Anxiety had been building up for Maddi Prince since freshman year. “Sitting in class was like having a heart attack for 50 minutes straight,” she said, “and getting out of bed was like climbing Mount Rainier.”
Prince, now 21, said she had been sexually assaulted during her first week in college at Gonzaga University, a private Catholic college in Spokane, Washington. For three years she threw herself into semester after semester of strong academic performance and a busy social life. But in the fall of her senior year, the bottom fell out quickly: Rather than go to class, she'd lay there, paralyzed by her anxiety.
Prince decided to have a conversation with an on-campus counselor to weigh the possibility of taking a leave of absence to focus on her mental health. But leaving is not always an easy solution. There's no standard road map for how to leave, how to come back, or any clarity on when or whether they are even allowed to come back at all. While taking time to heal can be beneficial for mental health issues, colleges can also leave people in the dark as they try to navigate an opaque system that, once they're outside it, treats them like strangers that may or may not have a place to return to.
Nobody tracks how many students taking a temporary leave from college for the sake of their mental health across the country, and colleges themselves don’t talk about the figures. But 75 percent of lifelong mental health conditions begin by age 24, according to the National Alliance on Mental Illness, a not-for-profit advocacy group, making students particularly likely to need help in some shape or form. In NAMI’s 2011 survey of 765 current or recent college students from 48 states and the District of Columbia, 73 percent of those living with a mental health condition said they’d suffered a mental health crisis while at university. Thirty-one percent were so depressed, they found it difficult to function. Without help, NAMI reports they’re more likely to have lower GPAs, drop out, and become unemployed.
There's no standard road map for how to leave, how to come back, or any clarity on when or whether they are even allowed to come back at all
“I had no other support from the university," said Marina* a student in her senior year. “I felt very much left out and isolated, despite my tutors knowing about my (mental health) issues." Marina, whose name has been changed, was pursuing a degree in fashion design at Nottingham Trent University in Nottingham, England, and had been struggling with depression and anxiety for two years. “One tutor watched me cry whilst still asking me questions that I didn't feel comfortable answering,” she said. “I felt pushed to take a leave of absence.”
Colleges like Nottingham Trent make provisions for allowing a student to leave for mental health reasons, but then slam the door shut behind them—as Marina said eventually happened to her—and say the student must reapply for admission if they ever want to come back. There's no standard agreement among universities for what a mental health break looks like, how it's recorded in students' personal records, and how they're allowed to come back.
Imagine applying for a leave of absence, only to find out that you need to immediately repay your semester's financial aid as you walk out the door, or that your school won't refund any of your tuition. Or that after you do take your break, your college transcript will permanently note that you took a leave of absence, information that could be interpreted in any number of ways by any future graduate school, scholarship fund, internship director, or employer.
“For whatever reason, I cannot hold a poker face to save my life, but hiding my mental illness was second nature,” said Laura*, a 22-year-old student, who attends Seton Hall University in South Orange, New Jersey. The senior, whose name has been changed, had been having trouble in class since her sophomore year of high school because of depression and anxiety. Starting in her first semester in college, Laura was hitting weed hard as an escape from her falling grades. By spring of her sophomore year, she said she drank the pain away constantly.
“I reached out to Counseling and Psychological Services first (my freshman year),” Laura said. “The counselor I was seeing mentioned on several occasions that I was on the list of people the university was concerned about.” Yet none of her professors or any other school officials reached out to her. Laura pursued counseling her sophomore year, but despite having her on a “list,” said the school didn't make a move to encourage her to do so. Finally, it was an on-campus counselor who brought up medical leave. But Laura stressed that it was very much her own decision.
“Many times, students are aware they need some sort of support or intervention,” said Scott Bradley, a program coordinator for student life and engagement at New York University. Before NYU, he was a graduate assistant for the University of Southern California's Support and Advocacy department, where he worked with all students who wanted to take a health leave of absence. “These leaves are not discussed as a disciplinary measure, but as a way to provide support to the student and make sure they can return as a healthy and productive member of the campus community.”
USC's policy on mental health breaks is one of the more permissive and transparent ones. Typically, the minimum break lasts for a semester. Professors rarely needed to know that a student took leave, Bradley said, and in most cases, the only staffers who knew were academic advisors, health leave advisors, and counselors. At NYU, he said that no matter when during the year the student takes leave, he or she must repeat the year, but at USC there's no limit to how long a student can take a break, and their spot at the college is saved for them upon return.
For both USC and NYU, students who want to return have to send the college a treatment plan, signed by a doctor, and a personal statement in which the student outlines what he or she hopes to accomplish by returning. An advisor or committee reviews the paperwork and then determines whether they're fit to return, which can be daunting for a student already struggling to remain afloat.
"My university is one of the reasons I'm still alive today, even though I still battle every day.”
It helps, however, if faculty members are aware of their students’ mental health. At Gonzaga, several of Prince’s professors noticed how she'd changed in the few times she showed up for class, and they reached out to Academic Advising and Student Therapy Services, who put her in touch with an on-campus counselor.
“I met with a nice woman who made me feel comfortable about how I was feeling, that I was not alone because she literally had a full-time job dealing with students like me,” she said. Prince ended up staying in school due to the support and not taking the break she'd been considering. “My university is one of the reasons I'm still alive today, even though I still battle every day.”
Other students don’t receive the same support. After four sessions over four weeks with an on-campus counselor, Marina left Nottingham in February 2018. She’d been told confidently that she could return when she was ready. With the support of family and friends, her mental health improved immensely. Better and ready to come back, Marina reapplied in advance of the fall semester and was told to get a doctor's note that said she was on antidepressants and seeking help, which she sent them straight away.
She heard nothing back until sometime in October, a month after school had started, when she got an email saying that she couldn't come back. Marina said she became suicidal. “I didn't get a call from anyone that actually knew me at the university,” she said. “They gave me no reason for the outcome.” (VICE contacted Nottingham Trent University for comment on how they handle students' mental leave, and Marina’s case, but never got a response. Update: After publication a spokesperson for the university sent the following statement: "We have a number of supportive policies and procedures to enable a student to take a leave of absence for reasons including mental health. This would be agreed between the student and the university and a return would be planned and supported.")
But Marina said she doesn’t regret the leave itself. “When I made the decision to leave, I felt so much relief,” she said. University was a toxic environment for her and her mental health improved massively when she left. Since then, Marina said she’s pursuing hobbies she'd fallen away from, and she's creating her own fashion brand.
Laura also said she doesn’t regret her leave. “I don't want to give the university shit, because even with all its issues I still love it,” she said about Seton Hall, “but I wouldn't attribute my 'getting better' to the school. Although without the medical leave, I would have 100 percent flunked out.” Her leave lasted for a year and a half, and because of that she had to apply for readmission, which Seton Hall granted. She's now back at the university, completing her degree.
“At the end of the day, all I want is to be proud of myself,” she says. “To tell myself that I am a hard worker who will overcome any obstacle.”