Illegal Mandatory Leave?

A new disability discrimination settlement at Quinnipiac University reinforces recent court decisions demonstrating the legal consequences colleges could face for removing a student with a mental health condition from campus.  

The settlement, made public last week, stems from the university’s decision to place a former student on mandatory medical leave after she sought counseling for depression. The university didn’t consider alternative accommodations for the student that would have allowed her to continue her studies. Consideration of such alternatives is required under Title III of the Americans with Disabilities Act, according to the settlement.

Higher education legal experts say the case represents of an important and challenging task colleges face. When is it O.K. to force a student from campus? And what’s the right balance for protecting the college from liability while protecting students’ rights?

The Quinnipiac settlement sends a message to administrators to avoid knee-jerk reactions to these sorts of tough questions, said Laura Rothstein, a law professor at the University of Louisville who specializes in disability law.

“That’s the value of a settlement agreement that gets high publicity in a case like this,” she said. “It sends a useful signal to higher education.”

The lawsuit against Quinnipiac was filed after a freshman went to the counseling center in 2011. It was her first visit to the center, and the students' lawyers think the counselors at the time made an erroneous assumption and overreacted to the student's comments, said Nancy Alisberg, managing attorney at the Connecticut Office for Protection and Advocacy for Persons with Disabilities, which brought the case on behalf of the student. The student doesn’t want what she said the counselors to be made public.

The student was transported to the hospital, evaluated and released a few hours later. In that period of time, the university had already placed her on mandatory medical leave, pending a review by a university-approved psychiatrist, according to her attorneys.

She didn’t pass the review, and she wasn’t allowed back on campus, even to retrieve her personal items, attorneys said.

Quinnipiac denies the allegations, according to the settlement. In an emailed statement, Quinnipiac said it is in full compliance with the requirements of the Americans with Disabilities Act, and that its standards exceed those of most other colleges. The university declined to speak further on the topic.

Following the Quinnipiac settlement, Paul Lannon, a Boston-based lawyer with Holland & Knight, advised all his college clients to review their mandatory medical leave policies.  He said the Justice Department’s decision in this Title III case is consistent with the position taken by the U.S. Department of Education’s Office of Civil Rights on Title II of the ADA, which allows removal of students only if they pose a “direct threat.” (There is, though, lingering confusion over whether that direct threat must apply to others, or whether it can apply to self-threat, some experts say.)

Blanket policies with rigid, pre-established outcomes won’t pass muster anymore, Lannon said. There needs to be an individualized assessment of the risk and behaviors in every case.

Legal and mental health experts agreed that there are times when it indeed may be best for a student to leave campus, even against his or her will. But colleges insist involuntary leaves are used only as a last resort, when students either refuse counseling services or are putting themselves or others at risk.

“The trick, of course, is defining what’s a true emergency from what’s maybe just an increased risk,” Lannon said.

Somewhere between 6 percent and 8 percent of college students report having serious suicidal thoughts, and between 1 percent and 2 percent of students will attempt suicide, said Victor Schwartz, medical director at the JED Foundation, a nonprofit organization that works to prevent suicide among college students.

The rate of suicide is less than one per 10,000  students per year.  Statistically speaking, sending home every student who thinks about suicide or is severely depressed just isn’t practical, Schwartz said.

College students have a lower suicide rate than individuals aged 18 to 25 who don’t attend college. In some cases, being in college may be safer for a student dealing with mental health conditions, Schwartz said. A student’s home life may be particularly volatile, or the structured academic setting could be helpful, for example.

A college can’t make a decision to remove a student without first gathering a lot of information about that student and what he or she needs. Hasty decisions are risky, Schwartz said.

“To have a kind of immediate trip wire policy doesn’t make clinical sense and probably will run afoul of the ADA,” Schwartz said.

A college that feels a student can’t stay in a residence hall because he or she needs supervision could recommend a brief period of hospitalization before returning to classes, or living at home while taking online courses.

Those sort of accommodations likely won’t need to be long-term, Schwartz said. Usually, a person with depression or other emotional disabilities is most at risk during a specific time of crisis. The goal for the college is to help manage through that time period.  

Experts also said that aside from running into legal trouble, colleges that set too low a threshold for taking adverse actions, such as removal from campus, could discourage students from seeking help.

“If you’re telling me that I’m going to be thrown out of school if I admit I’m depressed, that really sends the wrong message,” Rothstein said.

That’s one of the reasons why the former Quinnipiac student pursued the case -- to make sure that other students know that they should be able to seek help without fear, said Colin Milne, one of the lawyers who represented the student.

Under the terms of the settlement, Quinnipiac has to pay the student $17,000 in compensation and reimburse her for the $15,126 she took out in loans to pay her tuition. The university also has to develop a nondiscrimination policy and provide training on Title III of the ADA with an emphasis on mental-health-related disabilities.

Of the college policies she’s looked at, Alisberg said, it’s common for psychiatric medical leave to be treated differently than that for physical ailments, which was the case at Quinnipiac. Most policies also don’t explicitly require the college to seek reasonable accommodations for the student.

“There’s this pervasive feeling of fear whenever you use the term mental illness, and I think that causes a significant problem with respect to compliance of the ADA.”