Lucinda Roy spoke up when she sensed one of her students needed mental health treatment.
She took him out of class and tutored him. But the Virginia Tech officials said the disturbing writings and statements weren't specific enough to force him into counseling.
Eighteen months later, 23-year-old Seung-Hui Cho took 32 lives along with his own on the Blacksburg, Va., campus in 2007.
Tuesday afternoon, the English professor visited Columbus State University and gave the crowd of about 1,000 an inside look into the issues surrounding that infamous massacre.
Roy said she received death threats after speaking out against the missed warning signs. She asked, "Who is morally obliged to intervene? A teacher? A parent? Another student? A counselor? Law enforcement? And what are the legal ramifications of intervention.
"In the United States, the legal options in cases of students who exhibit signs of being deeply troubled are less plentiful than we imagine. So we play a game of Russian roulette in education and mental health, shuffling too many troubled young people through the system, convincing ourselves that no student would be crazy enough to load a gun and point it at someone's head."
Statistics show that 21 percent of college students, at some point, feel suicidal and can't function, Roy said.
"That means so many of us struggle with this," she said. "This can't be a taboo subject. It's too important, and students are too precious, and if we don't remember what a treasure students are and how everything we do is dependent on your future and you succeeding, then we do you a disservice.
"So our calling in life is to make sure that you succeed, because you're worth it, and we believe that, which is why we're on a campus like this."
During the time of the shooting, Virginia Tech had one counselor for every 2,500 students. Now the university has one counselor for every 1,750.
"That's still not a great ratio," Roy said.
The 2010 National Survey of Counseling Directors showed the average ratio on U.S. campuses is one counselor for every 1,600 students. CSU's ratio is 1:1,694, said clinical psychologist Dan Rose, director of the CSU Counseling Center.
Five or six years ago, Rose said, CSU counselors hospitalized a student for mental health reasons once every few years. Now, he said, CSU's five counselors send a total of 15-20 students to hospitals for such treatment per year.
"We're seeing a tidal wave of more disorders," Rose said. "It shows we're more focused on threats and being able to meet students' needs, but it also shows we're fighting a rising tide. There was a time when people with those disturbances wouldn't make it to college."
After visiting classes Tuesday morning and seeing the crowd at her lecture, Roy praised CSU for its diversity and proactively addressing mental health.
"To see how well you really related to each other -- I'm not saying that there aren't probably some problems with that, like any community -- but it seems to me that you have a particular role to play at CSU, because you understand something about diversity," she said. "You understand something about difference, and you've embraced it in a way that is a lesson to all of us."
CSU professor Terry Irvin, chairwoman of the basic studies department, said a committee chose Roy's book "No Right to Remain Silent" as the common reading for this year's freshman class because of its compelling message.
"We all can be advocates for mental health issues," Irvin said. "Students need to know that they can, if they see people that need help, they don't have to sit back. They need to let people know.
"Until very recently, most universities were in their little silos. If a student did something in one class or a dorm, nobody else ever heard about it. We have a system where that doesn't happen anymore. People turn in those (incidents) to a central place, and they're evaluated. We've got a ways to go, but we're well on our way."