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Lawsuit: Stanford violated students' rights in mental health response

Students hope to reform 'discriminatory' leave of absence policy

UPDATE: On July 16, Disability Rights Advocates filed an amended complaint to include three additional students who have joined the original class-action lawsuit. "Additional witness testimony indicates that this harm is system-wide," the legal nonprofit said.

In a class-action lawsuit filed Thursday, a group of Stanford University students allege that the university has repeatedly violated state and federal anti-discrimination laws in its response to students with mental health disabilities, including those who have been hospitalized for suicide attempts.

National legal nonprofit Disability Rights Advocates filed the lawsuit on Thursday on behalf of three students and a campus group that advocates for better mental health support. Though those are the named plaintiffs, the lawsuit states they represent all Stanford students with a mental health disability who may have been impacted by alleged "punitive, illegal and discriminatory" leave of absence policies and practices.

They are not seeking monetary damages but are instead pressing for policy changes at Stanford.

"We would like for this to be a teaching opportunity, especially for students in terms of what their rights are — that students with mental health disabilities are entitled to equal access to their school services and an individualized assessment that includes consideration of reasonable accommodations," Disability Rights Advocates attorney Monica Porter told the Weekly.

In a statement, Stanford spokesman E.J. Miranda said the university is reviewing the complaint. He did not make representatives from the Office of Student Affairs, Vaden Health Center or Counseling and Psychological Services available for interviews.

"The university cares deeply about the health and well-being of our students and has focused on making robust programs, facilities and services available to them," Miranda said.

The lawsuit alleges Stanford has violated the federal Americans with Disabilities Act, Section 504 of the Rehabilitation Act (which prohibits discrimination against people with disabilities in programs that receive federal funds) and the Fair Housing Act in addition to state civil rights and housing laws.

The three student-plaintiffs and one recent graduate, identified only by pseudonyms, allege their experiences taken together illustrate an "ongoing, systemic pattern of Stanford discriminating against students with mental health disabilities."

The students say they were pressured to take leaves of absence, unfairly asked to move out of their campus housing and required to meet "onerous" conditions to return to school, including writing personal statements "in which the student accepts blame for their disability-related behaviors," according to the lawsuit.

In each case, Stanford did not conduct a legally required assessment to determine what accommodations could be offered to the students, the lawsuit states.

Under the Dean of Student's Leave of Absence policy, Stanford can require students to take an involuntary leave of absence or "encourage" students to do so voluntarily. The policy applies when a student is at risk of self-harm or harming others; "significantly disrupts" or is unable to participate in educational activities; is "unable or unwilling to carry out substantial self-care obligations"; or "requires a level of care from the university community that exceeds the resources and staffing that the university can reasonably be expected to provide for a student's well-being."

The policy has strict guidelines for how mandatory leaves are put in place — including the creation of a three-member review committee that makes a recommendation to the dean of students on the decision — and how and when students can return to school.

One of the students, identified as Jacob Z., was hospitalized in February after experiencing suicidal ideation. A residence dean visited him in the hospital and told him he had "caused his dormmates psychological harm" and "had been a disruption to the community." The residence dean allegedly threatened Jacob with legal action and a ban from his dorm, the lawsuit states.

Several days later, another residence dean informed Jacob that the university was placing him on a leave of absence. After he was discharged to a local residential mental health treatment program, he received a letter from the second dean that Stanford had revoked his on-campus housing and he was "prohibited from setting foot in all Stanford residential areas." The letter cited as reasons his "inability to care for (his) personal safety" and an "unreasonable level of care required from friends and staff," the lawsuit states. Stanford also initially charged him a $450 administrative fee to process the termination of his housing contract.

Under the policy, students cannot live on campus while on an involuntary leave of absence.

Jacob appealed the involuntary leave of absence and asked to return to school with a reduced course load, a request supported by his psychiatrist. His appeal was denied.

In order to return to Stanford, Jacob must provide documentation of his mental health treatment, sign a release to allow the university to speak directly with his health care providers and submit a statement describing his "understanding of why (his) behaviors are of concern" and meet periodically with a residence dean.

Another plaintiff, identified as Tina Y., was placed an an involuntary leave of absence after experiencing a mental health crisis while studying abroad. After reaching out to her resident assistant for support, she was taken to a psychiatric clinic, where the director of her Stanford overseas program told that she had to spend the night or "else be removed" from the program, the lawsuit states.

The dean of students and a residence dean said she was "disruptive to her classmates and academic program and that her needs exceeded the resources the university could provide," the lawsuit alleges.

She successfully appealed the mandatory leave, though it was conditioned on attending three therapy sessions per week during the rest of her time abroad, transportation to which she had to arrange and pay for herself.

Another plaintiff, Erik X., was hospitalized after attempting suicide in early 2013. He alleges Stanford staff "coerced" him into taking a voluntary leave of absence and warned him, while in the hospital, that violations of the leave could result in probation or expulsion.

His campus housing was also revoked, citing language from the leave of absence policy. He, too, was charged a $450 housing fee to cancel the contract, according to the lawsuit.

He returned to Stanford in the fall 2014 quarter after submitting a statement that asked him to demonstrate "insight into the impact of (his) behavior on others," among other requirements.

The lawsuit also cites the experience of a recent Stanford graduate who was hospitalized following a suicide attempt in 2013. Afterwards, the university revoked her campus housing, gave her two days to move out and placed her on an involuntary leave of absence, according to the lawsuit. Stipulations for her return included meetings with campus counselors and administrators, a release that would allow the university to communicate with her doctors and the same personal statement required of the other plaintiffs.

She returned in fall 2013 and was placed on a second involuntary leave of absence after she engaged in self-harm, which she attributed to a sexual assault. The university deemed the self-harm behavior a "distraction to the community," the lawsuit states.

The lawsuit alleges that Stanford's leave of absence policy has also harmed the efforts of the Mental Health and Wellness Coalition, a group of close to 20 student organizations working to improve mental health awareness and support on campus. The group pushes for administrative changes, advocates for students and has provided training presentations to Residential Education staff, including on how to respond to students who have been hospitalized for a psychiatric crisis.

"The coalition's interests are adversely affected because it has expended and continues to expend resources to advocate for its members who are harmed by Stanford's discriminatory policies and practices," the lawsuit states.

The lawsuit notes the prevalence of student mental health concerns at Stanford. A 2014 survey by student newspaper the Stanford Daily found that of more than 500 respondents, 31 percent had experienced depression while at Stanford and 51 percent rated their stress levels at seven or eight out of 10.

A 2016 campus climate survey found that 45 percent of undergraduate men and women believe the university's support system for students going through personal crises is ineffective or very ineffective.

Stanford itself has noted a rise in student mental health concerns. Undergraduate residence deans' caseloads are up 57 percent compared to five years ago, with many cases "urgent in nature," Vice Provost for Student Affairs Susie Brubaker-Cole said in a May Stanford News story.

"They are seeing more difficult cases and more cases of a higher acuity," she said.

Porter, the Disability Rights Advocates attorney, said the nonprofit heard from concerned Stanford students in response to a post on the organization's website that invites college students who have experienced mental health-related discrimination to share their experiences.

She said students are often unaware that mental health concerns are protected under the same anti-discrimination laws that cover physical or learning disabilities.

While Disability Rights Advocates' past efforts to resolve the matter with Stanford have been unsuccessful, Porter said the nonprofit and its clients "remain very open to working with Stanford to the extent that they are willing."

She declined to state what the past efforts have entailed.

"The only goal here is to create positive and systemic change for current and future Stanford students," Porter said.

In a May 24 response posted on a university blog, Brubaker-Cole said that during talks with Disability Rights Advocates, Stanford adopted an interim policy on housing holds "that communicates our process clearly and transparently."

She did not deny the students' claims and said the university "appreciate(s) that these students have raised their concerns, and we will always engage with students who feel that we need to improve our policies and processes."

In March, she asked a campus mental health advisory board to develop a "comprehensive, public health approach to improving student mental wellbeing" that will start rolling out this fall.

"Student voices are essential to this ongoing process," Brubaker-Cole wrote. "We will also continue to evaluate our policies, including our Dean's Leave of Absence Policy, to ensure not only ongoing compliance but compassionate and appropriate care for individual students' health and recovery."

More information about university counseling and psychological services can be found at vaden.stanford.edu.

Any person who is feeling depressed, troubled or suicidal can also call 1-800-784-2433 to speak with a crisis counselor. People in Santa Clara County can call 1-855-278-4204. Spanish speakers can call 1-888-628-9454.

People can reach trained counselors at Crisis Text Line by texting 741741.

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Comments

27 people like this
Posted by Dromaius
a resident of Ventura
on May 18, 2018 at 4:34 pm

Dromaius is a registered user.

Wow- if these allegations are true then Stanford needs to ramp UP their training about mental illness.

I wonder if students who need to take a leave due to a physical issue (cancer, trauma accident,...) were treated differently.

We ALL need to do better with regards to being compassion, providing equality and supporting our differently-abled community members.

Remember, there are two kinds of people: the disabled, and the temporarily-abled!


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Posted by Dromaius
a resident of Ventura
on May 18, 2018 at 4:36 pm

Dromaius is a registered user.

*compassionate


28 people like this
Posted by atrocious
a resident of Stanford
on May 18, 2018 at 10:35 pm

If indeed correct, these allegations would be appalling. Over the past few years, I have had several students who returned to Stanford after leaves-of-absence for struggles with depression and/or SI, and all lived off-campus. Since many of the persons providing support for students who are struggling (academic director, residence director and RA) are associated with the residence halls, it is considerably more difficult to support students who are living off-campus.


2 people like this
Posted by Realitycheck
a resident of another community
on May 19, 2018 at 10:23 am

[Post removed.]


7 people like this
Posted by Semi colon
a resident of Old Palo Alto
on May 19, 2018 at 3:42 pm

Mental health encompasses the landscape of genius. Silencing, and worse penalizing, students in the throes of an episode of mental instability by a leading institution with access to world-class resources is cruel, misguided and potentially life-threatening.

Stanford University is located near Palo Alto, a community that has addressed student mental health after a series of incidents. Perhaps they should take note.

They could be icing out some of their most successful, productive, creative and potentially lucrative alumni donors.


3 people like this
Posted by Kristen
a resident of Barron Park
on May 21, 2018 at 11:03 am

On one hand its difficult for the general population and young adults to decipher behavior linked to mental health issues. As a student about the age of 19, what would you do if your housemate tried to commit suicide or went on rants and you had to study? Can you use this in your classroom as an excuse that your paper was late? Can you injure, insult or bully another student and claim its your mental illness and then we have the same situation the prison system has malingering. Who is doing it to get away with it and who it really not in control.???

This opens a can of worms.

Does the student disclose his mental issues to everyone ahead of time? Then where is his right to privacy? Keeps it private and young adult students have to guess?

Reasonable accommodation is not total accommodation.


10 people like this
Posted by former stanford student
a resident of Stanford
on May 21, 2018 at 12:45 pm

I lived in a (Stanford) dorm with a student who took a leave of absence for mental illness/self harm and had a rocky return to residential living.
Compassionate and abundant social and institutional support is important.
It is also important to realistically acknowledge how intimate (claustrophobic!) student housing is. The real impact on a roommate and dormmates when a student is experiencing life-endangering distress shouldn't be written off as a necessarily evil. It can be a 24-hour, terrifying job to care for a peer in crisis, regardless of how solicitous the adults involved in the case may try be. The adults get to go home at night and go "off duty," while the peer co-residents don't have that luxury.
My personal observation of our experience as a freshman dorm community was that we did not feel up to the task, and those with whom I discussed the situation thought it was a lot (too much) to ask of us as 18-19-year-olds. We became de facto familial caregivers. Anyone who has experienced caring for a close relative in suicide crisis understands the weight of that work in time, fear and emotional care. This extends across weeks or months, not just a day or two.
Being able to "come home" to the dorms after experiencing a crisis is a desirable goal, and I suspect it often works well.
But I understand first hand why there is a real impact on the community of young people who are involved if that return involves continuing issues around stability and distress. Stanford's concern for the larger residential community, in addition to the individual returning from leave, is not illegitimate in concept.


6 people like this
Posted by CoCo
a resident of Midtown
on May 21, 2018 at 2:28 pm

I am sympathetic to the individuals who have suffered from mental health issues while at Stanford, but I am also acquainted with someone who works with students in crisis at the University. The societal pressure to succeed and the stigma associated with mental illness sometimes works against students and families accepting that taking a leave of absence is, in fact, necessary. And the students and their families are often not taking into consideration/or are aware of the impact the illness and behavior has on their roommates. I sense from the Stanford "legalese" referenced in the article that the University is trying to balance the rights of the individual against the rights of the other students. It is a very fine line to walk. Likely the University can do more to compassionately guide students through a crisis, but if your student has been on the other side of this issue, as a roommate or friend struggling to help a mentally ill peer while still attending to their own studies, there is a very palpable sense of relief when the school takes a firm stand and does not allow a student who is not well to return to campus. I hope that the school and the advocacy organization can find common ground that respects the needs of all the students.


6 people like this
Posted by Sarah1000
a resident of Los Altos
on May 21, 2018 at 6:18 pm

Sarah1000 is a registered user.

CoCo- Major depressive disorder is a treatable health issue. Similar to other illnesses, like neuromuscular diseases, there may be periods of worsening symptoms. If these individuals had something like myasthenia gravis, for example, and needed assistance from their friends and school during a myasthenic crisis, would you still share the same view?


8 people like this
Posted by @Sarah1000
a resident of Fairmeadow
on May 21, 2018 at 9:38 pm

@Sarah1000 is a registered user.

I found the comments from the person who actually lived through this, just above, most helpful. Have you read them? Having not lived through this myself, I can only guess the answer to your question, but I would guess that any ongoing situation in which I felt my actions or inactions during a crisis could lead to the serious harm of someone would be stressful. The nature and frequency of those crises, and the intuitiveness of the type of action or inaction called for on my part would affect the level of stress. It can take doctors and nurses years of training to bring the appropriate emotional and physical responses to these situations.

No one is dissing major depressive disorder here. Far from it. They are just saying it's difficult and stressful to be a part of the live-in care for an afflicted individual.


Like this comment
Posted by Sarah1000
a resident of Los Altos
on May 22, 2018 at 8:32 pm

Sarah1000 is a registered user.

To @Sarah1000-
I have two college-aged children: one who was diagnosed with acute, adult-onset myasthenia gravis at 13, the other who was diagnosed with major depressive disorder at eight. Both of their illnesses at this time are “active but stable”. Both have several professionals who comprise their treatment teams. However, it is still possible that either could experience a sudden worsening of symptoms requiring a period of hospitalization to be stabilized. For a school to not actively encourage students in life-threatening circumstances to seek the help they need is morally reprehensible. To remove any students from housing and place them on involuntary leaves because they have a mental health rather than a physical health issue is discriminatory. You do realize that students will refrain from getting care and will die as a result of Stanford’s policy?


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Posted by Sarah1000
a resident of Los Altos
on May 23, 2018 at 8:19 am

Sarah1000 is a registered user.

El Camino Hospital in Mountain View (just down El Camino Real from Stanford on Grant Road) offers free mental health assessments. Just call 866-789-6089. El Camino’s administration, doctors, nurses and donors are very supportive of caring for the whole patient. A new, beautiful building dedicated just to behavioral health will be opening there next year.
Also to former Stanford student- I agree that other students should not be placed in a position of providing long-term care for any other student. The fact that Stanford students are expected to do so speaks to the lack of mental health services provided by Stanford University and Stanford Hospital. With high quality, consistent psychological and psychiatric care, most individuals who have a mental illness can function at a high level. Just like with physical illnesses, crises can be avoided with slight medication adjustments.


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Posted by @Sarah1000
a resident of Fairmeadow
on May 23, 2018 at 9:09 am

@Sarah1000 is a registered user.

I have great respect for what must be a very stressful family life for you. It sounds like you have managed to pull together good care, and do really well by your children.

You make one statement and ask one question that I will respond to.

"To remove any students from housing and place them on involuntary leaves because they have a mental health rather than a physical health issue is discriminatory."

To be honest, I have always had difficulty with the word "discriminatory". Is it "discriminatory" to put kids who struggle with math in a different class than kids who are good at math? Is it "discriminatory" to provide different treatments for different diseases? Or is it appropriate?

I would expect students to be put on leave if the university felt they could not receive adequate care and/or the situation was having a significant negative impact on others at the school. I would not expect this to be a "physical disorder" vs "mental disorder" test. It is the policy you want to understand. So the fact that some kids with mental disorders are asked to leave is not, in my book, in and of itself an issue. It would be expected. (And same for some kids with physical disorders.)

"You do realize that students will refrain from getting care and will die as a result of Stanford’s policy?"

I expect that if Stanford had no policy of putting very ill students on leave, then that would also result in students dying. Fortunately the choice isn't one or the other, we can strive for a "best policy". But that is the crux of the matter. Policies involve tradeoffs and constraints. Optimal outcomes for everyone are typically not achieved. You can imagine these policies are very difficult to compare and evaluate, especially when emotions run high.


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Posted by Stanfordgrad
a resident of Stanford
on Jun 5, 2018 at 2:42 pm

As an international Stanford student who was sexually assaulted by a peer in 2011, I can tell you that the consequences of this policy were very real. Out of fear of being coerced in a leave of absence which would mean losing my visa, I decided to not seek additional help or report the assault. The counselors I talked to were very clear that if I were to disclose concerning mental health issues due to an assault, they would have to report me to the school, which could mean a strongly encouraged leave of absence. On top of it, my parents told me that I would not be welcome home until I got my degree, so my only way to deal with the assault was to suck it up, and pretend I was somewhat ok. Is it Stanford job to fix all the issues in people's lives? Probably not, but they definitely made everything worse for me. I'd have settled for neutral.


Sorry, but further commenting on this topic has been closed.

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