Suicidal? Ask for help and lose your shot at a degree

After every suicide of a high-profile person, the single piece of advice rises to an almost unimaginable decibel: Just ask for help.

That can get you tossed out of college.

The New York Times reports today on a class action lawsuit accusing Stanford University of discriminating against students with mental health issues by coercing them into taking leaves of absence.

Taking a leave of absence to get help isn’t a bad idea, but it’s a fine line between referring students to help and shunning them.

“It may be paternalistic, but it’s actually for the student’s own good, to get them out of the jam that’s occurred that’s leading to their inability to function,” one expert tells the Times.

“Only half of college students experiencing a mental health crisis seek help, largely due to the justified fear of stigma and negative consequences,” the lawsuit says. “Too often, universities respond to disability-related behavior with exclusion, blame and draconian measures such as a forced leave of absence.”

“The law is unsettled,” said Karen Bower, a lawyer who has represented students suing universities for making them take mental health leaves. “‘Disruption’ is the new buzzword. Universities have claimed that students who use too many resources, inform friends of suicidal ideation or require wellness checks have all disrupted the campus or campus operations.”

The Stanford lawsuit says that students who were placed on leave were effectively banished from the university and stripped of their privacy and autonomy. Their own doctors were second-guessed by the university’s, the suit says, and the students were required to immediately withdraw from all classes, programs and housing. To return to campus, they had to write personal statements “accepting blame” for their behavior.

The consequences of taking a leave for a student in crisis can be dire. Students may lose touch with the friends they rely on, and find themselves isolated and ashamed. Some who were made to take leaves have tried to kill themselves at home. At the very least, they will graduate months or even years late.

Stanford says it “cares deeply” about its students, but refused to talk about cases cited in the report,citing privacy issues.

But there’s a heavy-handedness in the report that betrays the discrimination behind the treatment of mental health issues, even as people are increasingly willing to talk about them, confront them, and not be ashamed of them.

Lark Trumbly, a former student at Stanford, is more ambivalent about being sent home. Her freshman year, she passed out on the bathroom floor of her dormitory from a mix of pills and alcohol. A dean visited her at the hospital and told her that “students in my situation tend not to succeed at Stanford,” Ms. Trumbly, 23, said.

Her freshman housing was revoked, and she was told that if she was not living on campus she could not take classes, so she would have to take a leave, she said.

Going home to Sacramento was a disaster. Feeling isolated and bored, she tried to kill herself again. Stanford did not know about that attempt, and she was allowed to return. But after a sexual assault, she began cutting herself, she said, and was sent home again.

The second leave was better. She returned to Stanford later, got a degree in psychology and is now a mental health activist.

“I just wish I could have done it on my own terms,” she tells the Times.

“It’s a horrible practice because it discourages students from getting the help they need,” said Attorney Bower.

At any given time, about 5 to 10 percent of people on campus have suicidal thoughts. Are they going to kick them all out?

How well colleges take care of their students is going to be an increasingly important question because treatment and medication are allowing more high schoolers to go off to college in the first place.

Typically, the Times’ comment section is full of people who have it all figured out, interrupted occasionally by those closest to the problem and most educated about it, who acknowledge they don’t.

As a doctor, I find this sad article an alarm for the things that are very wrong about today’s increasingly stressful adolescence. I went to a highly selective college in 1960. At that time it wasn’t mandatory to be the editor, president, or captain of everything. I had not built houses for the destitute in the third world, started a high tech business, or written a best-seller.

Certainly, I’ve been blessed with normal mental health, but my stresses were ordinary and quite manageable. These days, college admission, and childhood generally, demand excellence in all aspects of life. How could the unreality of that not bring many to despair? And once in that unhappy state, the student’s institution is not allowed to contact the parent.

My goodness, how many 17 year olds can deal with all this without experiencing at least important anxiety? Colleges should challenge, but they shouldn’t kill.

(h/t: Paul Tosto)