Report Card: D- for Cornell’s Mental Health Leave of Absence Policy

In a scathing critique of student mental health at Ivy League schools, a new report gives Cornell University a grade of D- for its mental health leave of absence policy. No Ivy scored higher than a D, and Yale and Dartmouth were assigned F grades.

“The leave of absence policies do not reflect institutional commitment to supporting students with mental health disabilities,” the report said. “When it comes to inclusion of students with mental health disabilities, the Ivy League schools do not provide the leadership that the landscape of higher education desperately needs…The findings demonstrate that the Ivy League schools, the most elite institutions in our nation, are failing to lead the sector of higher education in supporting students with mental health disabilities.”

The Ruderman Family Foundation, a Boston-based organization advocating for and advancing the inclusion of people with disabilities in our society, issued the report in December. The report, “The Ruderman White Paper on Mental Health in the Ivy League,” was authored by Miriam Heyman, a foundation program officer responsible for the development and oversight of disability inclusion programs.

While generally critical of how universities are meeting student mental health challenges, the report focuses on the aspect of leave of absence policies. Noting that a health leave is a potentially useful mechanism enabling a student to focus on well being and recovery, “schools may also use the leave of absence as a tool for discrimination, pushing students out of school who are entitled by law to receive accommodations and supports which would enable them to stay.”

The report claims that college campuses are facing a unique crisis, arguing that the prevalence rates of mental illness among college students are far larger than prevalence rates for age-matched non-college individuals.

The Ruderman report says:

“Meanwhile, college resources provide woefully inadequate support to students. … The scope of the problem, combined with the lack of resources available to address the problem, is exerting a horrible toll. Suicide is among the most tragic consequences of untreated mental illness and it is the second leading cause of death of college students…”

“Clearly, colleges need to invest in increasing the availability of mental health professionals on campus. One clinician for every one thousand students is not enough, and this ratio represents the availability of clinicians on the campuses with the most resources.”

The report speculates that college administrators are wary of bad press coverage about campus suicides, and that their fear of a lawsuit if a student takes their own life motivates them to remove students from campus.

In the study, Ruderman cited “problematic” issues in seven of 15 categories related to Cornell’s leave of absence policy. It said there was “room for improvement” in two other issues, and that the university followed “best practice” in six others.

Here are the 15 categories and Cornell’s scores in them:

PUTTING A STUDENT ON LEAVE

1. Does the involuntary leave policy include “threat to self” language (with the premise that the inclusion of this language is facially discriminatory)?

The policy states, “…whether the student’s behavior is disruptive of the university’s learning environment and whether the behavior poses a direct threat to the safety of others…”

Grade: Best Practice

 
2. Do leave policies specify that the student is entitled to reasonable accommodations which would enable them to stay at school?

The policy states, “Consideration will also be given to accommodations that may reasonably be provided that will mitigate the need for the involuntary leave.” There is no mention of individualized assessment.

Grade: Ambiguous / Room for improvement

 
3. Do leave policies include language against generalization, fear, or stereotype?

There is no language against generalization, fear, or stereotype.

Grade: Problematic

 
4. Is there language about community disruption?

The policy states, “When there is an actual or the threat of a community disruption, Cornell University may place a student on an involuntary leave of absence.”

Grade: Problematic

 
5. Does the policy empower students to work with mental health professionals of their choice?

The student must get approval to take a leave and return from leave from Cornell Health (it can’t be an outside treatment provider). Also, a Cornell Health clinician or counselor will provide “…specific treatment recommendations as part of the HLOA agreement. Compliance with the treatment expectations is a primary factor in approving a student’s return to Cornell.”

Grade: Problematic

 
6. Can the student initiate the process at any time?

There are no health leaves of absence after the last day of classes.

Grade: Problematic

 
7. Are policies and procedures transparent?

All decisions regarding return from an HLOA are made by an interdisciplinary committee of Cornell Health clinicians. Student requests to return are denied only when the committee is unanimous in its opinion that a return is not advisable at this time. The return process checklist also provides transparency. Also, the involuntary leave policy states that involuntary leaves are imposed only “in extraordinary circumstances.”

Grade: Best practice

 
THE LEAVE ITSELF

8. Is there a minimum length of time for the leave?

The policy states, “The duration of the leave is to be determined by the vice president for student and campus life based on the facts and circumstances leading up to the imposition of the involuntary leave…For health leave, amount of time will depend on the circumstances.” The mental health provider report requests information, including “Once achieved, has the substantial reduction [in behaviors such as suicidal behaviors, self injury, food purging] been maintained stably for 3 consecutive months?” This may suggest that three months is the minimum duration.

Grade: Ambiguous / Room for improvement

 
9. Does the school specify a maximum duration or maximum number of leaves?

There is no language about maximum number or duration.

Grade: Best Practice

 
10. Does the policy identify a liaison or contact person at the school?

The policy does not identify a liaison or a contact person.

Grade: Problematic

 
11. Are students on leave prohibited from visiting campus?

The policy states, “The student may visit campus only as authorized in writing by the vice president for student and campus life.” The policy states, “Where appropriate, impose a persona non grata order on a student who has been placed on involuntary leave.”

Grade: Problematic

 
12. Are there work or school requirements?

The policy states, “It is expected that the student uses the time away from the University for treatment and recovery.” The policy states, “Until the student complies with the pre-requisites to enrollment mandated by the vice president for student and campus life. An individualized assessment will be made for the student to determine if the pre-requisites have been satisfied.”

Grade: Best practice

 
RETURNING FROM LEAVE

13. What is the deadline to apply for return?

The student must notify Cornell Health in writing of their wish to return by June 1 for a Fall return and November 1 for a Spring return. Submit documentation by July 1 for fall semester return, by December 1 for spring semester return. The score is based on the documentation deadlines.

Grade: Best Practice

 
14. Does the policy mention confidentiality, and facilitate confidentiality by specifying that medical records should be submitted to health services, not school administration?

Voluntary leave policy states – “December 22, 2017: Added note at end of procedures indicating that requests for health-care related leaves should be referred to Cornell Health to initiate the HLOA [Health Leave of Absence] process, and that academic units should not request health information or medical records directly from a student.” There is no explicit mention of confidentiality.

Grade: Ambiguous / Room for improvement

 
15. Does the policy facilitate student participation in university housing?

The policy does not mention housing.

Grade: Problematic

 
The rating system allotted a score of 1 if problematic, 2 if there was room for improvement, and 3 for best practice.

The Ivy League ratings:

Brown University: 29/45 D

Columbia University: 29/45 D

Cornell University: 28/45 D-

Dartmouth: 23/45 F

Harvard University: 28/45 D-

Princeton University: 29/45 D

University of Pennsylvania: 31/35 D+

Yale University: 24/45 F

A report on Cornell student mental health by the JED Campus program published in April included recommendations on health leave of absences:

“Develop/refine a written medical leave of absence policy that is consistent with JED Campus recommendations.”

“Ensure that all leave policies are transparent and easily accessible to the campus community.”

Cornell responded saying:

“Cornell Health continues to work with all of the academic units at Cornell to make the health leave process as straight forward as possible.

“The university’s Voluntary Leave policy was recently revised in December 2017 to address identified issues.”

In 2017, The Sophie Fund, an Ithaca nonprofit organization advocating for youth mental heath, released a proposal aimed at supporting students taking leaves of absence for mental health reasons from Cornell University, Ithaca College, and Tompkins Cortland Community College.

The proposal calls for an Ithaca community-based program featuring a “leave of absence coach,” a community outreach worker providing practical guidance and moral support for students in transition. It also proposes a website hosting useful information about college leave policies, strategies for fruitful time off from school, local housing options, and employment opportunities. To date, no tangible progress has been made in funding or implementing the proposal.

“Leaves of absence entail an often unexpected, abrupt, and painful loss of a structured environment that includes a support network of friends, professors, university staff, roommates and other fellow students, campus organizations, cultural and athletic facilities, and school medical providers,” the proposal says. “Testimonies from students on mental health leaves of absence relate how it can be a confidence-crushing experience that induces shame and guilt.”

Click here to download a copy of the proposal.

In April 2017 and again in August 2018, The Sophie Fund’s founders, Scott MacLeod and Susan Hack, called on Cornell University President Martha E. Pollack to launch an independent external-led review of student mental health. They said the review should include “Cornell’s policies, programs, and practices for students taking HLOA for mental health reasons.”

In a September 18 email to Cornell students reported by the Cornell Daily Sun, Vice President Ryan Lombardi announced plans for “a comprehensive review of student mental health” that will bring together “internal and external partners.”

In a September 18 email to the Sun, Lombardi said: “While for many years the university has engaged in regular assessment of student mental health needs and evaluation of services and programs, the decision to pursue an additional comprehensive review of student mental health reflects the University’s commitment to promoting health and well-being as a foundation for academic and personal success.”

Spike for Sophie

Cornell University’s Student-Athlete Advisory Committee (SAAC) is holding its annual fundraiser next week featuring a spikeball tournament and a bench press challenge. This year’s theme is mental health and all proceeds will be donated to The Sophie Fund.

47062102_2256667474426766_7830279113561604096_n

The “Spike for Sophie” fundraiser will take place in the Richard Ramin Multipurpose Room of Bartels Hall on December 5 from 2–4:30 p.m. The spikeball tournament is open to the whole campus, a single-elimination event with a $10 per team entry fee. Pick-up spikeball will be available. Teams, which will compete for 1st, 2nd, and 3rd place prizes, can sign up for the tournament at this link.

The event also includes “Bench Press for Sophie,” where Cornell student-athletes and coaches will raise money from their sponsors—family, friends, and professors—by bench pressing as many reps as they can—55 lbs. for women and 95 lbs. for men. The event will take place in the Friedman weight room.

There will be bench press t-shirts, sports massages ($1/minute up to 10 minutes), free food, and mental health information tables. Public Health Fellow and former Cornell football student-athlete Baba Adejuyigbe will staff the Cornell Health table. It will focus on educating students on the various mental health support services on Cornell’s campus in addition to counseling, with an emphasis on the new resources available to student-athletes. Representatives from The Sophie Fund will also host a table with information about the organization and to answer questions from students.

SAAC is the voice of student-athletes on the Cornell campus, and strives to promote a positive student-athlete experience through providing feedback to conference and national legislation on campus issues, organizing community service events, and acting as a communication line between student-athletes and campus administrators.

The NCAA Division 1 SAAC as a whole has put a focus on mental health awareness in athletics this year, so our SAAC here at Cornell took it upon ourselves to raise awareness and address the mental health issues on our campus. We believe mental health is a big and unaddressed issue in the student-athlete community at Cornell and we are committed to changing this culture.

Student-athletes face all the struggles of a normal student at Cornell, in addition to the time restraints of practices and workouts. Although student-athletes have superior time management skills, it is very common to feel extremely overwhelmed. Additionally, we constantly deal with the pressures of performance on a daily basis, which can take a toll on the mind.

National surveys show that more than 30 percent of student-athletes have experienced overwhelming anxiety. And 30 percent of college students reported feeling so down at some point during the previous year that it was difficult to function. A lot of student-athletes feel the pressure to be perfect all of the time, and the false perception equating mental toughness to mental health creates a negative stigma and culture where student-athletes are less likely to seek help. Student-athletes also deal with injuries, which can lead to a recovery process that is extremely taxing mentally. While being an athlete is not our sole purpose in life, it is still a huge part of our identity. Injuries can take this away from athletes, being unable to train with your team or compete in the sport you have dedicated so much of your life toward.

One in four college students has a diagnosable mental illness. Student-athletes in particular have reported 2 percent higher rates of stress than non-student-athletes. Mental health is a key component of athletic performance. As student-athletes, it is important to understand that mental toughness and mental health are separate ideals. Seeking resources is an act of strength, not a sign of weakness. With everyone’s help, we can decrease stigma around mental health and bring resources to create a culture of acceptance.

This is the message we strive to send with our #DontBearItAlone campaign. We were inspired by mental health initiatives such as #damworthit and #powe6fulminds launched at schools and Division 1 conferences around the country. Our #DontBearItAlone campaign aims to raise awareness and continue the conversation around mental health support on Cornell’s campus, with an emphasis on the unique struggles and support needed for the athletic community. This fall, we started hosting mental health awareness games through #DontBearItAlone in which athletes wear green attire such as shoelaces or ribbons in support of mental health. These games also have tables to give out mental health information, and educate students and other audience members on where to find support on campus.

SAAC’s mental health effort is in conjunction with all of the work that Cornell Minds Matter (CMM) and other campus organizations have been doing for years. They work closely with administration, faculty, staff, and students to help decrease the stigma surrounding mental health, increase awareness of this important public health problem, and improve existing frameworks surrounding support systems. SAAC focuses on raising awareness within the athletic community in particular, but we work together with other student organizations on campus to make our voice and our efforts stronger. “Spike For Sophie” is co-sponsored by CMM, the Spikeball Club, Athlete Ally (LGBTQ+ inclusion in sports), and the Red Key Athlete Honors Society.

—By Morgan Chall and Jenna Phelps

Morgan Chall ’19, a varsity gymnast, is co-president of Cornell University’s Student-Athlete Advisory Committee (SAAC) and the NCAA Ivy League SAAC Representative. She is a student in Global and Public Health Sciences. 

Jenna Phelps ’20, a volleyball middle blocker, is the SAAC public relations chair. She is a student in applied economics and management.

Follow Cornell SAAC on Twitter: @cornellsaac

Follow Cornell SAAC on Facebook: @bigredSAAC

Follow Cornell SAAC on Instagram: @cornell_saac