No trust without transparency

Dean Holloway, Dr. Genecin, Dr. Siggins, Dr. Blue and Professor Rogers,

We are grateful for the opportunity that last week’s mental health forum offered to express concerns about administrative policy and the services of Yale Mental Health and Counseling, and we are encouraged by the progress the forum represents. This conversation marked a large step forward in administrative visibility on the issue, and we trust that you have heard our voices and thought over our concerns and suggestions.

However, despite frequent assurances that the administration is receptive to the changes suggested by the student body, we find that barriers to the success of this dialogue persist. We still await answers to many of our questions on policy and statistics in mental health care and withdrawal; we continue to fight for transparency in the reform process. In this letter, we illuminate some of our most urgent concerns and provide constructive suggestions for their resolution.

First, we are unsettled by the lack of transparency from the administration in matters of institutional reform, which we believe surpasses the level of discretion necessary to protect medical confidentiality. We reiterate Yale College Council President Michael Herbert’s request that the administration commit to providing a point-by-point response to the Report on Mental Health (September 2013) and the Recommendations for Improvement to Withdrawal and Leave of Absence Policies (March 2014). We do not demand definitive acceptance or rejection of any recommendation, but we do ask that the administration acknowledge and reply to each. We also ask that the administration cite any legal restrictions preventing the Review Committee on Withdrawal and Readmissions from releasing information about its proceedings. These acts will further understanding between students and administration.

Furthermore, there is currently no publicized timeline for the anticipated hiring of new MH&C staff, nor any offer of a provisional date for the release of the coming report by the Review Committee on Withdrawal and Readmission. The administration has repeatedly asked students to have faith in the committees and individuals tasked with discussing and enacting changes, but we in turn ask for evidence that our most urgent needs will be met with prompt and decisive action in the coming weeks.

Second, we are concerned by the administration’s assertions that student perception of MH&C is misinformed or distorted. We worry that this belief may preclude a thorough investigation of the miscommunication between MH&C and students. We acknowledge that many students have had positive experiences with MH&C, and that published student experiences do not reflect overall rates of patient satisfaction. Still, a significant number of students report unsatisfying or unacceptable interactions with MH&C. We believe that if the administration makes information on MH&C policies more readily available, we can better distinguish legitimate policy shortcomings from incidents of miscommunication.

In particular, we request publication of the operative standards for involuntary withdrawal and an overview of the involuntary withdrawal process. This is absolutely necessary when Yale administrators, rather than clinical professionals, have the ultimate say in determining a student’s future. Far too many students do not seek professional help or do not disclose the severity of their symptoms out of fear that their statements will be grounds for involuntary hospitalization or involuntary withdrawal. Although the best course of action for students varies on a case-by-case basis, the absence of information on the process discourages some students from obtaining the treatment they need to heal and thrive. If MH&C desires to close this information gap, we believe that this is a necessary first step.

Third, we emphasize that the burden of recognizing MH&C shortcomings does not lie on the patients. We trust that the administration was indeed unaware of specific policy violations, such as the failure to follow up after missed appointments or the enforcement of a twelve-session maximum for one-on-one counseling. But when such policies are not publicly or easily accessible, students cannot be expected to notice or report violations. We urge you to release a clear, comprehensive handbook of Yale’s policies and statistics pertaining to mental health. To facilitate low-stakes avenues for patient-provider communication, we call for the distribution of simple post-visit patient satisfaction surveys and feedback tools to all patients of Yale MH&C.

The student body and administration must stay firmly focused on these mental health care issues and remain committed to maintaining productive collaboration. We urge you to move forward with the proposals we have outlined, and we look forward to a climate of constructive dialogue and reform that does not end with this academic year.

Respectfully submitted,

Chris Cappiello ’15, Joseph Cornett ’17, Hiral Doshi ’17, Aaron Gertler ’15, Carlee Jensen ’15, Christopher Landry ’15, Jessica Liang ’17, Alexa Little ’16, Adrian Lo ’15, Tammy Pham ’15, Šimon Podhajský ’16, Caroline Posner ’17, Korbin Richards ’15, Nathan Sitaraman ’15, Geoffrey Smith ’15, Charlotte Storch ’15, Ella Wood ’15

March 5

The above was sent as an open letter to the aforementioned individuals.