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The New College Dropout

Colleges are shipping depressed students home. Campuses are opting for medical leave rather than treatment.

While most college freshmen spent May of 2005 cramming for exams, Sue Schaller spent it as a cashier at a women's clothing store near her hometown of Arlington, Virginia.

That previous fall, Schaller had been at New York University, earning A's and B's, when administrators told her to take a leave of absence. She had confided to a counselor that she felt depressed and, at times, suicidal. She was briefly hospitalized. Although Schaller was soon feeling better and her doctor even requested that she be allowed to stay, officials wouldn't budge. "I told the administrators that I wanted to be at NYU," Schaller says. "I loved my classes and my life at school."

Whether to force troubled students off campus is a quandary more colleges are struggling to handle, as the rate of serious emotional issues rises among college students. By many measures, psychological distress—including anxiety, depression, substance abuse and self-harm—is up dramatically among undergraduates. In a survey, more than 90 percent of college counseling centers reported seeing more students with serious mental health problems than in years past. Colleges face the difficult task of balancing the needs of distressed students with the responsibility to provide a safe learning environment for all.

But there's an elephant in the room: the threat of lawsuits. For New York University, it's a very big elephant. In the last 18 months, six NYU students have jumped to their deaths, although the school acknowledges only four as suicides. When Elizabeth Shin, a student at M.I.T., committed suicide in 2000, her family sued the university for $27 million, alleging the school failed to provide adequate care. Her family lost the case.

NYU's tactic may represent a new direction in campus mental health care. At Cornell University in New York, administrators say that forced medical leave is rare. However, that may be because students are given a "choice" by the school: six months of voluntary leave or 12 months of involuntary leave.

For some students, leaving campus can also mean leaving high-quality mental health care and university hospitals, which are traditionally key to helping troubled students get back on their feet. NYU spokesman John Beckman says the university considers whether students will be in therapy when making medical leave decisions.

Schaller says no one at NYU ever asked if she would be in counseling, or even if she had insurance to cover it. And, she says, the university hasn't contacted her since. Her parents' insurance plan has covered her therapy.

Some students say they might fare worse if kicked out of school. Harvard College senior Kristin Waller, who has dealt with depression since age 14, says she considers herself lucky that the university has not required her to take time off because she couldn't afford therapy and medication on her own. Throughout middle school and high school, her family was on welfare. At times, Waller says, she's felt "miserable" and suicidal in college, but she is now doing better.

Maggie Olona, director of the student counseling service at Texas A&M University, admits that college administrators know families aren't always supportive, either financially or emotionally. But that doesn't mean colleges must fill the void. "Even if home is not a supportive place, it's the responsible place," she says. Of the one or two Texas A&M students placed on leave each year, most return to school within 12 months and are more successful than before, Olona says. Administrators at NYU and other universities echo these sentiments. Colleges usually require a physician or therapist to certify a student for return.

Some colleges have another strategy: The University of Illinois at Urbana-Champaign mandates counseling for suicidal students. Student must attend four therapy sessions following a suicide threat or attempt. Paul Joffe, director of the suicide prevention program, says the university's suicide rate has been cut in half since the program began in the 1980s. Of the 2,000 students who have gone through the sessions, only one has been asked to take leave. The student returned and graduated.