In The New York Times continuing coverage over the Tuscon tragedy, Sulzberger and Gabriel reported yesterday about limits colleges face dealing with mentally troubled students.

In September, Pima suspended Mr. Loughner and told him not to return without a psychologist’s letter certifying that he posed no danger. But it took no steps to mandate that he have a psychiatric evaluation, which in Arizona is easier than in many states.

Laura J. Waterman, the clinical director of the Southern Arizona Mental Health Corporation in Tucson, criticized Pima officials for not seeking an involuntary evaluation. “Where does it reach a level where you say this person shouldn’t be a part of any community and we have a responsibility to do something about that?” she said.

I posted recently on college needs–triggered by another NYT article by Trip Gabriel.

“It is part of our practice to provide students with information of where they can go,” said Charlotte Fugett, an official at the college. “It’s their responsibility to find a practitioner.”

Last year, Pima updated its policies for dealing with disturbed students, as did campuses across the country after several deadly shootings, including the killing of 32 at Virginia Tech. The college created a team of senior officials to identify students who might pose a threat to themselves or others. They began meeting the same month that Mr. Loughner was suspended.

Paradoxically, suspending students like Mr. Loughner may push them over the edge by adding to their grievances and isolating them from people who could monitor them, said experts on campus violence.

A theme of this event, and a theme of all my posts on mental health, is that this is a very difficult issue. But real, live consequences can result. Mental illnesses progress. They take many forms. The science has gaps; is confusing. Yet just like other chronic medical diseases they can worsen over time.

Seek treatment. Ask for help. Get treatment. Ask you friends, family, colleagues to seek help.

Pima had done what most colleges would in placing the responsibility to get a mental health exam on the student, especially since, as the college says, it also delivered the ultimatum to Mr. Loughner’s parents, with whom he lived.

Stella Bay, the police chief for Pima, said the college could initiate an involuntary evaluation only if a student posed “an imminent danger.”

But that assertion seemed to reflect a misunderstanding of the state’s laws regarding involuntary evaluations. Dr. Waterman, of the Southern Arizona Mental Health Corporation, said a mandated evaluation required only some evidence of danger. “It’s a broader standard,” she said. “And it costs nothing to make a phone call and talk about it and consult with a professional.”

I recently posted on the Great Progress HOP and the SHYMCA are making locally on mental health first aid. Expect to hear more soon.