Feeling Suicidal, Students Turned to Their College. They Were Told to Go Home.
When Harrison Fowler heard about the counseling center at Stanford, where he enrolled as a freshman last fall, he decided to finally do something about the angst he had been struggling with for a long time.
The results were not what he had expected. Asked if he had ever considered suicide, he said yes. The center advised him to check himself into the hospital. From there, he was sent to a private outpatient treatment center, where he was prescribed an antidepressant that he said triggered horrible suicidal fantasies. It wasn’t long before he was back in the hospital, being urged to go home to Texas.
“No, I can’t go home,” Mr. Fowler, 19, recalled saying. “This is partly y’all’s fault for putting me on medication. I reached out for help and now I’m suddenly getting blamed for it.”
Mr. Fowler ended up having to take a year off. He is now part of a class-action lawsuit accusing the university of discriminating against students with mental health issues by coercing them into taking leaves of absence, rather than trying to meet their needs on campus.
Stanford says it has behaved properly. But the case lays bare the conundrum universities face — amid a national epidemic of students dealing with depression, anxiety and suicidal thoughts — in responding to a broad array of mental health issues on campus. Some accuse colleges of being too detached, waiting too long to notify parents when students are in trouble, if they notify them at all. Others say schools are too quick to cast off students to avoid lawsuits and bad publicity.
“Only half of college students experiencing a mental health crisis seek help, largely due to the justified fear of stigma and negative consequences,” the court papers say. “Too often, universities respond to disability-related behavior with exclusion, blame and draconian measures such as a forced leave of absence.”
The suit is the latest in a series of challenges to mental health leave policies, at schools like Princeton, Hunter College, Western Michigan University, George Washington University, Marist and Quinnipiac.
Stanford’s website says that a leave may be encouraged or required for a student whose psychiatric, psychological or medical condition “jeopardizes the life or safety of self or others, or whose actions significantly disrupt the activities of the university community.”
The cases described in the court papers include a student who had an anxiety attack, one who was harming herself, and others who had thoughts of suicide or tried to kill themselves. Legal experts say that under federal regulations, it is clear that students can be barred from campus if they pose a threat to others, but less clear if they pose a threat only to themselves.
“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.
But staying on campus, where social and academic pressures can be grueling, has its own risks for students in distress.
In a statement, Stanford said that it “cares deeply” about its students, and that “in extraordinary circumstances, it may be in the best interest of the student and the community that he or she leave campus for a time.”
It said it could not comment on the individual cases without breaching confidentiality. But it denied that it forced students to take leaves.
Dr. Victor Schwartz, a psychiatrist and chief medical officer of the Jed Foundation, a suicide prevention group, said the leaves can serve a good purpose. “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,” he said.
Some students say leaves have been good for them.
A stress fracture ended Rebecca Minsley’s dream of becoming a ballet dancer, and she was depressed when she arrived at Bates College in 2014, she said. She swallowed a handful of pills but quickly sought help at the campus health center, which wanted her to leave, she said. Her mother and a dean successfully fought for her to stay, arguing that she would just become more depressed at home. By her second semester, she stopped getting out of bed and going to class. When she was asked once again to take a leave, she agreed.
Back in her mother’s New York City apartment, she spent months in bed, feeling like a failure. Eventually, with the right medication, she was able to hold down a job and move into her own apartment.
Ms. Minsley, 23, returned to Bates last fall, after more than two years away, and has been receiving support from Fountain House College Re-Entry, a program that has sprung up to fill the niche of helping students on mental health leave. “It was terrifying and really, really difficult, but I really needed it,” she said of her leave. “I think I’m leading a much happier life.”
A spokeswoman for Bates, Marjorie Hall, said the college gave every case “individualized consideration.”
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. Ms. Trumbly found a job teaching science in an after-school program. She became a mental health activist, and graduated from Stanford last year, one year late, with a degree in psychology. Now she teaches at a private school. “So far, so good,” she said.
Her friends and her parents were supportive, and looking back, she thinks she could have stayed in school if Stanford had been more flexible. “I just wish I could have done it on my own terms,” she said.
It is clearly worth setting back someone’s academic career by a year or two if that will keep them alive, advocates say. But they argue that universities, fearing lawsuits, too often have a blanket policy of making students with mental health issues take a leave, when federal disability law requires them to decide each case individually.
“It’s a horrible practice because it discourages students from getting the help they need,” said Ms. Bower, the lawyer.
Advocates note that it would be impractical to kick out everyone who has a suicidal thought. “At any given moment in a college classroom, there will be between 5 and 10 percent of students who’ve had a suicidal thought in the previous, let’s say, two to three weeks,” said Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention.
Stanford denied claims in the lawsuit that it had a blanket policy of barring students who have been hospitalized from returning to campus.
The question of how responsible universities are for the well-being of their students has become more urgent, as schools face a rising number of students with mental health issues. Many college administrators say that medication and therapy have allowed more students with these issues to enter college in recent years.
Mr. Fowler feels betrayed by a university he trusted. He went to the campus counseling center his freshman year as part of a self-improvement plan, he said.
“I wanted some help for once,” he said. “I thought it was going to be completely positive and beneficial.”
Asked a series of questions at the center, he admitted having suicidal thoughts and agreed to go to the hospital “to be safe,” he said. Then he agreed to go to a private outpatient treatment facility, and ran the two or three miles each way, he said, because “I didn’t have money to get an Uber.”
He believes that the antidepressant the outpatient center prescribed him was the cause of the worst thoughts of suicide he had ever had. He confided in a resident assistant, who called the counseling center, saying it was protocol. When Mr. Fowler refused to go to the hospital again, the police were called, and he was taken there in handcuffs.
A dean came to visit; Mr. Fowler had met him before, during the first hospitalization, and their exchange was “very friendly, two black men talking,” he said. This time Mr. Fowler was stunned when the dean told him he would probably have to take a year off. He signed a form agreeing to a leave of absence, he said, because he believed it was the only way the hospital would let him out. “It was almost like a plea deal for like a prison.”
Stanford said in court papers that Mr. Fowler’s leave was voluntary.
Students placed on leave received letters from the dean of students. Mr. Fowler’s said that the student residence staff had found him “disconnected” from other students, and that in October, “it was determined that you had possession of a knife and you stated the intention to take your own life.”
“Being from Texas, Harrison carried the knife out of habit,” Monica Porter, a lawyer for the plaintiffs, said.
In November, according to the letter to Mr. Fowler, he had told a friend that he planned to kill himself by overdosing on Tylenol.
He was not allowed to return to his dormitory from the hospital, he said, so his mother packed his things. Being home in Beaumont, Tex., has been “suffocating,” he said. He misses Palo Alto. In Beaumont, “people look at me crazy and call me racial slurs if I’m going on runs,” he said.
He is going back to Stanford in the fall, but he is still angry. When he learned that a legal center called Disability Rights Advocates was suing Stanford over its leave policy, he asked to join. He signed on, he said, because “I don’t want people to be scared to reach out for help.”
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.
Alain Delaquérière and Susan Beachy contributed research.