Why More Universities Need to Prioritize Mental Health Care

Published: Mar 17, 2023  |  

Clinical psychologist and professor at Yale School of Medicine

Image by Nikki Muller

In Colorado, House Bill 1007 passed in the House and is heading to the Senate. The passing of this bill would add the suicide crisis and national suicide hotline numbers to college student IDs.

At the Colorado State Capitol, student mental health is being prioritized. Universities and elected officials around the U.S. should take note.

Yale’s recent changes in its mental health leave and withdrawal policy is taking a step in the right direction by recognizing the importance of seeing mental health distress as a disability needing accommodations, not as a threat or reason for expulsion. But there is still much work to be done. 

First, college administrations should embrace students who are struggling as valued members of any university community, acknowledging suicidality as one aspect of the continuum of human experience. I know about this firsthand.

A journey through mental health recovery to academic success

I’ve worked as a clinical psychologist at the Yale University School of Medicine for the past 18 years. But the journey toward my PhD was not along a straightforward, easy path. I was at times depressed, suicidal, psychotic, and even was committed to a psychiatric hospital. Taking a year off from graduate studies, I lost 40 pounds, stopped speaking, was heavily medicated and was hospitalized for psychosis. Fortunately, thanks to health insurance through my parents, I accessed private mental health care with a psychiatrist and therapist for weekly visits. My costs were reimbursed at 100% with no session limit.

During my year off, I was able to separate all my treatment from my education and returned to college with no administrator the wiser, never fearing that my depression or thoughts about suicide would affect my college standing. A combination of white privilege, money, insurance and luck shifted my trajectory from potentially becoming a permanent mental patient to a fruitful academic career as a professor in psychiatry.  

Unfortunately, most students wouldn’t have had access to the same resources that enabled me to get the help I needed. Until we have universal healthcare, mental health support options are limited for most, and the majority of college students will rely on services and decisions made by their educational institution. With the huge increase in mental health problems reported by college students, this is a worsening epidemic, especially when considering the lack of capacity at universities to support the number of students in need.

Getting students the mental health support they need

Recovery oriented care is a necessary part of the solution. Recovery in mental health is the idea that people can thrive even while living with what is termed mental illness. Work, school, parenting, and hobbies give people meaning and purpose and aid in the recovery process. As one person put it, “work is my therapy.”

Research has also shown how important peer support (help from others who have similar experiences), supported employment, supported education, and social connections are in facilitating that recovery. We must remember these factors in creating systems and policies not only at our community mental health centers, but also in our colleges and universities.

Making these and other reasonable accommodations, as outlined by the National Council on Disability, can help students stay on campus during times of increased distress. Examples of good practices exist, such as this guide produced by the Boston University Psychiatric Rehabilitation organization in collaboration with The Ruderman Foundation. Additionally, the Substance Use and Mental Health Services Administration (SAMHSA) has a guide for school administrators on how to better support students with psychosis.

Recovery incorporates elements of a disability approach, where those with a psychiatric disability need accommodations when in a job or school setting. The Americans with Disabilities Act addresses this by prohibiting discrimination against people with disabilities, including in educational settings. And on the grassroots level, one website is creating a ratings guide for and by students with disabilities—a kind of Yelp for universities on services for those with disabilities or who identify as neurodivergent.

To lose all valued social roles (student, university community member, pre-med) as a punishment for mental health challenges is the wrong approach. Such roles build a stronger sense of esteem and research confirms that supported education and supported employment have strong outcomes for those with serious mental illnesses.

I’m grateful that I didn’t experience forced withdrawal from school or the hoops erected to re-enroll because of mental health crises. Unfortunately, too many students have not had the same grace extended to them. When university policies prioritize liability concerns, they also miss out on the incredible strengths, talents and gifts that these students bring to campus, because—not in spite—of their mental health experience.

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