Thursday, January 2, 2014

Students, Suicide and OCR

It is a sad fact that some college students are suicidal. What should a residential college do about them? Sometimes, as a last resort, they are medically withdrawn and sent home for treatment. Now, the OCR of the Education Department seems to oppose that.

Nearly three years after a revision of federal regulations, colleges and the U.S. Education Department’s Office for Civil Rights are still squabbling over when potentially self-harming students should be sent home – and in at least one case where OCR intervened, the reinstated student went on to commit suicide.
Experts say that the case at Western Michigan University, where student Jackson Peebles filed a federal discrimination complaint with OCR after being involuntarily withdrawn due to suicidal tendencies, is not the only one where a student has hurt him- or herself after pushing for readmittance.
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 Earlier this year, the Gazette reported, Peebles, an honors student, won an appeal to return to campus after alleging that Western Michigan discriminated against him because of his depression and anxiety. But eight months after his withdrawal and winning appeal and less than a month after hearing that OCR said Western Michigan must revise its policy, Peebles committed suicide Oct. 20 in his Kalamazoo apartment, where a roommate found his body. [my bolding]
This situation is a mess.
In the face of this uncertainty, many college officials believe their only option now when students refuse to leave is to force them through the student conduct process, where they could be suspended or expelled without the benefit of preserving their academic record – and, of course, causing additional stress.
“We hope it is not the government’s position that suicidal students must now be placed before regular student run judicial bodies,” the letter says, “simply because this process is the same one used with all other students.”
Despite airing these concerns, college officials are still downright confused about what they are and aren’t allowed to do. Is involuntary withdrawal now a per se violation of the ADA, the letter asks, or did DOJ simply remove a “safe harbor” and in doing so tell institutions they must be even more meticulous in navigating the disabilities law? Is “consideration of a student’s mental health issue” – for example, having a behavioral intervention team review a given student – the same as “discrimination based upon a mental health issue”? And is it acceptable to have policies that apply to all students equally but address concerns arising from mental health issues, such as a health review for students returning from medical leave?
Judging from the current environment, the only way the federal government will backtrack is probably if all colleges can articulate and employ a reliable and medically sound self-threat test to be used across the board, Lewis said, as well as show that they’ve attempted to inform students about the benefits of voluntary withdrawal.
In the meantime, Lewis said, the most important thing is for campuses to do is make sure they’ve got all the necessary support systems in place – and are using them – for self-harming students who either refuse to leave or who are involuntarily withdrawn and then readmitted. That also means being in close touch with the student’s emergency contact.
“The student comes back, they’re suicidal, you have to take them and then they harm themselves – the question that’s going to be asked is, what kind of support did you put there?” Lewis said. “I want to be able to say in my own mind and my own heart that we did everything we could.”
A few years ago I had a student who was briefly sent home after a suicide attempt but managed to convince campus officials that she was stable enough to return. Privately, the student messaged her advisor that staying home with her family for months on end would drive her crazier. In this case, the quick return to campus seemed to be the better course of action, and the student successfully completed the year, graduated, and got a decent job in an attractive city. On the other hand, there are students like Peebles, where a return to campus yields harm to self, and trauma for roommate. To me, this underscores the wisdom of dealing with students in these circumstances on a case by case basis, with 'harm to self' the basis for a defensible medical withdrawal policy. If the OCR wants a single policy involving a reliable test for self-harm (hell, there isn't a totally reliable test for mono), then in my view, it is posing a threat to students.



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