Mental Health Rights
I experienced my first mental health crisis when I was a student in college. I was depressed, anxious, and could barely leave my room to go to class. I would struggle to get dressed and walk down the hill toward the science center, and by the time it came into view, I would say to myself “not today” and head back to bed. The resident assistant in my dorm suggested I make an appointment with the counseling center on campus, so I did. The counselor suggested I consider dropping my senior thesis research project, so I did. That’s how I went from being a biochemistry major at Wellesley College to a student at Harvard Law School, with a desire to be a legal aid lawyer.
Fast forward two years. When I arrived at law school, one of the first things I did was visit the student health services office and make an appointment with the on-campus psychiatrist. I also joined almost every student organization on campus, started a new organization, cooked dinner for my dormmates on Wednesday nights–pretty much everything except read the cases and prepare for class. One day, the resident assistant in my dorm suggested that I buckle down and focus on briefing cases and going to class. I told her to get off my back or I was going to jump off the roof of Langdell Hall, the law school library.
The next day, I was at my on-campus job when one of my fellow students, who was also my supervisor, came in and said, “Don’t you have an appointment with the psychiatrist today?” That should have been my first clue that something was not quite right. When I went to the psychiatrist’s office, my father was there, which was definitely a sign that things were not right. The psychiatrist announced that she was sending me to McLean Hospital, a psychiatric hospital. I swore at her and my dad and walked out of the building, where I was met by several Harvard University Police Department officers and escorted back into the building. That was my introduction to the intersection of mental health and the law, and the start of a career that has led to my position as Executive Director of Connecticut Legal Rights Project, a nonprofit agency that provides legal services to low-income people living with mental health conditions.
I share the story of my personal experience because I think people should know that my opinions on these subjects are not purely theoretical. The law does not exist in a vacuum, and policy decisions must reflect the input of relevant stakeholders–those who have been and are most likely to be impacted by policy changes.
Too often, when faced with a student in mental health crisis, schools respond by forcing that student to accept “help” in the guise of coercive treatment, followed by suspension from school, followed by the creation of barriers to the student’s return to school, followed by failure to reasonably accommodate that student’s disability–in other words, discrimination.
Too often, when faced with a student in mental health crisis, schools respond by forcing that student to accept “help” in the guise of coercive treatment, followed by suspension from school, followed by the creation of barriers to the student’s return to school, followed by failure to reasonably accommodate that student’s disability–in other words, discrimination. Students who are perceived to have a psychiatric disability may also face discrimination based on a diagnosis they don’t even have. The school’s reason for such a response is based on misguided perceptions, rooted in stigma and bias, of the student’s risk of committing potential violence. In the wake of tragic events such as school shootings, it is understandable that legislators and other policymakers feel the desire to do something, but when the rush to do anything is so strong that it involves a failure to pause, reflect, and consider different perspectives, we end up with flawed policies.
One such policy is Florida’s Marjorie Stoneman Douglas High School Public Safety Act, passed in 2018. This law requires, among other things, that districts collect sensitive mental health information from students as a registration requirement for the new academic year, and it mandates the establishment of a statewide database to collect and store information about students who may present a threat. The categories of information to be collected about students include those who have undergone psychiatric examinations or treatment, which unfairly targets students with any mental health history and fuels the myth that people with mental health diagnoses are prone to violence. This law will further stigmatize people who undergo mental health evaluations and treatment and may discourage students from seeking the help they need.
Students and their parents need to understand and assert their legal rights under various laws, including FERPA, HIPAA, IDEA, Section 504, and the Americans with Disabilities Act. The laws that protect the rights of disabled students define students with mental health conditions as students with disabilities. And all students have privacy rights, as do all medical patients.
There is nothing wrong with encouraging someone in distress to access voluntary supports and services. Responsible authorities should have accurate, up-to-date lists of community resources. However, true help is not coercive. People find multiple pathways to recovery. More people need to understand that medication is not the solution for all or, statistically, for most people. It is the solution for some, so people must have access to medical care so they can make informed choices, in consultation with the medical professionals of their choice.
Support from peers is also critical, and as more young people are open about living with mental health conditions in a way that society did not allow several decades ago, on- and off-campus groups provide safe spaces for healing. For this reason, schools must find better ways to support their students in mental health distress, rather than creating obstacles to their education. Forced medical leave policies mandate a break in relationships that provide community support to people who most need it. Putting conditions on students’ return to school–especially if the same conditions apply to everyone who takes a medical leave, without an individualized assessment–makes it harder for students to return and regain a sense of normalcy. Students who need time to attend medical appointments or peer support groups should be accommodated within reason, so that they can take care of themselves and meet their school obligations.
People must also recognize that simply because a student performs well in school does not mean that all is well. For many of us, school may be a refuge and the one place where we know the expectations and that we are capable of meeting them. School, however, should also be a place where failure is allowed so that students can learn from it. Forced leaves from school increase trauma and forever change the relationship between students and schools. All would be better served if we worked to keep students connected to their school communities.
Kathy serves as Executive Director of Connecticut Legal Rights Project, Inc. (CLRP), a statewide non-profit agency which provides legal services to low income individuals with mental health conditions on matters related to their treatment, recovery, and civil rights. She combines her personal experience as a recipient of mental health services and her legal background to speak to issues affecting those living with mental health conditions.