The Perfect Storm A perfect storm may be defined as "a particularly bad or critical state of affairs, arising from a number of negative and unpredictable factors" (Oxforddictionaries.com, 2014, n.p.) This could describe the current state of mental health concerns on college campuses. With advances in treatment, many more students with mental health issues are able to attend college than in the past (Dunkle, 2009; Massie, 2010; Meunier & Wolf, 2006; Watkins, Hunt, & Eisenberg, 2011). Surveys conducted by the American College Health Association and Directors of Counseling Centers show that increasing numbers of college students are reporting symptoms of depression and other severe psychological issues as well as taking psychotropic medications (Castillo & Schwartz, 2013; MacKean, 2011). The campus environment can also be stressful for many students. "Approximately 1,100 college students between the ages of 18 and 24 commit suicide, and nearly 24,000 attempt it" (Rodriguez & Huertas, 2013, p. 53). Add to the mix that mental health conditions such as bi-polar disorders begin in the age range associated with traditional college students (Massie, 2008; Meunier & Wolf, 2006). Rather than proactive planning and care, institutional policies addressing student mental health concerns have been based in fear and a desire for these students to go away Research Questions Specifically the research questions are: 1. What is the current jurisprudence regarding the liability of institutions of higher education when the student is considered a threat to self? 2. Is there synergy between the courts and changes to Title II regulations by the Department of Justice and enforcement of these regulations by the Office of Civil Rights? 3. Taking into consideration the current jurisprudence and the synergy between the courts and changes to Title II regulations, what are the implications for institutional policies and practices when the student is considered a threat to self? Definitions Direct Threat Provision: § 35.139 of Title II of the Americans with Disability Act (ADA) which was amended in 2010 by the Department of Justice so that direct threat may only be defined as a threat to others (Lannon & Sanghavi, 2011; Lewis, Schuster & Sokolow, 2012). Under this provision students who are a direct threat may be removed from campus without violating the ADA (Lannon & Sanghavi,