HARVARD GAZETTE ARCHIVES

Experts Discuss Campus Health Issues at UHS Symposium

By William J. Cromie
Gazette Staff

Speakers at Harvard University Health Services' Centennial Celebration Symposium gather beforehand. From left, Herbert Benson, chief, Division of Behavioral Medicine, Beth Israel Deaconess Medical Center; David S. Rosenthal, director and Henry K. Oliver Professor of Medicine, University Health Services; Mark L. Rosenberg, assistant U.S. surgeon general; and Allan Brandt, Amalie Moses Kass Professor of the history of science, Harvard Medical School.

Stress, student suicide, smoking, and alcohol abuse were discussed at a Nov. 19 symposium held to mark the 100th anniversary of the University Health Services (UHS).

Assistant U.S. Surgeon General Mark L. Rosenberg told about 130 attendees gathered at the American Academy of Arts and Sciences in Cambridge that suicides among teenagers have tripled since 1950. "While depression is often cited as a major factor in adult suicides, one large study found that most young people who committed suicide were not depressed," he noted.

Among this group, impulsiveness plays a big role. "Between one-fifth and one-third of serious suicide attempts stem from impulsiveness," Rosenberg said. Such people think about suicide for less than five minutes before trying to kill themselves.

As an example, he related a heart-wrenching story about a neighbor's daughter who tried to commit suicide at age 17. While drinking with her boyfriend, she suddenly grabbed a gun from a table, put it to her head, and pulled the trigger without any warning. She survived the attempt, but is severely brain-damaged.

Impulsivity is a risk factor for young people of all ages and socioeconomic levels, including college students, according to Rosenberg. "Impulsive people can be intelligent," he commented. He recalled meeting a number of them while attending Harvard as an undergraduate (AB '67) and graduate student (MD '71, MPP '72). "College life may also add extraordinary stress brought about by the drive to succeed and social isolation.

"It's common to treat suicides as unpredictable accidents," Rosenberg continued. "But it is possible to recognize the symptoms and to take actions that prevent people from trying to kill themselves." For the 17-year-old he described, one obvious course of action was to eliminate ready access to a loaded gun.

"Many colleges and communities offer crisis centers and hot lines, but there's evidence that they don't work as well as generally believed," Rosenberg said. "Much more is needed. The most powerful preventive measure is public education. Key people, such as faculty, tutors, and physicians need to be trained to recognize risk factors such as high stress, social isolation or lack of attachment, and mental instabilities. When such factors are present, young people should quickly be put into contact with those best suited to help them. When suicides do occur, cases should be carefully reviewed to determine any common risk factors."

Rosenberg commented that the UHS is "doing a good job in all these areas."

Stress and Relaxation

In another symposium presentation, Herbert Benson, founder of the Mind/Body Medical Institute at Beth Israel Deaconess Medical Center, described a way for students to manage stress. The Institute, now affiliated with UHS, offers relaxation and meditation training.

These techniques not only calm people, they have also been shown to lower blood pressure and reduce chronic pain. Benson noted that using words of prayer or visualizing spiritual symbols can evoke relaxation, as can deep breathing and repetition of a neutral word like "one." "Relaxation can be tailored to your belief system," he maintains. "Your body and mind work together to promote healing."

Smoking and Drinking

Allan Brandt, Kass Professor of the History of Medicine, pointed out that cigarette smoking was rare in 1898, when UHS was established. He commented on how technology, including machines that roll cigarettes, and advertising, much of it deceptive, have helped make smoking a worldwide health problem.

Brandt, also professor of the history of science, expressed concern over recent studies that found cigarette smoking among college students has risen by 28 percent between 1993 and 1997. Among high-school students, it increased 32 percent from 1991 to 1997. He attributed this to tobacco companies trying to hook younger and younger people on nicotine as older smokers die from lung cancer and other tobacco-related diseases.

"Some advertising is now being directed to 3- to 6-year-olds," Brandt asserted.

Binge drinking is also on the rise among college students. According to a Harvard School of Public Health study, almost half (44 percent) of students go on alcoholic binges, defined as four (for women) or five (for men) consecutive alcoholic drinks. David Rosenthal, director of UHS, pointed out that Harvard students are somewhat below the national bingeing average, 41 versus 44 percent.

One in five students who drink engages in unplanned sex. One in four falls behind in his or her school work. One in three has regrets of some kind about how they behaved while drinking.

And, Rosenthal reminded the audience, two-thirds of all suicide attempts involve alcohol.