Table Of ContentThe Virginia Tech Massacre
Developmental Perspectives In Psychiatry
SERIES EDITOR
James C. Harris, M.D.
Johns Hopkins University
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James C. Harris, M.D.
The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health
Policy on Campus and Beyond
Edited by Aradhana Bela Sood, M.D., MSHA, and Robert Cohen, Ph.D.
The Virginia Tech Massacre
Strategies and Challenges
for Improving Mental Health
Policy on Campus and Beyond
Edited by Aradhana Bela Sood
and
Robert Cohen
1
1
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Library of Congress Cataloging-in-Publication Data
The virginia tech massacre : strategies and challenges for improving mental health policy on campus
and beyond / edited by Aradhana Bela Sood, Robert Cohen. — 1 Edition.
pages cm. — (Developmental perspectives in psychiatry)
Includes bibliographical references and index.
ISBN 978–0–19–539249–4 (hardback)
1. College students—Mental health—United States. 2. College students—Mental health
services—United States. 3. Virginia Tech Shootings, Blacksburg, Va., 2007. I. Sood, Aradhana
Bela, editor of compilation. II. Cohen, Robert, 1941– editor of compilation.
RC451.4.S7D48 2014
616.89—dc23
2014014462
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
For my Mother
Sushila Avasthy
and
For my Sister
Neeharika Naidu
Two women who gave me
The courage to notice injustice
The will to be an (un)tempered radical with
an optimism to believe in the possibility of change
—B.S.
For Katherine Cohen-Filipic and Alison Moritz
and
To the memory of
Ronald Townes and Frank Palumbo,
Who knew too well our mental health care system
—R.C.
CONTENTS
Foreword by James C. Harris ix
Acknowledgments xiii
About the Editors xv
Contributors xvii
PART ONE: LESSONS FROM VIRGINIA TECH
1. The Tragedy at Virginia Tech 3
Aradhana Bela Sood
2. An Unchecked Descent into Madness: The Life of Seung-Hui Cho 13
Hollis Stambaugh and Aradhana Bela Sood
3. Insights from Interviews and Other Firsthand Accounts 33
Aradhana Bela Sood and Hollis Stambaugh
4. Getting into the Mind of the Killer: A Psychological Autopsy
of Seung-Hui Cho 45
Aradhana Bela Sood
PART TWO: MENTAL HEALTH CARE ON CAMPUS
5. Failures in Campus Mental Health Systems: Lessons from Virginia Tech 65
Aradhana Bela Sood and Adele L. Martel
6. Best Practices and Resources: National Models for College Student
Mental Health 93
Adele L. Martel and Aradhana Bela Sood
7. Predicting Violence in Public Places 127
Cheryl S. Al-Mateen, Sala S. Webb, and Aradhana Bela Sood
PART THREE: THE MENTAL HEALTH CARE SYSTEM
IN THE UNITED STATES
8. Mental Health Services in the United States: Problems
and Promising Approaches 157
Aradhana Bela Sood and Robert Cohen
vii
viii CONTENTS
9. Global Perspectives on Mental Health Care 179
Robert Cohen and Aradhana Bela Sood
10. Toward More Responsive Systems of Care: Challenges and Strategies 195
Robert Cohen and Aradhana Bela Sood
Conclusion: Closing Thoughts 215
Aradhana Bela Sood
Postscript 229
Appendix 231
References 235
Index 255
FOREWORD
The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health
Policy on Campus and Beyond is the first book-length examination of this tragic event
by one of the principal members of the investigating commission. It is strengthened
by being a first-person account and a continuing reflection on what happened at the
time of the event and what has transpired since then. This case study of the perpetrator,
Seung-Hui Cho, provides a lens through which to examine the current state of college
mental health and provide recommendations to avert future campus disasters.
The events at Virginia Tech spawned an extensive reevaluation of the origins, roles,
importance, and availability of mental health services on college campuses; the preva-
lence of mental disorders in youth transitioning into adulthood (emerging adults aged
18–25); individual rights and privacy issues for college students and their families;
needed changes in privacy laws; and, inevitably, the continuing role of stigma and cul-
tural beliefs regarding mental health in students’ decision to utilize available services.
This book is a welcome examination of how the tragedy came about, what lessons can
be learned, and what changes in college mental health policy and reforms to mental
health systems have been initiated and those that still need to be instituted to prevent
other such tragedies.
The lead author and her team are well qualified to write this book because of
their special knowledge of what happened at Virginia Polytechnic Institute and State
University (Virginia Tech). As the psychiatrist on the Virginia governor’s commis-
sion, Dr. Bela Sood had personal access to family members, faculty, administrators,
and state officials. As a commission member she was intimately involved in the dis-
cussions that led to new legislation, policy changes, and recommendations made in
regard to the mental health system. Within a year after the disaster the Virginia legis-
lature improved the emergency mental health evaluation process, modified criteria for
involuntary commitment, tightened procedures for assisted outpatient treatment, and
increased state funding for community mental health services. This book examines the
effectiveness and implementation of these changes and asks: Has there been meaning-
ful change?
Throughout the book the authors continually refer back to the Seung-Hui Cho
case as they examine college mental health, mental health practices more broadly in
ix
