CHAPEL HILL Editor’s note: This story contains reporting about suicides, a topic that will be disturbing to some readers.

The messages on the brick were beginning to disappear, the colors fading. They were part of a memorial in The Pit at UNC-Chapel Hill, in the middle of campus where students came to grieve the loss of their own.

The empty chairs arrived first, three of them placed side-by-side. Then the flowers and the poems and the post-it notes, small squares with loving messages to those lost and to anyone who needed to be found. Someone colored in the bricks in front of the chairs and wrote in large letters:

“Your fire will never truly die. R.I.P.” That was the part that was starting to fade, the part that a UNC senior named Christie Scialabba kneeled down to color in again, pieces of chalk turning into nubs in her fingers.

Scialabba had already walked the mile and back to Target with candles to replace those that had melted when she noticed the chalk messages disappearing.

“I don’t want it to fade quite yet,” she said. “I don’t think the emotions are gone. They’re far from gone.”

A weekend of tragedy at UNC-Chapel Hill started the morning of Oct. 9, when a freshman ended his life at Hinton James Residence Hall. Fewer than 24 hours later, UNC police responded to an attempted suicide across campus, at Granville Towers. The word attempted was later removed from the university’s police log.

In the aftermath of that weekend, student leaders pushed the university to cancel classes for a Wellness Day. Not far from the memorial one day last week, there were dogs to pet and free doughnuts to help lift spirits. Next to the empty chairs, there was a table with representatives from UNC Student Wellness, which includes the university’s mental health services.

Some students wondered where the help was before tragedy struck on a campus where some say they wait weeks for mental health appointments.

As a systemwide report made public in May makes clear, a pair of mental health crises have been brewing throughout UNC system campuses for years. A year and a half of the pandemic worsened both, but did not cause them.

The first crisis, the university system’s report says, is “the escalated demand for student mental health services.” The second: the “strained capacity” to provide those services.

The disparity is not limited to UNC-Chapel Hill, or any particular campus, the report found. It is present to varying degrees at all 16 public universities across this state. From the largest to the smallest. From those with the most resources to the state’s five HBCUs, which relative to their peers, are often forced to spend less per student on mental health services.

Abby Pallant, who left handwritten notes on each of the chairs at the UNC memorial last week, spoke not of a weeks-long wait to receive mental health counseling, but one she said lasted months. “I’m on a waiting list,” she said.

“It’s a tragedy that it had to be this that would open people’s eyes,” to such serious need, Pallant said.

The current wait for therapy appointments at UNC-Chapel Hill is usually a week, but emergency, walk-in and group therapy help are offered daily, Vice Chancellor for Student Affairs Amy Johnson told faculty last week.

Yet disparities between UNC System students’ need for mental health care and the supply of that care have been concerning for years. So much so that the UNC System Board of Governors in September 2020 commissioned a wide-ranging study.

The resulting report — a 50-page document titled “Healthy Minds, Strong Universities: Charting a Course to More Sustainable Student Mental Health Care” — details the state of student mental health and the services schools provide to address it.

It tells the story of campuses overwhelmed by need, ones ill-equipped to offer prevention as a cure. Not just the workload has changed, campus mental health specialists say, it’s the work itself.

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“But now,” Barnette said, “we’re seeing folks with serious mental health issues, you know, dually diagnosed, a lot of trauma that may have started even from home now to college. ... We see a lot more stress and anxiety and depression.”

About one quarter of students at UNC System universities had taken psychiatric medication within the past year, according to report data from Healthy Minds Network, an organization that tracks and studies the mental health of American college students.

Keeping up with their needs with limited resources is challenging, say people across the system working to raise the profile of the problem. “It’s really difficult,” said Monica Osburn, N.C. State’s counseling services center director. She led a subcommittee that examined the state of university mental health services across the state. “It’s very difficult.”

UNC schools spend an average of $125 per full-time student on “mental health expenditures” — including staffing and services — according to the report. No school spends more per-student than the North Carolina School of the Arts ($316), followed by UNC-Asheville ($239) and N.C. State ($204).

Four of the five state-supported HBCUs, meanwhile, spend less than that average, with Elizabeth City State ($130 per student) the exception.

“There definitely has been an imbalance” in resources, Barnette said.

Barnette said she’d raised concerns about inequity with the UNC System, and that despite it she’d still managed to triple her staff in her 15 years at A&T — from four, including herself, 15 years ago to 12 now.

“We as directors and staff, included, are just stretched so far with, you know, trying to just meet the basic needs of the counseling center,” said Barnette, who led one of the subcommittees that presented the report to the BOG. “Because we are inundated with students, constantly seeking services.”

Barnette’s peers around the country could tell similar stories, and did during a conference last week in Seattle.

There, those charged with protecting the mental health of college students across the nation gathered to share best practices, but also to counsel each other and offer support. They all shared the unenviable task of addressing a problem that shows no signs of abating, and doing it with limited funding or staffing or both.

There were days of seminars and breakout sessions with titles like “Reimagining Youth Resilience” and “The COVID-19 Effect,” which sought to examine how the pandemic has altered college students’ mental health. And certainly, experts say, the moment has made everything more difficult for college students, the way it has made everything more difficult for most of us.

For college students, the report the UNC System Board received in May laid out the data: that between 20% and 30% of students, nationwide, arrive in school with a previously diagnosed mental health disorder. That between 10% and 15% of students nationally endured “serious thoughts” of suicide in the previous year before the release of the report.

By comparison, in 2007, 6% of students experienced suicidal thoughts in the previous year, and 1.5% reported having a plan to carry out suicide. That’s the earliest year that data is available from the Healthy Minds Network. By 2020, 14.1% of college students nationally had endured suicide ideation, and 5.9% had a suicide plan.

North Carolina faces challenges off college campuses, too. A 2019 study in JAMA Pediatrics, found the state ranks last nationally in treating children with mental health disorders. It found that 72.2% of North Carolina children with a mental health disorder did not receive necessary treatment from a mental health professional.

Invariably, some of those children will grow into young adults who matriculate to state universities that also lack resources.

“In an ideal world, getting help happens quickly,” said Dr. Amy Ursano, a UNC School of Medicine associate professor who specializes in child and adolescent psychiatry. “And almost in a preventive way, we should be putting a lot more efforts towards stopping things from progressing than having to arrive too late.”

In the week after UNC-Chapel Hill confirmed a student suicide on campus on Oct. 9, UNC Police conducted 14 well-being checks, according to its public log, and facilitated five “voluntary commitments,” as they’re described in the log. In the previous week, before Oct. 9, campus police reported one well-being check and no commitments. Police conducted four other well-being checks on campus since classes started in August.

There is no way to know how many students enrolled in UNC campuses take their lives each year. The UNC System does not track that information, according to a spokesperson, leaving the choice to track suicides up individual schools.

“What I can say generally about university approaches is that tracking student suicides, or even merely dealing with the topic, can heighten fear of liability for universities,” Rob Cramer, an associate professor in UNC-Charlotte’s Department of Public Health Sciences, wrote in an email.

Cramer, who researches suicide, wrote that if universities recorded suicide data, it “means potentially being accountable.” He referenced an early-2000s lawsuit that attempted to hold MIT liable for a student’s suicide there.

Despite the three-chair memorial in the center of the UNC-Chapel Hill campus, the university has not confirmed how many students have died by suicide there this semester. The police log indicates there were at least two this month. A entry from September logs an early morning suicide at the Forest Theater on campus.

Days after campus police responded to the suicide at Hinton James, the student’s obituary appeared online. He’d been a high school valedictorian, a hockey player, a “friend” and “Tar Heel forever ... absolutely loved by all,” according to the messages in chalk next to the empty chairs.

Members of his family — an aunt, cousins, a grandmother — went to The Pit last Wednesday to mourn, though one said they were not ready to talk. Students passing by let them grieve, alone, in front of the flowers and notes.

The visitors leaned down to read some of the messages, ones that said “I can’t imagine the pain you’ve been through” and “you deserved more” and “I am so sorry” and “I miss you man;” empathetic messages next to ones of affirmation: “You are loved” and “you are worthy” and “I’m happy you exist.”

After the UNC System leaders received the mental health report in May, they announced a $5 million grant from the Governor’s Emergency Education Relief Fund to “rapidly expand mental health services for students statewide.”

About $1 million of that money will go toward “Mental Health First Aid Training,” with the goal of training 10,000 staff, faculty and students at schools across the state.

UNC-Charlotte, for instance, received in August a Garrett Lee Smith Campus Suicide Prevention Grant, which is federally funded and provides more than $300,000 over three years. In an email, Cramer, the UNC-Charlotte professor and suicide researcher, noted that Charlotte — both the city and the university — had “been rocked by a series of traumas in the last few years.”

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The suicide prevention grant will not necessarily alleviate the burden on the campus counseling center, Cramer wrote, but will allow the university to use a “wider public health model” of prevention.

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Last week, UNC-Chapel Hill students were left to lean on one another. They visited the memorial in The Pit throughout the week. They held each other. They left more messages on the brick.

Notes covered the empty chairs, colorful squares with supportive words, and they were written as much to those who could no longer read them as those who could. Lisette Vasquez, a sophomore from Kinston, was among those who walked alone to the memorial and left a message. Last Tuesday afternoon, she knelt down and picked up a piece of white chalk and began writing large block letters. When she was finished her message said:

CHOOSE TO STAY

CHOOSE YOURSELF

YOU MATTER

Staff reporter Kate Murphy contributed to this report.