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Five Tips on Taking a Mental Health Break From College

By Lindsey Bever, The Washington Post

Nov. 11, 2022 -- Some 40 percent of college students in the United States struggle with anxiety, 45 percent with depression and 16 percent with suicidal thoughts.

These numbers, from a survey conducted last year by the Healthy Minds Network, have more than doubled in the past decade. Many students are considering taking time away from school to tend to their mental health - and it is something that should be encouraged, experts say.

Still, navigating those waters may be intimidating. Students may have concerns about how to take a leave of absence, how it will impact their academic career and their plans for the future.

Here's what mental health experts in academia recommend.

What are the signs I should take a break for my mental health?

It is not uncommon for college students to struggle with mental health issues such as anxiety and depression and continue to be able to function in an academic setting. But when those symptoms start to interfere with your day-to-day life - your ability to attend classes and engage with the material, eat with friends in the dining hall or take part in extracurricular and social activities - it's time to evaluate whether you should take a semester or two to get mental health help, experts say.

Kimberly Blackshear, director of the Time Away Office at Duke University, said that in the past, there were concerns that students who took time off may not return. "We used to have this concept of a bootstrap mentality where you've got to just grind and push through," she said.

But this generation places value not only on their mental health but also on their education, she said.

Blackshear said a medical leave may be a positive thing - not just for a student's health. "It may be a really positive thing for their academics," she said. "It may be a really positive thing for their career trajectory."

"So I really hope that we move away from the negative stigma associated with medical leave equals crisis," she said. "Medical leave is really about prioritizing a student's health and giving them an opportunity for overall growth."

- Where do I start?

Students who believe a leave of absence is best for them should take it. But first, talk it through with a school counselor, adviser or other professional on campus who handles such matters.

"Have you tried counseling? Do you need a reduced course load? Or might a change of housing help? Are there things that would help you feel better and be successful if you stayed?" said Nance Roy, chief clinical officer of the Jed Foundation, which works with more than 400 colleges and universities in the United States to examine their mental health policies, programs and systems.

Roy said most of the time, students still decide to take a leave, but talking it through will help you ensure you are not making a rash decision.

Once you have made up your mind, find the right campus contact for mental health leaves of absence, which should be listed in the student handbook.

Roy said the Jed Foundation recommends that colleges and universities establish a one-stop shop where students can get information and then prepare for their time away. "Usually by the time someone's ready to take a leave, they're pretty vulnerable. You don't want to have them running around campus" to get their approval, she added.

Know that some schools, however, do have multiple offices students need to visit.

Because it can be a difficult time and some students may struggle to navigate the process on their own, experts suggest including a family member or other support person in the discussions with the school or having a therapist help you work through the steps needed to take your leave.

In any case, it is imperative that you understand the process for your leave and your return.

- How do I protect my self-interests when taking leave?

Students need to understand their school's medical leave policies and procedures to protect their academic careers and financial interests and to make sure that, eventually, their transition back to campus is a smooth one.

For those who have a chronic mental or physical health condition, ask about tuition insurance plans at the start of school. If you then need to take a leave of absence for a medical or mental health reason, you may get reimbursed a significant portion of your tuition, said Victor Schwartz, senior associate dean for wellness and student life at CUNY School of Medicine.

In many cases, however, issues arise without warning. If that happens, make sure you get information about what is required for you to take a leave, what you need to do during your time away to satisfy school requirements, and how long you can stay on leave before you will need to reapply to the school.

Ask what will happen with tuition, scholarships, student loans and transcripts. And for international students, make sure you learn how to avoid any potential problems with your visa. "These things can be dealt with, but you need to be aware these are issues that can come up and have an impact," Schwartz said.

"There's often fear that the school is going to put undue impediments in terms of the student coming back. And there certainly are cases you can find out there where that's occurred," he said. In such instances, he said, disability attorneys or groups such as the Bazelon Center for Mental Health Law can represent students in conflicts with the school. "But most administrators and deans are really looking for students to succeed and come back to school," he said.

- How can I make the most of that time away?

Students should start by seeking the appropriate treatment for their challenges.

Find a psychiatrist, psychologist or other treating physician - if you haven't done that already - and start treatment, including taking any medications that are prescribed for you. Blackshear said she recognizes the vulnerability that it requires to take that step, but "that's really where students have to be, is to fully engage in treatment and follow the recommendations of their treatment providers."

While you are undergoing treatment, she recommends rest from the daily grind - spending time with your support system, reading for pleasure, and establishing a regular routine for exercising, eating and sleeping.

Once you have started making progress, Blackshear said, add an element of productivity. Volunteer. Get an internship or a part-time job. Audit a class - as long as your school permits it. "It allows them to practice the skills that they gained during the course of their treatment in an environment outside of their house," she said. "Then we're able to evaluate where they are - if we need to gain more skills, if we need to shift treatment."

This helps students develop a sense of confidence when they see they can be productive again. "And that productivity can help them prepare and transition back into the educational setting," Blackshear said.

Many colleges and universities also strongly recommended this step. Roy, an assistant clinical professor in the department of psychiatry at the Yale School of Medicine, said schools need to see that the student has been able to resume a normal level of functioning before he or she returns to school. They may want to see documentation from the treating physician or therapist, citing the diagnosis, treatment and the clinician's opinion as to the student's ability to return to campus and be successful in a classroom.

- What is the healthiest way to resume classes?

Some students may need to continue treatment even after their return to college. So establish a provider at or near your school before you head back to campus. That way, you're not struggling to find one while trying to reintegrate into campus life. "It's a lot to navigate when you come back, and you don't want at the same time to be running around trying to find a therapist," Roy said.

Then when it comes time to choose your courses that first semester, consider a lighter load. Experts warned against feeling that you need to try to make up for the time you lost.

Also, keep a balanced schedule. "We mean balance as in balancing our brain. We don't want to take four STEM classes. We don't want to take four English classes," Blackshear said. "We want to make sure that we have a balance where we're using both sides of our brain and we're balancing classes that have a different volume of assignments so, that way, we're not bogged down with too much."

Outside class, continue to practice self-care with good exercise, nutrition and sleep habits.

And when challenges arise again - which they may - use the coping skills you developed during your time away. If you need support, "reengage with either the clinician you saw before or someone else," Roy said.

She said students should be applauded for having the wisdom to care for their mental health.

"Oftentimes, I think students feel somehow that they're a failure because they have to take time away when, in fact, we want to promote the opposite message: 'No, you're the smart ones for knowing that your health is important,'" Roy said.