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 These listed suggestions such as extending the petition deadline for voluntary leave and allowing some withdrawn students to have access to the University’s resources.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.”

  • phantomllama

    Lorraine Siggins seems to think that students struggling with mental health problems should, as well as seeking treatment, feel able to make complaints and pore over websites for inconsistencies.

    It is unrealistic to expect that having begun treatment – often a difficult and courageous step in and of itself – that students will be able to do this. Is it too much to ask that Yale’s mental health team work in partnership with students, rather than openly admitting that an adversarial approach is the only way to get results? That Ms. Siggins has made this suggestion is further evidence that she is fundamentally out of touch with the way in which her profession has developed, and with the realities of the failings that have occurred under her watch.

    I have never had any personal contact with Ms. Siggins, but her situation seems to me to mirror that of Rodney Cohen, as she has now so thoroughly lost the confidence of those who she is employed to serve. It is surely time for her to move on and allow the department to be renewed by someone with a clean state and fresh ideas.

  • theantiyale

    “Anything other than that is an affront to students.”
    Carry on.

  • aaleli

    Bottom line Yale is admitting too many high strung students. It was obvious to us when the first question out of one parent’s mouth, at Calhoun during Bulldog Days, was “what are your mental health resources?”. (I understand issues crop up in the college demographic with no previous symptoms, but for those already in therapy or on meds, it’s a red flag).Yes, genius and mental illness often go hand in hand but it’s generally a lose/lose proposition for the student and the institution to pile on more pressure. Why would any student, parent or University think this was advisable?

    • JRose

      Because that’s discrimination.

      • aaleli

        Discriminate:• the ability to discern what is of high quality; good judgment

        Lest we forget, the ability to discriminate can be a positive thing.

  • hounten

    I understand the concerns listed here, but I just wanted to stress that, as someone who knows Holloway very well, I can say that there is no individual who cares more desperately for this student body. Holloway is a very intelligent, caring, and thoughtful individual, and the College is lucky to have him in this position. Consider the sacrifice he has to make, as someone with a family with children on campus, to put himself in front of these attacks in front of everyone as he strives to make things better.

    Changes need to be made, but work with him, not against him…he is 100% on your team.

    • anubis

      ^Isn’t the directionality here a bit backwards? Shouldn’t *he* be working with the students?

      • hounten

        No. I was imploring students to work with Holloway. He is certainly working on the students’ behalf.

    • Ece FNW

      Yeah, I’m sure he’s a great guy. It’s a difficult position to be in, to be the human face of a corporation that, by its very structure, has a default position of resisting change as much as possible. But having a nice administrator doesn’t change the institution. I’m sure he engages with the position with as much integrity as he can, and students certainly seem to respect that.

      I hope, of course, that that means that he is grateful for all of the ways in which students are willing to relentlessly push the administration to break out of its tremendous corporate inertia. I hope he’s honored to be a channel for the righteous protest that emanates from these students. I hope he’s humbled by the chance to put himself on the frontlines in pushing his colleagues to end their university’s abuse and negligence.

  • hounten

    One other thing that strikes me here – when the student was explaining how she was contemplating suicide over $30,000 in student debt, I sensed a profound lack of perspective on her part. $30,000 in student debt isn’t very much – the monthly payments would be around the same as two cell phone bills. How is it that you think people pay for law school, or for medical school? With a Yale degree, $30k over 15 years should be more than manageable.

    The real concern I had was that the student thought that it was reasonable to consider suicide over that burden – I hope that the administration took that as a reminder of how important it is to provide mental health support for students.

    • Ece FNW

      Wow, these comments really miss the point. The point she was making wasn’t that it would have been better for her if she hadn’t taken time off, or that she would have preferred it if she had committed suicide. The point is that SHE WAS REALLY SICK and Yale’s policies made it more difficult for her to take care of herself. Of course she showed “a profound lack of perspective.” She was depressed to the point of suicide, and Yale does a horrific job of helping students in these situations make the decisions they need to make in order to care for themselves.

      To say that it’s acceptable for students with mental illnesses to be saddled with tens of thousands of dollars of debt is bigotry. To have a policy in place that imposes such a disparate burden is a violation of disability rights.

      • aaleli

        Oh dear lord.

      • 15gladyskravitz

        BIGOTRY? Seriously? Not only does the admissions committee need to scour apps for students who are coming unglued, but apparently for students who can cogitate beyond buzzwords.

      • yalie2

        What you’re proposing, though, is waiving a $30,000 bill because she was depressed. That she was unable to continue is not a failure on Yale’s part, and it’s hard to see why Yale should be footing the bill for it. It certainly would be nice if Yale were to do something like that (though I’m not sure if giving such discounts is the best use of $30,000) but it’s hardly bigotry to say that Yale is not responsible for refunding her purchase because she found herself unable to use all of it.

        Actually, if she is on financial aid, Yale will give her an additional semester of financial aid, up to $25,000 or so. If she’s not, then presumably her family has resources to cover a good chunk of her cost of attendance. So it seems unlikely that she’d simply be taking on $30,000 in debt.

    • Alexa Little

      Hi, Alexa Little here.
      I’m the student you’re discussing.

      I’d like to address a couple of points in your argument.

      For one, $30,000 is a lot of money. I find it very hard to believe that you wouldn’t struggle to pay another $250 in bills every month. On the other hand, if you wouldn’t, feel free to send me the money — I could certainly use it.

      I’m facing a lot of criticism now for choices I considered in a moment of intense physical and mental pain. From my point of view, it’s like criticizing a drowning person for inhaling water, or a person getting stung by bees for running around too much. When you’re in that amount of pain, your view tunnels down to escaping the pain. It’s very, very hard to make a rational decision in that context.

      As an exercise, I would like to challenge people to imagine the most painful moment of your life — total agony, the worst pain you’ve ever felt. Then imagine trying to choose between this 10-15 year debt, or suffering for another month in that same agony. I think it brings my perspective, at the time, into a little more focus.

      I didn’t comment in the forum to say that suicide was the answer. I spoke out because this system is unjust. I will be paying off debt for the next 10-15 years of my life because I got too sick at the wrong time.

      And, if speaking out about this can save one student from considering the choices I had to, then I think I’ve succeeded.

      • yalie2

        It’s very unfortunate that you’re facing criticism for your choices. Having had to withdraw for mental health reasons myself, I know what an awful experience it can be. While I think it is reasonable to discuss what Yale should do about situations like yours, it is unfair to criticize your decision to withdraw or make light of how difficult it was for you. Also, talking about it publicly, both at the forum and on her using your real name, is very helpful to the conversation, even though it is very intimidating.

        I’m interested to know more about why you think it is unjust and what you believe would be a more just way for Yale to handle it.

        The extra debt would come from having attend Yale for an extra semester since the one in which you withdrew didn’t count for credit, correct? If you’re on financial aid, you should get another semester of financial aid, so you wouldn’t be paying the whole $30,000. If you aren’t on aid, presumably you would not need to shoulder the entire burden yourself, being from a high income family.

        My reply to Ece FNW above describes my concerns.

  • GBC

    A Yale student who would kill herself rather than incur $30,000 in debt needs a reality check and guidance well outside the scope of what Yale is, or should be, equipped to provide.

    • anubis

      Yale *wasn’t* equipped to provide it. That’s the point — ensuring that it can be in the future! Don’t be deliberately callous just to score rhetorical points on the Internet.

      • GBC

        Honestly, that level of assistance is not what Yale is for. Yale is a place for intellectual discourse and investigation, not an asylum for any student who needs one. It is surely within Yale’s rights to compel such students to seek treatment. Someone who would sooner kill themselves than voluntarily leave the school is precisely the target of forced removals, for good reason.

        • anubis

          Perhaps that is so, but the process of demarcation and determining who ought to be forcibly removed — and *what happens after they are* — are both critically flawed at present.

        • winter

          The question is not whether or not she should be seeking treatment, but rather whether she should be forced to incur $30,000 of debt in oder to seek that treatment.

        • Ted Tak

          Exactly how long would it take to pay off $30,000 fresh out of college (excluding readmission class costs, and other incurred expenses)? So much for the “reality check.”

  • yalie2

    Regarding the 12 visit cap- whether it actually exists or not – when I started going to Mental Health and Counseling I was told that their services were for short term, acute care. If patients required long term care, they should seek out a physician who is in their insurance network.

  • Tammy Pham

    Discussion and criticism is great, but please be respectful of those who had the courage to publicly share their stories in hopes of inspiring change. Furthermore, many of the students who spoke up are upperclassmen who will not be at Yale long enough to benefit from any upcoming improvements–they share their stories not for themselves but for future students.

  • concerned

    The above mental health schema is too, too corporate of a sensibility. And utterly shocking to an individual not of a corporate background. Yes folks, an unanticipated 30+ grand college debt is daunting to any student attending Yale in the absence of “corporate sponsorship”. And who will go on to collect those debt payments? A corporation. Heavily subsidized scholarship students, pay attention!

  • Doc1943

    To put this in perspective and to be fair to all sides, I would like to know the number of students who seek mental health treatment at Yale and what are their diagnoses
    and what is their treatment . And I would like to know the if the incidence
    of mental illness a Yale is changing one way or another and how it compares with
    the rest of the country. How many of these sick students graduate or withdraw?
    It is hard for me to get a sense of the nature and the magnitude of the problem .

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