The rampage carried out nearly a year ago by a Virginia Tech student who slipped through the mental health system has changed how American colleges reach out to troubled students.
Administrators are pushing students harder to get help, looking more aggressively for signs of trouble and urging faculty to speak up when they have concerns. Counselors say the changes are sending even more students their way, which is both welcome and a challenge, given that many still lack the resources to handle their growing workloads.
Behind those changes, colleges have edged away in the last year from decades-old practices that made student privacy paramount. Now, they are more likely to err on the side of sharing information -- with the police, for instance, and parents -- if there is any possible threat to community safety. But even some who say the changes are appropriate worry it could discourage students from seeking treatment.
Concerns also linger that the response to shooters like Seung-hui Cho at Virginia Tech and Steven Kazmierczak, who killed five others at Northern Illinois University, has focused excessively on boosting the capacity of campus police to respond to rare events. Such reforms may be worthwhile, but they don't address how to prevent such a tragedy in the first place.
It was last April 16, just after 7 a.m., that Cho killed two students in a Virginia Tech dormitory, the start of a shooting spree that continued in a classroom building and eventually claimed 33 lives, including his own.
Cho's behavior and writing had alarmed professors and administrators, as well as the campus police, and he had been put through a commitment hearing where he was found to be potentially dangerous. But when an off-campus psychiatrist sent him back to the school for outpatient treatment, there was no follow-up to ensure that he got it.
People who work every day in the campus mental health field -- counselors, lawyers, advocates and students at colleges around the country -- say they have seen three major types of change since the Cho shootings:
* Faculty are speaking up more about students who worry them. That's accelerating a trend of more demand for mental health services that was already under way before the Virginia Tech shootings.
Professors "have a really heightened level of fear and concern from the behavior that goes on around them," said Ben Locke, assistant director of the counseling center at Penn State University.
David Wallace, director of counseling at the University of Central Florida, said teachers are paying closer attention to violent material in writing assignments -- warning bells that had worried Cho's professors.
"Now people are wondering, 'Is this something that could be more ominous?' " he said. "Are we talking about the Stephen Kings of the future or about somebody who's seriously thinking about doing something harmful?"
The downside is officials may be hypersensitive to any eccentricity. Says Susan Davis, an attorney who works in student affairs at the University of Virginia: "There's no question there's some hysteria and there's some things we don't need to see."
* Changes are being made to privacy policies. In Virginia, a measure signed into law Wednesday by Gov. Tim Kaine requires colleges to bring parents into the loop when dependent students may be a danger to themselves or others.
Even before Virginia Tech, Cornell University had begun treating students as dependents of their parents unless told otherwise -- an aggressive legal strategy that gives the school more leeway to contact parents with concerns without students' permission.
In Washington, meanwhile, federal officials are trying to clarify privacy guidelines so faculty won't hesitate to report potential threats.
"Nobody's throwing privacy out the window, but we are coming out of an era when individual rights were paramount on college campuses," said Brett Sokolow, who advises colleges on risk management. "What colleges are struggling with now is a better balance of those individual rights and community protections."
The big change since the Virginia Tech shootings, legal experts say, is colleges have shed some of their fear of violating the federal Family Educational Rights and Privacy Act.
Many faculty hadn't realized that the law applies only to educational records, not observations of classroom behavior, or that it contains numerous exceptions.
* The stigma of mental illness, in some cases, has grown. "In general, the attention to campus mental health was desperately needed," said Alison Malmon, founder of the national Active Minds group. But some of the debate, she added, "has turned in a direction that does not necessary support students."
All the talk of "threat assessments" and better-trained campus SWAT teams, she said, has distracted the public from the fact that the mentally ill rarely commit violence -- especially against others.
"I know that, for many students, it made them feel more stigmatized," Malmon said. "It made them more likely to keep their mental health history silent."
Sokolow, the risk consultant for colleges, estimated in the aftermath of the Virginia Tech and NIU shootings, the schools he works with spent $25 on police and communications for every $1 on mental health. Only recently has he seen a shift.
"Campuses come to me, they want me to help them start behavioral intervention systems," Sokolow said. "Then they go to the president to get the money and, oh, well, the money went into the door locks."
Phone messaging systems and security are nice, he said, but "there is nothing about text-messaging that is going to prevent violence."