others around him who might need a friendly ear or a nudge toward resources that can help.

“The role is not to diagnose or address these challenges,” Palma said. “One thing they teach is: Approach someone, listen to someone.”

Palma spoke of some of the stressors that college students confront.

“These days, a lot of students think it’s not enough to just go to classes,” Palma said. “They think they have to have an internship, they have to build a resume.”

Additionally, he said social media can give students a false sense of their peers and the world around them with misinformation or carefully curated profiles that rarely reflect the ups and downs of everyday life.

The pandemic drastically altered routines before and after COVID vaccines were available.

“One thing it’s important to recognize is that before the pandemic, students increasingly were experiencing more mental health issues,” Palma said, “It’s important to remember that in terms of mental health, there is no normal.”

‘Bridge that gap’

Adun Akinola, a UNC-CH freshman planning to get a degree in neuroscience and a minor in health and society, wrote a message in white chalk on the brick plaza on Tuesday and then carefully stepped over the other messages, trying not to smear chalk as she took hers back to a container in the middle of them all.

She didn’t know any of the students who had died over the past month, but she could feel the weight of the crisis.

Students at UNC-CH leave messages of support and encouragement on a brick plaza during World Mental Health Day. Photo credit: Anne Blythe

“It’s two months in and a lot of heavy stuff already,” Akinola said of the fall semester. “We’re all just trying to be here for each other, and care for each other so that we know that we’re not alone.”

Some of her friends knew someone who saw the reported suicide at Hinton James dorm.

“I have friends who live in there, and a lot of them knew some people who saw the whole thing,” Akinola said. “It was almost like primary, secondary, tertiary trauma from all of this. People who saw it happen, people who know the people who saw it who are trying to get them help, and people who know those people. We’re all just holding a lot and trying to make space for a lot.”

Though Akinola had not heard of the Mental Health First Aid training, she was intrigued by it.

“It’s definitely something that will help dissipate the stigma and help us be more direct with these sorts of things, and really bring it to the forefront and give it the esteem it needs in order for us to prevent or know how to react to these things in a way that cultivates a better culture,” she said. 

“Sometimes asking for help is the hardest part. There needs to be something done on the part of the university to bridge that gap between the students and the resources.”

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Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.