Verbum Ultimum: When Leaving Isn't the Answer

by THE DARTMOUTH EDITORIAL BOARD | 10/8/15 8:12pm

In this Homecoming special issue, The Dartmouth examines mental health on campus. The phrase “mental health” has increasingly become a synonym for depression, anxiety and general stress — and we often forget about the host of other mental illnesses and chronic conditions that people face. Despite being less visible, mental well-being goes hand-in-hand with other factors that shape our lives — our sex, gender, race, class and sexual orientation — as well as our pasts, particularly for those who have experienced sexual or other violence.

With this in mind, we have decided to devote our editorial to the question of medical leave — the College’s most notorious institutional policy concerning mental health. The negative impact of mental illness and disability on academics is readily apparent. Medical leave is seen by administrators and students alike as a remedy to such issues when they compromise academic performance. This policy sounds like a common-sense way of helping students recover, but the College does not provide any evidence-based justification or publicize any data regarding how commonplace — or successful — these leaves are. Without any quantitative analysis that demonstrates improved outcomes for students who take medical leave versus those who do not, we must turn a critical eye to the practice.

A compelling downside of medical leave is that it amounts to putting one’s college career on pause — a decision that should not be taken lightly. In the post-graduate world, it is not possible to put life on pause, not even to look after one’s mental health, and doing so can have serious repercussions for one’s professional and personal life. Yet college is supposed to prepare us for success in the adult world. We cannot learn how to do that if there is a blanket prescription of checking out of Hanover to get better, and as a result few chances to learn how to cope with challenges and maximize success in spite of them. Moreover, withdrawing from the College can cause social disruption and alienation from friend support networks. Administrators and students must weigh the benefits of a medical leave against its not insignificant costs.

Certainly, medical leave is warranted in many instances. College is not always the best environment for a speedy recovery. Yet removal from one’s social environment is, likewise, not ideal for all mental health conditions. What troubles us is not the practice of medical leaves in itself, but instead the use of medical leaves as a blanket solution in cases where increased institutional support on campus would suffice. Further, students’ autonomy must always be preserved in the decision-making process — a student should never feel pressure to take a medical leave simply for lack of a better option.

It should be noted that the College is not unique in its medical leave policy, but the ubiquity of mandatory or suggested medical leave alone does not validate the practice. Indeed, medical leave requirements at our peer institutions have attracted student criticism. A Sept. 2010 Brown Daily Herald feature highlighted two students’ frustrations with medical leave and complications gaining readmission to the University, whose protocol is in line with the College’s. In July 2012, the Bazelon Center, a mental disability legal advocacy organization, lodged a complaint on behalf of a student against Princeton University for coerced withdrawal due to mental disability. Following a student suicide, a March 2015 story in The Atlantic documented Yale University students’ concerns about forced withdrawal of mentally ill students resulting from its policies on medical leaves of absence. Cases like these suggest that medical withdrawal policies can end up distressing a student and even impeding treatment or recovery.

We urge the College to review whether its current practices are delivering the best possible outcomes for students. The College has the resources to provide students who wish to treat or recover from a mental health issue with the option of remaining in Hanover and continuing their studies. Compromises like granting more than three two-course terms by special request, or allowing a “Hanover FSP” as a form of medical leave for students receiving treatment who cannot — or perhaps should not — return home, would not require significant investment. Ultimately, medical leave should be treated as a measure of last-resort rather than a go-to option, and, most importantly, the College must inform students and preserve their autonomy throughout the process.