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News, Views and Careers for All of Higher Education
March 13, 2006
Counseling Crisis
Don’t be afraid to get help. That’s the message colleges bombard students with — telling them that there is no shame in seeking psychological help from campus counseling centers, where professionals can help them deal with a range of problems. But a number of students say that there is in fact good reason to be afraid — afraid that the very counseling they are encouraged to have could get them expelled.
Related stories
- Predicting and Preventing Campus Violence, April 7
- Student, Interrupted, Oct. 15, 2007
- Settlement in MIT Suicide Suit, April 4, 2006
- Psychological Troubles on the Rise, March 29, 2006
- Not So Confidential Counseling, Dec. 2, 2005
Several students nationwide who have been suspended as a result of seeking treatment, oftentimes for severe depression, are fighting back — both in court and through the Department of Education’s Office for Civil Rights — on the grounds that federal and state disability laws protect their right to stay on campus. Policy and health experts say that universities may be creating legal risks for themselves by barring some students with mental illness, rather than helping them deal with their conditions.
Jordan Nott, a 21-year-old former student at George Washington University, has become a poster child for this movement. He sued the institution and several individuals at the university in District of Columbia court, alleging they “disciplined him, threatened him with criminal prosecution and ultimately ended his college career at the school of his choice” after he sought help for depression at the university’s counseling center.
Nott’s lawyers argue that federal laws, including the Americans With Disabilities Act and Section 504 of the Rehabilitation Act as well as other federal and local laws, should have prevented the university from taking action against him. In court documents, lawyers for GW have denied Nott’s allegations and have asked that his case be dismissed.
Such battles are coming at a time when more students than ever before are arriving on campus with diagnosed mental health issues. According to the 2004 National Survey of Counseling Center Directors, 85.8 percent of counseling directors believe that in recent years there has been an increase in the number of clients with severe psychological problems, and 90 percent believe that students with significant psychological disorders are a growing concern on campuses.
Some institutions, including GW, have considered controversial counseling waivers, which would allow the information of students who seek services at university counseling centers to be shared with administrators. Lawmakers in Colorado are currently considering legislation that could force students seeking help at campus counseling centers to grant Colorado colleges and universities permission to notify a parent, friend, professor or anyone else they desire — if counselors believe the student is considering suicide or may be a danger to himself or herself.
Stephen Behnke, director of ethics at the American Psychological Association, says that such protocols are “immensely troubling” because they would remove a patient’s confidentiality. “There are already exceptions to confidentiality in order to address emergent situations, such as a risk of harm to self or others,” he says. While such exceptions vary from state to state, the general pattern is that a counselor may take action to force someone to be hospitalized to avoid doing harm — to the patient or others — but these waivers don’t generally give broad rights to disclose a patient’s condition, and many psychologists believe that such a system could discourage students from getting help.
Officials with the American Council on Education said in a recent legal brief that they are worried that court and political actions could discourage colleges from helping students facing psychological problems. In February, the council joined with seven other higher education associations in submitting an amicus brief in support of the Massachusetts Institute of Technology’s petition to appeal a trial court’s denial of summary judgment for two non-clinician administrators in a case focusing on the extent to which student life staff can be held responsible for preventing a student’s suicide.
In 2002, the parents of Elizabeth Shin filed a $27.65 million wrongful death lawsuit suit against MIT, charging that its counseling service failed to take their daughter’s depressed situation seriously. Two years earlier, Shin, then a student at MIT, lit herself on fire in her dorm room and died as a result of burns. Ultimately, MIT was cleared of wrongdoing, but some counts filed against individual MIT administrators are still going forward.
“If administrators are required to prevent suicide when they become aware of a student’s problems, some reluctantly will avoid involvement with at-risk students,” according to a statement from ACE. “And some will feel they have no choice but to take the most extreme approaches to at-risk students — trying to have them hospitalized or forcing them to withdraw from the university or notifying their parents — even when the mental-health experts determine these steps are not in the students’ best interest.”
Nott believes that GW’s response in his own case — and the university’s consideration of the waiver plan — indicates that administrators are overly concerned about protecting themselves, rather than caring for the overall well-being of students. “When you are looking out for your own liability, you’re not really looking out for the interests of the student, you’re looking out for yourself,” he says. “I suppose every person has to look out for themselves, but this goes way beyond a certain line.”
In fall of 2004, Nott asked his roommate to accompany him to GW’s hospital for psychiatric help. He was feeling depressed and thinking about a close friend, also a student at GW, who had committed suicide in the spring of that year. The student had jumped out the window of his dorm room while Nott and two other friends stood in the hallway, trying to open his locked door.
Nott was prescribed Zoloft, an antidepressant, that fall, and was using it as prescribed. On the night that he went in for psychiatric help, he says that he was disturbed by his depressive thoughts, having read articles about correlations between suicide and antidepressant use. He says that he was not suicidal at any time.
According to one of his lawyers, Karen Bower, of the Bazelon Center for Mental Health, caregivers at GW Hospital promptly informed university officials of Nott’s request for psychiatric help. Within 12 hours of his hospital admission, she says, Nott was given a disciplinary letter barring him from his dorm. And within about 36 hours, George Washington leveled disciplinary charges against Nott and told him he had to withdraw from the university or face suspension, expulsion and/or criminal charges.
The university charged Nott with violating its Code of Conduct by engaging in “endangering behavior,” which is defined as “behavior of any kind that imperils or jeopardizes the health or safety of any person or persons,” including “actions that are endangering to” oneself or others. He was put on interim suspension by the university, evicted from his dorm room, prohibited from attending classes, and barred from GWU property and events. Nott says he was warned that if he came onto campus for any reason, he would be considered a trespasser and could be arrested. Nott, who lives in the Washington area, still cannot visit friends or attend public events on the GW campus.
“The problem is — after I checked myself into the hospital — the school never contacted me, except to say that I was basically suspended,” recalls Nott. “The university counseling center should not be involved in that way. They shouldn’t be punishing you, instead of addressing the issues that you’re concerned about.” He’s now a senior at the University of Maryland.
Nott says he expects to graduate this summer, “depending on how hard I work my butt off.” ”I’m focused on finishing as soon as possible,” he says, noting that he’s working a part-time job as well. “It’s a challenge, but I’m managing it, and I’ll get through it.”
“Depression — a lot of it is genetic, and a lot of it is circumstantial,” says Nott. “There could be circumstances in the future that cause me to get depressed, but I hope not.” He is currently not on any psychologically-related medications.
Nott adds that he would never seek help at a campus counseling center again. “I would go outside to a private doctor, something not affiliated with a university,” he says. “It stinks because I don’t want to discourage people from getting help. You just have to be really careful about where you’re going to go.”
George Washington officials defend their handling of the case. “By law, we cannot talk about the records of a particular student,” according to Tracy Schario, a spokeswoman for GW. “However, in the overwhelming majority of cases, the university has been able to provide appropriate assistance through existing resources and without the need for separation from the university.”
She says that more than 50 students with suicidal thoughts or behaviors go to GW’s counseling center each year and that “the great majority of these students is guided to appropriate services and support within and outside of the university and remain enrolled as students.”
“A few students rise to the level of risk that requires time away from campus and/or classes for more intensive treatment and family support,” says Schario. “Time away provides relief from the stress of campus and academic life in order for students to recover and learn to manage their symptoms and psychological concerns. We hope and expect that these students will recover, return to campus and function fully as successful students.
“In the case of Jordan Nott, it was certainly our hope and expectation that after receiving proper treatment and successfully resolving his concerns that he would return as a full-time student and resume life in the residence halls,” she adds. “Although he is no longer at GW, we are happy that he is pursuing completion of his academic degree. We wish him well.”
Nott’s situation is not unique. In fall 2004, Sue Schaller, now 20, says that she was forced to take a “mandated leave” from New York University, even though she felt like she was recovering from her depressed and suicidal feelings. After communicating via e-mail with a staff member at the university’s counseling center, saying that she was thinking about suicide, she was convinced to sign in for admission to NYU’s Tisch Hospital, and was treated for four nights for depression. The doctor who treated her there advocated that she be allowed to return to NYU, according to Schaller.
“The administrators seemed only concerned that I would try to kill myself,” she says. “The doctor was the only one who seemed to care about me.” Ultimately, Schaller returned home to Virginia to live with her family and sought private counseling.
“I’ve had to deal with so much, based on that experience,” says Schaller, who, last semester, was allowed to re-enter the university — without receiving credit for her previous coursework. She lost a total of one semester of coursework. Upon returning, she was required to see a health professional at the university’s counseling center regularly throughout her first semester back. “Obviously, they want to keep me on their radar,” she says.
“If I ‘screw up’ again, I’ll get the boot,” says Schaller. “But, I shouldn’t have to feel like I screwed up just because I tried to get help.” Schaller chose not to file suit against NYU, although she believes she would have a legitimate case under anti-bias laws. “It would be like David taking on Goliath,” she says.
NYU officials say that mandated leave is used only as a last resort. Less than 0.3 percent of the approximately 3,400 students who visit the university’s counseling center are required to leave. NYU says that it cannot comment on Schaller’s specific case, due to privacy laws.
“These policies send a message to students that they’ve somehow failed,” says Bower, one of Nott’s lawyers. “And others may be discouraged from seeking help for serious conditions.”
Several students have filed complaints with the Department of Education’s Office for Civil Rights, saying that they’ve faced similar situations as Nott and Schaller. In four recent cases, the OCR has sided with such students. OCR is responsible for enforcing Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination based on disability by recipients of federal financial assistance from the U.S. Department of Education.
Last year, the office sent a letter to Lee Snyder, president of Bluffton University, in Ohio, stating that the university’s forced removal of a student who attempted suicide did not comply with federal law. In spring 2004, a female freshman at the university cut herself and took an overdose of pills in an apparent suicide attempt, according to OCR documents. The student was hospitalized for about one week and was diagnosed for the first time with bipolar disorder. “During her hospitalization she worked with mental health professionals who agreed that it would be beneficial to the student to return to her studies upon her discharge,” according to OCR documents.
However, three days after the student’s suicide attempt, a university official spoke with the student’s mother and told her that the student was being immediately withdrawn from the university.
In 2004, after the student and her mother filed a complaint with OCR, the office found that “the actions taken by the university regarding the student were discriminatory.” OCR found that the university removed the student following her suicide attempt because of its perception that she was mentally ill and incapable of functioning as a student and that it made the decision without providing the student notice of a hearing or an opportunity to be heard. OCR also noted that the university “did not consult with medical personnel, examine objective evidence, ascertain the nature, duration and severity of the risk to the student or other students, or consider mitigating the risk of injury to the student or other students.”
Bluffton ultimately agreed that it had violated the law and has worked with OCR to rectify the situation for the student by reimbursing her for room, board and book fees she paid while at the university. It also made several policy changes, requested by OCR, so that future students are not removed in the same way. OCR documents did not indicate whether the student has re-enrolled at Bluffton or at another college.
According to legal experts, two court cases, Schieszler v. Ferrum College and Shin v. MIT, have weighed heavily — perhaps too heavily — on the minds of many administrators in their decisions to remove students. In the former case, a federal court in Virginia found that a private college had a legal “duty of care” to a known suicidal student in a residential setting. The case centered on Michael Frentzel, a freshman at the Ferrum College in 2000. In February of that year, he had an argument with his girlfriend. Soon after, he sent a note to his girlfriend, in which he indicated that he intended to hang himself with his belt. College officials, including a resident assistant, became aware of the note after the girlfriend showed it to them. A few days after the note was written, Frentzel hanged himself in his dorm room.
Frentzel’s aunt and guardian, LaVerne Schieszler, argued in court that college officials “knew or personally should have known that Frentzel was likely to attempt to hurt himself if not properly supervised,” and that they were “negligent by failing to take adequate precautions to insure that Frentzel did not hurt himself.”
The court ultimately found that a “special relationship” existed between Frentzel and certain college officials.
In the Shin case, too, a Massachusetts Superior Court concluded in 2005 that a “special relationship” existed between university staff members and Shin, since the staff members had specific knowledge that the student was at high risk of suicide and that it was “reasonably foreseeable” she “would hurt herself without proper supervision.” The case is currently being appealed by MIT.
“These rulings have alarmed college administrators nationwide,” says Gary Pavela, director of judicial programs at the University of Maryland at College Park and author of a new book called Questions and Answers on College Student Suicide. “Many fear they will be held liable for failing to determine when troubled or depressed students pose a heightened risk of suicide.”
Pavela says that many administrators have also failed to consider that other court rulings have indicated universities do not have “duty of care” responsibilities. In December 2005, for instance, a Pennsylvania trial court held that two Allegheny College deans had no “duty of care” to prevent the suicide of Charles Mahoney — a junior who had been treated for severe depression, but wasn’t known to the deans to be an immediate risk of suicide. Previously, in 2000, the Iowa Supreme Court affirmed the status of students as full adults, with primary responsibility for their own conduct. That would mean that administrators could not be held liable in situations where students commit suicide.
Pavela predicts that in the coming months many more students will choose to either pursue the Office for Civil Rights route or sue their universities.
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Comments
This is not only about the student with disabilities.
I had a student come to me and inform me that she is hallucinating and tempted to cut herself. My large lecture + lab course involves the use of sharp tools.
I had several immediate concerns: How do these two symptoms interact? Is the student a potential danger to herself? A danger to other students? What steps is she taking to return to a state of mental health and safety? How can I be confident that she can continue the coursework?
But nobody will answer my questions, because of confidentiality issues. The student has the power to help me be certain she is safe and can work around others by waiving confidentiality and allowing me to talk to those treating her. She has not done so.
Ask yourself — knowing the potential for harm, what would you do?
In addition to worrying about the students, I am worried about myself and the personal stress involved in this situation.
I am not advocating the rough and abrupt university responses described above, but am advocating allowing faculty to operate with openly-shared information. Limited open communication with others will benefit the student and the communities where these students study.
Anon, at 9:50 am EST on March 13, 2006
Students are not assured confidentiality when they talk to faculty or administrators. No one but counselors are bound by confidentiality, so there should be no limitations to faculty or staff sharing information with those who “need to know” about a student that is creating a danger to themselves or others. In fact, there seems to be an obligation to report this to someone that can help. FERPA protects student records, not student conversations with others. Faculty and administrators should not have to live with the burden of worrying about students when we come upon information. Once we know, we pass that onto a person qualified to truly evaluate the student. Then, we can sleep at night knowing that we’re not holding onto information that may come back to haunt us.
Though the article does not touch on this, students who are suicidal or even not suicidal often exhibit behaviors that become disruptive to the community environment, especially in-residence. Students that are consistently seeking attention from other students, staff, or administrators create problems independant from suicidal thoughts. A student with psychological problems can make an entire building of residents uncomfortable and even fearful for their safety. A campus has to evaluate the needs of the individual versus the community. Sometimes, students are removed not because we fear they will kill themselves, but because their pattern of behavior becomes disruptive to others which is a violation of student codes at most colleges and universities.
It seems like we’re getting sued either way. I’d rather err on the side of being too careful than not careful enough. Better to have a lawsuit for getting kicked out (which can later be repaired) than have a lawsuit for wrongful death.
Higher Ed Rules!, at 12:25 pm EST on March 13, 2006
Getting sued isn’t the end of the world
A better solution, which I have advocated for, it simply to require that students have insurance (as usual), and rent space to a “Doc in the box”-type place that would provide all infirmary-type care. Their office would not give the impression that it was part of the school. This would stop the blurring of the lines between health care providers and educational institutions, and eliminate all of this unnecessary confusion. (Some administrators don’t like this, because it would mean that they would lose their arguably improper access to some records that they enjoy at some schools.)
On the other hand, kids need to stop going to counseling. I never did. Nobody in my family never did. We turned out fine. And, as we all know, one can ruin their educational or professional career by going to counseling for anything.
Mr. Rules, Schools will be sued. But so what? People are sued every day. In most states, the appellate courts have explicitly said that the schools are not parents, and eventually, lawyers will simply not bring suits that will be dismissed for failure to state a claim upon which relief is available. (Indeed, wrongful death suits against schools are the exception, rather than the rule, unless the student is killed by some conduct that was simply the result of normal commercial behavior by the school.) If a school wants to provide normal health services to their students and keep itself free from liability, they should simply make health care available, but stop taking responsibility for it the repercussions of it.
Larry, at 12:45 pm EST on March 13, 2006
Comments
Larry, many people do have psycological problems that require examination, therapy and in some cases medication or even institutionalization. Most people do not, and I will agree that society has become over reliant on therapy and medication to solve some minor issues. However, that does not change the fact that some people have very real clinical depression issues (among other psycological conditions) that need professional treatment. I certainly would be careful about advocating any step that would deny them access to the resources they need.
That said, the lawsuits in this area are absurd. The school cannot solve all psycological problems. When it tries and fails, they are sued for the results. When they do not try, they are sued for negligence. When they try to pass the problem off to someone else, they are sued for that too, as the story indicates. This state of affairs helps no one but trial lawyers and a lucky few parents who win settlement or jury jackpots.
Kevin, Undergraduate, at 3:05 pm EST on March 13, 2006
“A few students rise to the level of risk that requires time away from campus and/or classes for more intensive treatment and family support,” says [GW spokeswoman Tracy] Schario. “Time away provides relief from the stress of campus and academic life in order for students to recover and learn to manage their symptoms and psychological concerns. We hope and expect that these students will recover, return to campus and function fully as successful students.”
What is that I detect rising from the swamps of Foggy Bottom? Well glory be, I do believe it is the odor of mendacity.
Sniffing around, at 3:20 pm EST on March 13, 2006
Kevin, In my culture, mental illness either doesn’t exist or is considered laziness. Nobody will be able to convince me otherwise. That said, as a lawyer, I realize that “the law” recognizes it as a force that can otherwise defeat the rational workings of the universe. To that end, my solution (i.e. outsourcing mental and physical health services) serves everyone’s needs, and keeps what is private private.
If you think that this is sophistry consider this: many people have never dated outside their race, and would, quite frankly, not want to. But, still most Americans will argue the right to marry outside one’s race is fundamental to a free society, and worth suing about. This is how I feel about mental illness.
The lawsuits in this area are not absurd. Of course, most of what the public hears about any lawsuit are press releases by a party that doesn’t like what happened. Litigation is, for better or worse, a means that anyone, can force society to articulate what normal standards of care are in a given situation. Because of litigation we known that in ever state that has had to address the issue that colleges generally don’t act as students’ parents. But, the issue isn’t so clear when the school begins to act a treater and then drops the ball midstream. In other cases, someone that starts helping someone generally has a duty to finish the job. (For this reason, I think that universities shouldn’t start helping.)
Your reference to “trial lawyers” makes no sense. Most civil suits do not actually end in a trial. The vast majority of trials are criminal in nature, anyway, and are tried by District Attorneys in state courts. So, unless you are repeating something you heard on the TV or some talk show, I don’t get your point in this area. But, assuming arguendo that some lawyer will make money from a lawsuit, why is this bad? To this point universities, and society as a whole have been unwilling and unable to articulate a theory of just how they should be treating students who, while old enough to drink, drive, join the military, vote, and have sex, somehow are stigmatized as non-adults because of their student status. This hypocrisy, itself is costly to society, and resolving it will require at least some transaction costs in the form of litigation.
Larry, at 4:20 pm EST on March 13, 2006
Mendacity?
What exactly about that cited statement do you find disingenuous or incredible? It seems pretty straightforward and accurate to me. But I am curious where the mendacity lies?
Student, at 4:20 pm EST on March 13, 2006
Blaming the victim
As someone who has suffered—and continues to be monitored—for major depression, I continue to be appalled at the way that mental illness is stigmatized in this country. Depression does not affect one’s intelligence and suicide/suicide attempts and suicidal thoughts are cries for help.
Some of our greatest writers/scholars/professionals have suffered (and continue to suffer) from mental illness.
Just as with other aspects of “diversity” and understanding of others, universities need to recognize that the psyche falls within different spectrums of mental illness.
Higher education is a reflection of society and its ills. Banning those with mental illness does not make it go away and sends the wrong message to the community. Shame on those who look down upon those in crisis as they may walk in their shoes one day.
LG, at 6:25 pm EST on March 13, 2006
One must presume that Larry has never seen a manic-depressive ramping up or someone hallucinating. Yet surely he is aware that people do sometimes hallucinate—if not, he should wonder why an entire class of drugs is called “hallucinogens” and is claimed to cause hallucination.
All human perception is chemically based, and while most of blessedly have mainly the right neurotransmitters in roughly the right balance passing through our bodies most of the time, it’s ridiculous (if not suggestive of mental illness) to say that no one is ever out of balance vis-a-vis his or her neurotransmitter balance.
It is solidly proven that many manic-depressives respond to treatment with lithium salts, which restores neurotransmitter balance for them. It’s mere denial (as well as human irresponsibility) to deny this in the face of hundreds of thousands of case histories.
Reality is not a matter of choice of belief, Larry, so the assertions of your “culture” that mental illness “either does not exist or is laziness” are suggestive of a culture out of step with reality. Given legal recognition of insanity, your status as a lawyer is somewhat troubling, as well, for your understanding and use of the law must be compromised by your choice to disbelieve in some aspects of the law.
Thane Doss, at 7:15 pm EST on March 13, 2006
Mendacity:1. The condition of being mendacious; untruthfulness.
2. A lie; a falsehood.
Yup, sounds like mendacity all right. They proffer the image of concern for student welfare and confidential counseling and then kick the students in the teeth (not to mention out of the university). And then they send out their professional (albeit incompetent) liars to try and repair the damage, and hide behind “confidentiality". This is pro forma administrative mendacity and cowardice. What they need is the biggest, baddest, trial lawyer around to kick them where it hurts — the wallet.
Bob at State U., Mendacity, at 11:45 am EST on March 14, 2006
I attended a small liberal arts college in Ohio, and was scheduled to graduate in 2004. I have bipolar disorder, and my senior year was very chaotic. During my final semester, I attempted an overdose, and due to the small nature of the school, the counselling office found out and summoned me to them for a ‘discussion’. During this discussion, I was forced to sign a waiver that stated I would not speak to my fellow students or my professors about ANYTHING personal, along with other unnecessary and unethical stipulations. About a week after I was forced to sign this waiver under threat of suspension, a professor of mine went to the dean and stated he felt the school was handling my situation badly. Interpreting his concern as me violating the waiver, I was sent via ambulance to the emergency room, where I was deemed ok by the staff there. However, I was not allowed back on campus, and finished my semester from home. The dean of my college told me I was playing games and manipulating the system. Funny how private institutions show that they care. Good luck anybody in the same situation. It was horrible. It felt good to post this.
Stephanie, at 6:35 pm EST on March 14, 2006
Constitutionally Protected Activities & Student’s Mental Health
According to Title 18 USCA Section 246 or 248, and in connection to Federally or State Supported facilities (i.e., via Grants), everyone is protected for engaging in constitutionally protected activities; that will be to have the right to an education on these Federally and State supported grounds. Also consider the fact that certain Universities have been known to rush or mandate students to seek counseling when a student may had been merely deprived of use or had bargaining issues about sport teams. In other words, there is always the danger of a case of a righteous student’s grievance (one which is subject to an ombudsman intervention) that snowballs into a mental health case and subsequent wrongful deprivation of education rights. Take into account the privacy and the confidentiality, which Dr. Behnke and the APA ethical codes have stated, the decisions are up to ethics professionals.
Kiumars Lalezarzadeh, Ph.D., Minister, Psychotherapist & Counselor at UIL, Q’s Ministry of AIWP, BHITS, ADHC, at 9:50 pm EST on March 14, 2006
Another issue
‘Home’ can be the worst, unhealthiest place for some of these students to be. ‘Home’ can be where (and why) the problem originated. Where they face abuse. Where they can’t get the help they need.
And yet they get sent home anyway, even when the therapists and administrators are aware of what they’ll face.
That, to me, is the clearest indication that the schools care more about their own liability rather than the welfare of their students.
Anon, Another issue, at 9:50 pm EST on March 14, 2006
Counseling Crisis
I read with interest the comments of anon, Stephanie and Bob. I would be interested to hear from them their suggestions on how the situations they describe or allude to might have been handled differently? I think it makes sense to look at the system and intent, but will be more productive to look at how to change.
Director, College Counseling Center, at 11:20 am EST on March 15, 2006
Responses
Since my previous response to Larry seems to have been lost, I guess I will respond again.
Larry, although there is debate among various groups of psychologists and psychiatrists and neurologists about exactly what constitutes a mental disorder, some states are generally held as a consensus by nearly all members of the relevant professions.
Significant disorders like Bipolar disorder, Clinical Depression, schizophrenia, and others are confirmed by brainscans and neurological tests. There are very few who would deny their existence.
It is not so much overzealous government prosecutors I think the schools fear as the prospect of being pillaged by the attorneys of student’s families or various NGOs that claim to speak on their behalf. It is often the financial cost of lawsuits that schools fear more than violation of criminal law, which is far more difficult to convict on. We now have a situation in which the universities can be sued no matter which course of action they choose to take – and as a result they choose to take whichever action minimizes or reduces their lawsuit load.
Stephanie, have you consulted any lawyer yet to see if the contract is valid?
Anon, the university is trying to minimize its liability. However, the university could just as easily as home be the source of traumatic problems. Furthermore, being removed from the university does not necessarily mean a person must go to their parent’s home.
Kevin, Undergraduate, at 1:05 pm EST on March 15, 2006
Modes of Change
A few years ago, a friend of mine found herself in a situation much like Stephanie’s, though not quite as severe in terms of conditions. My friend had tried to kill herself on several occasions, though not very whole-heartedly, and had been vocal about her efforts: calling students and faculty to let them know her plans. I found this a little unsettling, but was glad that she WAS talking to me and telling me this “personal” information because it made me respond and try to get her the help she needed.
As a result of my contact with the school authorities about her situation, my friend was briefly sent to a hospital, evaluated, and allowed to return that semester. She might not have been allowed to return if it hadn’t been for my own strong urging that the school consider her International student status (post 9-11, she would have had to leave the country for the length of her leave of absence, and would likely not have the financial resources to return).
But the point is that the school asked her not to talk to her faculty or fellow peers anymore about her personal isssues. I could understand this on the level that it is frightening to have someone tell you they are thinking about suicide, but jeez louise, people—-I would rather KNOW and be able to intervene than have her remain silent and slowly execute her plans in shameful secrecy!!
I felt that counselling reacted quite appropriately in terms of hospitalizing her (this was during a “contagion” of suicides), but thought it was ridiculous to impose that restriction upon her return. It was awkward for her, making her difficult completion of the semester all the more painful. I told her it was FINE for her to violate the ban and talk to me whenever she wanted to discuss personal issues, and I think most students would feel the same way. Maybe not faculty, but students can handle this stuff... I think. It’s case by case.
Student, at 2:30 pm EST on March 15, 2006
communication
Isnt this really all about communication between the government and the universsity?
I have been a mental healht patient for a while but unlike the other people on this post...while i sympathise with Jordan Nott and hope he wins his case I think i also understand why GW did this.
As people above have mentioned, GW is worried that it will be sued if a sutdent dies and the court will take the side that the U has its uty of care. At the same time it faces overeacting and possibly harming the student with suspention.
Clarity about what the law requires in each case will take some of the paranoia out of the school and allow the GW staff to act with logic and confidence rather than their legal advisors.
So how do we create clarity? we can wait for the courts to decide exactly when and where a U has a duty of care. We can wait for the courts to define exacty what defines conduct that may harm self or others allowing the university to suspend the studnt. This will take years and will be a cost billions of dollors over dozens of cases in legal fees and other cots.
OR.... we have our legislature do its job. Congress at the state level should be dealing witht these issues and decideng these questions...they are too big to deal with from the bench.(i wonder what larry thinks about this)
student 2, communication at UMD, at 4:10 am EST on March 16, 2006
trying the reply again
Student2, I had a much longer response, but it didn’t get posted. I think that legislative guidance would be a great thing. It would be great to know whether schools owe no duty to their students to protect them from students they treat in a “medical” capacity. (Though at GW, the legislature is, for most intents, Congress.) Then, it would be much easier to determine whether a practice, mandated by a statute, is constitutional or not. However, since legislatures are often paralyzed on these issues (because the interests in these cases are almost in equipoise), this vacuum in the law will be filled by common law. Or, if people listen to me, schools develop a work-around and simply treat students in the way that a hotel treats its guests. (I don’t know what you mean by “Congress at the state level.” Are you referring to state legislatures.) Whether clarity in the law will result in logical activity by administrators is an open question. In my experience some statutes are abused by administrators as a means to do terrible things, and then use the statute as justification.
I don’t think it will take “years” for the courts to resolve these issues. I think, for the most part they have, finding that schools don’t owe most students a duty to treat them like children. There may be some liability when schools start treating an illness, but this is different. It probably won’t take “billions” of dollars, either.
Student1, For what it is worth, if my friend resulted in me going to a mental hospital, she wouldn’t be my friend anymore. Like it or not, many people “think” about suicide. Most then go back to thinking about pancakes or physics afterwards. This isn’t a reason to ruin someone’s life.
Kevin, You watch too much TV. You keep raising the bogeyman of “trial lawyers” without really knowing too much about costs of litigation. To be honest, for most lawyers that practice in “conventional” torts, there is little money to be made in gray areas of the law, as the possibility of recovery is limited. Schools simply don’t spend that much on defending themselves from lawsuits by students that were injured by other students that were treated for “mental health issues” or from such students themselves. At many schools, litigation costs are mostly derived activities that a non-educational institution undertakes (driving busses, breaching contracts with vendors, etc.) Some schools have high litigation costs in employment-related areas (that is, professors claiming that they didn’t get tenure, were harassed, etc.)
Also, Kevin, your use of the term “NGO” is confusing. This is a political science term that has no place in the law, because it refers to just about everything that is NOT a government entity. Whatever the case, should an organization wish to sue on behalf of its members in a federal court they must meet the Hunt v. Washington State Apple Advertising Comm., 432 U.S. 333, 343 (1977) test: (1) its members would otherwise have standing to sue in their own right; (2) the interests it seeks to protect are germane to the organization’s purpose; and (3) neither the claim asserted nor the relief requested requires the participation in the lawsuit of each of the individual members. So, if an organization doesn’t have a member that was actually injured, then there is no real threat.
Larry, at 6:50 am EST on March 16, 2006
Interesting Points by Larry
Hi Larry,
Well, I think you raise some interesting/important points.
1) My friend WAS initially very angry with me. She felt betrayed, scared, appalled, etc... She didn’t feel that she needed to be hospitalized as a result of her speech acts. I visited her in the hospital, and tried to explain that I had not expected the school to take such drastic measures. I really *hadn’t* expected hospitalization to be the outcome; I had simply said that if she wouldn’t go to counselling, then perhaps counselling should come to her. Boy, did it ever...
2) I still believe I did the right thing, and that the school took the appropriate measures in response. She’d made several past attempts to hurt herself (so it wasn’t just thoughts and vague statements, but also clear plans). It was during a very difficult time at our school, and no one could afford to take risks. She came out of the hospital with a renewed sense of mission: to finish her semester, and not to hurt herself anymore. She was too angry at the school to kill herself. 3) Where the school could have acted more compassionately was in not “stigmatizing” her upon her return. She felt stigmatized by the wording of whatever statements counselling issued to her. I was very surprised by the conditions, since I knew of other students who’d been on leaves and had no such conditions upon their return. But I do understand the personal turmoil involved when people turn to you for help, and you don’t have the professsional resources to be able to assist them; it is really scary and stressful for people on the outside, trying to be helpful.
My friend’s anger eventually turned to acceptance and understanding. (I think).
But I think the heart of this problem boils down to the future: once the student is back on campus, how to help them feel like they are a “normal” member of the community, even though they’ve had a rough time in the past.
Student, at 9:41 am EST on March 16, 2006
What colleges doing will cause the opposite
What the state of Colorado and some colleges are trying to do will cause the opposite results.
Counseling is most effective when there is an understanding of client privacy and confidentiality. The client is them more willing to seek help. To take away or modify confidentiality would create a situation where students would avoid help and then by avoidance nothing is done to assist a person in a crisis situation. The lack of help may actually increase problematic situations.
On the other hand many students with depression, anxiety, psychotic episodes, Bipolar disorder lead positive productive lives. Loss of confidentiality and disclosure would put unwarranted focus this situation by revealing that they live with a problem, and could ostracize them from a college classroom/program/college.
This is a slippery slope issue. Suddenly in addition to counselors, this will lead to college social workers, nurses, and doctors will evolve into having to report publicly what is private in all other areas of life. This will create a situation where EAP and clinical training labs will have to report things for people on campuses that are using services.
To top it off things disclosed will be used against an individual for entry, jobs, grades and will harm individuals who just happen to need therapy.
Counselors have both licensure policies and professional ethics to follow. If there is a situation of danger to self and others, then there is a required duty to warn. States require many things, such as child abuse, to be reported as well.
The most effective way to handle situations is for colleges to set up procedures to warn and monitor individuals by the counseling staff. Re-staffing budget cutting depleted counseling staffs is another thing that would help. Setting up crisis management plans to help college enrolled individuals in crisis.
38 year Counselor, at 10:35 am EST on March 16, 2006
Two sides?/trust
GWs treatment of Mr. Nott appears and may well be stigmatizing, discriminatory and extreme. However, if you read between the lines of the GW spokesman, it appears that there may be extenuating circumstances that they are not at liberty to discuss, which may have made them believe that Mr. Nott was an immediate danger to himself and/or others. Remember that the patient/client is at liberty to present their side as much as they want, however, law and ethics forbids professional counselors from disclosing most facts about any patient.
My hope is that these discussions will result in heightened awareness about the challenges in both presenting to treatment and to treatment of emotional problems.
At our center, we discuss confidentiality, limits to confidentiality (under state law) and informed consent. A copy of this informed consent is given to the student. If we break confidentiality, except when required by law, we can lose our license or be sued.
Remember, the vast majority of counseling centers maintain confidentiality of many extrememly distressed students. It must be that way. Otherwise, why would you trust your therapist with your darkest thoughts. The healing relationship is based on trust. Together, let’s find ways to maintain that trust.
Anonymous Counselor, at 1:40 pm EST on March 21, 2006
As usual, it appears as if...
educational staff/employees are more concerned with covering their own behinds rather than the safety of the students who rely on them. I loathe the selfish behavior many educators exhibit when faced with situations that involve the health and well-being of students. I have a question: Are employees at the university level mandated reporters of abuse/neglect? If an insructor at a college/university is concerned that a student may harm oneself or another, it needs to/should be reported, even if it is not federally mandated in the same manner as for K-12 institutions. TO THE COLLEGE LAB INSTRUCTOR who posted at the top of this chain who is concerned that a student of his has access to knives after learning of the “cutting” thoughts she was having: You did what you should have done by reporting what this student chose tell you. Good job following through promptly in a professional manner. I think it is ridiculous, however, that you believe you are either entitled to a progress report or any information regarding this person’s medical status! It is not your right, nor is it right for you to question this student’s right (or ability) to attend class/lab. Assuming thst this student was evaluated properly, her continued placement in your class is appropriate, and you have no grounds to appeal. Your post gives me the impression that you feel burdened by her presence in your class. Did you assume that she would just go away after reporting what she told you? I find your concerns regarding this student’s access to “knives” or whatever in your laboratory apalling and offensive. This woman chose to confide in you, you rightfully contacted the qualified/assigned resources, and now you view her as a time bomb, unlike the rest of the population. Yet they all of your students have at least one thing in common: they each have the right to be there. I’m beginning to fear for my former students currently attending college. Will they make a choice to share their history of emotional disturbance or confide in an instructor whom they trust? In seeking guidance, will the existing expectations of success be altered for these youngsters now that history of a disability has been shared?
HS Teacher, at 5:40 am EST on April 1, 2006
Diversity for all...Except Mentally Ill
The Americans With Disabilities Act DOES apply at colleges. The schools who expel students for mental illness deserve to be sued.
A student with severe epilepsy COULD harm himself or others during a seizure...shouldn’t he be expelled, too?
A student with Tourette’s Syndrome COULD harm herself or others when her tics include lashing out with her fists. Shouldn’t she be expelled?
A student who uses a wheelchair COULD harm himself by mis-navigating an incline on campus, or he COULD cause harm by running over a classmate’s foot. Shouldn’t he be expelled, too?
No, it’s OK for all THESE people with disabilities to attend college, AND to be treated fairly and respectfully. If you have a mental illness, though, you’re better off keeping your illness to yourself and seek treatment FAR AWAY from anyone involved with your school.
Kathy, at 10:40 am EDT on April 5, 2006
mental health treatment by non students at universities
Questions:
If a non-student experiences a mental health crisis at a university hospital — are they also being judged by a student code of ethics?
What are the laws that protect non-students with mental illnessess in university settings — like denying entry to a university medical facility based upon mental illness issues.
What can non-students do to help in this fight against the discrimination of the mentally ill at universities?
Why do universities teach psychiatry and research psychiatric medicines when they cannot ‘deal’ with the mentally ill?
Why are universities allowed to research mental health issues if they have proven their inability to handle mental health issues in reality?
What are the laws that protect the mentally ill from harm from the very medicines mandated (in some incidences). Many of the SSRI’s and the newer antipyschotics have been proven to cause adverse effects in patients, and yet students, who are over the age of 18 have no warnings for these type reactions in many cases (ie: suicide thoughts from SSRI’s). How many will now suffer diabetic reactions from Zeprexa, and what ‘treatment’ were these patients afforded when they went into a diabetic attack and someone thought they were simply being psychotic? Prozac can cause some people to go psychotic and to have suicidal thoughts (children). How contradictory is this ... very. Now that the student is over 18, does that mean that prozac or other SSRI’s will not cause suicidal thoughts. 18 ... the magic number — now that the person is an adult ... there is no way this person can be adversley effected by SSRI’s??? Is this what highly educated people really think? What at 18 causes a person to have an adult mind that cannot be effected by the suicidal effects of SSRI’s? Is this a proven fact beyond shadow of a doubt that every person brain changes into something else at the age of 18?
How can the very universities that research these medicines turn around and bannish people from their universities (students and non-students alike) for the very reactions to medicines that they themselves helped research and ‘pass’ on to the unsuspecting consumers.
The state of affairs of mental health nationally may be better than the era of lobotomy ... but it is still harmful to the very people it portends to ‘help’. How can students and non-students be banned from universities due to fear of harm to self or others when these very universities support or prescribe (or give unsuspecting research targets) medications that harm?
No wonder many mentally ill persons do not seek help. The help harms ... and all harmful ‘therapy’ given by, at, or mandated by for being at universities at the wrong time or as an unsuspecting research target should be expelled from the education system as it does to mental health patients on the basis of student-code-of-ethics and harm, or better yet, on the basis of hyprocratic oath.
So many questions ... so many lives destroyed by the money and power hungry pharmaceutical companies and the people who support their harmful and decietful practices ... many of which can be found at the collegiate research level.
What can be done to stop this outrage? Do these people need to be forced into some kind of treatment or banned from the instistutions of higher learning for which their harmful actions against mental health patients are perpetrated?
Maybe someone could do some research on that. How does the mental health of persons increase when they can actually trust the persons they turn to for help to not destroy them or give them medications that might permanently damage their brains, their lives, and quite possibly the lives of others. My mental health would improve tremendously if I no longer had to fear for my safety everytime I ask for mental health assistance.
anonymous, mental patient at none thanks, at 9:00 pm EDT on May 17, 2006
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suicide removal
As the parent in the case of frentzel vs. Ferrum, I would like you to know that the facts are distorted as to what happened the day Mike Commited suicide. The media reports over several days and a note. this is NOT TRUE, Mike had bruise marks on his neck and was holding a belt, when the dorm monitor was notified by his girlfriend. The dorm manager correctly notified the police, who notified the Dean who notified a psychiatrist. All seen Mike with briuse marks around his neck, holding a belt, and he stated he was suicidal. After speaking with the Dean and a psychiatrist,BOTH left Mike alone to talk with his girlfriend. Mike emailed his girlfriend, which popped up on all computers in the dorm, “Tell —- will always love her". The girlfriend showed this to the Dean and psychatrist in her room. They made no effert to return to Mike. He was found hanging from that belt 15 minutes later. Upon seeing Mike hanging, with that belt, the Dean ran from the room throwing up. A student grabbed Mike and was able to start his heart. He died 2 days later. I do not know the answers on student mental issues. But this issue was gross misconduct oon the part of three professionals, who should have had Mike sent to a hospital or at the VERY least monitored.. Believe me, I would rather that my son lost credits or was dismissed from school. He asked for help, it was not forthcoming.
LVerne Schieszler, at 11:05 am EDT on September 19, 2007