Getting Through College with a Mental Disability

We’ve been talking a lot about how university faculty and staff individually respond to students with disabilities, as well as attitudes from universities as a whole towards identifying students with potential mental health problems. I’ve noticed a lot of stories in the comments on those posts about the struggles individual readers had when navigating the university system, so wanted to share my own story and my perspectives about what made it possible for me to get through and graduate from university despite the onset of my bipolar during my freshman year. I can tell you in two words what made the difference for me: class privilege. I believe that without the money and other associated trappings of upper-middle class status I got from my parents, I would not have finished school and likely would have become homeless and unable to access meaningful mental health care. Which in turn would have certainly resulted in my death by suicide. I think it’s important to look at how and why class made such a significant difference in my experience those years, to identify policies and mechanisms that need to be adapted so that all students, regardless of class status, have the opportunity to finish their educations.

Although I had experienced some relatively mild depression during my senior year of high school, it wasn’t until my freshman year of college that I started to experience significant symptoms. I had moved thousands of miles from home to go to school in a city where I had no friends or family. The only person I knew on campus was my high school boyfriend, who I was still dating at the time. Things started going downhill for me:  I started staying in bed more often, sometimes for entire days, I stopped going to class,  but most often, I thought of death. I had an almost endless range of plans and procedures that I didn’t carry out because all of them seemed to require too much effort. I discovered self-harm, which I thought I’d invented. And I was terrified at how easy it seemed to be to get potential weapons, to cause myself harm.

At that point, I went to the student counseling center. When the day of my appointment finally came, the woman, a master’s student, took out a set of Native American tarot cards. I still remember how shocked I was.  I got up and left, demanded a new counselor, and came back a few weeks later for my return appointment – again with a master’s student, who wanted only to talk about my parents. I have some pretty obvious sources of psychological trauma – past sexual assault, then-current psychological abuse from my boyfriend – and my parents are not one of them. At least that student could hear how seriously dangerous my current depression was and gave me some samples of anti-depressants to take. Those pills triggered my undiagnosed mania and sent me into a two-day spin of increasing self-harm and lying to people in the dorm to get ahold of knives or razors or anything with a blade, culminating in a psychotic break when I tried to jump out the 3rd story window of my friend’s dorm room because I knew I could fly and wanted to test it out.

That landed me in the psych unit of the nearby community hospital. The hospitalization g0t my meds straight and got me on a mood stabilizer and got me set up with some tranquilizers for breakthrough hypomania or anxiety, so I was much more stable than I had been on the meds prescribed to me by the university health center. But a week after I was released, my roommate and best friend was hospitalized after a suicide attempt and sitting in the waiting room with her to be admitted triggered me badly enough that a few days later I self-admitted because I was scared of doing myself serious self-harm. And that’s when things went seriously sour with the university.

The university did not want me to return to the dorms after leaving the hospital, ostensibly because my behavior might frighten, upset, or otherwise disturb other dorm residents. The RA had also reported scabs on my arms (from self-harm) as suspected heroin use, so I had to disclose my self-harm to dispell that. (Although I’m not sure which would have been preferable from the university’s standpoint). If I’d been expelled from the dorm system at that point, I would have had to drop out of school as there was absolutely no way I was able to maintain an independent residence. Alternately, I could have couch-surfed.

So my parents threatened to sue the university for discrimination on the basis of mental disability. This required a whole lot of privilege – comfort with the judicial system, awareness of civil rights protections, financial ability to hire an attorney, willingness to disagree with the authority of the university. And although they hired an attorney and paid a fat retainer, the university caved before they actually had to file a suit. They agreed that I could return to the dorm system, but moved me to a new dorm across campus where I knew nobody and my roommate had had a double room to herself and greatly resented my arrival.

After I returned to school, my parents chose to pay for my ongoing mental health care out of pocket so I didn’t have to rely on the student counseling service for treatment. They paid for a private psychiatrist and a therapist who I saw twice a week – at what must have been astronomical cost to them. I know they are still involved in some collections disputes with the hospital, some 15 years after my hospitalization.

That’s a lot of personal story, but I think there are some really important points to examine. First, at no time during any of this was I ever in academic trouble nor did I need or request any academic accommodations (part of my problem was defining myself as someone who did well in school so I didn’t allow myself to waver academically, including being released from the hospital in the morning and taking a final that afternoon). Discussions about accommodating students often (reasonably) focus on academic accommodations, and I think there’s an assumption that any student having significant problems would be identified through the academic context before they needed housing or other accommodations. I am still not aware of how or if the office of students with disabilities would handle this kind of issue or whether they advocate on the student’s behalf. But accommodations in dorm life are just as crucial for students with disabilities as academic accommodations, especially when they live on campus and have no other real alternatives.

I often the housing concerns framed as a concern for other students – being around someone with a significant mental illness might traumatize them. And I agree that finding me dead in a bathroom would have traumatized someone. But my self-harm and my mania did not seem to me to be any more potentially traumatizing for other students than my dormmates who would go to the communal bathroom to throw up after every meal, those who were using hard drugs like cocaine, or even those who would binge drink until passing out naked on the stairway, none of whom ever suffered any potential housing consequences. To say nothing of my then-boyfriend, who was then causing me active and ongoing psychological trauma through his emotional abuse and who got to stay in the dorm with all our mutual friends after I was shipped across campus. That I was the only student looked at by the university and potentially subject to penalties – and identified as potentially problematic because I sought lifesaving and appropriate care – speaks volumes about how students with mental disabilities are seen by administrators.

My second point of contention is the degree to which the university actively contributed to my mental health problems before penalizing me for them. The manic episode which triggered my initial hospitalization was a direct result of the anti-depressants they prescribed for me. And I wouldn’t have been such a disaster and in need of immediate and emergency medication if my treatment hadn’t been delayed by over a month because of the first unhelpful counselor. Despite this, their only proposed solution was to get rid of me entirely – which seems to provide a disincentive for the school to provide effective counseling services. If the school pushes students into crisis, it can then remove them from school and campus. So why try to effectively treat someone?

The final point is the one I started with – it was solely due to my class privilege and the unwavering support of my privileged parents that I was able to fight the university to remain in the dorms and finish school. It was also due to them that I could access meaningful mental health care and treatment that allowed me to keep going in school. And it is stupid as hell that my luck in being born into such privilege was the determining factor in whether I moved forward or dropped out. Unfortunately, until the overall approach of universities towards dealing with students like me is drastically overhauled – to see us not as a threat to other students but a valuable part of the student community, to support us rather than trying to eliminate us out of fear – privilege is going to continue to be one of the most relevant factors.

I’m still thinking about how to best move forward on these issues. I have not done a great job of following up with my own university, primarily because I never want to speak to or be involved with them in any way ever again. But it seems like these issues must affect a sizable number of college students and contribute to the systemic problems that make it more difficult for people with mental disabilities to obtain higher education. I remember my time in college as a terrifying and desperate effort not to get kicked out – surely we can do better for the next generation of students.

24 Comments

  1. You raise a really good point here when you talk about housing issues; many college focus their interventions in the academic sphere, and only deal with issues which come up in student housing when a student is deemed “trouble.” Which means that the warning signs go unremarked and people do not get assistance in a timely fashion. (An RA who has had a few hours of “sensitivity training” is not prepared to deal with these kinds of issues.)

    I see a lot of discussions about mental illness in student housing framed as “well we need to intervene before the student causes trouble/upsets other students,” effectively erasing the student who actually needs help. Hence you have things like students experiencing manic episodes and getting kicked out of school when this is, in fact, exactly the wrong thing for those students. Meanwhile, eating disorders, sexual assault, and drug use run rife in the dorms at many colleges and universities (evidently walking in on people vomiting all the time isn’t upsetting or traumatic).

    It seems like alumni-based pushes for better intervention and policies would be a good start for the next generation, for alumni who have the ability to get involved at that level.
    .-= meloukhia´s last blog ..Inappropriate Word Use: Don’t Do It =-.

  2. i agree that the focus seems to be on the other students (those presumed to be neurotypical, although they may not be) rather than the student who is in active need of help. and focusing exclusively on those other students seems to do a disservice to everyone – the other students get the unfortunate message that should they ever have problems themselves, they will and should be instantly removed. i’m not sure that’s a message a teaching institution should be instilling.

  3. Yes, that’s not really the takeaway you want to leave students with: “Need help? We’ll help you by kicking you out.”

  4. Being viewed as a threat or disruption to other students really resonates with me. I appreciate I was just one out of 70 or so, but so often the way my high school dealt with my severe PTSD (not recognised as such as the time) was to view me as a nuissance or a disruption (“I’m not going to have you disupting other people’s learning by staring off into space”). It can be very hard, particularly for young people, being made to feel responsible for someone who has a mental health condition and resulting behaviour that they can’t understand, but the real problem is that so many young people with mental health conditions find their flatmates and friends to be the most trustworthy people to turn to. It that lack of support which causes the real problem.

    And yet, again, I was priviliged as well; people may have treated me badly, but I was also expected to pass. I was expected to get to university. I was given catch up work. A friend in a similar position and at least as capable, was continually pressured to drop out. She was the first in her family to complete school, and now has a university degree – and that was not because of any help from the school.

    When I got to university I didn’t have those problems to any significant extent (mainly due to a change in my surroundings) but there were residual issues, plus a different disability, and it was those experiences which put me off seeking any help or accomodation (even though I now know the disability service to be hugely helpful).
    .-= anthea´s last blog ..Dyspraxia and Gender: Part 1 =-.

  5. abby jean, I was a sophomore several years ago, and save a few details, our experiences were identical. (This actually made me cry.) I had the serious misfortune of being admitted to the hospital the same day as the Virginia Tech shootings. I cannot tell you how much I had to “perform” to be allowed out of the hospital, because they didn’t want to let me back into the dorms and they wouldn’t release me from the university hospital unless I had housing. My class/race privilege definitely came into play: I knew the right things to say and the right ways to act, and I was a cute petite blonde who certainly didn’t look threatening, unlike those “scary homeless people” also on the ward. (Heavy, heavy sarcasm here.) I’m considering submitting a guest post on performance, and I think this was the kick I needed to get writing on it this weekend!

  6. Meredith – I’d love to read what you say about performance. i experienced a lot of that, also, trying very hard to “act like a sane person” to gain back my rights and privileges, including getting let out of the hospital. (that’s a whole other story.) i was also aided by being white, i’m sure. but i continue to notice times when i’m performing (usually trying to pass) more consciously than others.

  7. This post really resonates me. I graduated college last spring, and had numerous problems with living in the dorms. For me as well, class privileges alleviated some of the problems which came from being a neuro-atypical student, although for me it was more that my family was able to afford a small private college which was somewhat more understanding and accommodating. But, yes, I definitely think that conversations about disability accommodations in university settings need to focus on living accommodations just as much as academic accommodations. And this conversation needs to *not* happen in the context of protecting presumably neurotypical students from the crazies.

    I definitely agree that better mental health services are needed on many campuses. (Tarot cards? Yikes.) I hope that these mental health services can be neurodiversity-friendly, though. Some of the problems I ran into at college were the result of people interpreting my normal way of functioning as “insane and clearly in need of immediate correction.”

  8. This really hit home with me. I nearly got kicked out of the dorms when I was a freshman, for being anorexic. They did have an eating disorders clinic on campus, but they refused to treat me. Why? Because I was “too sick.” So I could stay on campus, I just couldn’t get treatment. I don’t understand how that makes sense. I was extremely underweight, which apparently disturbed my roommates…and only got worse as the semester wore on. But I had no academic problems – like you, doing well academically was how I defined myself, and somehow I managed to maintain a near-4.0 GPA. I eventually had to withdraw for the spring semester to be treated in the hospital, and fortunately had no issues once I returned the next fall.

  9. Great post. Housing treated me like shite after my suicide attempt. They pretty much explicitly said they didn’t want “people like you” living there. So, I don’t. And I tell everyone I know not to give them money.

  10. Wow…

    Was the ‘counsellor’ who gave you the meds actually qualified to give out meds? In Australia, no one other than a qualified doctor of medicine would be able to give out meds and it is very rare to get samples of anything.

    Your description of how you refused to allow yourself to waver academically sounds a lot like me. I had a terrible time with depression and anxiety at various times during my uni studies but because I continued to get excellent grades, no one at uni took me seriously about my mental health issues.
    .-= Bri´s last blog ..Joining the Fat feeds – some admin stuff =-.

  11. Bri – i can’t recall the details, but i’m certain someone wrote a prescription. as for samples, i recommend meloukhia’s post on the roles they play in US care.

    i’m struck by the common notes in the comments – the varied ways in which people’s functionality was impaired, the difficulties in accessing meaningful care and treatment, and the blanket treatment from institutions. which has clearly resulted in the systemic exclusion of people with mental health disabilities from dorm life. i’d advocate a more tailored, individualized response, but i also am not sure i want the universities to have access to the full psych records of students. there’s certainly a lot of competing interests here – i’d just like to see those of the student with a disability protected more than they are now.

  12. @Bri: In the U.S., doctors, psychiatrists, and nurse practitioners can all prescribe antidepressants (among other things), and samples are pretty common. When I was on antidepressants, my NP gave me some samples at every appointment to save me money.

    This story reminds me a lot of something that happened to a girl at my undergrad college–she checked herself into the hospital, got treatment, her doctors said she was fine to go back to school. The college said she couldn’t live in the dorms because she “might be a danger to the other students” or something (and there had been a girl who, iirc, fell out a window and died earlier that year–I can’t remember, but she might have been drunk–so there was also this supposed fear that she might further traumatize the students). But they ALSO wouldn’t let her live off campus because she wasn’t a senior. So, either her family didn’t have the resources or the energy to fight it and she dropped out, moved back home, and went to community college. I don’t know what happened after that.

    But this kind of treatment of students is or at least SHOULD be illegal (perhaps colleges manage to skirt the edges of the law by not directly expelling students but instead denying them housing). And it’s why so many students don’t trust school mental health services. I always had the feeling they were looking for mysterious warning signs that would lead to me getting kicked out. I think it’s really common.

  13. My uni has a fairly good example of good practice; counsellors are qualified, the ones who are volunteers are partially qualified and on their way to being qualified in counselling. There’s a mental health nurse on staff. Serious problems are referred on to NHS mental health services (I’ve got middle class privilege too, and I’ve never used anything but the NHS. Sometimes had to wait a while, but it’s always been there). The university is signed up to local commitments about suicide awareness training, and are very active in trying to get as many of the staff and student body along to training. There is variability in academic departments as to which are more or less helpful – but disability services seem good at warning people and offering to help fight their corner!

    I’ve heard other UK universities aren’t as good, but I’m not sure that any are quite as bad as described here.

    Dorm life – well, people only tend to live in halls for the first year of university, and I think they’re much more independent than US dorms anyway. I’ve never lived in them here, so can’t comment. You can get some activities of daily living support round campus via the ‘non-medical personal help’ portion of the Disabled Student Allowance (assuming the gods like you and the wind is in the right direction, as with all benefits), and I know some people who’ve used Direct Payments for care at university – both things that can help with living out of halls.

    Yet another US post that makes me want to go and hug the NHS, for all its faults. Samples given out by a student? I’m glad that this sort of abuse of dangerous medication is banned in this country.

  14. Wow, the idea of a nurse giving samples of anti-depressants is a little unsettling to me, personally – here, it’s doctors and psychiatrists that can prescribe anti-depressants. Often a psychiatrist will do the initial year or ten months worth of prescription/refills, then send you back to your PCP/GP to continue having them prescribed. MSI (the provincial medical plan – if you’ve lived here for more than a certain length of time you have/are eligible to have it, no matter how much money you have or don’t have or whether you’re currently working or not) doesn’t cover the meds, but it does cover the psychiatrist completely, and it will also cover counselling as long as it’s deemed medically necessary.

    I’ve been fairly impressed with my school’s counselling centre, though they need more counsellors (my counsellor really wishes they had a psychiatrist on staff, too) they really do their best with what they have, and the counsellors are really dedicated. If you’re having one of those days and you’re having major problems and need to talk to them they’ll stay after hours or give you extra time in their office. I never had any major problems while still living in the dorm, but I know one girl who did, and she never got kicked out of the dorm or school or anything

  15. A nurse practitioner has much more extensive training than “just” a nurse, and can do most of the things that a doctor can do except for surgery. Many people have a nurse practitioner as their primary care person.

    Only doctors, nurse practitioners, and (depending on the state) midwives are allowed to prescribe medications, including giving out samples. If this was a master’s student who was not also one of those things, then it would be illegal in the US just as it is in the UK. I suspect that probably what happened is that the psychiatrist at the counseling center wrote the actual prescription and got the samples out of the cupboard, and the master’s student was the one who handed them to the poster. However, it is of course bad practice to do so without having the psychiatrist him- or herself do an evaluation, and it sounds as though that did not happen. If the master’s student did just give out the samples of her own accord, she broke the law quite seriously.

    I do not know about other universities, but at my university, the disability office handles a lot of non-academic accommodations. You have to request them, though, and a lot of people do not know that you can. Disability offices’ profiles are much too low for my liking. Sometimes I felt as though my entire TA-ing life was spent informing students about what they could get through the disability office, and they were always shocked.

  16. I’m willing to bet that the possibility of litigation from parents, those of the students with the unaddressed mental health issues as well as those of others in the dorms, has influenced these university policies. And the message there is “we fear the threat of litigation and the ensuing publicity more than we fear that we may have failed or excluded a student who needed help or care.”

    The infantilization of young adults feeds this, too. Rather than letting young adults deal with whatever issues arise, and helping when necessary, there is a trend towards preventing them from having any adult issues/experiences. Universities may complain about “helicopter parents,” but by cowing to that group, they’re feeding the monster. Living in close quarters with someone who is in the throes of a crisis could be a difficult situation, but that can be dealt with in a number of ways, and in ways specific to the individuals involved. Who knows, maybe a roommate could end up with a keener sense of empathy rather than just be traumatized. And maybe sometimes, splitting up the roommates is the right answer. But not exclusion or expulsion.

    I’m sure that my daughter, now 7, will go to school and live amongst strangers someday. And the thought that she might have a roommate who is in crisis is unsettling. But I’ve dealt with that myself- my dad completed suicide two years ago after numerous attempts and hospitalizations. Some of the attempts put the family in the path of direct, physical harm. Would I help my child find other housing if the situation were dire? Yes. But I would be appalled if the university’s “help” came in the form of these policies.

  17. Since this post is tagged “intersectionality”, I feel like I ought to mention being disturbed by your use of “Native American” as a description. It is, of course, true that tarot cards don’t belong in a medical setting, but specifying that they were “Native American” seems unnecessary, and in this comes across as being racially othering. (–Not to mention that, at least in my limited understanding, tarot is a fundamentally European idea, and all of the “Native-inspired” tarot cards I’ve seen seem to be extremely appropriative, and not terribly Native.)

  18. My circle of friends always interpreted our college’s policy of booting troubled students out of the dorms as a “no one dies in Disneyland” sort of thing.
    I don’t think the school would have been more helpful if you had been struggling academically. My ADD and depression definitely and visibly impacted my academic performance, but the one counselor I saw just said that I maybe wasn’t ready for college. (Too late! What was I supposed to do, go back to high school?) Basically my disabilities, though I don’t remember if I brought them up (they’re hardly rare), were ignored in favor of blaming my academic difficulties on personal weakness or lack of maturity. I didn’t even bother making a second appointment, partly because it would be weeks until I saw someone and it was all kinds of hassle.

  19. Thank you for sharing your story. I’m a college student with bipolar and PTSD. I’m also a mother of two kids with special needs. I’m sorry you went through this. I can definitely understand not wanting to go back and be involved with that university again, but sharing your story is definitely encouraging to people like me. I’ve dropped out. The combination of school, my mental issues, and my children’s needs became overwhelming. I’m hoping to go back in a year.

    I also liked how you brought up the class privilege and what role it plays. I had never thought about that before.

  20. D – thanks for the feedback. i’m sorry it was racially othering – it was certainly not my intention. i described the cards that way because that’s how the counselor described them to me. i don’t feel qualified to speak to whether tarot cards can be incorporated with native american ideas and traditions, and never actually saw the cards themselves or how they were used, so can’t speak to whether they fit with my understanding of tarot. i included the detail simply because i have a very clear memory of sitting in that room and being told that was how i was going to be treated and wanted to share my story in the post.

  21. D- Hi, since I am both Native American and a practicing Pagan, I wanted to speak up that I don’t find her description it specifically racially othering or odd as a descriptor, (unless you feel othered as a self identifying Native American, as I would not want to erase your experience), but since I have studied both and am both, I can say that her description here isn’t anything but specific in my experiences.

    While Paganism and tarot certainly have many roots with the the ancient Celts (and mainly European as you pointed out) the modern Pagan movement is far more eclectic than that. Many people find their way to Paganism via other channels, for instance, for me it was a combination of a friend’s family religion and my own Native American heritage which I had a chance to re-explore after my daughter’s birth. The Neo-Pagan movement has many intersections with Native American spirituality which was very welcoming to me. Now, there are places where there is some appropriation involved, but I am sure it works both ways, if you asked those holding to the more pure Ancient Ways. I am sure they are intended to be sold to non-Natives who just ZOMG adore “all that Native stuff” just as much as to people who use them b/c they feel connected to their Native ancestry, as I do.

    Tarot cards work along the same lines. Were you to walk into an occult shop (or even your local Borders) looking to purchase a deck you would find shelves lined w/ the many varieties of tarot available from the traditional to decks w/ artwork specifically for LGBTQI. I have owned a Native American tarot deck myself. The description is specific and appropriate, as the cards would be different depending on the deck. You use them the same, but the artwork is different for the same cards.

    I hope I didn’t step on your toes, Abby.

  22. And, my sentence structure is awful. Apologies. I R Tired.

  23. Thank you Abby Jean for sharing your story. It certainly resonates with me as I was kicked out of student housing after a suicide attempt shortly after being diagnosed with bipolar disorder my sophomore year. I was also informed, the following summer, that the girl I was supposed to room with the next year was uncomfortable about my mental illness and requested to switch rooms.

    I can also say that I only finished school and am where I am today (professional school) because of my father, who had knowledge and resources at his hands, and was able to take advantage of Family Medical Leave. He ended up having to move out to where I was studying for the rest of the year (halfway across the country for a few months) in order for me to finish the semester and not be forced out of school. I was certain that if I quit school then, I would never start again. Staying in school helped me to remain connected with reality, and finally find the right treatment for me.

    When I share my story, people are always shocked. People don’t realize that this is the norm – in fact, being expelled is often the norm, and I really got off easy and was otherwise treated well by my school. I realize that schools must consider the other students, but kicking a troubled student out is so often not in their best interest.

  24. I read this and I cried. I’ve been through so much because of ableism at University. Thank you for writing this.