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Marcus was in many ways an ideal patient: he was bright, insightful, motivated, and put into practice what we discussed in session. Throughout his adolescence he was the glue that held his single-parent household together while his mother was at work, and his family was proud of his accomplishments. He fulfilled a lifelong dream by being accepted into a prestigious East Coast school. The first in his family to attend college, he excelled academically but, during his freshman year, began exhibiting signs of the bipolar disorder that ran in his family. The college mental health center recommended that he take a break, so he did, not knowing that he would need their permission to be readmitted.
I began treating Marcus after a colleague left our agency and transferred his case to me, and most of our work together focused on reviewing his coping strategies and identifying the warning signs of a mood episode. I gladly wrote a letter to his college assuring them of his progress and recommended that he be readmitted. I was shocked when he returned from his interviews to tell me that his request had been denied. Visibly disappointed, he told me that the dean had agreed with him that he seemed to be in great shape, but it was a general unwritten policy of the school to make students who had taken a break for mental health reasons sit out for an extra semester just to make sure that they were truly stable.
A confluence of factors make college a time when many students experience the onset or exacerbation of a mental health condition. Some disorders like schizophrenia typically manifest around that time, while others are brought out by multiple coexisting stressors: stringent academic work, lack of familial support, new friendships, serious romantic relationships, and so forth. More than a third of college freshmen worldwide experience a mental health crisis in their freshman year. Yet the policies of colleges and universities often fail to reflect up with this reality.
Marcus’ experience is unfortunately not unique. As Esmé Weijun Wang recounts in her essay “Yale Will Not Save You,” she was asked to leave Yale after being psychiatrically hospitalized in two successive academic years. Her ID was confiscated, leaving her father to pack up her dorm room, and she was told to be at JFK that evening. Someone from Yale even called her father that evening to ensure she was in New York and not in New Haven. Unlike Marcus, she was never readmitted.
It is often the most prestigious schools that do the worst by their students with mental illness. A recent study from the Ruderman Family Foundation graded Ivy League schools on their policies regarding students with mental illness, and the highest score was a D+ (University of Pennsylvania) while Yale and Dartmouth both scored an F. We like to think we’ve moved beyond the antiquated view which equates mental illness with moral failure, yet you would not know it to look at the policies of some of our country’s best schools. With my own patients I’ve found that community colleges are often more understanding and accommodating, most likely because they have more experience in meeting students where they are rather than trying to get them to fulfill predetermined expectations.
Students with mental illness should be accommodated under the Americans with Disabilities Act, but far too many are seen as a liability rather than an asset. College is supposed to be a time when young minds are shaped for the benefit of future generations. We have mountains of qualitative and quantitative data that shows those with mental illness are just as capable of leading meaningful lives as those without. It’s way past time for our colleges and universities to get with the times and do right by all their students.
