In the wake of the recent Northern Illinois University shooting and the 2007 Virginia Tech massacre, the trend of taking harsh disciplinary actions against students with mental illnesses is on the rise. Instead of receiving vital treatment at a time when half of all college students admit to being so depressed that they can hardly function, many feel punished for reaching out. Countless students have been kicked off campus -- some even locked out of their dorm rooms - after seeking help for depression and other psychological problems.
The campus mental health model, critics claim, is shifting from one of compassion to chastisement, and at times, outright discrimination. Fears of violence and liability, along with dwindling student services budgets, are evidently fueling the controversial shift.
Students Fight Back
Jordan Nott, a former George Washington University student, sued the school after he was suspended following a 2004 mental health hospitalization. He alleged that information he shared with counselors about his severe depression was revealed to university administrators without his consent, leading to his suspension and eventual withdrawal.
According to Nott's attorney, Karen Bower, of the Bazelon Center for Mental Health Law, her client's confidentiality and right to remain on campus were protected by the Americans With Disabilities Act, among other federal and state laws. Nott later settled out of court for an undisclosed amount.
In 2006, MIT reached a landmark settlement with the family of Elizabeth Shin, who fatally set fire to herself in her dorm room in 2000. Shin's parents claimed that MIT failed to protect their daughter, who was treated by school counselors consistently for a year for severe depression and suicidal thoughts. The Shins' initial $27.65 million wrongful death lawsuit sent shockwaves throughout college administrative offices nationwide.
Bower said she receives several calls a week from students who have been kicked off campus. The grounds for their involuntary leave range from a bipolar student's minor reaction to the sleep aid Ambien to an immediate dismissal stemming from an instant message containing depressive thoughts.
And the punitive reactions are only getting worse. Eastern Illinois University now uses behavioral contracts to hold students accountable for controlling behavior related to mental illness. In one case, a student with an eating disorder was asked to sign an oath stating that she would "refrain from behaviors that contribute to disordered eating patterns (such as purging, laxatives, etc...)."
At Arizona State University, a committee is considering adding a mandatory mental health screening to the school's application process. Colleges Under Pressure to Bolster Counseling
Colleges and universities are struggling to expand outreach efforts in response to escalating demands from students and parents.
In hopes of amplifying campus mental health awareness, the University of Maryland dangles incentives in the form of for-credit stress and time management courses. Two-thirds of the 4,000-plus American colleges and universities now offer similar classes. At ASU, students are given the choice of individual, couples and group therapy, as well as body image and substance abuse counseling and anonymous online depression screening.
"It's a tragedy that it's taken these violent incidents for the powers that be on campus to say, 'We need to do something about this,'" said Alison Malmon, founder of Active Minds, Inc., a student-led nonprofit mental health advocacy organization with chapters on college campuses across the U.S. and Canada.
Malmon suggests schools step up their mental health services by merging campus counseling centers and campus medical centers, intensifying outreach during mid-terms and finals and streamlining the critical intersection of on- and off-campus mental health resources.
Sadly, Malmon said, none of the upgrades will do any good if students are too afraid and too ashamed to take advantage them.
The Confidentiality Conundrum
Under federal law, schools can legally remove mentally ill students for disruptive conduct (if they would do the same to non-mentally ill students for similar behavior). There is an exception, however: When a student poses an "imminent risk" to himself or others, clinicians are free to share pertinent details with parents, police and administrators without gambling liability.
All too often - and, more frequently, after it's too late -- intricate, intimidating privacy laws are blamed for silencing communication about potentially dangerous students.
"So often people who are confused about the confidentiality laws say, 'We couldn't do anything. We couldn't tell anyone,'" said Bower. "Officials at institutions of higher learning have to stop worrying so much about liability. They should simply do the right thing."
Under the Americans With Disabilities Act, every otherwise qualified student with a disability (mental or physical) has the right to:
- "Reasonable accommodations" and academic adjustments (reduced course load, alternative test formats, etc.), as determined on a case-by-case basis
- File a complaint if appropriate accommodations and support services aren't provided
- Equal access to academic and student services, jobs and facilities
- Appropriate confidentiality regarding information about a mental illness or other disability
Questions parents and students should ask about prospective schools' mental health policies:
- What accommodations are made for students with depression, anxiety, bipolar disorder, eating disorders and other mental health conditions?
- How is the confidentiality of students who seek counseling protected?
- Which mental illness related behaviors could potentially warrant disciplinary actions and/or mandatory leaves of absence?
- Are students who are forced to withdraw eventually allowed to reenroll?
- What evidence, if any, must be provided to satisfy the conditions for reenrollment (written statements from licensed therapists confirming treatment, behavioral contracts, etc.)?
- Is tuition reimbursed for classes/credits missed due to voluntary and involuntary medical and psychological leaves of absence?
- Do students have the right to a hearing and/or the right to appeal mandatory medical and psychological leaves of absence?
- Are "at-risk" students subject to mandatory psychological evaluations?
Mental health resources and advocacy groups students can contact for more information, referrals and legal advice: