Seventy percent of Yale Law School students who participated in the school’s Mental Health Alliance survey have struggled with mental health issues at some point during their law school careers.
The report, which was released Monday afternoon, is the first of its kind at the law school. Titled “Falling Through the Cracks,” it consisted of an electronic survey sent out to all YLS students. Out of YLS’s student body of approximately 650 students, 296 responded.
Fifty percent of all respondents indicated that mental health challenges affected their ability to perform well academically and 56 percent said that these issues affected their social relationships. A quarter of the 82 students who eventually received treatment for their mental health issues sought that support from off-campus providers.
“One of our major goals is communicating a pretty simple message in the law school, which is that it’s normal for students to have mental health challenges while at YLS, and YLS provides woefully inadequate coverage for these problems, which are so common,” said Jessie Agatstein LAW ’16, a member of the Mental Health Alliance and one of the report’s authors.
The report showed that while 77 percent of students who experienced mental health challenges considered seeking treatment, only 62 percent ended up doing so. The other 38 percent said they did not seek treatment because of a lack of trust in Yale Health’s mental health and counseling services and confidentiality policies, as well as extremely long wait times for services.
In addition, the report said students feared talking about their mental health challenges would yield exclusion from faculty, administrators, peers, and state bar associations, which often require information about mental health prior to acceptance. In addition to describing student grievances, the report also outlined several recommendations to enhance mental health services for YLS students.
Included in the report are several goals, notably expanding YLS health insurance coverage to include off-campus mental health treatment, reducing wait times during the academic year and prioritizing faculty training, student programming and informational and support resources to destigmatize mental illness.
The report was released at a law school event Monday afternoon. In a packed lecture hall, roughly 100 YLS students shared experiences of slow wait times and unclear consultation policies while seeking treatment, as well as negative experiences with Yale Health.
Students raised concerns about not being informed of the number of mental health visits for which they are eligible on the basic Yale Health plan. Although no formal indication is present on the Yale Health website, students interviewed said that when they finally spoke to a physician, they were informed of a 12-visit maximum for students with basic coverage.
Comments in the YLS report indicated that students, as a result, had trouble planning how best to utilize Yale mental health services. Some students had to see off-campus mental health specialists after realizing they would need more than 12 consultations to resolve their mental health problems. Others went to off-campus providers from the very onset due to distrust of Yale Health’s quality of service.
“The 12 therapy visits per year policy is not public,” Agatstein said. “I should know that before I sign up for therapy.”
Because the Yale Health Plan does not cover mental health providers outside of Yale Health, students who are interning or vacationing outside of New Haven are left without good options for mental health care, Agatstein said. She added that these limitations in access make Yale’s mental health coverage more limited than coverage at peer institutions.
Agatstein advised attendees to get health coverage through Connecticut’s health care exchange, which lists plans that cover more than 12 therapy visits, as opposed to using the basic Yale Health Plan. She explained that while such a solution might not be good for Yale as a whole, it is a good immediate solution for students seeking care.
Agatstein noted that students felt Yale Health was overly concerned about protecting its own liability at the expense of patient care. In general, students who are on medication for mental illness are only given one-month prescriptions. YLS Professor Yair Listoken LAW ’05 explained that the requirement to refill prescriptions monthly is far more laborious than the requirement at typical health providers, where patients come to refill their medication every three or six months.
Chief psychiatrist at Yale Health Lorraine Siggins could not be reached for comment on Monday afternoon.
YLS professor Ian Ayres, who said he was very surprised that so many students were having mental health challenges at YLS, said he hopes moving forward students will be able to come to professors and other people at YLS to seek support.
Matthew Kemp LAW ’15, who contributed to the report, said he hopes the release of the report will make students more open to talking about mental health challenges.
“One of the most shocking things is that well over half of the students have had a mental health issue and so many people have sought treatment but nobody talks about it, even among close friends,” Kemp said. “Once a bunch of people who seem super normal and cool and fun talk about it I think it would be a lot easier for [other] students.”
Listokin acknowledged that faculty members are often unaware of the academic pressure they are placing on students.
“We don’t design our curriculum with any conscious thought of student mental health — that does not mean we’re right,” he said, adding that faculty members want to push law students to achieve their full potential, but that it is hard to know when to stop.