Students deemed too risky for campus are put on medical leave that can end up being permanent. How can schools balance students' rights with campus safety concerns?

Denis Jr. Tangney / Getty Images Brown University

Early in the morning on Oct. 10, 2014, Dave woke up to the Northwestern University campus police knocking on his dorm room door. They were there to tell Dave, a visiting student at the school, that he had received an urgent no-contact order. But it wasn’t from a person. It was from the Ivy League university that Dave had been trying desperately to return to after a forced medical leave.

The police read the letter aloud, which was signed by Brown’s chief of police, in earshot of Dave’s curious floormates. “Effective immediately, you are prohibited from contacting anyone from Brown University, either by email or phone calls,” it said. From now on, Dave was allowed to contact Brown, where he was technically still a student, only by hard-copy correspondence. Dave was also forbidden from entering any property owned by Brown. For Dave, the letter, which Brown sent directly to Northwestern administrators and campus police, was the humiliating culmination of nearly two years of acrimonious back-and-forth between him and his onetime dream school. Dave is one of many college students across the country who say their schools forced them to go on medical leave, then made it next to impossible for them to return. The Department of Education’s Office for Civil Rights won’t disclose how many students with mental disabilities submit complaints, but students across the country have also filed lawsuits and written campus newspaper op-eds on the topic, and lawyers who specialize in higher-education disability discrimination cases say they regularly get calls from students who find themselves pushed out of school, without clear guidance on how they can try to get back in. The emotional health of incoming college freshmen is at its lowest point in at least three decades, according to the annual American Freshman Survey. More than 30 percent of students say they have felt so depressed in the past year “that it was difficult to function,” according to the American College Health Association, and more than half have felt “overwhelming anxiety.” Suicide is the second-leading cause of death among college-age students. No school wants a suicide — or, even worse, another Virginia Tech — on its campus. But those types of tragedies are rare, and under federal civil rights laws, schools can only remove a student with mental health issues from school if they pose a direct, significant threat to others that can’t be eliminated by additional supports and services. Several decisions from the Office for Civil Rights have found that schools must be clear about what’s expected from students who want to reapply, and that schools must explain their reasoning if they tell them they’re not ready. Brown would not comment specifically on Dave’s case, citing privacy laws, but internal emails between administrators obtained by BuzzFeed News shed light on the highly confidential process that plays out at elite schools across the country that struggle to balance student rights with liability concerns and campus safety. In March 2013, Brown put Dave on medical leave following a tumultuous first semester as a transfer student that ended in a suicide attempt. In the year that followed, Dave applied himself to his rehabilitation with the same work ethic it took him to get into a top-ranked college. He started intensive therapy, went on antidepressants, quit drinking and doing drugs, aced the classes he took at UC Berkeley and Northwestern as a visiting student, and even started his own successful nonprofit. But Brown denied his readmission requests five times, telling Dave he still lacked the “insight” he needed to return to campus. The more vague administrators were about what it would take for Dave to come back, the more frustrated Dave became. As they grew less responsive, Dave grew increasingly persistent. And that’s when the situation escalated. Last month, the Department of Education’s Office for Civil Rights opened an investigation into whether Brown discriminated against Dave by repeatedly denying him readmission. The department is also looking into Dave’s claim that Brown retaliated against him by closing down his university email account after Dave continued to email administrators, asking them for more information on how he could return to campus. Did Brown truly have reason to believe Dave posed a substantial threat to others on campus? Or did university administrators do what was easiest for them at the expense of what was best for Dave?

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Dave, who is referred to here by his nickname to protect his privacy, was raised in the Bay Area to what he called “stereotypical first-generation parents.” Dave started studying for his SATs when he was in the sixth grade. His parents sent him to a competitive private high school and put immense pressure on him to get into an Ivy League university, and he did: Columbia University in New York. But Dave lasted there only a year: He said he had problems within his social group after he testified in a contentious campus sexual assault disciplinary hearing on behalf of a friend. The experience left Dave depressed and anxious, but still determined to graduate from an elite school. He took a year off, then enrolled at Brown for the January 2013 spring semester.

Dave’s grades at Brown were excellent, as always, but he grew even more depressed and anxious. In March, his suitemate complained to the Office of Student Life that Dave drank, smoked marijuana, and fought with his ex-girlfriend from Columbia, who had been staying with him for a few weeks. The Department of Campus Safety visited his dorm twice in two weeks, once to break up a drunken fight between Dave and his ex, and once because Dave passed out in front of his door. Administrators reached out to Dave to offer support and discuss their concerns. In internal emails, they wrote to each other that Dave’s behavior and language in meetings and emails was troubling. “It seems Dave will need to be kept on [The Office of Student Life’s] radar,” one dean wrote on March 18. “If you think intervention is necessary, please advise.” Two days later, Dave posted a Facebook status saying he had been clinically depressed for over five years and planned to kill himself. A friend called campus police, who found him sitting at his computer, crying next to a half-full bottle of vodka. They took him to the hospital. A few days later, Maria Suarez, the associate dean of student life, wrote an email to his father confirming that Dave had been placed on a medical leave of absence for the semester. When Dave got out of the hospital, he would not be permitted on Brown property without her authorization. “These have been dark days for Dave and your family but I am confident that with the right treatment Dave will persevere,” Suarez wrote. The medical leave was involuntary, but Dave soon realized it was for the best, he said. He stopped drinking and using drugs, started seeing a psychiatrist two to three times a week, went on antidepressants, and began meditating and exercising. He took courses at UC Berkeley and ended his relationship for good. Six months later, Dave submitted a request to return to Brown in January 2014, outlining the changes he had made and submitting a statement of support from his psychiatrist. It was denied, as was his appeal. Brown needed to see a longer period of sustained stability, Suarez said, and encouraged him to write about his insight into his struggles with substance abuse. Dave took this to heart when he submitted his next request in April, now over a year after his suicide attempt. He wrote that he had continued to see his psychiatrist two to three times a week, was taking organic chemistry classes, was working as a private tutor, and had founded a successful nonprofit company. He went into detail about some of the skills and shifts in attitude he had learned, and said he planned on scheduling twice-weekly psychotherapy sessions while at Brown. He included a lengthy letter from his psychiatrist stating that “any further extension of his leave would be counter-productive towards his well-being.” His psychiatrist said that Dave was committed to sobriety and had not had any depressive episodes in the year since he had returned home. Although schools are allowed to deny readmission to students who go on medical leave if they pose a “direct threat,” a student who wants to return to school after taking a medical leave for mental health issues “should not be subjected to more rigorous standards or procedures” than a student who went on leave beacause of a physical condition, says the Bazelon Center for Mental Health Law’s “Know Your Rights” guide, which notes that an opinion from the student’s mental health professional should usually be sufficient. “Keep in mind that a school cannot require that a mental illness be cured or that disability-related behavior not recur” unless it creates a direct, irreducible threat, it says. On June 2, Brown denied Dave readmission again. The committee was concerned about his “lack of insight” concerning the health and behaviors that resulted in his medical leave, Suarez wrote. “When you next apply, it is imperative that you speak to your impulsive, risk-taking behaviors and subsequent disruption to our community during your brief time on campus,” she said. When Dave asked for more information, she clarified: “Specifically, your multiple suicidal gestures, your questionable boundaries, your aggression, and disruption to the community. The criteria for readmission is as nuanced and multi-faceted as all of the issues and circumstances that led to your medical leave.” Dave tried his best to do so in an appeal. It was unsuccessful. “As you know, campus life can be stressful and demanding,” Suarez wrote. “We need to be confident that when you find yourself misunderstood, disgruntled and/or upset you will not lash out in a manner that can result in serious harm to yourself, community disruption or violation of the student code of conduct.” Schools can face legal consequences if they remove students with mental health issues. Earlier this year, Quinnipiac University in Connecticut settled with a student who they had placed on mandatory medical leave after she was treated for depression. The decision sent a message to schools to avoid knee-jerk reactions and rigid, blanket policies, legal experts told Inside Higher Ed.

But schools have to balance potential legal action with whether the student’s return would be in his or her best interest, not just the university’s, said Peter Lake, a law professor and higher-education consultant. “Schools have to consider whether they have the right resources to help the returning student be safe, healthy, and succeed academically,” he said. “And, of course, they have to consider whether they would be a risk to others.” The larger question, Lake said, is what to do with students who might always struggle to fit in at elite institutions, who he called the “academic homeless.” Civil rights laws and cultural destigmatization of mental health issues have made it possible for more students to attend top universities, he said. But even so, we have to “come to grips with the fact that there are just some people who aren't best suited for the environment,” he said. "It’s not good for them, it’s not good for us,and it’s maybe even dangerous.” A spokesperson for Brown said the school was committing fully with the Office for Civil Rights' inquiry. “Brown is like other colleges in balancing multiple needs when supporting students with mental health issues,” she said. “This includes a commitment to ensuring that all students can pursue their academic and social pursuits in a safe environment, as well as thoughtful consideration of what is in the longterm best interest of the individual students confronting mental health issues. We take the interests of the entire Brown community into consideration.” Dave isn’t the first student to criticize Brown’s medical leave policy. Students have complained about how hard it is to return to Brown’s campus in multiple campus newspaper articles, and it has even attracted national coverage. Dave’s attorney, Karen Bower, said the problem isn’t specific to Brown, but that Dave’s case, and the school’s policies, seemed particularly vague, as well as “harsh and punitive.” She pointed to Brown’s new policy, which requires students on medical leave to submit their return applications six months in advance instead of what used to be three, as a further attempt to impede students with mental health issues from returning to campus. “Schools have to realize that the person on leave is still their student, and that they have an obligation to help them return to school and succeed,” she said. “Too often, it seems that schools are looking for these students to be completely cured and super healthy, a standard they don’t apply to other students.” There are consequences to keeping a student on extended leave, she said: Student loans can accrue, the university can cut off health insurance, and students lose their on-campus support network. The process is also often unclear and anxiety-inducing, she said, especially for students that have worked so hard to get to where they are. “Once a student is on leave, they are very closely scrutinized and their behaviors and words, including normal expressions of frustration with the readmission process, are pathologized. The students are treated as if they have an anger problem or personality disorder,” she said. “It’s not surprising that they might be frustrated and act out when they are trying their hardest to come back.”

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