‘You’re a Case Number’: The Bureaucratic Gaps Behind Harvard’s Mental Health Leaves of Absence
Content warning: Mentions of suicide and self-harm; descriptions of depression, anxiety, and other psychiatric conditions.
Jazzy muzak plays over the phone pressed to my ear. Sitting alone in my room, the world blurring before my eyes, I fight to contain my sobs and take deep breaths before I’m connected to someone on the suicide and crisis lifeline. A crippling, all-encompassing feeling of loneliness wracks my body, and my chest feels like it’s caving in, squeezing wave after wave of pain out and over me.
Suddenly, the line clicks. “Hello?”
Her name is Rachel; her voice is soft and soothing and reminds me of the color cinnamon. She asks if I feel grounded, and I tell her I’m lying on my couch under my thick, fuzzy blanket to feel safe. “Feeling safe and feeling grounded are two different things,” she explains gently, then walks me through a grounding exercise. By the end of our call, the exhaustion sets in. I don’t feel less sad, but the pain has subsided, giving way to a quiet, tired numbness that has become all too familiar.
Most days of my sophomore year unfolded like this: emotional rollercoasters and spirals that would intensify at various points throughout the day, often leaving me to withdraw to my room as soon as I could and curl up in a fetal position on my couch. I dissociated almost every day. I hurt myself. I called 988 so many times I could predict what they’d say and do. I thought about taking my life, multiple times a day, and, in the spring of 2023, made two extremely halfhearted attempts within the span of a week, though thankfully, neither resulted in hospitalizations. This was the reality of struggling with severe major depressive disorder, generalized anxiety disorder, and complex post-traumatic stress disorder, diagnoses I received that year.
Truthfully, I knew I would never hurt myself to the point of needing medical attention — the thought of my loved ones served as a life raft, keeping me afloat even among the darkest, most tumultuous waves. Yet a bleaker force restrained my self-harming behaviors as well, hanging thick and oppressive over me, like smog: If I told any adult on campus what I was going through, if I went to Harvard’s Counseling and Mental Health Service, I would very likely be packed away on an involuntary leave of absence.
According to the leave of absence policy today, the reasons students can be placed on an involuntary leave are related to either academic or disciplinary infractions or “medical circumstances,” which include mental health conditions. Such circumstances entail behavior that “poses a direct threat to the health or safety of any person, or has seriously disrupted others.”
Moreover, the administration will not automatically allow students to return to the College following a hospitalization that “raises serious concerns about the student’s health or well-being,” or other circumstances that raise such concerns and “reasonably call into question their ability to function as a student in the Harvard College environment.”
Though I seemed functional — excelling in school and extracurriculars and taking care of my physical health — and fought to keep that facade, I felt that if I let anyone in on my inner turmoil, I would be seen as a liability, someone unfit to be on campus.
Moreover, I knew if I were to take a leave, I would have to slash through layers of red tape to return. This includes seeking psychological and psychiatric care; providing “evidence of productivity,” often in the form of employment; meeting with CAMHS for approval to return; obtaining letters from providers and employers testifying to your readiness to return; and writing a statement about why you should be allowed back.
During the leave itself, I would also effectively be cut off from Harvard’s community and resources; in most cases, you cannot reside or work on campus while on a leave, nor can you participate in extracurriculars or access school facilities.
Notably, these are requirements specifically for those on leave for mental health reasons, whether voluntary or involuntary. The process for going on leave for any other reason, such as for a disciplinary infraction, travel, or professional development is much easier to navigate.
In 2018, the Ruderman Family Foundation, a Boston-based disability rights advocacy group, in conjunction with legal, psychological, and educational experts, published a study scoring leave of absence policies for students with mental health conditions at Ivy League schools. None of the schools received grades above a D-plus; Harvard received a D-minus, tying with Cornell for the second-lowest score. That same year, the parents of Luke Z. Tang ’18, who died by suicide in Lowell House in Sept. 2015, filed a lawsuit against the College and several of its employees, alleging that the school was negligent in its engagements with Tang and their failure to prevent his death.
As of the 2023-24 school year, the College has implemented changes to its leave of absence policy. But the nature of these changes are relatively limited — they primarily outline in further detail the criteria for requiring a student to be placed on involuntary leave.
College spokesperson Jonathan Palumbo declined to comment on the criticisms in this article.
The goal of this piece is not to weigh the pros and cons of taking a mental health-related leave of absence. Rather, I want to examine the role the College plays in how students make — or don’t make — decisions to take such leaves.
Though the College undoubtedly carries a degree of responsibility for its students, the nature of this responsibility remains unclear. The College’s leave of absence policy is essentially a one-size-fits-all measure to address these cases, but such universalizing often can’t take into consideration the variance of experiences for students suffering from mental health issues. So I set out to uncover the reasons behind these policies, as well as their effects; for some students, whether they take a leave and how they do so could be, and has been, a matter of life or death.
‘School as Police’
Teresa, a College undergraduate who spoke on the condition of anonymity, tells me she struggled heavily with depression and anxiety her first semester of college and relapsed with self-harming. When her proctor and dean heard about this incident, her dean strongly advised her to take a leave, as did CAMHS when she went in for an evaluation and treatment.
“I understand where the College is coming from, but I felt like it was almost like they were giving up on me, in the sense of, ‘You cannot handle this environment, you might as well just leave,’” she explains.
And Teresa didn’t want to leave. She had spent a lot of time and effort forging new connections with other people and felt that being forced to leave her friends behind would worsen her mental health. Deepening these fears was the lingering trauma of being involuntarily hospitalized for a suicide attempt in high school.
“I was basically taken away from everything I knew, my entire family, so I know firsthand how traumatizing that can be,” she recounts. “So having this fear always in my mind, like, ‘I know I’m not well, but if I seek help, will I only exacerbate my current condition?’ It’s very hard.”
So Teresa stayed quiet the best she could, though that came at a price as well. “There were some times where I would just wake up, and I wouldn’t know what to do with myself because I knew that I was not in a great mental condition, but I didn’t really know where to go to seek help and where to start,” she says. “I was just so afraid of being taken away from my friends and everything I built up in my first year.”
Fortunately, circumstances improved greatly the following semester. Teresa began taking an antidepressant through CAMHS and received further support from the Office of BGLTQ Student Life, which made her feel “safe and welcomed and supported.” Things weren’t perfect; she would run into issues with CAMHS when it came to medication refills, going cold turkey for a few days and experiencing a relapse in depressive symptoms as CAMHS would take days to respond to her requests or have technical issues. Still, she found herself in a much better place, which she credits to the fact that she did not take a leave of absence.
“It would have been crushing for me to have stayed at home,” she says. “I would have missed so many things, I would’ve never met such amazing people as I did second semester. It would have been absolutely horrible.”
As I spoke with Teresa, something in my heart twisted. I knew how isolating and anxiety-inducing it all was — being afraid of reaching out for help, afraid of being removed, afraid of losing what you’ve built at school.
Mere months before my conversation with Teresa, I’m sitting in a music room in the basement of Standish Hall, speaking to my therapist on a video call. My laptop rests on the keyboard; beside it, a pack of pocket tissues.
As always, she asks me about my self-harm — the frequency and my triggers — and I tell her. Then, she asks, “When you hurt yourself, how do you do that?”
This catches me off guard. Does she really want to know? After a long pause, I tell her. “But it’s never enough to warrant medical attention or anything,” I add at the end. “Mostly it’s because I know if I have to go to the hospital, then the school will kick me out. Same reason why I don’t ever have any intent to act on my suicidal thoughts. Though I guess there are also other, more important reasons for that one.” I let out a dry laugh in an attempt to lighten the mood. See? Things aren’t that bad! I would never go to the hospital, and I have real reasons to live!
It doesn’t work. My therapist leans forward, brows furrowed. “You know what I find extremely sad about that?” she asks. I look down at my hands; I already know where she’s going with this. “I think it’s extremely sad that you’re limiting your self-harm because you’re afraid of being kicked out. It’s not that you know you have people here to turn to for support. It’s that you’re afraid. And when I hear that, I hear school as police.”
School as police. My throat constricts. “Yeah,” I manage to squeeze out. “Yeah, that’s what it feels like.”
It was hard to tell sometimes whether my feelings of distrust and not being cared for stemmed from legitimate fears of the administration’s possible response to me, or from my disorders and the ways they distorted how I viewed the world. After talking to Teresa, my fears felt more valid now that they were grounded in hers.
From looking into the archives of past student handbooks, I found that the College has historically used leaves of absence as a punitive measure. It’s unsurprising, then, that so much fear surrounds the idea of being placed on a leave.
From at least 1984 to 1998, the College handbooks did not have any sections discussing placing students on leave for medical reasons. Involuntary leaves were instead filed under a section titled “Unsatisfactory Records and Discipline.” An oddly foreboding message remained until the 1996-97 school year: “A student who has twice been required to withdraw from the College will ordinarily not be readmitted.”
The College began to more explicitly discuss putting students on leave for medical or “emotional disturbance” reasons in 1998, separate from the general section on requirements for withdrawal.
This change followed discussions among Harvard University Health Services, Harvard University Police Department, resident deans, and former Dean of the College Harry R. Lewis ’68 in response to a situation where a student “was suddenly released from a hospital to a House, with inadequate opportunity for the House to arrange appropriate accommodations,” wrote Lewis in a memo at the time. The administration realized they finally needed to formalize the process of students taking leave for mental health reasons.
But despite this new explicit acknowledgment of mental health conditions, the language of much of the 1998-99 policy characterizes students with these conditions as problems. A new section titled “Effect of Health Issues on Dormitory or House Residence” opens with a series of statements that emphasize the College’s concern for the well-being of the members of its houses, which means “safeguarding the right of all community members to be free of undue disruption in their academic and residential lives.” The following sentence states: “In a residential college, an individual student’s physical illness or emotional difficulties affect not only the individual, but also others in the community.”
This language remains almost exactly the same in the 2023-24 handbook. And indeed, from speaking with students and alumni, I found that the College responds in this heavy-handed way to students whose behaviors are seen as dangerous to themselves or to the community.
‘No Human Touch’
Even with his relative willingness to talk, Joseph C. Felkers ’22 seems reluctant to tell me too many details about his experience. Though he just graduated, he still fears some form of repercussion from the school.
The journey to and through Felkers’ leave of absence was a long one — one kick-started by a misdiagnosis from CAMHS.
Felkers began developing signs of depression the summer after his freshman year, and the following fall, CAMHS diagnosed him with major depressive disorder and prescribed him an antidepressant. During his appointment, Felkers’ doctor gave him a brief disclaimer: If he in fact had bipolar disorder instead of major depression, the antidepressant would likely trigger a manic episode. But the doctor “made it seem pretty inconsequential,” Felkers recalls, so he took the medication.
And launched into a full-blown manic episode.
“Pretty quickly after taking that medicine, I kind of lost my shit. I started staying up for nights on end. I at most went five nights in a row without sleep,” Felkers says. “I was clinically psychotic, like I thought the government was chasing me and I was a spy, and hearing voices and shit, it was crazy.”
That November, the weekend after the Harvard-Yale game — during which he hadn’t been sleeping at all — Felkers visited HUHS urgent care and told a nurse he thought he was having a manic episode. The nurse “totally brushed me off,” he recalls. “She was just like, ‘Oh, it’s just classic anxiety. You’re having a panic attack, try breathing exercises, whatever, go home.’”
Two days later, as a result of his mania, Felkers was detained by HUPD and involuntarily hospitalized before being committed to McLean Hospital. Once he was discharged, the administration placed Felkers on an involuntary leave for the rest of the semester, though they allowed him to finish his papers and projects from home given how late in the semester it already was.
Felkers, however, did not want to stay on leave. This was before the pandemic — during which the number of students taking time off increased — and leaves of absence were not as common as they are today. He admits he was “really afraid of that administrative restraint being placed on me and how it looks socially.” He also felt that he had been mistreated by CAMHS and filed a petition against his leave.
In his petition, Felkers cited three points: his misdiagnosis by CAMHS, the invalidation of his symptoms by the CAMHS nurse, and his lack of a decent relationship with his assigned therapist, even after he had expressed his concerns to CAMHS administration. Even during his interview with his case manager, Felkers recounts, he felt demeaned. “It was not a pleasant experience, I’ll say that much,” he tells me.
The Administrative Board ultimately approved Felkers’ petition, and in the spring of 2020, he prepared to return to campus. But shortly after, the pandemic struck, and Felkers effectively spent the remainder of that semester at home.
When I ask him how he felt throughout this entire process, he frowns. “I have two answers,” he finally says. “One is just confused, like really lost and not understanding — but two, symptomatic.” Felkers explains that he was placed on a heavy antipsychotic medication, which made him “totally zombied out.” Still, he remembers feeling vulnerable; his involuntary leave, compounded with blockmate drama, left him feeling like he didn’t have many people at Harvard he could rely on.
Shortly after he was sent home during the pandemic, Felkers was notified that he had been selected to do a creative thesis for his English concentration. Over the next two years, he would write a collection of poetry that would serve as his “anchoring point all throughout the rest of my journeys through college, with that catastrophe right behind me.” He took another leave of absence — this time, voluntary — in the spring of 2021 and traveled abroad with one of his blockmates, doing freelance business strategy work for various clients.
Looking back, Felkers says he regrets appealing his involuntary leave. He was, after all, “very ill.” But the necessity of the leave didn’t change the fact that Felkers felt the school had mistreated him. “I’m sure they did their best trying to be respectful to me and work with me the best they could, but it still came across as very isolating and devaluing and just kind of embarrassing,” he recounts. “I felt like I was being talked down to by Harvard like a baby.”
He adds that the heavily bureaucratic nature of going through a leave of absence further creates a sense of dehumanization. “There’s no human touch in the experience,” he says. “You’re a file. You’re a case number. You’re an issue email that somebody is getting.”
CAMHS declined to comment on Felkers’ story, citing a policy against discussing individual student matters.
My conversation with Felkers took me a while to digest. That the College could make such a consequential mistake was one thing, but what was more shocking to me was how coldly they continued to treat Felkers when placing him on leave.
But interestingly, the College’s treatment of every student with severe mental health conditions isn’t always so intrusive; rather, their response seems to vary greatly based on how unwell the student seems to be.
‘How Did No One Prevent This?’
As soon as Grace Benkelman ’25 returned to campus the fall of 2022, she noticed that her roommate, Luke T. Balstad ’25, “felt like a shell of a human.”
“He clearly was very preoccupied,” Benkelman recalls. “He just felt really distant, and he would sleep all day. I would come back to our room, and he’d be sleeping, and then he would go to bed at nine, and it was just – it was so hard to watch.”
Luke was diagnosed with bipolar disorder that summer while he worked with the Broad Institute, Benkelman tells me. At the time, he was experiencing a manic episode, but as fall crept around the corner, and as he struggled with adjusting his medication, he slipped into a severe depression.
The administration was aware of Luke’s situation; prior to the beginning of the semester, he had met with a professional associated with the College to establish that he was ready to return to school. But as the semester progressed, it became increasingly clear to Benkelman that Luke was struggling. He talked to his adviser and decided to drop a class. Still, the depression was debilitating, and he was hospitalized at McLean around late September due to issues with his medications.
Though Benkelman felt that Luke should have returned home to fully focus on managing his mental health, Luke was more hesitant to take a leave. As much as he was struggling, he had strong friendships at school and was worried about losing a year with them. “It felt like there was nowhere for him to go,” she says.
Throughout the entire process, Luke was basically alone. Though he shared some details with Harvard administrators, Luke’s primary confidant was Benkelman. She listened to him and supported him the best she could, and when he decided to leave, she helped him pack and ship some belongings while keeping the rest to store over the summer for him.
“I was just worried throughout the entire thing,” she says. As she talks about this time period, she fights back tears. “I just felt helpless. He basically only talked to me about this. He didn’t have the energy to talk to our other friends or his other support systems, so I felt like I was very much the only one involved in this situation.”
On top of that, Benkelman recalls that the administration was relatively hands-off throughout the process of Luke’s leave. Though she does not know what Luke discussed with Quincy House Resident Dean Nicole S. Simon or with other administrators, she recalls that after every meeting, he seemed to sway in a different direction, lacking direction on what exactly he should do. To Benkelman’s knowledge, no CAMHS psychologists or psychiatrists were involved in the process. Much of the responsibility, it seemed to her, fell to Simon, who acted as Luke’s primary point person — though she, like every other resident dean, is not a licensed professional trained to assess the needs of a student struggling with mental health.
After having a stress-induced seizure in October, Luke finally decided to take a leave. He filed his paperwork and booked his tickets home three days later.
A week after leaving, Luke texted Benkelman expressing that he might return to campus. “I think he finally got home and was really feeling what he was missing out on,” she says. He met with Simon to discuss the possibility of him returning to school. She strongly urged him to take the year off, but acknowledged that since his paperwork still hadn’t been processed, he could technically still change his mind. Benkelman views the whole situation as “poorly handled.”
Luke ultimately decided to stay at home, but instead of resting and recovering, he began “trying to fit into this new scene of ‘go, go, go,’” Benkelman says. He took up a full-time job as a barista, she guesses, to fulfill the employment requirement of his leave.
“I was worried because it felt like this should have been a time where he was only focusing on one thing, which was his mental health and his medication, and it was very concerning to see that that was not what was happening,” Benkelman says. “But Luke always put other people first, and he always put on a brave face. And so I would call him, and he’d be like, ‘Oh, I went on a run today.’ He would talk about his situation as if he was doing alright, when in reality, it was very draining.”
In November, around a month after returning home, Luke took his life. When Benkelman received the news from Simon, she felt shocked and horrified, but she says part of her “felt like, ‘How did I not see this coming? How did no one see this coming? And how did no one prevent this?’”
She’s still processing his death, she tells me. “I feel like this entire thing was like a big explosion, and there was just this cloud of, ‘Wow, Luke is dead,’” she says. “And everyone else around me was continuing to walk forward, so I continued to walk forward.”
She adds, “I was in a state of shock for a month.”
Initially, Benkelman says, she felt guilty about Luke’s death because she had been the most involved in his process of taking a leave and had encouraged him to go home. She believes that if he had stayed at school, he would still be alive. But over time, she slowly began to wonder why the administration had acted the way they did. Why had the administration not provided Luke with more support? Why was there no follow-up after he had left?
“It just felt very unorganized and depersonalized for such a sensitive topic,” she says.
CAMHS and Simon declined to comment on Luke’s case.
After talking to Benkelman, I sit in my room, processing everything. The lack of involvement from the College, especially in comparison to the response that Felkers had received following his hospitalization, seems shockingly inconsistent.
I sink into my couch and stare up at the ceiling. And I begin to cry — not just because of Luke’s story or because Benkelman’s grief was devastating to bear witness to, but also because what Benkelman said kept echoing in my mind: How did no one see this coming?
The reality is that mental health conditions, especially more severe ones like bipolar disorder, are incredibly complex. No single policy can reasonably be expected to serve as the “solution.”
At the end of the day, a one-size-fits-all policy for an issue so colored by nuance will be imperfect — and this imperfection means that some students, like Luke, will fall through the cracks.
This is not to say that the leave of absence policy always fails. In some cases, it works, as further conversations with students and alumni showed me. But even these positive experiences come with caveats.
Lesser of Two Evils
When David M. Hirsch ’90 arrived at Harvard from his hometown in Eau Claire, Wisconsin, he struggled with adjusting to college. He did poorly his first semester but didn’t reach out for help because he “was ashamed,” he recalls. After taking a voluntary leave the following semester, he returned to the College — and failed all his classes.
“It was one of these things that I have nightmares about now. It’s something I know other people have nightmares about, except I really did it. I went to the first day of classes,” Hirsch says, “and then I just never went to them. I went, took, and failed the final for all four of these classes.”
At Harvard, Hirsch was thrown into an environment that was different from what he was used to, and that impacted him — hard. “I really struggled,” he recounts. “I was far away from home, I did not have the same sort of family support that I did at home, and in general, I didn’t apply myself very well. And the problem is that I didn’t have the resources to pick up and keep going.”
The Dunster resident dean informed Hirsh that he would have to take a leave of absence. But Hirsch didn’t want to leave; he was afraid to tell his parents what had happened. He stayed on campus as discreetly as he could the following semester, residing in his dorm until the resident deans caught him in March and reiterated, firmly, that he had to go.
Returning home, however, wasn’t as disastrous as Hirsch had expected. Though he met with a therapist for a while, he found that what most helped him was his family’s support, as well as the job he picked up as part of his requirement to return. Hirsch decided to work at a local Kinko’s since he had experience from working at Gnomon Copy while at school. The work, Hirsch recalls, provided him with the structure and accountability that he had lacked in college and gave him a sense of competency.
“I knew I had to fix this. I was definitely ashamed, I was definitely as low as I could go, I felt like,” Hirsch recalls. “Maybe I couldn’t do academics — that remained to be seen at that point — but I could definitely make copies. So I felt good about it.”
Hirsch also began playing in a band, which would spark a lifelong engagement in music, and met his now-wife. With this newfound stability in his life, Hirsch ultimately decided to extend his leave, staying at home for 18 months before he felt fully ready to return to campus.
Upon returning, he lived off-campus, first with a friend studying at the Graduate School of Arts and Sciences, and then, when she graduated six months later, with his now-wife. Determined to set himself back on track, attending classes during the day and working full-time in the evenings, Hirsch graduated three years after his return with a degree in English and American Literature and Language. With his years of experience working in copy shops, he proceeded to work at Kinko’s in Harvard Square before taking software developer jobs and, eventually, studying medicine and working as an obstetrician-gynecologist.
“My life is what it is because of all that,” he says of his leave. “It was the low point or the kick in the pants that I really needed to understand that I needed to make some lifestyle changes and get some help. Harvard really helped me through that by making me work for it and believing in me, not just booting me completely, but saying, ‘Okay, go figure yourself out.’”
Still, Hirsch acknowledges that an involuntary leave of absence might not be the best response for every person. His family was particularly supportive of him, and he says he can imagine that for a student who lacks that kind of care at home, leaving school may not be as helpful as it was for him.
Vandie A. Dumaboc ’26 was one such student. Like Hirsch, she did not want to go home. But when her depression left her bedridden the spring of her freshman year, she felt compelled to choose what was at that point the lesser of two evils.
“I was doing well in my classes. I just could not get out of bed,” Dumaboc recounts. “It was just not sustainable, but I wanted to drag it out as much as possible because my other option was going back home — which is what I ended up doing — but home is not really a safe space for me.”
On the whole, going home to Chile proved helpful for her: She managed to find treatment, as mandated by the terms of her leave, and took up a fulfilling job working as a pre-K to eighth-grade English teacher at her former school.
Still, Dumaboc faced a host of challenges. Her home environment felt unsafe — there was a history of family violence — and she had to readjust to both a lack of independence and caretaking responsibilities for her younger sister. She also missed her friends from school. “I did feel very, very alone,” she tells me. “The friendships I made here are incredible friendships, and I rarely had connected like that with people back home.”
Worse still, the conditions of her leave were hard to meet because she is an international student. According to the requirements, she had to seek therapy, but it was hard to access in Chile. It took several months for Dumaboc to find a therapist and a psychiatrist, and after a few sessions, her therapist ghosted her. She also struggled to secure her job in a timely enough manner to fulfill her work requirement. “In Chile, finding a job at 19, without a university title, and without using family connections, and getting paid more than $400 a month?” Dumaboc says. “Impossible.”
Her eventual return was also complicated. She couldn’t place international calls, so she had to email CAMHS to set up the mandatory meeting prior to her return. CAMHS took a month and a half to respond to her, which placed further stress on Dumaboc because her F-1 visa expires every year. If she wasn’t able to return to school, she would have to reapply for her visa — and she would be cutting it close since she had limited time to do so with only one embassy in Chile to go to — and she would have to find a new job before her current job contract ended in December.
Dumaboc’s anxiety was at an “all-time high,” she says. “I remember I was doing very well, mental health-wise. And then when I started the process of sending emails and not getting any responses, I did have a depressive episode, and I think it was triggered by that. So it’s very ironic that the service that’s supposed to help you with your mental health was the triggering factor of a depressive episode.”
Dumaboc says she felt the administration had been dismissive with her case and that she was treated impersonally.
She adds that the policy clearly did not account for her experience as an international student with an unsafe home environment. “One question I was never asked from Harvard was, ‘Do you have a safe or safer space back home?’” she says. “I would like Harvard to actually think about that.”
Though the leave was ultimately helpful for Dumaboc, that she had managed to come back even with all the challenges she faced was no small feat. And it raises the question: Why is the process of returning still so difficult, even for students who no longer face the challenges that required them to leave in the first place?
‘A Walking Liability’
The hurdles to returning from a leave of absence that Dumaboc discusses are part of a broader pattern in mental health leaves at the College: It doesn’t take much for someone to go on one, voluntarily or not — but to return from or even dispute one requires significantly more effort.
On top of the requirements for proof of productivity and treatment, students must notify the College of their desire to return at least 12 weeks prior to the semester that they want to come back. Yet, when it comes to mental health, a lot can change in 12 weeks. A student who doesn’t currently feel ready may not be able to make a compelling case to return, but their state now doesn’t accurately reflect how they’ll feel by the following semester.
In the current handbook, the College also states that students whose petitions to return are denied can file an appeal to the Harvard College Administrative Board — but only if they follow the College’s guidelines: They must discuss new agreements to engage in treatment or provide “materially relevant” information, or provide evidence of an error in the Ad Board’s decision-making process, within just five calendar days.
The policy seems like it’s structured so that students are incentivized to stay on leave for the full year that is required of them. Even then, the hurdles to returning remain.
One of the reasons, Dumaboc believes, may be a fear of liability. In Massachusetts, schools can be held liable for a student’s suicide on campus if they knew about the student’s suicidal ideation but did nothing. Indeed, though the case was ultimately dismissed, Harvard did face legal repercussions in response to Luke Tang’s death after he died on campus.
“Sometimes, it felt like they treated me like a walking liability,” Dumaboc says. “I guess it makes sense for an institution to want to take a step back from any legal repercussions of someone who can cause damage to their image. But also, you have to think that we live here. This is an institution that deals with humans on the daily, and we’re also under their protection.”
“I believe that the University should have more responsibility in how they deal with these cases,” she adds.
The student handbook states that when deciding whether to place a student on a medical leave of absence, the College takes into account “the nature, duration and severity of the risk” — it does not define what “the risk” refers to — and whether “reasonable modifications of policies, practices, or procedures,” such as course accommodations, will “mitigate the risk.”
Such “reasonable modifications,” however, do not include those that would “fundamentally alter the academic program or unduly burden the College’s resources or staffing capabilities” or those that would “exceed the standard of care that a university health service or the staff of a residential college can be expected to provide.”
In other words, when it comes to dealing with students with mental health conditions, the College takes the current institutional systems as a given. Rather, it expects these students to conform to its systems and standards.
Palumbo, the College spokesperson, declined to comment on a series of questions about the decision-making behind the policy and placing students on leave.
This expectation of conformity to the College environment may be why students must provide “evidence of productivity” in order to return. While Hirsch found the structure of a job beneficial in his time away from school, Benkelman is skeptical of the requirement. She questions why the College would require this of someone if they are expected to take time away from school for the sake of their mental health.
“If you have bipolar disorder, which is the leading mental illness that leads to suicide, then it should not be, ‘Go back home and get a job,’” she says. “It should be, ‘We are going to, as an institution, check in on you and have mental health professionals involved in this to decide what is best for you at this time.’ And that absolutely was not working at a coffee shop for Luke.”
The administrative oversight of students struggling with their mental health doesn’t stop at the gaps in the leave of absence policy. It is inseparable from what many students see as a systemic lack of institutional support for mental health resources on campus as well.
“I think CAMHS needs to be reformed,” Benkelman says. “I’m sure you’ve heard so many horror stories about people trying to get appointments. I just feel like it’s very, very difficult to actually find mental health care on campus.”
A spokesperson for CAMHS stated in an email that they are “committed to providing comprehensive mental health care” and “continue to focus on recruitment and further developments to services,” including the hiring of “over a dozen” clinicians this past year.
Still, shortcomings in the College’s support for student mental health add to a culture of mistrust in the institution’s ability to care for students.
“We are always telling people, ‘Don’t be afraid to get help, don’t be afraid to reach out,’” Dumaboc says. “How do we make the system so that people are not inherently scared to reach out?”
To Hope, To Love
Teresa tried to hide her mental health struggles out of fear of removal. Felkers was misdiagnosed by HUHS and placed on an involuntary leave because of it. Luke fell through the cracks of the leave of absence policy. Hirsch floated around college before crashing and leaving. Dumaboc almost couldn’t come back.
Each of these people’s experiences differ. Yet one thread tied them together: Bureaucratic solutions to mental health conditions often don’t work. And these failures happen for a range of reasons, chief among them the inherently impersonal nature of these policies.
The truth is, there is no quick fix for any of this. There is no quick fix for mental health problems. There is no quick fix for policy reform. And coming to this conclusion at the end of all of my researching and reporting felt, to put it mildly, disheartening.
But I have to hope.
***
Warm folk music fills Memorial Church, mingling with the sunlight filling the high-ceilinged room. Brightly colored flowers match the summery outfits that the attendees don — floral dresses, pastel button-downs, sandals and sneakers. At the entrance to the service, a few of Luke’s friends hand out sky-blue programs and point the stream of people flowing into the church to a poster wall filled with Post-it notes conveying messages of love.
It’s been five months since Luke’s death, and at the invitation of some of our mutual friends, I’m at his memorial. The warmth, the color, the light, the life — even though I never met him, all of it feels strangely perfect for this event.
As his friends read their stories about him, many shed tears, and I find myself getting choked up too. They speak of his overly-sugary IHOP order, his infectious laugh, and the poems he collected; his warm “How are you?” texts, his attunement to nature, and his chaotic morning routine; how he’d never end a phone call without saying, “I love you,” how he’d stop and say hello to people on the street, and how he saw beauty in every little thing. They remember his kindness. They remember his boundless gratitude and love for the world.
As I reflect on the memorial in the following days, I think about my own experiences with suicidality. I think about what others would say and remember about me if I were gone. I think about what I would say about others if they were gone. I think about how fragile it all is — how terrifyingly easily these vivid, little things we know about each other turn into bodiless memories.
I think about my work on this piece. I think about the layers and layers of societal and institutional failures that create a world in which we are inundated with headlines about mental health crises with seemingly no end or solution. I think about the historic stigma surrounding people with mental disorders — that they’re unstable, undesirable, unfit to remain in their communities. I think about the stark individualism that pervades even our conceptions of healing and care. I think about how easy it is to respond to people struggling with their mental health in broad, impersonal ways. I think about how all of this intertwines with our mental health leave of absence policy.
But most of all, I think about love.
If you or someone you know needs help at Harvard, you can contact a University Chaplain to speak one-on-one at chaplains@harvard.edu or here. You can call the Suicide & Crisis Lifeline at 988 or text HOME to the Crisis Text Line at 741741.
— Magazine Editor-at-Large Kaitlyn Tsai can be reached at kaitlyn.tsai@thecrimson.com. Follow her on Twitter @kaitlyntsaiii.