Absent, Alone, Apart

Published on March 4, 2015

For months in 2014, Josephine would wake up every day hoping for an email from her adviser telling her she could come back to Columbia.

As she waited, she took classes, she went to therapy, and she worked a tutoring job. She would often send emails to her adviser and even call, asking for an update. But her adviser, merely a messenger, wasn’t hearing back from anyone, either. Josephine says she submitted all her readmission forms far ahead of the deadline, and she made herself completely available, aside from the one week she spent as a camp counselor without access to email. After months of anticipation, her first substantive communication from Columbia, though, came that very week, she says, in the form of a terse email pressuring her for a quick response.

Josephine, whose name has been changed due to the sensitive nature of her story, came to Columbia with the class of 2015, a happy first-year who loved her new school. But near the end of her sophomore year, Josephine says, she was raped on campus. She returned in August to work during the New Student Orientation Program, confident that the student she says raped her would not be on campus during that time given that he was not participating in the NSOP. However, when she learned that the other student was, in fact, on campus, she became distressed and called Counseling and Psychological Services.

“I was so mad that I was supposed to have this guaranteed time and the fact that someone was allowed to continue to break the rules after doing something that terrible really upset me,” Josephine says.

When she went in for her first-ever CPS appointment, Josephine thought she might cry and maybe even come back for a second session. But instead, she found herself overwhelmed as the counselor strongly suggested that she take a medical leave.

“I was so shocked,” Josephine says. “I thought it was going to be a routine visit with a psychologist, where you talk about what’s bothering you, and you come up with solutions.”

It’s no secret that Columbia can be a stressful school, especially for students struggling with mental health issues. In the past few years, Columbia has seen a rise in conversations about mental health. New student clubs and organizations have sprung up to help students address mental health issues, and a group known as the Mental Health Task Force successfully pushed for changes to the University’s policies about leaves of absence last summer.

While they are on campus, students have access to support services, friends, counselors, and advisers who are ostensibly there to help them through their pain.

Still, sometimes the best of friends and the most understanding therapists are not enough. Some students need to get away from the Columbia environment in order to get better. Taking a leave of absence can be a healthy, even a powerful choice for students struggling with their mental health. Columbia and Barnard administrators say they support this choice, and that they want students to “get better,” so they can return as productive members of the community. And yet, even with positive encouragement, it remains a difficult choice, and one that administrators can either empower or complicate.

Columbia’s attitude toward leaves of absence seems to be that students want distance from the stress—and the people—of the University in every way possible. This may be true for some students. But the assumption of such a hands-off attitude and Columbia’s and Barnard’s rigid policies often result in a feeling of isolation that students describe as punishment, not recovery. The consequence of Columbia’s policies, then, is a feeling of abandonment, which, when added to depression and anxiety, presents a fundamental failure to help students recover from mental illness.

Taking Time Off

There are several different types of leaves that students can take from Columbia: “voluntary leave,” which allows students to take time off to pursue opportunities such as jobs or travel; “voluntary medical leave” or “medical withdrawal,” which gives students time to recover from a mental or physical illness that is interfering with their Columbia experience; and “involuntary leave,” an extreme measure that administrators can take “when there is compelling information to suggest that the student is engaging in or is at heightened risk of engaging in behavior that could lead to serious injury to others, including as a result of physical or psychological illness.”

Columbia does not release the number of students who take medical leaves, but a spokesperson did tell me that the number of students who take voluntary medical leaves of absence each year can range from five to 20, across Columbia College, the School of Engineering and Applied Science, and the School of General Studies. Involuntary leaves of absence, I was told, are “extremely, extremely rare.”

“There have been many years in which no involuntary leaves have occurred,” a statement from the University says.

At Barnard, the options are simpler: students can take a voluntary medical leave, but the school does not place students on involuntary medical leave. “With medical issues we can talk to students about leaving, we can say it’s an option, but students always have to be on board with wanting to leave,” Natalie Friedman, Barnard Dean of Studies, says.

When a student wants to initiate the leave process, they can do so by talking to any number of people. At Columbia, this includes a counselor at CPS, a physician at Primary Care Medical Services, their academic adviser, or their dean of students. At Barnard, this list includes Furman Counseling Center, Primary Health Care Service, a student’s class dean, or the dean of studies.

For medical leaves, the student must get their treating medical or mental health professional—or someone at one of Columbia’s or Barnard’s offices—to certify that a medical leave is warranted. Administrators, along with help from the appropriate campus medical office, review this paperwork before granting a leave. Columbia students are also usually asked to consent to an exit interview with a Columbia medical or mental health professional. They may also be expected to contact other offices such as housing or financial aid to make arrangements for their withdrawal. Once the withdrawal paperwork is officially filed, students have 48 hours to move out of their residence hall.

And when the student decides they are ready to return to school, the process begins again. Many students say they experience difficulty with readmission, as it involves not only paperwork from their treating medical or mental health professional, but also an in-person assessment at Columbia or Barnard. Students must submit all paperwork by June 1 if they wish to return in the fall and by November 1 if they wish to return in the spring. After they’ve submitted the appropriate forms, students wait to hear from a committee composed of doctors and administrators from various offices. Only after they are cleared do students hear about housing and pick classes for the coming semester—which can sometimes be as soon as a week away.

(Jenna Beers)

Cut Off From Support

Greg, a Columbia College junior who asked that his name be changed for privacy reasons, says that even before he thought about taking a leave of absence, he already felt a lack of support at Columbia. “I never had a relationship with my adviser,” he says.

This is a common complaint among students, and is likely a consequence of Columbia’s advising system, which includes 29 advising deans for a student body of 6,240. Because advising deans typically advise a large number of students, many students never form close relationships with their advisers, instead navigating Columbia—and potentially the decision to take a leave of absence—alone.

Administrators say it’s not that they don’t care, but that there are lots of factors to balance, and many mental health situations are complicated. Dean of Undergraduate Student Life for CC and SEAS Cristen Kromm says that advising deans provide advice to students regarding leaves of absence on an individual basis and try to come to the best solution for each student. This seems ideal for students who have developed a close relationship with their adviser. But when an adviser or a CPS counselor is meeting a student for the first time, conversations are inevitably worse informed.

The information gap reveals itself especially when it comes to assessing a student’s best options. When students prepare to leave campus, they sign a form that prohibits them from using Columbia facilities and from being on campus during their time off. (Barnard has a similar policy.) This often creates a catch-22: A student may want to leave school in order to take care of their health, but in order to take care of their health, they feel they need their support network in place—and that support network is often at school.

“The thinking is you’re not part of the community,” Friedman says, “and in the case of a medical leave it’s a voluntary thing, so it’s perhaps a good thing for a while. The thinking, too, is you’re not enrolled, you’re not paying the tuition, you’re not using the resources that other students who are paying for it are using.”

However, when I discussed this with Dean of Advising for CC and SEAS Monique Rinere, GS Senior Associate Dean of Students Ana Maria Ulloa, and CPS Executive Director Richard Eichler, all three said they believed students taking medical leaves were welcome to visit friends on campus, and even to stay overnight. GS students are not asked to sign a form prohibiting them from time on campus, but Rinere and Eichler seemed surprised by the policy stated on a form their offices ask students to sign. But despite these administrators’ confusion, students are acutely aware of this policy, and many say it contributes to their feeling of exclusion.

Though students are removed from potential existing support networks on campus, students interviewed for this piece expressed concerns that Columbia does not sufficiently take into account the varying degrees of support students can receive at home.

Greg says no one at Columbia ever asked him where he was going on his medical leave of absence. He is not on good terms with his family back in Georgia, and so even though he knew he wanted to get away from Columbia, Greg says, “Going home wasn’t an option.” Greg did not feel comfortable informing his family that he was taking a leave, and instead went to stay with extended family in Texas.

He says he feels lucky his extended family was supportive, but for all Columbia knew, he walked out of the gates with nowhere to go. “They just deactivated my student ID, took me out of Columbia housing, and said, ‘See you in a year,’” he says.

I’ve heard situations like Greg’s mentioned often when students discuss the issues that surround leaves of absence, so I asked administrators how they deal with them.

“This is an extremely rare hypothetical that you’re talking about. It may come up once a year,” Rinere says. “In those cases, we may work with a student to identify an aunt or an uncle or a grandparent who could offer the student a place to stay and help them structure a life around that new location.” But, as Greg’s situation demonstrates, these conversations don’t always happen.

At GS, though, administrators say this is included as part of the conversation they typically have with students before authorizing a leave of absence. “How will you be seeking care for yourself? Who will be your support network during that time? These are things we all talk about,” says Ulloa.

Still, a student does not need to be faced with a family situation as extreme as Greg’s for school to be the healthier environment. Sometimes, even students who are close with their parents prefer living independently or surrounded by friends.

Nazia Jannat, a Barnard student who was placed on academic leave in January 2014 after suffering from depression and what would ultimately be diagnosed as bipolar II disorder, says she struggled to find work during the first few months of her leave, which left her feeling lonely and more depressed than ever.

“Until the early afternoon, I would just be home by myself, especially when I hadn’t started work yet or when I didn’t have babysitting. Babysitting would start after school so I would leave around 3 or 2 or something. In that way, half my day would be gone,” says Jannat. “I had trouble sleeping, pretty much turned into a couch potato, had nothing to do with myself, seeing all of my friends on social media doing X, Y, and Z, and me being a recluse at home.”

The fear of being isolated—among other reasons—can make taking a leave of absence seem daunting to many students. Eichler says that counselors and advisers might raise the question of whether it’s a good time for a student to be in school, but that shouldn’t be confused with being told to take a medical leave. “I think that distinction between opening up different conversations and possibilities sometimes gets lost,” he says.

However, that’s not how Josephine sees what happened to her. “The school saw me in a moment of duress,” Josephine says. “I was trying to be proactive and help myself by going into psych services, and I didn’t disclose anything that would indicate that I was unstable, but they thought it would be better for me to not be here.”

Lost in the Bureaucracy

One of the reasons that Josephine says she was so reluctant to take a leave of absence in the first place was that she did not want to be out of school for a full year. At the time she was going through the withdrawal process, one year was the minimum amount of time any student could take off for medical leave. Since then, Columbia’s policy has changed to allow for one-semester medical leaves, after work from students on the Mental Health Task Force.

Despite this change, other aspects of Columbia’s and Barnard’s policies remain unflinchingly rigid, sometimes serving to limit the activities of students taking time off or discouraging them from certain choices that could make them feel less isolated during their recovery.

“Sometimes there are lots of other reasons for staying in school other than just academics. School can be really important for them, it’s how they identify,” says Karen Bower, an attorney who specializes in disability discrimination in higher education. “Then when a student goes back home, it’s not as though they have their old support system back there. They’re back in their old environment, but their friends are off at school.

“Other than family, they don’t have people around to support them. They’re very isolated.”

Students on leave are often encouraged to “be productive” during their time away. This can mean focusing on treatment, finding a job or internship, or in some cases, taking classes at a school near the student’s home. Some physicians or psychologists recommend that students take classes while on leave so that they have a routine and do not get completely out of the habit of academic work. However, Columbia does not allow students to earn credits toward their degree while on medical leave, regardless of what school from which the credits are.

Rinere says this policy is based on the idea that students left school to focus on their health, not academic work. “When students are on a medical leave they’re supposed to be getting better,” she says. “The thought is that tending to your health and going to college have gotten to a point where they’re not compatible.”

Interestingly, Barnard does accept credits so long as the registrar approves them, just as if a student were studying abroad. Friedman says Barnard wants students to have the option, if it’s medically appropriate.

Some of Barnard’s policies demonstrate a more flexible or personal approach than Columbia. But not everything is easier at a smaller college, and students taking leaves of absence are often likely to be the ones who experience the bureaucracy firsthand.

In fall 2013, Barnard student Elyse Pitock’s health was rapidly deteriorating as she struggled with anorexia. After deciding to take spring 2014 off so she could go to an inpatient treatment facility in Denver, Colorado, Pitock initially went to her class dean, who she says was helpful and supportive.

But when Pitock was asked to sign a form withdrawing her from Barnard housing, she learned that she would not be guaranteed housing upon her return, and that Barnard was charging her approximately $1,000 in cancellation fees for the spring semester—the same fees the college would charge if she was leaving for a non-medical reason.

“Considering Barnard has a housing shortage and they were going to be able to fill my room … it seemed pretty unfair,” says Pitock. She says she was also told that if she wanted housing when she returned to Barnard, she would have lower priority than first-years, those on the normal, guaranteed waitlist, transfer students, and even students returning from leaves who hailed from geographically farther away, under the rationale that she could commute from her home in Philadelphia if necessary.

Pitock says she asked if there was a possibility of making an exception to the loss of housing and the fee, due to her medical circumstances. But, according to Pitock, Dean of the College Avis Hinkson said that Barnard couldn’t make an exception for her, or else it would need to accommodate everyone.

Hinkson, however, says Barnard’s position as a small college allows it to operate more flexibly than a large university. Before Barnard, Hinkson was the dean of undergraduate advising at University of California, Berkeley, so she has seen both environments.

“We’ve got lots of blanket policies. We do spend time enforcing those policies, but also [spend time] in hearing somebody out,” says Hinkson. “You’re certainly going to find the student who says, ‘I met with Dean Hinkson and she told me no.’ But the difference between here and [a school with] 18,000 [students] is that they met with me and told me and that I understand.”

But ultimately, what’s the difference between being told no at a school with 18,000 students and being told no at a school with 2,500?

“For me, that has been the most outrageous moment of the entire thing—just to be treated so callously,” Pitock says. “It was already a pretty traumatic experience, facing treatment for what was rapidly becoming a life-threatening illness, and then to be treated with such disrespect by the school really added to the anxiety of the whole experience.”

(Tiffany Lee)

Radio Silence

While every person’s experience with mental health is unique, and requires different kinds of support, there are a few basic factors on which most agree. Almost all the students I talked to—even the ones who ultimately appreciated their time away—spoke about feeling lost in the bureaucratic process, feeling isolated from their friends, and feeling generally excluded from the Columbia community.

For some, their leaves were defined by weeks spent waiting for emails that never came. Others merely noted a hands-off approach and shrugged it off as part of going to school at Columbia. In some cases, students felt trapped in a process beyond their control, not knowing who was deciding their fate or even what information those people had available to them. And even for students for whom the decision to leave was relatively simple, Columbia complicated the process.

For Daria Jung, a SEAS junior who took a leave of absence last year, time away from Columbia helped her recognize and get treatment for her depression. But although she’s glad she took time off, she feels Columbia was less than supportive of her decision.

“The thing that was really disappointing when I was interacting with my adviser was how long and how many emails it took back and forth,” says Jung. “I realize he’s busy and I’m not technically a current student, but I almost felt like an afterthought.”

In Greg’s case, he experienced a lack of communication all the way through his leave of absence. After Columbia deactivated his student ID, Greg says he pretty much got “radio silence” from the school. “The only thing I would hear from Columbia was them updating my student statements on SSOL,” he says. “I didn’t hear from an actual person unless I reached out.”

When I brought this topic up with Rinere, she acknowledged that advisers do not typically reach out to CC or SEAS students while they are on leave.

“I think when students are on medical leave, they need some time away from the University, so it might be perceived as intrusive to bother them while they’re away,” she says. At GS, on the other hand, Ulloa says advisers do make a point to check in with students taking medical leaves. This is also the case at Barnard. Rinere says she’s never heard a student complain about the lack of communication, but she would be open to changing the policy if students wanted the outreach.

While it may be true that some students don’t want to hear from a Columbia official during the time off, this can and does lead to students feeling isolated and wanting for help.

Josephine, who did not want to take a year off from Columbia in the first place, says she felt abandoned, particularly when she began trying to file her readmission paperwork. She says she first contacted her adviser in January 2014 about returning to Columbia in the fall. Ultimately, Josephine would not be cleared for readmission until mid-August 2014, approximately two weeks before she needed to return for school.

The deadline for readmission forms for the fall is June 1. The reason she initiated the return process so early, she says, was that she had seen those ubiquitous Summer Ecosystem Experiences for Undergraduates emails, and thought the program might be a good way for her to ease back into Columbia academics before a new school year. Her application to be readmitted early was eventually rejected. However, she did not hear back until the day the deposit for her summer program was due.

“Above all, regardless of whether or not I have a medical condition, you should remember that I’m a person and that people do need responses at some point,” she says.

Barriers to Entry

The long wait times between emails frustrated Josephine, but the most significant stressors during her year off, she says, were what she considered Kafkaesque solutions from administrators who were supposed to help her.

Despite sometimes feeling disconnected while taking time off, almost all students who take leaves of absence at Columbia and Barnard do return to the school. But even for those whose experiences are less involved than Josephine’s, the readmission process can be draining.

If a student stays in New York while taking time off from school, coming back to campus for the required medical or mental health assessment is not a huge challenge. But explaining your situation to a doctor whom you’ve never met before can seem intimidating, especially with readmission riding on the line.

“I was completely nervous going in to see Dr. [Mary] Commerford at Furman,” recalls Jannat. “I had no idea what to expect, but I wanted to make a good impression so I could come back.” After working on a political campaign, Jannat took classes over the summer and continued therapy during her time off. She was able to solidify her diagnosis as bipolar II, which she says Commerford pointed to as evidence for why she should be readmitted.

For those not on the East Coast, an in-person assessment can mean flying to New York for a special trip weeks before classes start, paying for a hotel, and then potentially last-minute shipping costs and another flight, assuming the student is readmitted. After Josephine was denied readmission in April, she asked if Columbia could keep all the forms she’d submitted and evaluate them again for the fall. But she was told they would still need to go through the entire process again, and that she’d need to come from her home on the West Coast to New York for her assessment.

“I asked if, during this time, there would be any accommodations that the school could help with, and they said no,” Josephine says. “My parents were livid. They were like, ‘We’re not going to pay thousands of dollars for you to go back there with no guarantee that you’ll be readmitted.’”

In addition to her concerns over the cost of the visit, Josephine says that the prospect of not finding out about her readmission until late in the summer heightened her anxiety. After several rounds of emails and calls to her adviser and a scheduling mix-up on CPS’s part, Josephine convinced Columbia to make her an appointment with CPS when she was already planning to visit New York near the end of July.

The CPS assessment, she says, was one of the most nervewracking parts of the process. After her first CPS appointment led to feeling pushed out of the college, Josephine felt that Columbia was now asking her to repeat the experience by meeting with an unfamiliar counselor, who had a large say in whether or not she would be readmitted.

Josephine says that on the day of her assessment, she marched into the office, armed with piles of documents showing evidence of the academic work she had completed, the job she held, and the therapy she’d continued during her leave of absence. She remembers thinking, “I’m not crazy; I’m perfectly fine to be here, what do you want from me?”

Although her interview went well, Josephine wasn’t confident she would be readmitted. “I was never told who was reading my file, what qualifications they had to be making this decision when they’ve never met me in their entire lives and have no idea who I am,” she says.

Certainly not every student experiences the same difficulties. And although students may feel nervous about talking to a doctor whom they haven’t necessarily met before, administrators feel this is an important part of the process. The school does require documentation from a student’s treating doctor, but they say the in-person assessment helps ensure a student has recovered enough to succeed academically and socially once they return to campus.

Beyond the actual decision itself, other logistical factors can complicate the process, too. Students are particularly worried about housing when going through this process. Both Pitock and Jannat knew they would not be guaranteed housing upon their returns, and so they both found apartments on their own. While they both say they benefitted from their time away, the off-campus living proved more isolating than Barnard’s dorms, which made the transition back into college life that much more difficult.

Jung, who initially took a voluntary leave but then switched to a medical leave, received housing upon her return to Columbia. “But I felt like stuff was triggering me, so I decided to live off campus. It was rough coming back,” she says. “Obviously people were welcoming, but I had missed a whole year of stuff that had happened. I also quit a lot of the clubs that I was a part of because I didn’t know if I was doing them for myself or for other people, so that sort of disconnected me from a lot of stuff.”

She notes that the communication she received after she returned from her leave was impersonal and burdensome. “I remember getting emails two or three weeks in from people I’d never ever heard of before saying ‘Hey, I’d like to check up on you,’” says Jung. “I felt like ‘I don’t want to talk to you about things that have happened to me if I don’t know who you are.’”

When the Center for Student Advising made changes to the leave-of-absence policies last August, Rinere said she would begin reaching out to students upon their return. But no students I spoke with were aware of these updated policies, and so seemed confused by actions that might have helped them if only they were articulated more clearly. Students returning from a leave of absence can also now request to switch to an advising dean who specializes in leaves of absence—something Jung actually mentioned she would have appreciated—but again, she had no idea that was an option.

*  *  *

Changes such as those made last summer have improved some aspects of the medical leave process, and students involved in mental health groups say they are encouraged to see people continuing to talk about mental health resources on campus. Those involved in pushing for support say they see administrators like Eichler and Medical Director of Columbia Health Samuel Seward as genuinely open to student feedback.

And yet, despite a slow but steady increase in the conversation around mental health, students who take leaves of absence often still feel that their actual time off is somewhat of a taboo.

More importantly, they say, their leaves left them feeling ambivalent, if not negative, about the University’s response to mental health. Jung points out that the conversations that do arise about serious mental health concerns are often fleeting. She points to the reactions to Columbia College first-year Joshua Villa’s suicide last semester. “Every time that happens there’s a little bit of heightened awareness, and stuff from the administration and they say ‘We care about you.’ But it’s like, do you really?”

This is not an imaginary feeling. Most students probably do not know about the death of Tejraj Antooa, a former SEAS student who took a leave of absence in spring 2012. Antooa killed himself in January 2013. Because he was still on his leave of absence from the University at the time, administrators decided not to announce his death to the student body as they do with students who are enrolled in one of the undergraduate schools. Antooa’s friends eventually got student councils to send out emails announcing their friend’s passing, but the lack of official communication reveals the attitude students suspect and that Friedman articulates: students on leave are not considered a part of the Columbia community.

Toward the end of our interview, as Josephine tried to sum up her thoughts about her leave of absence, she was clearly struggling to find a way to look at the year as a good experience. But in reality, her view was much more cynical. The time away did not help her grow or make her feel supported, she says. “It’s like they completely forgot that you’re not just a name on a piece of paper and that you’re an actual person,” she says. “That’s the saddest part of the whole thing.”

 

Clarification: Students in GS are not asked to sign the form referred to in the article that prohibits students from spending time on campus during leaves of absence.

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