Massachusetts Supreme Judicial Court Describes Legal Duty For University Suicide Prevention Efforts in Nguyen v. Massachusetts Institute of Technology

This client alert provides background on Nguyen and suggests some next steps for colleges and universities.

Background

Han Nguyen, who received his undergraduate degree at Stanford, enrolled at MIT’s Sloan School of Management in the fall of 2006 as a Ph.D. student, living off campus. Between 2006 and his death in 2009, Mr. Nguyen obtained mental health treatment from many different doctors and professionals in the Boston area, none of whom were affiliated with MIT. None viewed him as presenting an imminent risk of suicide.

In 2007, after his first year at MIT, Mr. Nguyen sought assistance for “test-taking anxiety.” He was referred to several different student support offices. Mr. Nguyen briefly consulted with one of the individual defendants, an assistant dean in MIT’s student support services office, and revealed that he had attempted suicide years earlier. Mr. Nguyen denied any present suicidal ideation, however, and he also insisted that he wanted to keep his “academic” problems separate from his mental health issues. Mr. Nguyen last consulted with any of the student resource offices more than two years before his death.

Mr. Nguyen struggled academically at MIT. Two more of the individual defendants, both professors in his program, were concerned and tried to help. Although they knew that Mr. Nguyen had test-taking anxiety and that he was obtaining treatment off-campus, he never informed them that he had any intention or plan to commit suicide, nor were they aware of his prior suicide attempts.   

In the summer of 2009, Mr. Nguyen obtained a summer research position at an MIT unit outside Sloan. Mr. Nguyen sent the supervising researcher a number of awkwardly aggressive email messages, and the defendant professors intervened to salvage Mr. Nguyen’s summer job. One of the professors called Mr. Nguyen to advise him on his interpersonal and communication skills; the professor later described this call as reading Mr. Nguyen “the riot act.” Shortly after that call ended, Mr. Nguyen went to the roof of the MIT building in which he was working and jumped to his death.

The Parties’ Positions and the Superior Court’s Summary Judgment Decision

Mr. Nguyen’s father sued, alleging, among other claims, that Mr. Nguyen’s suicide was foreseeable and the defendants did not do enough to prevent it. 

MIT argued that the defendants did not bear any responsibility for Mr. Nguyen’s death. At the outset, the defendants observed that Mr. Nguyen’s suicide was not foreseeable; Mr. Nguyen repeatedly denied suicidal ideation to the defendants as well as to his off-campus treating physicians and specialists, and the latter did not view Mr. Nguyen as presenting a risk of imminent suicide. The defendants also noted that Mr. Nguyen never relied upon them for his mental health treatment. To the contrary, he was offered help by a variety of MIT resources and he consistently turned it down, expressing his desire to separate his “academic” issues from his mental health issues. The defendants emphasized the privacy and autonomy rights that today’s university students have come to expect, and the risk to those rights from a rule that universities must require students to receive mental health care even against their will.

The Massachusetts Superior Court agreed with the defendants and entered summary judgment in their favor. The Superior Court rested its decision on foreseeability, finding on the facts of this case that none of the defendants had reason to know that Mr. Nguyen might be at imminent risk of suicide.

The Supreme Judicial Court Affirms Judgment for Defendants, and Announces a New Legal Standard

On appeal, the SJC elected to review the case directly, bypassing the state’s intermediate appellate court. It heard argument in November 2017, and affirmed the grant of summary judgment to the defendants in a unanimous decision on May 7, 2018.

The SJC began by noting that “[g]enerally, there is no duty to prevent another from committing suicide.” That said, the Court went on to explain that a “special relationship” may arise between a university and its students in “limited circumstances” which justifies “affirmative, albeit limited, duties in regard to suicide prevention.” The SJC stressed that this duty arises only “[w]here a university has actual knowledge of a student’s suicide attempt that occurred while enrolled at the university or recently before matriculation, or of a student’s stated plans or intentions to commit suicide.” The SJC stated that this duty “is definitely not a generalized duty to prevent suicide,” and that the “duty is not triggered by a university’s knowledge of a student’s suicidal ideation without any stated plans or intentions to act on such thoughts.” With respect to non-clinician university faculty and staff in particular, the SJC “stress[ed]” that they are “not expected to discern suicidal tendencies where the student has not stated his or her plans or intentions to commit suicide,” and there is no affirmative obligation on non-clinicians to “probe or discern suicidal intentions that are not expressly evident.”

The SJC then charted a roadmap of “reasonable measures” for a university to follow when this duty is triggered. In non-emergency situations, the university should initiate its suicide prevention protocol or, if it does not have such a protocol, “contact the appropriate officials at the university empowered to assist the student in obtaining clinical care from medical professionals or, if the student refuses such care, to notify the student’s emergency contact.” In emergency situations, the university should contact police, fire or emergency medical personnel. The SJC emphasized that in “all but emergency situations” a university may rely on “the student’s own capacity and desire to seek professional help,” and suggested that courts will give deference to universities if they comply with their own protocols.   

Applying its newly formulated legal standard to the facts of this case, the SJC held that none of the defendants had a duty to prevent Mr. Nguyen’s suicide. The SJC noted that Mr. Nguyen had denied suicidal ideation to MIT’s student support services, and that his prior suicide attempts were years before he matriculated at MIT. As a result, there was no duty. The SJC also observed that Mr. Nguyen’s rights to privacy, autonomy, and self-determination were properly respected by MIT’s deference to Mr. Nguyen’s decision to decline MIT services and instead to seek treatment elsewhere. Likewise, the SJC held that no special relationship was created between the defendant professors and Mr. Nguyen, because they were not aware of any plan or intention to commit suicide. The SJC noted that they were not trained clinicians and could not have “intuited” that Mr. Nguyen had any suicidal intent where even his treating mental health professionals did not consider him “imminently suicidal.”

Lessons from Nguyen for Universities

While universities today no longer stand in loco parentis to their students, it is common for universities to provide assistance, consistent with their resources, to students in obvious need.  Even without a legal duty sounding in tort, it is human nature to want to help others. The SJC’s decision is an important legal victory for universities confronting claims based on student suicides. The Court firmly rejected the plaintiff’s claim that a student suicide is foreseeable based merely on knowledge that a student is depressed or anxious, or even expressing suicidal ideation – something much more concrete and specific is needed before a duty arises. The Court also rejected the plaintiff’s argument that a university must override a student’s autonomy and privacy interests by insisting that the student receive mental health treatment. And the Court quickly disposed of the plaintiff’s theory that even a harsh conversation between a faculty member and an anxious or depressed student can give rise to liability for the student’s subsequent suicide.

But the decision still leaves open the possibility of university liability for suicides in a narrow category of cases in which the university, although aware of a recent suicide attempt or threat to commit suicide, does not adhere to its own suicide prevention protocols, or does not escalate the situation to mental health professionals, emergency contacts, or (in a crisis) the authorities. In comparison to a simple “no duty” holding, the Court’s decision also leaves universities open to the risk of costly discovery over who knew what when, and what they did in response. 

In light of this decision, universities might consider taking some of the following steps:

• The SJC’s decision suggests that courts will defer to reasonable suicide prevention protocols adopted by a university. The more widely accepted the protocols, the more likely courts will be to defer to them. Universities therefore might collaborate in, and should be alert to, the articulation of “best practices,” and proactively justify any departures in their own protocols from what are considered best practices.
• While the SJC suggested that adherence to protocols might be something of a safe harbor, universities should expect any departure from its own protocols to be challenged. Thus, faculty and administrative staff education will be important. And while remaining reasonably protective of students, universities should take care that any protocols not be so easily triggered, or so burdensome to deploy, that adherence would be difficult to ensure.
• The duty recognized by the SJC for non-clinical faculty and administrators is generally satisfied by escalating a situation to someone more capable of addressing it:  on- or off-campus mental health professionals, parents or other emergency contacts, or the authorities in the event of a crisis. In addition to training on protocols, universities might take steps to ensure that “hotline” numbers are well-publicized to professors and administrators. Universities might also consider including in their protocols a clear delegation of responsibility over off-campus communications to a trained specialist, rather than leaving it to individual faculty and administrators. Finally, universities should consider taking steps to ensure accurate recordkeeping of all communications that might be used to establish compliance with the SJC’s new reporting duty.
• Nguyen is a common law decision and can be overridden by statute. In light of the serious student privacy interests at stake, and the uncertainties created by Nguyen’s vague formulation of the duty of care, universities might consider prompting legislation, akin to the Family Educational Rights and Privacy Act, to set reasonable boundaries on their sharing of student mental health information with third parties, including medical providers, parents, and authorities.

At bottom, the SJC attempted in Nguyen to thread a needle between encouraging universities to address the risk of student suicides, while avoiding unmanageable detection and prevention burdens for universities and respecting student autonomy and privacy. As in Nguyen, the facts of a particular case will be important to the outcome of any litigation. Universities that adopt and adhere to reasonable, “best practices” policies will be best prepared to comply with the limited duty of reasonable care for suicidal students as described by the SJC.