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Yale settlement highlights college student mental health needs

NATHAN ROTT, HOST:

We want to talk now about some of the mental health challenges college students face as a new school year begins. We're going to start with one school, Yale University, before widening the conversation. And a quick warning - this story talks about suicide. A few weeks ago, Yale reached a landmark settlement in a lawsuit brought by an alumni group alleging the school discriminated against students with mental health issues.

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UNIDENTIFIED JOURNALIST: Yale University settled a lawsuit with students...

ROTT: According to the agreement, the university will now allow students more flexibility to take lighter course loads and to keep their health care while on medical leave. That's in addition to other policy changes. But Yale only agreed to these changes after a group of current students and alumni sued the university. The group that filed the suit, Elis for Rachel, was formed after first-year student Rachael Shaw-Rosenbaum died by suicide in March of 2021. The alumni group claimed Yale's policies at that time limited her options for care. For example, if she had taken medical leave for mental health reasons, she would have had to unenroll from the school without a guarantee of readmission. She'd have been banned from campus and also lost her student health insurance.

WILLOW SYLVESTER: It was very clear which policies at Yale had contributed to Rachael feeling that she wasn't able to get the help that she needed.

ROTT: That's Willow Sylvester, co-founder of the student group Mental Health Justice for Yale and a core member of Elis for Rachel. According to Sylvester, there were many problems that prevented students from accessing the care they needed.

SYLVESTER: Students being on months-long waiting lists and feeling like they weren't being heard, students who felt like they were facing consequences for being honest about how their mental health was on campus and being treated more as a liability rather than someone who Yale was invested in taking care of.

ROTT: According to Zack Dugue, Rachael's boyfriend at the time of her death, these policies were a source of fear for her.

ZACK DUGUE: I think the school failed her. I think these policies scared her in a way that they - I mean, you think about it. Like, what's the point of a withdrawal policy? It's to make students feel safe. What they created for her was, like, a fear and, like, an environment kind of fear. And that's what they did for a lot of students.

ROTT: After doing research and presenting demands to the Yale administration, the group filed their lawsuit in November of 2022. Just last month, the university agreed to a settlement. Under the agreement, Yale will make changes to the policies that Elis for Rachael sought to improve. Lily Colby, who graduated from Yale in 2010, is a co-founder of the group.

LILY COLBY: The settlement includes changes to the medical leave, changes to part time as a reasonable accommodation. Students are allowed to stay on their health care. I'm thrilled that we were able to make such a big difference in such a short amount of time.

ROTT: In a statement, Yale's Dean Pericles Lewis said they were pleased with the outcome of the settlement and that the university, over the past few years, has significantly expanded resources for students seeking support. But we wanted to broaden the conversation to students at other universities or institutions around the United States. For that, we called Dr. Jessi Gold, an assistant professor of psychiatry at the Washington University in St. Louis, who specializes in the mental health of college students, and she also got her doctorate at Yale. Dr. Gold, thanks for being here.

JESSI GOLD: Thanks for having me.

ROTT: So we've been talking about the legal settlement at Yale regarding their policies and mental health resources for students. But I'd imagine that access to mental health resources is a large issue across colleges and universities all around the US. Is that true? Is that the case?

GOLD: I think when you think about access, you can kind of think of college like a microcosm of the rest of the country. So we have poor access to mental health, period. But on college campuses, there's more awareness, more conversation around it, and it's a population that's really struggling. So there's a lot of need, and that need isn't always met. I think people try and try to provide as many resources as possible. But it's often for the people who are most struggling - so the intervention side and not a lot on the prevention side. And it's definitely something that needs more resources and needs more help, but it's sometimes hard to know exactly what that is.

ROTT: So I mean, we're talking about an Ivy League school here, Yale, but have you seen similar pushes to change policies at different universities, different institutions, state universities, junior colleges?

GOLD: I think this is a common conversation. I think it's a reactive conversation, meaning that it's coming from lawsuits. It's coming from poor outcomes. And that isn't always the greatest, but it often leads to a lot of change. And I think when you see another university, especially one that is well-known, going through something like this, it leads you to think about your policies and leads you to change them. So I do think it is a common conversation to talk about leave, to talk about supporting students appropriately and making sure you don't also end up in the papers.

ROTT: What does taking more proactive approach look like? You're saying that a lot of this is reactive. It's from a lawsuit or a settlement. How do we get ahead of the curve?

GOLD: I think it's really important that when you're thinking about leave policies in particular, that you're being flexible, that you're not saying everybody's mental health looks the same, or everybody struggling with a mental illness, even the same mental illness, looks the same and should be treated the same way. So not everybody should be removed from school. Some people might benefit from that, but some people, that's removing their purpose, their identity, their social support, and sometimes even their treatment providers - right? - If they're getting care at school. Mental health is something that you absolutely have to deal with on a college campus. And that means you have to have these policies in place, but you also have to be thinking, what's the next step? What's the next thing we need to be thinking about? How can we make sure that people feel not just, like, adequately supported but completely supported?

ROTT: You know, my mom's a high school teacher, and she's talked about how hard people have struggled, how many students have struggled when they've come back from the pandemic. I think I've read study after study after study kind of, you know, highlighting that issue. Is the pandemic a big cause of the spike in depression amongst college students that we've seen at different universities?

GOLD: I think it's important to think about the pandemic as, like, a compounding factor and a stressor but not to neglect where we started. So we've always seen high rates of stress and high rates of anxiety and depression in college kids. But I think when you look at how has the pandemic changed, college changed during the pandemic. People were home. Their social supports were taken away. And that really compounded a lot of existing mental illness, created new mental illness. And as a result, we're sort of seeing higher numbers, and it's going to not go away magically now that the pandemic has lessened, we're going to still see that over time because these things don't just go away, and a lot of mental health outcomes are long-lasting.

ROTT: Dr. Jessi Gold is an assistant professor of psychiatry at Washington University in St. Louis, and she specializes in the mental health of college students. Thanks for taking the time to talk to us.

GOLD: Thanks for having me.

ROTT: And we should say, if you or someone you know may be considering suicide or are in crisis, please call or text the 988 Suicide & Crisis Lifeline. Again, 988. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Nathan Rott is a correspondent on NPR's National Desk, where he focuses on environment issues and the American West.