Part II of a three-part series on mental health at Harvard. Part I was published on Dec. 10, and Part III on Dec. 14.

In retrospect, Mackenzie believes she grew up with depression. Forced to deal with serious medical issues and abuse at home from a young age, Mackenzie found herself living with negative body image and self-esteem. Questions of sexuality and gender identity that arose in high school only complicated her emotional development.

When two of her blockmates decided to take time off due to mental illness in her sophomore year of college, Mackenzie became more withdrawn. When a third blockmate attempted suicide, the stress became overwhelming.

Mackenzie realized she needed serious professional help. Instead of visiting Harvard’s Mental Health Services, she opted to see an outside therapist.

“I had heard from a lot of people who didn’t trust them. I felt that just by the nature of being a college mental health organization with hundreds of patients per therapist, it’s not possible to deliver the care I needed,” she says.

Like other students interviewed for this series, Mackenzie had heard rumors from her peers about University Health Services. The reports she heard were “almost uniformly negative.”

Anyone confessing a mental illness will be forced to take time off, some fear. Others worry that those who do need time off campus to heal are hemmed in by the school’s insurance policies. Many share frustration with the process by which students who need less urgent care arrange appointments. In sum, these concerns paint a discouraging picture of Harvard’s services for some of its most fragile students.

TAKE A TIME OUT

Martin’s depression and suicidal thoughts escalated during his freshman fall. In November, when he was unable to sleep for nine days after a personal assault, Martin admitted himself to the hospital for suicidal ideation and paralyzing depression.

Though the rest of his freshman year was successful by many measures—nearly perfect GPA, lots of extracurricular activities, plenty of friends, and parties almost every weekend—Martin still suffered from feelings of inadequacy.

“The thoughts continued to haunt me throughout the summer. A few weeks before school began, I realized that I didn’t want to come back at that point,” he says.

He had discussed the possibility of taking a year off with his resident dean in the spring. The dean had assured Martin that voluntary leaves do not entail contracts, so Martin made his travel arrangements.

Then, just weeks before he was scheduled to depart, Martin heard from his dean that he would have to sign a waiver forcing him to work for six months of his year off and undergo a UHS evaluation before he would be allowed to return.

“It was a really upsetting interaction with the University,” Martin says. “I was told all the way up through summer that I would not have to sign a waiver since I was not being forced to take time off.”

Martin worries that stories of administrative pressure like his might prevent students from reaching out for help out of fear that they might be forced off campus or prevented from returning if they choose to go away.