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Comment by rdtsc | Hacker News Reader

Schools don't give a shit about you. Whatever they do in these cases is driven by "What can we do to not lose money? What can we do to not get sued? What can we do to avoid a PR disaster?".

Keeping that student is perceived a liability for them. As they honestly put it they don't really think they will be safer at home, and it is obvious they don't care what happens. They just don't want to deal with it. They see this person as a risk not worth taking.

> If I were a liar, I would never have gotten myself into this mess. Fuck me for not being a liar.

You sometimes have to be a liar when dealing with large bureaucratic systems. A large school is certainly one such thing. They do not have your best interests in mind. Healing you is not on their priority list. Be honest with people you trust and love. Don't treat institutions as moral agents.

You'll even find sometimes your doctor's #1 priority might not be to heal you. Their goal could be to perform more surgeries. So all of the sudden you are told to get surgeries. Get second opinions. And so on.

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This observation isn't really a complaint about Yale or college in particular.

Yale is not her parents, not her church, not the Connecticut Health Service, not the National Health Service. What does Yale owe her any more than all the rest of us owe her?

Schools used to be thought of as parent-substitutes of sorts in the past. In loco parentis was used to refer to this idea. Women would be subject to curfews for example and so on.

The idea is really about what she expected her school to be -- a welcoming community that will help her grow or something of that sort (she took the marketing flyers literally). Was she naive to believe that? A lot of young people make that mistake. Some from affluent small town communities have not had to deal with large bureaucracies before. This is their first go at it.

This here is the crux of the issue. Young, impressionable people believing what the school is selling. And you can argue till the end of the Earth about who's fault it is, but the reality is that the world is full of people who are in turns impressionable and opportunistic.

I loved my alma mater, but I also never for one second believed that anyone outside of the few professors I was close to and still keep in touch with, actually cared about me as a person.

The author's experience with mental health issues was a perfect shit storm of being cut down after taking their warm-fuzzy message hook-line-and-sinker, AND a broken health care system in general.

I would also argue there are no easy answers. It's not my place to suggest reforms, but if you're admitting someone to a psych ward and you know that at least one time they slashed their thigh open with a pocket knife, how can you possibly take their word for it that they aren't going to use the drawstring on their pants, or the plastic cover of a notebook to try self harm again? It's a no-win situation, and those are the worst.

The best case would probably be to abolish psych wards and give everyone one-on-one access to a counselor 24-7 so they can hang out and be 100% sure they're not in danger. But I'd also note the world has moved "forward" a lot in terms of stigmas and treatment of the mentally ill. Is their room to improve, hell yes. But to ignore the almost death-camp like environments of the homes for the feeble minded just a century ago, we're doing okay.

Removing ligatures is fine. Removing actual sharps is fine. I don't know the plastic binder, so maybe removing that is fine too.

Making someone strip naked for a search is not fine. Giving an intimate search is also not fine. Threatening to restrain them to a bed is not fine. Keeping them in their room is not fine. Keeping them on a locked ward is not fine. Etc etc.

If her account is accurate I am shocked by how bad her treatment was. I've attended many a&e units with someone with severe deliberate self harm (much worse than described in the article) and that person got much better treatment. Not just medical clinical treatment, but the humane stuff too.

In fact, may colleges make this a core tenant of their sales pitch... "We're a community here, you're not a number! Small class sizes! Professors get to know their students! The Dean gets breakfast in the dining hall with the freshman!" etc. etc.

Yale has blatantly discriminated against someone with a mental health problem. There was no attempt to make reasonable accommodations, to make adjustments if possible to enable her to continue to stay.

Swap mental illness for wheel chair use or deafness and you start to see why your position is so unreasonable.

The "reasonable accommodation" for someone with suicidal/self-harmful thoughts and actions (active cutting) is sending them to a psych ward for treatment. Which they did.

If a person in a wheel chair had their legs bleeding out, would it be discrimination to send them to the hospital for treatment? Or just the right thing to do?

If anything, they were exactly the opposite of discriminatory, as post-treatment, they let her (now with the "mental history" label attached) back in, right?

I don't know enough about this person to say whether it was the right thing or not, but in general suicidal thinking combined with self harm shouldn't be enough to deny someone access to University.

Self harm is for some people a protective measure that prevents suicide. It's possible that a bit of supervision and temporary lighter workloads would have helped.

I have been careful use use weasle words - "if her account is accurate" etc - because it's possible that the only option was for them to remove her temporarily and their weird system needs her to reapply.

And I'm not sure if they get a pass on not discriminatory. Excluding people with current mental illness, but accepting people with a mental health problem in their history isn't really good enough in the 21st centuary. Again, I don't know what their policy is so I should not judge them, but what do they do with people who disclose hearing voices or psychotic episodes or bi-polar mania or eating disorder? (Anorexia is far more dangerous than self harm, even including the suicidal thinking).

"in general suicidal thinking combined with self harm shouldn't be enough to deny someone access to University"

I would agree with you, but I sympathize with the University as well. In our litigious society, Yale could easily be sued by the parents of the suicide victim. Worse, once a school starts "treating" a student for mental health issues they by default assume some responsibility for that person. If the OP did eventually jump from the roof of Vanderbilt hall, people would be asking, "why didn't they send her home?"

The university could have treated her with more compassion and respect, but their ultimate decision to remove her was probably their best course of action.

This is an excellent point.

Fear of litigation has made it difficult for people or organizations to be generous; their first priority has to be CYA unless they want to risk financial ruin.

You are betraying complete ignorance of how humane and effective treatment for acute psychiatric conditions is supposed to work. The account in this article, assuming it is correct, has so many red flags I don't even know where to begin.

Here's what Yale themselves say about disability: (http://yalecollege.yale.edu/content/resource-office-disabili...)

> Often, the physical barrier is the easiest to remove - the attitudinal barriers are much more difficult. To create a university community, which is truly accessible to and inclusive of all persons, including people with disabilities requires the participation of each and every member of the community. Toward this goal, the Office serves as a resource and a catalyst for change by providing technical assistance, information, and disability awareness training to any member of the Yale community.

Yale is her community while she's there. That's why it matters.

I can't tell if this is a joke or not. You do realize that going to a school like Yale costs almost $60,000 a year, right?

The $60k is for rendering an education, not providing psychiatric counseling and a safe environment for recovery.

You probably charge your employer $60k (+/- whatever) for rendering services; are you now obligated to help your boss (or CEO/whoever) through an episode of bipolar? Schizophrenia? I mean, they gave you $60k, right?

My colleagues were very supportive during a bout of anxiety and depression I had in 2012. I couldn't sleep properly for 2 full weeks and was a complete mess. They let me take an unscheduled absence (paid) for a few days because in the long run I'm more useful and productive to the team if I have a chance to heal when I'm unwell. A psychological illness is as real as a physical one and just as damaging. I'd rather be in a society that cares as standard, rather than counts the dollar value.

The $60k is for rendering an education, not providing psychiatric counseling and a safe environment for recovery.

Have you looked at a catalog for Yale or any similar private school? They're not primarily selling education.

Besides, the "education" is no different from what you'd get at a much less expensive, much less well-known school. You're paying for the "community" and the experience and the brand.

Source: I paid for my own Yale degree.

> You're paying for the "community" and the experience and the brand.

Totally agreed.

But my point still stands; slightly refined:

providing a snobbish "education" != providing a safe place for people with psychiatric disorders.

I would not have used the term "snobbish", but, well, you went out of your way to mention your Ivy League degree, when it didn't fundamentally address my point that anyone paying for any college, regardless of cost/status, should be expecting to get psychiatric services along the way.

Congrats, you're special, thanks for letting us know. :-)

> Totally agreed.

What constitutes community in your agreement? For many part of community giving support to those who are going through a rough time.

> paying for any college, regardless of cost/status, should be expecting to get psychiatric services along the way.

Universities often require health insurance if enrolled. Often it is required you buy it through the University. Universities roll many services into one package. It is not uncommon for University programs to target bettering both physical and mental health.

Psychiatric services are just one more Health benefit. Is there a reason to exclude it as part of the package? If it normally is excluded, what reasoning lead to this decision?

> Congrats, you're special, thanks for letting us know. :-)

What are you trying to communicate with here?

> Psychiatric services are just one more Health benefit.

Right. AFAIK Yale has those, and is where the gal went. And they made the decision "this is too serious for us" and sent her to Yale-New Haven, which has a real psych ward.

I am sure Yale has counseling/Health Services for non-clinical depression/etc., but I don't think people appreciate the environment you need for patients with active, dangerous psychiatric illnesses (harmful thoughts/etc.) who are actively going through med changes, that may actually worsen their condition before the right balance is found.

No way Yale, or any college, is going to have those facilities. They sent her to specialists, which was the right thing to do.

Keeping her at Yale under the care of people who are not trained/equipped to help her, would have been worse.

E.g. Yale probably has nurses/doctors to apply bandages, prescribe basic meds, etc., but would you get cancer treatment there? They can't provide everything.

> What are you trying to communicate with here?

I was admittedly being sarcastic and trying to point out the guy was, IMO, bragging about his Yale degree, and talking about the "brand" he paid for, when it really didn't change my point that you don't pay any college, Ivy League or otherwise, expecting that they'll also help you through your serious psychiatric illness while you're there.

Yale requires the purchase of specialty care coverage as a condition of enrollment. This includes 60 days of in-patient psychiatric care annually. Students are paying with expectation that the college will help them out, since that's exactly what it says on the tin.

Most schools provide psychiatric counseling (and primary care, and immunizations, etc) as part of the medical services paid for by the student life fee.

Mental illness is a disability and is protected by the ADA, so if she had been an employee and not a student she would have had stronger legal protections.

I'm not sure how it works in your reversed example of an employee supporting an employer. The decent thing to do is to support the reasonable adjustments, and to not be a dick when they return to work.

And, while they might require some time off, and maybe hospitalisation, they probably shouldn't lose their job amd have to reapply for it.

The rest of us would also be dicks if we cut ties with her after learning she was going through a personal struggle.

Personally, sure. Institutionally, not so much.

I'm sympathetic, I just don't see what place Yale has in this.

> Personally, sure. Institutionally, not so much.

I don't even know what that is supposed to mean. I'm not institutionally a dick? Is that even a meaningful sentence?

An institution does not have emotions, just like a corporation does not have morals. It's not capable of being an asshole or your best friend. That's what they meant.

In order to call Yale a dick, you'd first have to personify it, but that's a literary trick and not reality.

The decisions of "Yale" the emotionless institution are made by people. I don't want to get involved in discussing this particular case, but I am very bothered by the common sentiment that groups of people should not be held to the same ethical, moral, emotional standards as the individuals within the group.

I never said Yale shouldn't be held to such standards as individuals are. I merely pointed out that, as much as we'd like to believe, and our laws try to contain, organizations of people are by their nature amoral. You can wish Yale could be held to that standard, but it's the individuals that steer the org that need to held accountable.

To cite another case, United Fruit enjoyed cheap land and labor in Guatemala. In the late 40's and early 50's, populist movements started springing up in the country until one day a land-reform minded president was democratically elected. Someone at UF called up some friends in the U.S. government who knew some folks, who organized an assassination of the president by the CIA.

United Fruit is not evil. A vast majority of the people who made up the corporation were probably blissfully ignorant of what the group they were members of were doing. And it's unreasonable and irrational to expect corporations of a certain size to have "all the facts." Instead, a small cabal of individuals colluded to implement a policy that devastated a small Central American democracy for the rest of the 20th century.

In the same way, Yale is amoral. It is not capable of making moral decisions the way individuals in leadership positions are. And American corporate law should reflect that. Instead we get bullshit like corporate campaign reform that allows individuals with an agenda to wield the power of the hundreds or thousands because there's a chance that the that individual's position will positively impact the corporate body.

When the leadership of a company is performing evil acts via the company, that is equivalent to saying that the company is evil.

It doesn't matter what the minor ignorant workers are doing. A ruthless dictator's fingers and toes aren't evil, but he is evil.

>United Fruit is not evil.

Of course it is. Just look what they did!

Corporations are people, my friend. That's a legal reality.

Corporations are people, my friend. That's a legal reality.

Corporations can live forever and suffer only mild losses for egregious ethical failures. They demand sacrifice (of time from the proles, and of ethical compromises from the powerful) that in theory benefits "the company" but actually is for the benefit of the highest officers (priests).

That's not a person. That's a (not necessarily benevolent) god.

It's sort of like an implied contract, you can't pretend to care about people and then shaft them.

Well, legally you often can, but it's a pretty shitty thing to do.

>You sometimes have to be a liar when dealing with large bureaucratic systems. A large school is certainly one such thing. They do not have your best interests in mind. Healing you is not on their priority list. Be honest with people you trust and love. Don't treat institutions as moral agents.

You know, this seems pretty obvious, but that hadn't clicked for me until just now.

thanks.

I'm not arguing against your point that a college's decisions with respect to student retention are made in the interests of the school rather than the student.

However, you're ignoring the enormous pressure on institutions (especially the prestigious ones like Yale) to maintain a high 4-year graduation rate and a very low dropout rate. Most of these colleges will do absolutely anything in their power to keep students from dropping out, so I'd say her chances of being readmitted were very, very high.

I know because I went to one of these schools. Many of my peers were forced to take time off for reasons ranging from mental health to academic probation to disciplinary action. I know one student who was forced to take time off from my college for three separate semesters for three different incidents. The top-tier institutions give students an incredible number of second chances.

Which isn't to say this falls into the same category as someone who, say, did LSD, got naked and had a physical altercation with the town police.

My only point is this: saying a university perceives troubled students as liabilities is an enormous oversimplification of the factors that go into an administrative response to this kind of situation.

But I do agree universities generally act in their own interests.

And good for them. Well, not good for them, but it's certainly not their place to be surrogate parents.

There is a huge area between being "surrogate parents" and being outright inhumane.

> For more than a day no one had any idea where I was — not even my parents.

The rest is equally horrifying, but this boggles my mind on top of all that. Is it too much to ask to at least inform her parents? What could be a sane justification for not doing so?

I believe it's illegal for the school to share that information with parents, provided the student is an adult and hasn't given consent.

But it's perfectly legal for someone to decide that an adult is still suicidal when they say they are not, having them taken away and locked up without allowing them a phonecall? If that's mental healthcare in the US, I wonder what abduction is like.

Please understand I'm not justifying or defending, only explaining.

I know. Still, there is a difference between them not having consent because they weren't given consent, or because they haven't even asked for it. Maybe not legally, but I morally for sure. (I simply assume that the article isn't leaving out that they asked her, and that she said no.)

As "not surrogate parents" they don't really have a place to say she can't go there either.

Yale does have the right to decide if she attends or not, and here's why:

Every individual has the right of free association. If you're hosting a party, you have the right to tell one or all of your guests to go home, whenever you want, for any reason (and they have the right to never come back if you mistreat them). The same applies to larger groups of people: the right of free association doesn't disappear when they form a group such as Yale university. Whatever rights a group has are ultimately no more or less than the rights of its individual members.

Some people say that rights entail certain responsibilities. On that view, however, rights are indistinguishable from gifts. If rights entail responsibilities, you don't actually have the right to choose your friends; society merely tolerates your choices, so long as you follow parameters set by others. Your own judgement and preferences become a secondary concern, to be overridden by the group. (If this sounds farfetched, recall that eugenicists employed this type of thinking in their calls for forced sterilization: the rights of the "unfit" be damned, they said, for the good of the group hangs in the balance.)

I want to clarify my general point on rights entailing responsibilities just a little further: my view of rights is not a sanction of wanton irresponsibility. No one has the right to push a person off a cliff (excepting situations of self-defense). Nor do they have the right to smash people's windows, steal car stereos, etc. Put another way, no one has the right to violate another's rights.

I'm out of time, so I'm going to stop here, even though there is obviously a lot more to cover on this topic.

> What can we do to not get sued?

I don't understand why this is a bad thing.

Lawsuits are society's way of telling organizations, "don't let this happen again".

So, let's assume, yes, this college is worried about a lawsuit from the girl hurting others.

You assert, "those jerks, they're only focused on avoiding a lawsuit and covering their ass."

Well, yes, because society has told them "if you let this girl/other students get hurt because you ignored an obvious threat to their safety, their parents will sue the hell out of you".

So, in reality, the threat of a lawsuit is, by proxy, actually protecting the other students. How is that a bad thing?

(Frankly, I would give Yale the benefit of the doubt, and assume they were directly concerned for the safety of this and other students, instead of only concerned about the lawsuit, but, either way, the results are the same: no one got hurt, she got help she needed, and she's back.)

I'm having a hard time seeing how Yale's decision would protect other students -- on the contrary, the message that would send to other students is, "you better not do something to deviate from the norm in an undesirable way or you won't be wanted here."

Certainly in this case the girl wasn't a direct threat to anyone else, the only threat I see here from the University's perspective is to their image as an institution that admits "cutters".

> the message [...] you won't be wanted here

You're taking a very specific, dangerous situation (an active psychiatric illness) and making a large extrapolation to "any deviation from the norm".

People will active psychiatric illnesses are supposed to go to psych wards for immediate medication, and then are supposed to have months of follow up while they heal, adjust to meds, and learn to cope.

This official had an extremely bad choice of words, but what everyone is missing is that the right thing happened. She's healing. She's back. She's not dead.

Yes, she harbors a lot of resentment about what happened, but a lot of times people in these situations don't realize what really is for their own good. Unfortunately. Hopefully she can come to realize this eventually.

> wasn't a direct threat to anyone else

Have you read the other comments in this thread about suicidal (only self-harm) people, once in the hospital, slashing staff with a razor blade?

I assert people with psychiatric illnesses are not as predictable as you seem to think. Especially when they're going to be going through a med change, which is often a crap shoot about which meds help and which can actually make it worse.

Do you have training/experience to the contrary? I am admittedly not an expert on "cutters". Maybe we need a "IANAP" (I Am Not A Psychiatrist) disclaimer.

What psychiatric illness was she diagnosed with that would make her a threat to others? I couldn't find anything beyond self-harm, and not to make light of it, but a survey seems to suggest that incidents of adolescents and adults self-harming and having suicidal thoughts is actually pretty high [1], and I doubt a high percentage of these people posed a danger to others. This case is probably more serious than the majority in the survey, but then where exactly do you draw the line in assuming she's a threat to others?

Also, the one comment you're referring to referenced an OD patient being physically restrained by medical staff -- are you going to tell me this is sufficient anecdotal evidence to make her a threat to other students?

[1] http://www.nursingtimes.net/survey-finds-worrying-number-of-...

People with mental illness are far more likely to be the. I tim of violence than the perpetrator of violence.

In this very case she didn't harm any other person but was assaulted herself!

So a few high profile lawsuits from rare events have skewed the perception of mental illness, and now someone with zero intent to harm other people is treated as being a risk to other people? To me that feels like a sub optimal but obvious happening.

It feels like stigma is increased, not decreased.

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