When it’s Okay to Return to College After a Mental Health Leave of Absence
The first answer is that it’s situational. There are generalized timelines you can subscribe to (see below), but it really boils down to that specific student and their needs. It can depend on what happened, and the reason a student took leave. It doesn’t matter whether the leave was proactive in taking a break prior to the start of a semester, or a necessary decision due to a mid-semester crisis. It gets classified the same.
Most colleges and universities will require a student to remain in communication with university officials. That might be a Case Manager, Counseling Department Representative, or Dean of Students. Staff will want to know: What did you do? Where did they go? If you worked with mental health professionals, can the school get a letter of support on behalf of your return? Most colleges won’t let you take a medical leave and just return subtly without some sort of re-enrollment support.
Parents are sometimes quick to push for a return to campus sooner than a student is ready. If the crisis seems to have stabilized, the notion of “being back to the grind” with the college semester brings normalcy, and familiarly with expectations. But, depending on the struggles of the young adult we can be premature in the return. Below are ways for parents (and students) to gauge when it’s okay to consider a return to campus:
A minimum of 6 months of stability and recovery. This is inclusive of mental health and substance abuse when it comes to sobriety and regulation. This includes the student being on the correct medication regimen with little to no side effects, and being able to self-administer safely. If the student has started new medications within two months of a return to college, note that there is risk to potential side effects while they’re back in the classroom.
If the student specifically had a psychotic episode (whether drug-induced or not) or Bipolar episode (specifically first episode of mania) you want to take extra precautions around returning too soon. The first year is going to be the most crucial to stabilize and heal the brain, and you can anticipate many ups and downs. Being back on campus before 12 months can potentially set in motion the cycling of manic episodes. Be especially careful if this is you or your loved one.
The student’s sleep cycle is consistent, they are on a routine, and are well-rested. Sleep is at the foundation of recovery.
The student has an assembled team of outpatient providers off-campus to ensure they have the support they will need to return. A team could include any of the following: Individual therapy, group therapy, support groups, mental health apps, drug testing, psychiatrist, Executive Functioning Coach, Mentor, and home pharmacy with prescription refills ready. This list isn’t all-inclusive of everything that exists, and it’s important to emphasize that the student is not solely relying on on-campus resources as those may not be available in an emergency.
With stability, the student has agreed to co-create an Advanced Directive. This is something they will want to complete, and then formally register within their state. Once registered and all parties supporting the student have a copy, then share with all the outpatient providers. That way if an emergency takes place, all parties are aware of the plan the student initiated.
Understand that some mental health diagnosis (or medical conditions) may recur across the lifespan. That said, a student needs to register through The Office of Disability Services to get accommodations. Examples of diagnosis that are eligible for accommodations include: Schizoaffective Disorder, Mood Disorders (Depression, Bipolar), Anxiety, ADHD, and Eating Disorders. Sometimes it can take upwards of two months to get accommodations approved. Returning too quickly without accommodations approved is another set-up for failure.
Agreeing to return with a reduced courseload. If the student is chomping at the bit to get back to enroll in 15+ credits that first semester, it speaks to their cognitive dissonance around the reality in what they’re capable of. It also highlights they aren’t focused on their mental health stabilization but rather getting “back on track” academically. It’s a recipe for another crisis on the horizon.
In all of the above, it’s imperative to know that the student is leading this. Often, I work with parents who are taking the lead on completing all return-to-college requirements. This is a litmus test in identifying motivation, resilience, and also to note if the simple tasks of some of the above prove to be too overwhelming. That’s be a good indicator that returning to campus will be too much, too soon.
College isn’t going anywhere. A student’s health is always going to need to take priority. The 18-25 age range is known for first-episodes of significant mental health challenges, especially mood and thought disorders. It’s better to be slow to return, light on the courseload, and to ease back into the stressors of daily life rather than drink from the firehose after a recent medical emergency. Let’s focus on the health and wellbeing of the student and not their matriculation towards their degree completion.
For questions or comments contact Joanna.
