Yale’s Mental Health Policies Under Fire

[TW: suicide] The Washington Post on November 11 published an investigative report detailing how Yale University’s mental health services, policies, and practices fail to adequately support students, and even intimidate some from seeking help they need for fear of being forced to withdraw from the school.

Yale University campus, New Haven, Connecticut

The headline on the Post article was “‘What if Yale finds out?’: Suicidal students are pressured to withdraw from Yale, then have to apply to get back into the university.”

The article cited interviews with more than 25 students who “described a university flush with money, yet beset by inadequate services and policies that often fail students in crisis.”  Yale’s endowment, the Post said, is worth $41.4 billion.

The article said some students told of never hearing back from Yale mental health counselors after seeking help. Others said that the short counseling appointments they received were not helpful and even “made things worse” by not providing enough space to work through problems.

Some students reported that they hide mental problems and suicidal thoughts to avoid triggering withdrawal policies “they believe are designed to protect Yale from lawsuits and damage to its reputation.”

The Post report described how students pressured or forced on medical withdrawals were barred from classes, gyms, libraries, extracurricular activities, and even setting foot on campus; for some, that meant losing routines, research, and connections with friends and mentors, things that provided purpose, identity, and support when students needed it most. Additional student worries included losing medical insurance and the potential impact a mental health withdrawal could have on their future applications for post-graduate study.

The article described a variety of daunting requirements that students on a mental health withdrawals must fulfill to be reinstated at Yale: submitting an essay, providing letters of recommendation, interviewing with Yale officials, taking two courses at another university during their withdrawal; proving that they had been “constructively occupied,” and demonstrating that they had “addressed their problems.”

The Post reported how some students forced to withdraw from a prestigious university they were so proud to attend experienced feelings of anger, failure, frustration, being broken and dehumanized. “They make you feel like you’re the best of the best, like this bright and shiny thing,” one student told the Post. “But as soon as something’s wrong, they want nothing to do with you.”

The article quoted an alum on how her withdrawal two decades ago still haunts her. “It’s the betrayal you feel, the violation,” she said. “Realizing how unimportant you are to this institution that you had such high hopes for. The trauma of how they treated me has outlasted many other issues I had.”

Students interviewed by the Post described being pressured to withdraw from Yale immediately after being hospitalized for a mental health crisis. In one case, a student was transported to a hospital after university officials learned that she was cutting, which the Mayo Clinic terms “non-suicidal self-injury… to cope with emotional pain, sadness, anger and stress.” At the hospital, they forced her to withdraw and return home. Seven months later, she attempted suicide while applying for reinstatement to Yale. She wound up applying to and attending Northwestern University.

Another in an occasional series of articles about student mental health. For more information, go to The Sophie Fund’s Student Mental Health Page

The Post related the story of Rachael Shaw-Rosenbaum, who died by suicide during her first year at Yale in March 2021. According to the article, her family said that she took her own life after contemplating the consequences of withdrawing from the school. The Post said that two days before her act she had written on Reddit of her worry of being forced to withdraw from Yale if she sought treatment for suicidal thoughts she was experiencing.

The Post cited rights advocates who argue that “many schools have hustled those students off campus instead of treating them as people with disabilities who are entitled to special accommodations to remain.” The article said critics claim that Yale has been slower than some elite universities to accommodate students who don’t want to leave.

The Post article referenced a 2018 study by The Ruderman Family Foundation that gave Yale an F grade for its withdrawal policies. The Post also noted that Yale is one of only two Ivy League schools that have not joined a four-year program at The Jed Foundation to improve campus mental health policies.

Yale officials responded harshly to the Post article, saying that student well-being is their primary focus, that virtually all students who request returns to campus after a medical withdrawal are readmitted, that Yale continues to expand its mental health services, and that the Post article perpetuates a stigma about taking mental health withdrawals.

“Addressing students’ mental health is a complex and nuanced endeavor, which this article ignored,” Paul Hoffman, director of Mental Health & Counseling for Yale Health, and Pericles Lewis, dean of Yale College, wrote in a letter to the newspaper published November 15. “The article could put more students at risk in its misguided focus on continuous enrollment rather than considering the value of taking time necessary for mental health care.”

On November 16, Yale President Peter Salovey said in a statement to Yale alumni and friends that the Post article “fails to acknowledge the support, processes, and policies in place or the positive outcomes associated with our work.”

He said that Yale students utilized approximately 55,000 mental health visits in 2022, and that Yale’s counseling center provided treatment to more than 5,000 students. He noted the “surge” in demand for mental health services across the nation, and that Yale responded by reviewing its policies, loosening its reinstatement policy, and adding new counseling services.

“I found the Washington Post article deeply disturbing for the misinformation it contains about Yale and for the harm it can do to students by perpetuating the damaging narrative that it is more important to stay in college than to take time to heal,” Salovey wrote. He did not provide any examples to support his allegation that the Post article contained falsehoods or inaccuracies.

“As a clinical psychologist and faculty member who has worked alongside mental health and student affairs colleagues at Yale for four decades, I am disappointed that the Post article misrepresents our efforts and unwavering commitment to supporting our students, whose well-being and success are our primary focus.”

While touting Yale’s concern for students and policies and services to support them, neither of the university’s statements acknowledged or responded to the criticism, frustration, anxiety, and anger broadly voiced by students in the Post story about policies that fail to support students and inadequate mental health services. The letter to the Post noted that confidentiality prevents Yale from commenting on specific student cases.

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.

28th Annual Tompkins County Mental Health Conference

Scott MacLeod, co-founder of The Sophie Fund, was the keynote speaker at the 28th Annual Tompkins County Mental Health Conference on November 18 with a presentation titled “Zero Suicide Model in Tompkins County.”

The conference featured presentations on the new national 988 Suicide and Crisis Lifeline system and a panel on community mental health resources. Teressa Sivers of the Finger Lakes Independence Center chaired the steering committee that organized this year’s conference.

MacLeod began his talk by describing how he and his wife Susan Hack established The Sophie Fund in 2016 immediately after the suicide death of their daughter Sophie, a Cornell University art student. He explained that they were motivated by “a determination to prevent further young people in the Ithaca community from dying by suicide.”

He outlined The Sophie Fund’s areas of work, including raising awareness, facilitating mental health training and programming, and mental health policy advocacy. He said that the nonprofit had distributed more than $35,000 in grants for training and programming through a donor-advised fund at the Community Foundation of Tompkins County.

MacLeod described what he called a “mental health crisis” in the United States, citing data that 51.5 million American adults, and 7.7 million young people aged 6-17, had experienced mental illness in 2019. He said that the Centers for Disease Control and Prevention reported a 35.2 percent increase in the national suicide rate between 1999 and 2018.

The mental health crisis is notable among college students, MacLeod said, with nearly half participating in a 2019 survey reporting that academics had been “traumatic or very difficult to handle” and 19.8 percent feeling “so depressed that it was difficult to function” at some point in the previous 12 months. Another survey indicated that 36.9 percent of students seeking counseling in 2019-2020 had made a suicide attempt, he said.

MacLeod said that The Sophie Fund launched a “Zero Suicide Initiative” in 2017 with a presentation for Tompkins County’s top healthcare leaders by Michael Hogan, a co-developer of the Zero Suicide Model, and Sigrid Pechenik, the then-associate director of the New York State Suicide Prevention Office. In 2022, The Sophie Fund hosted a “Call to Action,” a series of five presentations and trainings on Zero Suicide for healthcare leaders, clinicians, and social workers.

The Tompkins County Suicide Prevention Coalition voted to recommend the Zero Suicide Model for the county’s healthcare providers in 2018, and in 2022 included promoting the model as one of the goals of its 2022-2025 Strategic Plan. Responding to the strategic plan, healthcare leaders formed the Tompkins County Zero Suicide  Steering Committee and held their first meeting on November 10, MacLeod said.

MacLeod explained that the Zero Suicide model is partly based on research that 80 percent of people who died by suicide had healthcare visits in the 12 months prior to their deaths, indicating that such visits provide a vital setting for identifying suicidal individuals and directing them to appropriate care.  

Zero Suicide calls for treating suicidality directly rather than as a mere symptom of a mental health disorder, MacLeod explained. The model outlines a systematic clinical approach for screening patients for self harm, and then engaging at-risk individuals in care management, evidence-based treatment, and safe care transitions, he said.

MacLeod quoted the Zero Suicide developers explaining that “suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted health care system,” and that suicides can be prevented by closing those cracks.

The panel on the 988 Suicide and Crisis Lifeline featured presentations by Tiffany Bloss, Executive Director, Ithaca’s Suicide Prevention & Crisis Service; John Halaychik, Communications Center Manager, Tompkins County 911 Dispatch Center; Susan Spicer, Mobile Crisis Team, Tompkins County Mental Health Services; Nicole Roulstin, 211 Tompkins/Cortland Contact Center Manager, Human Services Coalition of Tompkins County; Larry Albro, Warm Line Representative, Mental Health Association in Tompkins County; and Natalya Cowilich, Community Outreach Coordinator, Family & Children’s Service of Ithaca.

The community resources panel included presentations from Sally Manning, Convener, Tompkins County Suicide Prevention Coalition; Tiffany Bloss, SPCS; Karen Heisig, Area Director, Greater Central New York Chapter, American Foundation for Suicide Prevention; Melanie Little, Director of Education, Mental Health Association; and Sandra Sorensen, Executive Director, National Alliance on Mental Illness, (NAMI) Finger Lakes chapter.

Tompkins County Zero Suicide Steering Committee Gets to Work

Top local healthcare leaders on November 10 held the first meeting of the Tompkins County Zero Suicide Steering Committee to implement the suicide prevention model within and across healthcare systems serving the community. The meeting was attended by 17 healthcare leaders representing 11 provider organizations.

The leaders agreed to form the Steering Committee last July while participating in “Zero Suicide Roundtable: A Discussion on Best Practices in Suicide Prevention with Tompkins County Healthcare Leaders.” The roundtable was hosted at the Statler Hotel by The Sophie Fund and Tompkins County Mental Health Services.

Tompkins County healthcare leaders roundtable July 20, 2022

The creation of the Steering Committee is pursuant to Goal 2 of the Tompkins County Suicide Prevention Coalition’s Three-Year Strategic Plan 2022-2025 adopted in February 2022. One of Goal 2’s objectives is to “form a Zero Suicide Work Group comprised of leading health and mental health providers to share ideas, experiences, and challenges, and lead collaborative, sustainable efforts to implement the Zero Suicide Model throughout Tompkins County.”

The Tompkins County Health Department provided a fellow, Zoe Lincoln, to serve as the Steering Committee coordinator to provide administrative, communications, and operational support. The Steering Committee agreed to regularly report back to the Coalition on its activities and results.

The Zero Suicide Model is an emerging standard designed to save lives by closing gaps in the suicide care offered by healthcare providers.

The model provides a practical framework for system-wide quality improvement in areas including training staff in current best practices, identifying at-risk individuals through comprehensive screening and assessment, and engaging at-risk patients with effective care management, evidence-based treatments, and safe care transition.

According to the Zero Suicide website, “The foundational belief of Zero Suicide is that suicide deaths for individuals under the care of health and behavioral health systems are preventable. Zero Suicide is based on the realization that people experiencing suicidal thoughts and urges often fall through the cracks in a sometimes fragmented and distracted healthcare system. Studies have shown the vast majority of people who died by suicide saw a healthcare provider in the year prior to their deaths. There is an opportunity for healthcare systems to make a real difference by transforming how patients are screened and the care they receive.”

READ more about the Zero Suicide Model in Tompkins County

At its inaugural meeting, Lincoln briefed the Steering Committee on suicide data, noting that suicide is the second leading cause of death among Americans aged 10-34. Lincoln outlined initial steps to be taken by participating organizations, such as forming Zero Suicide implementation teams and conducting the organizational self study assessing their current state of suicide care.

“I am here because I am passionate about preventing the unnecessary losses of community members, friends, and family to suicide,” Lincoln said. “I believe this group is going to be a powerhouse for change and action across our county. We can all do our own actions and work on our own approaches in our organizations, but I really think the best work is going to come when we come together and work collegially.”

Speaking at the July roundtable, Harmony Ayers-Friedlander, deputy commissioner of Tompkins County Mental Health Services, said:

“Your presence here today serves as a reminder of just how important this work is. Zero Suicide works. Because it gives us hope that we can make a difference, direction through a systems-based framework when faced with the complexity of human suffering, and real tools that help us at each step of the way.”

Organizations agreeing to participate in the Steering Committee are:

Tompkins County Health Department

Cayuga Health

Guthrie Cortland Medical Center

Northeast Pediatrics & Adolescent Medicine

Family & Children’s Service of Ithaca

MindWell LLC

Alcohol & Drug Council of Tompkins County

Cayuga Addiction and Recovery Services (CARS)

The Reach Project, Inc.

Cornell Health, Cornell University

Center for Counseling and Psychological Services, Ithaca College

Health and Wellness Services, Tompkins Cortland Community College

Suicide Prevention & Crisis Service

U.S. Department of Veterans Affairs

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.