Uncompromising Roommates

[jym626]

<p>So, back to the thread topic-- the roommate. Hows Betsy and her family, OP?</p>

[justmytwocents]

<p>If you’re curious (tangentially related), here are recaps of some recent Department of Education Office of Civil Rights decisions related to mental health & ADA protections (some of them involve dorms) – recaps courtesy of the Bazelon Center, [Campus</a> Mental Health > Legal Action](<a href=“http://www.bazelon.org/Where-We-Stand/Community-Integration/Campus-Mental-Health/Campus-Mental-Health-Legal-Action.aspx]Campus”>http://www.bazelon.org/Where-We-Stand/Community-Integration/Campus-Mental-Health/Campus-Mental-Health-Legal-Action.aspx).</p>

<p>

Georgetown University (Oct. 13, 2011): Per this decision, if the student presents a health professional’s approval for returning to college following medical leave, the school may require a second assessment only under “extraordinary circumstances” and must be able to articulate a rationale for this requirement. It violates Section 504 when the school fails to give notice of what constitutes sufficient documentation to return following medical leave, or fails to articulate its rationale for finding documentation insufficient.</p>

<pre><code>St. Joseph’s College (Jan. 24, 2011): The student was suspended after she “appeared delusional” and “was behaving incoherently” in two encounters with a second student. The College was found in violation of Section 504 for a history of applying separate, unpublished emergency suspension procedure to students with perceived mental illness that offered no notice or opportunity to present evidence.

Spring Arbor University (Dec. 16, 2010):The University could not require a student with bipolar disorder to submit medical records as a condition of return from medical leave because the University did not require students taking medical leave for other reasons to submit medical records. Petitions from students with mental illness may be handled differently only to the extent necessary to prevent direct threats to the safety of others. Admission of a student creates the presumption of qualification; subsequently, the University needs to have cause to require a student to prove that he or she is qualified. Here, no cause was found because the student withdrew voluntarily, in good academic standing, and with no disciplinary record.

Mount Holyoke College (Jul. 18, 2008): There was no violation of Section 504 in requiring the student to take medical leave when the student presented a danger to self. Fact that no student had ever been sanctioned for suicidal or self-injurious behavior itself (including eight who remained on campus without interruption) suggested no general stereotyping on the basis of mental illness. Behavior agreement as condition of return was permissible because it only called for cessation of behaviors causing fear for safety, not complete cessation of all disability-related behavior.

Marietta College (Mar. 18, 2005): Dismissal of the student shortly after matriculation, following disclosure of past suicide attempts, violated Section 504 because:

1. Staff psychologist’s two sessions with student were insufficient evidence to demonstrate “high probability of substantial harm” rather than “speculative” risk.
2. Student must be allowed opportunity to challenge the emergency dismissal decision. Opportunity to provide medical information as condition of return is not a substitute for this right. Compare to DeSales University below.

DeSales University (Feb. 17, 2005): There was no Section 504 violation in the student’s two-day removal from campus after staff expressed concerns about suicide risk, because the University promptly allowed the student to return upon receiving doctor’s note. Student successfully challenged removal and returned without restriction. Denial of housing for the following semester violated Section 504: although the University had legitimate concerns about disruptive behaviors, receipt of housing was conditioned on elimination of all behaviors resulting from mental illness (conditions on return or continued participation must be narrowly tailored to purpose of removing direct threat). Student was also denied opportunity to challenge the decision to impose these conditions.

Bluffton University (Dec. 22, 2004): In involuntarily withdrawing the student after suicide attempt, the University failed to adequately assess direct threat because it “did not consult with medical personnel, examine objective evidence, ascertain the nature, duration and severity of the risk … or consider mitigating the risk of injury.” The University also violated the minimal due process requirement because it provided the student with no notice or opportunity to be heard, refused to reconsider decision after receiving letter and phone call from treating counselor, and lacked Section 504 grievance procedure. The University’s requirement that the student must submit medical documentation as condition of return violated Section 504 because only students with perceived mental illness had ever been required to submit documentation.

Guilford University (Mar. 6, 2003): The student was involuntarily withdrawn after College’s director of counseling reported self-injurious behavior. This violated Section 504 because:

1. Although the College arguably had nondiscriminatory belief of danger due to actual self-injury by student, the direct threat evaluation was insufficient because the decision to withdraw the student was made after a single cutting episode, and the director of counseling did not attempt to contact the student’s treating psychologist.
2. The College failed to give adequate due process because (a) after student mentioned new treatment plan, she was denied any opportunity to discuss it, (b) College did not consider alternatives less severe than withdrawal, and (c) College lacked formal procedure for involuntary medical withdrawal and instead used a “voluntary” withdrawal procedure that the student could not challenge.

Woodbury University (Jun. 29, 2001): Exclusion of a student from student housing during intersession due to prior self-injurious behavior was justified by the reasonable belief that circumstances during intersession would parallel prior triggers for self-injury. However, similar reasoning would not justify exclusion from housing during the regular semester when those triggers would not be present.University may not require blanket disclosure of all medical records as a condition for return; University may only request information addressing “particular issues of legitimate concern.”

National University (Mar. 23, 2000): Policy that expressly allows for suspension or dismissal of students if they have or have had “emotional, psychological or personal problems” which pose an “appreciable risk” of harm to self or others or render student “unsuitable” for program may be discriminatory; risk assessments must be individualized, must identify specific behavior that creates risk, and must find a “significant risk” and not merely an “appreciable risk.” “Suitability” for a program as a criterion for dismissal of a student is impermissibly vague; academic and technical standards must be clear and “essential to the program of instruction” or “directly related to licensing requirements or professional standards.”

San Diego Community College (Dec. 30, 1999): Use of disciplinary process to exclude student violated Sec. 504 because College failed to make objective assessment or even identify specific behavior indicative of direct threat; decisions were made on basis of uncorroborated rumors, and decision that student was a threat was made only after student had been cleared of all alleged misconduct.

Gonzaga University (Nov. 8, 1996): The University violated Section 504 by (a) impermissibly asking about disability on the application form, and (b) requiring the applicant who disclosed disability to undergo a medical evaluation to be considered for admission. An applicant may not be subject to adverse action for refusal to provide disability-related information. Questions about disability on application forms are unlawful except for the limited purposes of remedying past discrimination and affirmative action to increase participation of persons with disabilities. Inquiries to determine necessary accommodations are allowed only after an applicant has been admitted.

Skagit Valley College (Apr. 21, 1993): In considering the student’s petition to re-enroll, the College impermissibly relied on a stereotype of disability in rejecting the letter from health care provider stating that the student was now stable and complying with treatment, and in demanding assurance that student “would not engage in disruptive behavior in the future.” The College lacked basis to reject the letter, and had no affirmative evidence that disruptive behavior would reoccur other than diagnosis itself and an “argumentative attitude” in a phone conversation concerning status.

Thomas M. Cooley Law School (Aug. 9, 1991): The Law School impermissibly asked about mental illness on an application form, placed an applicant with history of depression in a separate pool requiring special committee approval, requested additional information from the applicant’s psychiatrist, and used mental illness as grounds to reject the applicant despite an academic record that would normally merit automatic admission. Questions about disability on application forms are unlawful except for the limited purposes of remedying past discrimination and affirmative action to increase participation of persons with disabilities. The Law School must indicate that the question is optional and may not deny admission or place additional requirements on an applicant on the basis of a disability.

Western Washington University (Jun. 19, 1991): The University suspended the student from RA position after a psychiatric hospitalization, rejected letter from the treating physician, and demanded “extensive evaluation” by “a qualified mental health professional” because the University considered the general practice physician unqualified to do the psychological evaluation. This violated Section 504 because the University failed to articulate grounds for demanding additional evaluation: no recurring behavior concerns, no consultation with another professional to determine validity of doctor’s opinion, and no attempt to contact doctor to determine basis of opinion. The University must have good cause to demand a second psychological evaluation.

</code></pre>

<p>The current legal climate seems to hold that a university cannot in a blanket way “evict” a student from a dorm because of a mental health symptoms or suicide threat…(I use the phrase “climate” because this is a mish-mash of OCR decisions, legal settlements, a few cases that actually have findings, etc). It’s a largely different story when it comes to violence or threats of violence to others (as in this case).</p>

[cobrat]

<p>

Perhaps, maybe…if they were warehoused for a protracted period and did not know. Again-- it implies a long term placement.

</p>

<p>Many were warehoused. In fact, some of the very mental health activists and professionals in the deinstitutionalization movement you cited earlier used that very term often to describe the abuses and way suspected/mentally ill people were treated by mental health institutions back then.</p>

[Pizzagirl]

<p>Cobrat, for once could you stop hijacking a thread with yet more “tales of what your random friends say so you’re convinced you’re now the authority”? </p>

<p>Back to Betsy. OP, how is Betsy doing? </p>

<p>And why wouldn’t a violent attack on others or their belongings be cause for expulsion from the university? Why should mental illness be an excuse?</p>

<p>It’s for this reason I think a restraining order is a good thing to start up if the roommate ever finds her way back to campus.</p>

[jym626]

<p>Again, with hopes of getting back to topic- </p>

<p>Marsian:
Your post # 124 is excellent. In this particular case, while it is sad that the roommate had what sounds possibly like a psychotic break, she engaged in dangerous behavior with destruction of property. This should not be taken lightly. Agree that especially if the parents are in denial or are also threatening, that the police (town police, not campus police) should be involved. Filing a police report, with photos and other evidence, is self protective. Also agree that if at all possible, a third party from the school should be involved in handling and/or overseeing the removal of all of RMs items from her dorm room. And someone should be there with Betsy and her parents to protect her and see that none of her items (if she hasnt already removed all her possessions from the room) are undisturbed. </p>

<p>What an unfortunate and traumatic situation for both Betsy and her RM. Heart goes out to all. And hopefully the RMs parents will be less accusatory and in less denial about their daughter’s status and needs.</p>

[Pizzagirl]

<p>A review of RA training is also warranted. The RA should have been able to have said “this is above my ability to handle” and gotten the counseling center involved. It is simply wrong that Betsy had no recourse to a roommate making unreasonable demands about sharing space.</p>

[jym626]

<p>Good point, PG.</p>

<p>One of my s’s friend’s roommates had sounded like a psychotic break (perhaps a major depressive disorder with psychosis) early in their freshman year. Don’t recall all the specifics as it was many years ago, but IIRC, the roommate was becoming increasingly withdrawn, sounded paranoid and delusional and made some threatening, accusational statements. My s tried to be helpful to his friend and the roommate, but they were smart enough to know that this was over their heads, and also, fortunately, since they had a residential college system, they were able to quickly involve both the college masters and the RAs (a grad school couple who lived in the college) and the friend’s roommate was hospitalized. He apparently had decided to discontinue his meds when he got to college and had a relapse. Don’t think he ever returned to school.</p>

[dadx]

<p>All of this reinforces what I tell my kids all the time. “Watch out for yourself”. (I say that with an inflection that implies to protect yourself, rather than one the implies taking advantage of others, btw.)</p>

<p>I don’t think this episode fits a “psychotic break” model. I think its closer to some combination of paranoid schizophrenia and obsessive compulsive disorder. The paranoid part of it is fundamentally a different type of mental illness, I believe, than depression. Much of the discussion here carries an implication that the roommate is in control of herself, even if marginally. I don’t think this is the case. People with these more serious illnesses are not in control of themselves. They behave in ways that they cannot “help”. Its because of the way they see the world. This is why, in some males, it winds up as a mass murder. </p>

<p>I have a lot of concern about having the government develop the power to put people away, but certainly there are instances where it ought to happen. Look at the recent Navy yard shootings. Classic. </p>

<p>There is a movie coming shortly(actually, next year, according to the latest release) about John DuPont (played by Steve Carrell), who was clearly mentally ill. He wound up murdering an olympic athlete in broad daylight, for no apparent reason, in front of the young man’s wife, and other witnesses. This was with no provocation, as the athlete was simply standing in the yard of his residence, and DuPont drove up in a car and shot. I’ll be interested to see how all of this is portrayed and what message people come away with. People seem to agree that DuPont was a paranoid schizophrenic.</p>

[jym626]

<p>Not sure I follow your thoughts, dadX. Some patients with a severe major depressive episode can have psychotic features with that, which accompanies the affective component. Its called a major depressive disorder with psychosis, or a psychotic depression [Psychotic</a> Depression | Psych Central](<a href=“http://psychcentral.com/lib/psychotic-depression/0001291]Psychotic”>http://psychcentral.com/lib/psychotic-depression/0001291) What you seem to be describing is perhaps behavior associated with delusional thinking or command hallucinations. Betsy’s RM may have been developing an incipient schizophrenia, but I dont hear anything that would suggest OCD. The rigid rules about thights, time to return to the room, visitors, etc sounds more like part of the disordered thinking than to any ritualistic behaviors, although the “rule-bound” component can overlap with OCD symptoms.</p>

[dadx]

<p>I’m not educated on these categories, but have made some observations over the years watching others behaviours.</p>

<p>Regardless of the diagnosis, I think its unarguable that the student in question here should do everything possible to maintain a safe distance between her and the roommate. Some of the comments, especially the early ones, seemed to regard this as a push-pull over “pecking order” in the room. I’m in the mental illness camp, which is different, because you’re not dealing with someone in the range of normal. Don’t expect to “stand your ground” in any way in these cases. Get out of there.</p>

[jym626]

<p>Agree. As I say, we cannot rationalize irrational behavior. There is a significant difference between an “alpha dog” roommate pecking order vs underlying disordered thinking. Agree that in the situation described here it clearly sounds like a MH issue, though it might not have been apparent to Betsy at first, especially if she has no experience in these matters.</p>

<p>As for my s’s friends roommate, he shared that the roommate had had a previous episode in HS. In college he D/C’d his meds, started drinking and had a relapse. Began cutting, threw a knife at the roommates computer screen and the wall.</p>

[Hanna]

<p>“And why wouldn’t a violent attack on others or their belongings be cause for expulsion from the university? Why should mental illness be an excuse?”</p>

<p>It is cause, and I doubt mental illness is going to be an excuse in the eyes of either the law or the college. This is a criminal situation. If the college has any clue, it will treat it like one.</p>

[Consolation]

<p>Wait a minute. Yes, what the roommate did was technically criminal. But do we really want to see a person who is clearly suffering from mental illness processed through the criminal justice system, with potential jail time and a criminal record for life?</p>

<p>I appreciate that it is a balancing act on many fronts, but this does not seem like a constructive approach, to me.</p>

[poetgrl]

<p>She at least needs to go home and not live with other students. </p>

<p>If the family does not cooperate, the school needs to do what it can to get her off campus. </p>

<p>Also, Betsy and the other students have a right to be safe in their dorm. </p>

<p>ETA. Now that the school knows this? If something god forbid were to happen they would be liable. </p>

<p>I really think we’re not figuring this out very well yet. But once there’s been violent behavior, you lose your rights to some extent</p>

[Consolation]

<p>I agree with all of your points, poetgrl. It is the violence of her act–even though no one was actually hurt–that creates the balancing act situation, for me. It certainly indicates that she has the <em>real potential</em> to move on to striking out against an actual person, not just their belongings.</p>

<p>I think the school would be perfectly justified in expelling her. How can they, in good conscience, subject their other students to the threat she represents? Even if she received treatment and reapplied two years from now and were given a single…</p>

<p>On the other hand, if they simply expel her, they might be pushing the problem on down the road to some other school. She could get some treatment, go to school again next year, and the same thing or something worse could happen again. It seems that there is no guarantee that her parents will take this as seriously as it deserves. And, perhaps more to the point, if she is over 18, they can’t FORCE her to be treated. Not unless they go to court and have her declared incompetent or something, and I strongly doubt they could. Many of us have had experience with friends or family members who are in dire need of treatment but also in complete denial, and they will prevail.</p>

<p>Which argues for the criminal justice system, IF it can force treatment, and if it would create a record that she would be required to disclose to another school. </p>

<p>I’m conflicted.</p>

[poetgrl]

<p>If the violence hadn’t occurred the school might be able to direct her to get help. </p>

<p>Really, she might never behave this way again. Dorm room freshman year is tough on the sanest kids. </p>

<p>It is the mothers reaction which really frightens me for the sake of this young woman’s future treatment. TBH. </p>

<p>Either way, she can’t be kept on campus. JMO</p>

[SansSerif]

<p>A thought about the mother’s reaction - perhaps the story she hears from her daughter was totally twisted and false? Making up stories about how Betsy was a nightmare and she snapped because she just couldn’t take it any longer? A mom in denial would believe that. She’d believe anything that would let her blame someone else instead of facing that her daughter has serious problems.</p>

<p>It’s the “my special snowflake would NEVER do that” on a much bigger level.</p>

[cobrat]

<p>

I think the school would be perfectly justified in expelling her. How can they, in good conscience, subject their other students to the threat she represents? Even if she received treatment and reapplied two years from now and were given a single…

</p>

<p>While this reaction is understandable it seems if the school receives a request for reapplication in 2 years after she’s received treatment and been cleared by mental health professionals, they may have an uphill legal fight to keep her out due to the legal case outcome citations on the ADA and its application to suspected/confirmed mentally ill students by justmytwocents. </p>

<p>

Which argues for the criminal justice system, IF it can force treatment, and if it would create a record that she would be required to disclose to another school.

</p>

<p>From reading some past cases where criminal defendants were judged innocent due to insanity, including examples like Dr. James St. James or John Warnock Hinckley Jr., the criminal justice system can force treatment whether for a short term as in the former or indefinitely as with the latter. </p>

<p>As for creating a record to force a disclosure of the event in question, I’d be interested to hear if the ADA policies meant to protect the mentally ill from discrimination in the education setting…including disclosure of medical records/incidents pointing to mental illness may cause a potential legal conflict. </p>

<p>Even if the incident is violent and life-threatening as this case shows.</p>

<p>

I’m conflicted.

</p>

<p>Me too.</p>

[poetgrl]

<p>Sanserif. You make a good point. </p>

<p>Still the phone call to Betsy was damned aggressive IMHO.</p>

[jym626]

<p>To the attorneys out there:
What is the legal term for the potential liablilty for, maybe at least negligence (?), if something has happened once, the risk has been identified, but the responsible party doesn’t rectify it and the situation arises again. The example that comes to mind is if, for example, an apartment complex has a faulty lock on their pool, or a broken fence, has been made aware of the problem because a child got in, but didn’t adequately fix it and another child got in and was injured. Would that argument (I forget the term, but it isn’t forseeable risk, I dont believe-- thats a different concept) if the school is made aware of the destruction of property and threats made to the roommate, ultimately allows the student to return and the situation recurs? </p>

<p>This is such a tough call… Nowadays, students are typically required to be medically cleared by their treating doctors before a school will consider allowing them to return. But does that absolve the school of any responsibility if they were aware of a known risk and, for whatever reason, it recurrs? This is such a tough one.</p>