Medical leave policies for mental health criticized at Duke and peer schools

A number of college students suffering from mental illnesses have spoken out against their respective schools’ medical leave policies recently—including some at Duke.

A 2013 survey conducted by the American College Health Association found that more than 30 percent of college students reported feeling depressed and unable to function, 80 percent felt exhausted from causes other than physical activity and more than 50 percent felt overwhelming anxiety in the past 12 months. These statistics coincide with critiques of various college administrations’ policies towards mentally ill students, Duke’s included.

“Universities approach the question of medical leave in different ways,” said Ira Burnim, legal director of the Judge David L. Bazelon Center for Mental Health Law. “Some are very supportive of students with mental health issues, and others act very reflexively.”

Students on medical leave wishing to return to Duke must complete their two semesters of leave before becoming eligible to submit a readmission application. This includes a $30 application fee, personal statements of how time on leave was spent, details on medical treatments and recommendation letters from supervisors and healthcare providers. Decisions are made by a committee that consists of an academic dean, the director of the office of student returns and other chosen representatives from Duke health units or the Academic Resource Center, according to the listed policy.

The Office of Student Returns did not respond to multiple telephone and email requests seeking comment.

Sophomore Danica Liu—who has taken two medical leaves for mental illness— recently authored a piece on the blog Develle Dish, which is run by the Duke Women’s Center, about her experience with the process and advocated for a change in the University’s current mental illness policy to make it more adaptive to different students.

“I think that right now what they can do is make it so that it’s not a uniform policy,” Liu said in an interview with The Chronicle. “It doesn’t make sense to say medical leave—what is medical? How do you describe a problem as being medical as opposed to psychological?”

In her piece in Develle Dish, Liu wrote that the Duke policy of having to submit certain pieces of medical information is a breach of personal privacy during the readmission process.

Jeff Kulley, associate director for clinical services at Duke’s Counseling and Psychological Services, said students considering taking a medical leave of absence release clinical assessments to their deans but emphasized that specific details about the contents of CAPS counseling sessions remain private.

“It’s important to clarify that this is a summary document describing the form of therapy, the frequency and duration of appointments and overall progress towards goals,” Kulley wrote in an email. “In other words, mental health providers do not disclose specific details about what students revealed in counseling sessions because professional standards emphasize respect for privacy.”

The review process for students returning from medical leave is based on the circumstances under which students left campus, according to the Office of Student Returns’ website. The committee, however, maintains its right to ask for more documentation if there are inconsistencies or lack of clarity in the documents provided.

Freshman Hannah Moyles, who has been advocating for the initiation of a chapter of the National Alliance for Mental Health on campus and says she is herself afflicted with mental illness, also criticized Duke’s policy towards campus visitation while on leave. Both personal and medical leaves cut off access to housing, student activities and visits to campus for the duration of a student’s withdrawal from the University.

“You can’t take part in any student activities, and I feel like for a lot of students that is not going to be really good for them, to be isolated from their friends,” Moyles said.

Moyles additionally expressed concern that the current procedure for readmission might be deterring students from seeking help for mental illness.

Similar concerns have been raised at several peer schools.

“The school has to make an individualized determination based on the best available evidence, including the best available medical evidence,” Burnim said. “Some schools do that—they look at the case, try to learn and engage with students and family.”

The Bazelon Center helped a Princeton student file a lawsuit against the university in 2012 on claims that he was coerced to withdraw from the school after attempting to commit suicide in his dorm room. Princeton’s alleged efforts to remove the student from its campus violated the Americans with Disabilities Act as it pertains to continued education, Burnim added.

“The law is pretty clear—the law being the Americans with Disabilities Act—that if someone has a mental health condition, then they are allowed to continue in school as a student, if they meet the academic and behavioral requirements of the school,” he said.

Princeton’s current policy states that a student will be placed on involuntary leave if they are shown to present harm to themselves or others or are “unable or unwilling to carry out substantial self-care obligations.”

Yale junior Frances Chan wrote a piece for The Huffington Post last month, saying that she was told she would have to be put on medical leave if she did not attend weekly weigh-ins to monitor her low body mass index, despite claiming that her low weight was genetic and she did not have any eating disorders.

Yale College states in its academic regulations that it “reserves the right to require a student to withdraw for medical reasons” if a medical problem is deemed serious or a student becomes a danger to themselves or others as determined by the dean of the college, the director of Yale health or the chief of the mental health and counseling department.

A USA Today article presented a similar case at Brown University last year, when student Okezie Nwoka was rejected from readmission after a semester of leave on the grounds that he had not completed the mandated two semesters away from campus before returning to the university.

The two-semester minimum for medical leave is also mandated by Duke and Princeton.

“I think students are really come out as mentally ill because they’re terrified of the consequences,” Moyles said. “A lot of times, they just end up having to suffer in silence rather than getting the treatment they need.”


Share and discuss “Medical leave policies for mental health criticized at Duke and peer schools” on social media.