The Handbook / Chapter 6

Mental Health

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CHAPTER 6 | Mental Health

Some applicants will face a dilemma when applying to college— whether or not to share their mental health history. They have to choose between communicating something they may consider central to who they are and their fear that colleges will be disinclined to admit them if they do. Should they write about their battle with depression or, instead, about mentoring needy sixth graders?

Go all in or make the safe bet?

As an admissions officer, I was faced with a similar, but different quandary. While I admired an applicant’s courage in revealing their challenges, I had to consider whether the college could manage the student’s needs in the event of a crisis. Each instance required a medical assessment. The process was complicated, but we eventually worked through it. Admissions decisions went both ways.

As a counselor, I am a student’s champion, someone with whom they can safely and confidentially share their inner lives. Sometimes this includes discussions about loneliness and depression.

On the morning of the solar eclipse, I opened an email from Emi Neitfeld, author of Acceptance, a memoir tracing a troubled childhood that spun through foster homes and psychiatric care. Throughout, she believed an elite college education would be her salvation. Her early application to Yale in 2011 included a detailed inventory of her mother’s obsessive hoarding and Emi’s misprescribed overmedication. She was rejected.

Undeterred, she applied to ten colleges, including Harvard, just weeks later. By then she had rethought the wisdom of her previous candor. She concocted a simplified scenario to explain her multiple high schools, omitting any mention of her mother’s, or her own, difficult past. When an acceptance letter from Harvard arrived, Emi reacted to the news like any kid, jumping joyfully up and down with her arms thrust skyward.

Looking back on the experience, Emi wished she had had better advice about disclosing her story when applying to college. I thanked her for her honesty. Ironically, our time in Cambridge overlapped though we never met. And, no, I wasn’t involved in deliberations on her application.

Emi Neitfeld’s experience highlights the predicament other students face. While it may serve as a warning, it provides too little data to draw any meaningful conclusion. The decision must be made by each individual based on their particular circumstances and desire for transparency. But there is no mistaking her takeaway as she wrote in the New York Times:

Officially, colleges say that students can share as much about their mental health as feels comfortable. But in practice, it seems clear that schools are nervous about accepting adolescents who divulge psychiatric histories.

We’ll look at the arguments on both sides.

The incidence of teenagers experiencing mental health disorders has grown over the last decade. The World Health Organization (WHO) estimates the number at one in seven between the ages of 10 and 19. The same stigma around mental health care that complicates the application process plays out in the larger community. A young person may avoid seeking help at all for fear of social exclusion. Those who do receive treatment feel they may be judged as damaged and may elect to keep the information private. Their problems range from emotional to behavioral to eating disorders, no different from an older demographic. Those in good therapeutic care among supportive families and caring professionals are a small, fortunate minority. A significant number of young people go entirely untreated.

Inside the statistics lurks another dark truth. Those who face financial hardship and the resulting chaotic family fallout are even more likely to suffer mental health challenges. They are also less likely to have access to treatment. So while all young people, regardless of their resources, are vulnerable, children of the affluent are awash in treatment options while more vulnerable populations often go without.

With the passage of time, the world has slowly come to acknowledge how commonplace mental illness is. Acceptance still lags but each generation pushes the window open slightly wider. No family is spared— someone in every extended family constellation is touched. While progress is made, the world still looks at mental illness differently from other illnesses. A cancer survivor is celebrated for their courage and resilience. Hospital staff line a festooned corridor, ring a bell, and cheer at their departure. Even with a good prognosis, a patient discharged from a psychiatric hospitalization is looked at with a degree of suspicion. Old prejudice dies hard. For centuries people were considered crazy or not crazy. Now there are hundreds of diagnoses, with new ones added every year.

Without knowing who will read your application, you can assume they will have had some experience with applicants unpacking their medical histories, psychiatric and otherwise. If you decide to share yours, do so without apology or shame. You will have decided on transparency because of the great significance it holds for you and the personal growth you experienced as a result. Knowing this will be key in your reader’s mind. Be sure to take us through the totality of it. The college will want to know how you are managing your recovery and your hopes for the future. Has the experience helped shape your future plans and career options?

I would suggest you reach out to a parent, counselor, or mental health professional before submitting your application to help you achieve the best balance. How graphic is too graphic? How much is palatable? What information makes for TMI? Might you decide to disclose some, but not all of your history?

One of the ironies here is that you, and presumably many others, may choose to keep these matters private. This is a fair, and possibly wise, choice if Emi Nietfeld’s experience is any indication. It is safe to assume that every admissions cycle there are many applicants with undisclosed mental illnesses. How does the college manage with them?

Every day. Students seek and receive help every day.

One mental health professional with whom I spoke stressed the need for students, once ensconced on their college campus, to seek the help they need to ease the transition to a new, more independent life. The help is there if you advocate for yourself.

Let’s look at the decision to withhold such information from your prospective college. Is there anything inherently wrong or dishonest in doing so? There is a gray area in which it can be argued that a college deserves to know what will be entailed in providing for you. But you are clearly within your rights deciding what, and what not, to share with the college. Maybe the more important question to have answered before enrolling at any one college is whether they have the resources to provide the care you may need. If they don’t know your diagnosis, can you expect them to provide for all your eventual needs?

If you think of college admissions as a potential partnership, you might benefit in the long run if your college knew everything important about you. If down the road you required treatment, or even hospitalization, you would take some comfort in having previously disclosed your condition. The mother of a counselee once convinced their child to fully unpack their history by arguing, “If they don’t want you for who you are, why would you even want to go?”

In the 13 years since Emi Neitfeld applied to college, the world has become more aware and perhaps a little more accepting. We have also been through a global pandemic that tested us all and exerted its own pressures on our mental health. Students worldwide had to deal with the stresses of on-line schooling and isolation. Admissions offices are very much aware of these effects on incoming students. Whatever you eventually decide to disclose in your application, you can be sure you are not alone in dealing with these issues.

I have advised students who have shared detailed stories of their struggles and those who ultimately decided against it. All were admitted to college. It’s impossible, after the fact, to know how their choices affected admission decisions and not one of my former counselees even thinks about it, I’m sure. Those who chose to disclose have expressed some satisfaction in knowing their college accepted them with full knowledge of their lives. But they all move on, making the best of the opportunities they’ve earned.

Whatever decision you make is the right one. I had a rebellious student whose personal beliefs would not allow them to be any less than 100% forthcoming. They wrote their personal statement about a psychiatric hospitalization and the conflicting advice they had received regarding revealing themselves in their essay, almost daring colleges to deny their application. Like most students, they were admitted to and rejected from a number of colleges. In this way, they were no different from students who had no such dilemma to confront.

This is hardly the last consequential decision they, or you, will face. Consider your options. Weigh the consequences. Make your choice.

And don’t look back.

Above all, remember that your mental health is more important than any one college. Show yourself the care and affection you deserve today and every day.