As college students across Maine head home for winter break, I think about the family of the bright and promising Bowdoin College student whose suicide was unthinkable. As a Bowdoin psychology professor emerita, I wonder how this tragedy might have been prevented.
According to the American College Health Association Spring 2019 Summary, 66 percent of college students experienced overwhelming anxiety (51 percent in 2011); 58 percent felt hopeless (47 percent in 2011); 46 percent felt too depressed to function (32 percent in 2011), and 14 percent seriously considered suicide (7 percent in 2011).
A Harvard Medical School assistant psychiatry professor, the executive director of Mass General’s Clay Center for Young Healthy Minds and a Clay Center research assistant noted that 80 to 90 percent of the over 1,100 college students who die by suicide each year had received no college-counseling help: “The stigma of mental illness (is) the greatest barrier to seeking help,” they said.
Aldo Llorente, M.D., the Brunswick psychiatrist who directed Bowdoin’s Counseling Center from 1977 to 1986, understood the problem. He destigmatized mental health treatment; there were no known suicidal events during his tenure. Here’s his approach:
• First-year orientation. Llorente greeted students at first-year orientation with “Students, do your best. But don’t worry about grades, because 50 percent of you will be in the top half of the class and 50 percent in the bottom half.” With these true words, he set the tone for his destressing, destigmatizing campaign.
• Play Pool with Aldo – assessment without stigma. Llorente played pool with students on campus at regularly designated times each week. Any student – with or without mental health problems – could play. Students flocked to the pool table, where Llorente assessed some discreetly. No one knew whom Llorente assessed: He talked to all pool players alike and considered three levels of treatment:
• 24-hour respite. “Students suffering from excessive stress is an intensifying problem,” Llorente reported in the 1977-1978 President’s Report. Such students were treated to “Aldo’s Spa” – a bubble bath, milk and cookies, and a sedative ensuring a good 10 to 12 hours of sleep. That got most students back on track.
• Conventional treatment. Students with ongoing problems were offered counseling and/or medication.
• Local inpatient psychiatric unit. Students who needed more intensive care were referred to the short-term voluntary 13-bed psychiatric unit at Brunswick’s Mid Coast Hospital. Medical leave was a last resort.
In 1986, Llorente left Bowdoin to head that local psychiatric unit, where his innovation continued. In his “wrap-up group” each evening, patients settled on a conversation topic themselves, so they could “sit at the doughnut-shop counter and talk about anything but their mental illness,” as Llorente put it.
Llorente created a practicum for students in my Abnormal Psychology course. The 14 undergraduates visited in pairs weekly, offering occupational therapist-approved activities like guitar-playing sing-alongs, origami and baking. Patients knew the students’ confidentiality training and could opt to stay in their rooms, which rarely happened.
Occasionally, practicum students encountered a Bowdoin student on the unit; one year, a student in the practicum became a patient. Hospitalized students unfailingly found that chatting with the practicum students was a non-stigmatizing way to transition back to campus.
Aldo also helped members of the community informally. In 1986 I suffered searing headaches upon recovering from influenza. Although I later learned how that winter’s flu strain caused viral meningitis, I had already been traumatized by the weeks of undiagnosed pain. Aldo visited me at home regularly, just to keep me company as I recovered. I memorialized his reassuring presence in my invited NPR “This I Believe” essay, which I delivered on-air. Click the link to listen.
Aldo Llorente died in 1995, at age 68. Adding to many friends and family at the memorial service were dozens of former patients, eager to pay respects to this most talented, dedicated and beloved psychiatrist.
The uncommonly successful methods created by Aldo Llorente cannot be implemented readily in our HIPAA-infused, treatment-regulated times. Yet some college counselors might be inspired to adapt his methods nonetheless, to normalize and so destigmatize the process of getting help. Desperate times call for innovative measures – including long-lost but tried and true ones.
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