I come from a place where mental illness is not a real thing. In Greece, we have different ways of talking about our emotions, ways that indicate their fleeting or durable nature. There isn’t really a way to say that someone is depressed; you can say they’re feeling depressed, or going through depression, but to claim that that’s an integral component of their identity sounds off.
Yale, on the other hand, takes a very different approach to mental illness. No one here is going to deny the validity of your experience, no one is going to tell you you’re exaggerating or that you’re just having a bad day. People will listen, respect and validate the struggle that comes with carrying this type of emotional burden on your back day in and day out.
A superficial look, then, on how Yale approaches mental health shows an image of a place where mental illness is destigmatized, treated with compassion and kindness and understood to be a valid experience. Our peers, mentors, professors and deans emphasize the importance of being happy. Our institution invests in study breaks, free yoga and meditation classes, therapy dogs and mental health resources that are available around the clock. On the surface, everything looks nice and shiny — utopic, almost.
But Yale is plagued by a profoundly dark, and well-concealed, infection. One that few people know about, and even fewer want to revisit long enough to recount. This is none other than the way in which Yale addresses those among its student body who face some of the most serious challenges of mental illness.
Most of us are aware that the American legal system considers the doctor-patient relationship to be a sacred one. The underlying duties that shape it are the duties of loyalty, care and confidentiality. These practically boil down to the notion that physicians have to act in their patients’ best interest, provide a standard of care that is on par with what other professionals would provide and protect their patients’ private information. The principle of confidentiality is one of the most respected and important among those duties, and the cases in which doctors are allowed to breach it are very few.
One of those cases is that of self-harm. If someone indicates that they have the intention to hurt themselves, their provider is obliged to violate the principle of confidentiality and to get that person committed for their own protection. Whether or not we have the right to determine what is in a person’s best interest is a long philosophical conversation that I will not engage in. Instead, I would like to focus on what happens to people who we deem should be committed. The way in which we deal with these cases is absolutely baffling and, to any reasonable person, completely incompatible with the duty of care.
If a student expresses a desire to hurt themselves to a member of Yale’s staff, they are required to refer them to a mental health professional, who is in turn bound to commit them to the psychiatric ward of Yale’s hospital. There, students are kept in isolation for many days, with little or no contact to their friends and support networks, made to take different combinations of medications that are meant to help them improve and treated in ways that are genuinely appalling. This is not evidence of an institution that aims to protect the well-being of its students; it’s evidence of a corporation seeking to minimize its liability exposure.
In a lot of ways, Yale has done a good job of fostering a welcoming, warm community for its students. The commitment to students’ mental health feels genuine, and I have been lucky enough to encounter numerous members of Yale’s faculty and staff who truly care about their students’ well-being. However, if we truly wish to claim that we care about students’ happiness, we need to take a long, hard look at how we treat those who are experiencing the most unhappiness — and we need to re-evaluate the way in which we engage with them.
Sophia Catsambi | firstname.lastname@example.org .