When students leave campus to go home due to mental health reasons, they are faced with a complex and stressful web of procedures and difficult choices which at times are beyond their control.

UPDATED: April 28, 2014, at 1:55 a.m.

This article was originally published in The Crimson’s 2013 Commencement Year in Review issue last May. It is being reprinted as the first in a three-part series on mental health at Harvard and has been edited to reflect the passage of time since its original publication. Part II ran April 29 and Part III on April 30.

David was thriving at Harvard. In his time on campus, he had excelled in classes that he loved and pursued extracurricular activities about which he was passionate. When he was diagnosed with clinical depression in fall of 2012, he did not skip a beat, seeking treatment using mental health resources provided by Harvard University Health Services.

Yet despite taking advantage of all of these opportunities, David decided not to return to Harvard in the fall of 2013. He is taking a leave of absence from Harvard this academic year, in part to address mental health concerns.

“At Harvard we have everything that we could ever want to be happy, but we’re not quite,” David said. “And we think that perhaps if we could step out for a while, we might be able to figure out what that is and come back and be happy.”

In the past two years, the issue of emotional and psychological well-being has dominated discussions about student health at Harvard. At a student rally in Harvard Yard, a town hall discussion hosted by administrators, and in private settings, students have sought to grapple with the usual sources of pressure, as well as the added stressors of several undergraduate deaths, including two that administrators identified as suicides.

Again and again in these conversations, community members turn to the topic of going home for mental health reasons.

For a handful of students each year, Harvard’s environment is too much to bear. In search of wellness, these undergraduates leave Harvard, returning home to a world without the worries of college life. But before they go, students must navigate a complex and often stressful web of choices and procedures that at times are beyond their control.

AN INHOSPITABLE ENVIRONMENT

When My Ngoc To ’14-’15 was hospitalized at McLean Hospital for suicidal thoughts, she felt torn about whether or not to stay at school or take time off. If she decided to go home, UHS would require her to seek some form of care before returning to campus. To would also have to engage in a productive activity for a period of stability, which usually lasts six months. When she was ready to come back, she would have to meet with UHS for an intake interview and then petition the Administrative Board with proof that she was ready to return to life at Harvard.

“It was a hard decision to make,” said To, an inactive Crimson editorial editor. “My doctors definitely wanted me to go home, but my family didn’t quite understand what depression was.”

In the end, however, the pressures of life at Harvard outweighed the costs of going on leave.

“I felt like if I went back to school, it would have just been worse because it would have spiraled,” she said.

To is not alone. Students and administrators say they agree that the pace of Harvard life creates an atmosphere that can often be hostile to a student’s recovery from mental illness.

“This is not a place to get well—not because we don’t have the resources,” John “Jay” L. Ellison, the secretary of the Ad Board, said plainly. “It’s because to be a student here, you are pulling in problem sets. You’re writing papers.”