Tensions ran high and voices were raised at yesterday’s forum on mental health and counseling. And as students pressured administrators for answers, questions lingered as to whether more transparency would come in the wake of the conversation.
“We appreciate a lot of your rhetoric, but there seems to be a tremendous lack of consistency about what we are hearing from you and the experience that other students are having,” said Yale College Council President Michael Herbert ’16, standing amidst some 200 seated students at the forum.
Herbert was attempting to extract a commitment from Yale College Dean Jonathan Holloway, who hosted the forum, to respond, point by point, to two YCC reports on mental health, released in the 2013-’14 academic year. He asked that Holloway address the requests outlined in the reports by the end of the 2014–’15 academic year.
Holloway would not commit to doing so.
At 6 p.m. Wednesday evening, students crowded into LC 102 to attend the forum. Joining Holloway on stage were Director of Yale Health Paul Genecin, Mental Health and Counseling Director Lorraine Siggins, MH&C Associate Director Howard Blue and English professor John Rogers, who is heading the committee reviewing withdrawal and readmission policies.
The town hall, which Holloway said was intended to clear up misperceptions about mental health services at Yale Health, quickly became heated, with numerous students directly confronting administrators about their own negative experiences with MH&C.
Most students interviewed said they were exasperated with what they described as the administration’s unwillingness to answer questions directly or take student feedback into account. The administration, many noted, exhibited a lack of awareness about students’ experiences with mental health services.
DEMANDING DECISIONS
Numerous students used the open forum as an opportunity to get direct responses about feedback individuals and groups had offered Yale Health in the past.
Herbert stood up in the forum to demand an official response to the YCC’s reports by the end of 2014–15 academic year. He was met by heavy applause from the audience. These listed suggestions such as extending the petition deadline for voluntary leave and allowing some withdrawn students to have access to the University’s resources.
“If we release recommendations, there should be a response. It should either be implemented, or there should be a public explanation for why [it is] not,” Herbert said, as he countered responses Siggins and Rogers had made about how much they valued student opinion. “Anything other than that is an affront to students.”
While Siggins responded by saying his request would be “taken seriously,” Herbert noted that even though the report was released nearly a year ago, the administration has still not acted on it. As a result, he said, it is difficult to believe that the student body’s views are being taken seriously. He added that the administration’s responses thus far to the cases such as the ones shared during the forum are the reason students distrust the administration.
Herbert told the News that in a conversation he had after the forum with Assistant Dean of Academic Affairs Pamela George, who also oversees the College’s Readmission Committee, George accepted Herbert’s demand to respond to the March 2014 report by the end of the academic year.
During the town hall, Stewart McDonald ’15 stood up with his laptop in hand, demanding why George had asked him personal and medical questions when she interviewed him for readmission.
Referring to information on his laptop, McDonald announced to the room that George was in attendance, pointing to identify her. He said she had requested “extensive” information about his outpatient treatment during his readmission interview, something he considered inappropriate considering she is not a mental health professional.
George responded to McDonald’s demand for answers, explaining that readmission decisions go through a committee, and as chair of the committee, she needs to understand a student’s experiences, “though not necessarily in detail.” Still, McDonald claimed that, regardless, George asked him for specific details, including medical details, despite the fact that a physician’s recommendation would already have been submitted as a required part of the readmission application.
THE ISSUE OF MONEY
Herbert was not the only one pushing for answers from the administration. Numerous students called for explanations of the high financial cost associated with withdrawal and readmission.
Alexa Little ’16 said the financial toll of the withdrawal process made her contemplate suicide. After seeing her health deteriorate midway through the second semester of her sophomore year, Little considered taking the rest of the semester off to seek medical treatment. She was in near-constant pain and experiencing panic attacks, but discovered that withdrawing would require her to continue paying tuition for the rest of that semester, despite not being on campus, as well as take out loans to pay for classes she would be required to take outside of the University in order to fulfill readmission requirements. As a result, she attempted to stay at Yale, regardless of her health.
But with one month left in the second semester of her sophomore year, the physical and mental pain Little was experiencing made her wonder whether she should stay at school and continue to suffer or assume what she said would have amounted to $30,000 of debt. After mulling over her choices, she thought of an alternate solution, she said.
“To avoid the debt, I wondered, ‘Should I kill myself?’” Little said. “I don’t think any Yale student should ask if their life is worth $30,000.”
The panel of administrators did not respond to Little’s testimony of her own experience. Rather, Holloway said financial considerations are being considered by the leave of absence and withdrawal policy review committee.
CONFRONTING CONFIDENTIALITY AND WITHDRAWAL
Though the forum’s tone was confrontational at times, both Genecin and Siggins said they were pleased with student attendees’ openness about their struggles with mental health services. Holloway opened the forum by voicing his hopes for a two-way conversation between students and faculty. But in an interview with the News before the forum, Holloway explained that there had been hesitancy about holding the forum in the first place because of fears that, in answering questions, administrators might violate federal confidentiality laws about patient information.
“We can’t even come close to describing a stitch that might reveal somebody’s identity,” he said, adding that panel members ultimately went ahead with the event so that they could receive feedback and dispel myths that they fear are preventing students from getting help when they need it.
Student attendees pushed back against administrators’ appeals to confidentiality.
Caroline Posner ’17, a staff columnist for the News who suffers from depression, anxiety and Attention Deficit and Hyperactivity Disorder, asked why the number of withdrawals per year is not made public, despite the fact that revealing this information would not identify students.
Genecin said that information is kept at the Yale College Dean’s Office.
“I don’t have that information,” Holloway replied.
Siggins said that the number of students forced to withdraw is in fact much lower than common perception holds. The misconception arises from students knowing one person who was forced to withdraw and then assuming that this is the norm for withdrawn students, she said. She added that very few students with mental health issues withdraw, and the majority of medical withdrawals are voluntary.
As administrators spoke about medical confidentiality, students shared their own experiences of keeping issues confidential, specifically the severity of their illnesses.
“I lied about the severity of my symptoms because there is a fear [on campus] that you will be sent home if you disclose this,” said Korbin Richards ’15, who has suffered with hereditary bipolar disorder.
Richards said that because students do not know how severe their mental illnesses must be to warrant forced withdrawal, many students hide it. Three students in the audience raised their hand and said they had also played down how ill they were to avoid forced withdrawal.
Siggins explained that forced withdrawals do not happen when students are experiencing mild symptoms.
Several students at the town hall criticized Yale Health for corresponding with patients over the phone, as opposed to email, which they said would be preferable.
In response, Siggins said the reliance on phones comes out of confidentiality concerns.
Yale Health’s legal counsel is concerned that, if therapist-patient email correspondences were permitted, clinical information could be shared. While email is not a secure system, patient portals such as MyChart are. Siggins did say that Yale Health is “actively exploring” the potential for patients to give advance consent to correspond about their mental health treatment via email.
MISCOMMUNICATING
Both the panel and student attendees agreed that there are miscommunications between the administration and the student body about mental health issues, but opinions differed as to where the confusion lies.
Addressing the panel, Posner said her therapist has been violating Yale Health’s policies by allowing Posner more than 12 therapy sessions a year. She asked the panel why that cap exists in the first place.
“What justification is there for having a number of times people are allowed to see a therapist?” she said, raising her voice to be heard over clapping from the audience.
Siggins’ response highlighted the extent of miscommunication. According to her, there is no uniform policy dictating a cap on therapy sessions, though Yale Health is reluctant to allow weekly sessions indefinitely, unless treatment is medically necessary.
Posner turned to the audience to gauge whether other therapists had informed their patients of the cap Siggins had just said did not exist.
“Raise your hand if you were told there was a 12-visit maximum for therapy visits,” Posner said, taking a rudimentary poll of attendees. Roughly 50 hands across the room went up, and three students said out loud that their therapist had informed them of a limit at their very first session.
Speaking over a flurry of voices in the audience, Siggins asked where that policy was listed on MH&C’s website. Students responded by noting that little information about therapy visits exist on the Yale Health website in general.
Throughout the forum, Siggins repeatedly invited students who notice violations of MH&C policy or have complaints about their care to contact her directly.
Miscommunications also became apparent during discussions of withdrawal and readmission policies. Siggins acknowledged that these policies need improvement, and added that students’ dismay at readmission policies present questions about what the word “readmission” means.
After being asked by Courtney Hodrick ’16 why Yale’s withdrawal policies differ from those at peer institutions, such as Stanford, Rogers said Yale’s policies — though they may seem different — are actually very similar to those at similar universities. The difference, he said, is one of terminology. He added that due to federal regulations, including ones related to financial aid, the University must have a cut-off point by which students must take a leave of absence in order to return the next semester. Yale only seems like an outlier with its early deadline to apply for leaves of absence because it uses the word withdrawal to distinguish absences that occur after this date.
“Readmission is nothing like getting accepted in the first place,” Siggins said, explaining that the terminology makes it appear as if it is difficult to be readmitted.
But multiple students stood up and insisted that the suffering that follows withdrawals is also caused by feelings of annexation from the Yale community.
“We are denied resources when we are withdrawn, and then they ask us to be constructively occupied,” said one student attendee, as onlookers nodded in agreement. Another student noted that the short notice that precedes readmission means that students have to plan for transportation, apply for jobs and then quit jobs, all at the last minute.
In light of the heated discussion, Herbert noted in an interview with the News after the forum the importance of keeping pressure on the administration to make changes. Specifically, he warned that if the withdrawal committee that Rogers chairs does not deliver results before the end of the academic year, there will not be enough time for the YCC to collect and present a formal response before the recommendations are turned into policy.
“The review of the policies could change nothing,” he said. “If it is left too late, there is no way for us to respond.”