"The issue of what to do in response to suicidal students is anything but a clear one" (Harshbarger, 2014, para. 3). How to best support students with severe mental illness is an ongoing challenge for institutions of higher education. Institutions must adapt to a rapidly changing landscape of evolving federal policy, case law, and notable public incidences. This dissertation examined two universities in crisis and how their policies evolved after the related incidents. Using a historical case study orientation, I conducted document analysis on policy related to student crisis at Appalachian State University and Virginia Tech. The results from this analysis can serve as a guide for administrators at other universities who are designing institutional policies to prevent mental health crises. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]