The disappearing act: taking a medical leave of absence from Tufts

This is the second part of a two-part article about Tufts students who take a leave of absence from school. This part focuses on taking a medical leave of absence from Tufts.

One night in October 2014, Nikhil Nandagopal bolted upright out of bed with the realization that something about his life needed to change. 

At the time, Nandagopal was entering the first semester of his sophomore year, balancing classes and extracurriculars while also battling multiple mental illnesses: obsessive-compulsive disorder (OCD), bipolar disorder and body dysmorphic disorder (BDD). He noted that he was having trouble finishing assignments and getting to class on time due to the mental health problems he experienced.

Following his midnight revelation, Nandagopal said he officially began the process of taking a medical leave of absence from Tufts.

“I knew I had to take it,” Nandagopal, who came back to campus this semester after a two-year medical leave, said. “I really needed to take time off for myself in order to heal."

According to Associate Dean of Student Affairs Marisel Perez, a medical leave of absence such as that pursued by Nandagopal is usually unplanned. 

While mental health is one reason why students pursue a medical leave of absence, Perez said that other medical problems may trigger the leave, particularly sudden, recently diagnosed illnesses. The leave option is recommended to students who "find it difficult to productively or safely manage the demands of their academics and campus life due to a health concern," according to theStudent Affairs website.

M.J. Griego, another student who returned to campus this semester after taking a year-long medical leave, also left Tufts in order to address mental health issues. According to a written response submitted to the Daily, Griego first sought help in fall 2014 as a sophomore.

Griego wrote that cold-like symptoms, which they now recognize as symptoms of depression, initially drove them to visit the Health Service.

“I was constantly fatigued, easily thrown off and had erratic eating habits,” they said. “Since college had started, I’d noticed a change in my response to stress. As soon as I underperformed once, I would attribute it to me being bad in general.”

Griego said they found Health Service's and Counseling and Mental Health Service's (CMHS) advice insufficient in helping their situation, and expressed frustration towards the "quick-fixes" suggested by Tufts counselors.

“I realized nothing helpful would come of seeing someone who tried to tell me breathing exercises on my way to class would in any way help my increasingly severe depression,” they said.

By spring 2015, Griego said they were experiencing suicidal thoughts, at which point their CMHS counselor suggested they seek an off-campus counselor.

“She gave me a page of phone numbers to find my own counselor, which wouldn’t have been a big deal if I were actually functioning,” they said. “But in the midst of depression I couldn’t even mentally grasp the steps it would take to call a bunch of counselors, tell them my story, get to their offices, decide who was best for me and then go to a session every week while trying not to fail all my classes.”

About midway through the semester, Griego said they learned of the option of taking a medical leave of absence, and decided that leaving would be preferable to staying on campus in their current state.

According to Perez, a medical leave of absence has specific benefits not offered by a personal leave of absence, such as the ability to have all classes removed from the student’s transcript for the semester(s) during which they take a medical leave.

On the other hand, Perez said that taking a medical leave of absence requires a formal approval process that includes documentation from a health professional to support the student's request for the leave, in contrast to the "revolving door" policy offered for a personal leave. Additionally, the process of reentry -- especially for a medical leave of absence caused by mental illness -- is longer and more complex.

Perez meets with all upperclassmen and graduate students who request to take a medical leave of absence to learn why they feel they would benefit from doing so. She then continues to communicate with these students during and after their leaves.

Associate Dean of Student Affairs Christopher Rossi handles first-years considering or pursuing a medical leave of absence, which he described as "a daunting process."

“Medical leave isn't for everyone, but we can help a student navigate through that together,” Rossi said.

Perez said that before a student leaves campus -- unless the medical leave is due to an emergency situation -- they must have an exit interview with one of the university’s clinicians or doctors. This is an opportunity for the health professional to get a better sense of the student’s condition, connect students with resources near home and give students free clinical referrals.

Throughout the student's medical leave, Perez and Rossi said they communicate with students to help them prepare their application for reentry that the Health Accommodations and Medical Leave Committee (HAMLC) evaluates at the end of the leave. This application, as well as an interview, determines whether the student is prepared to return to campus, according to Perez.

Multiple departments sit on the HAMLC, according to Perez, including Health Service, CMHS, the Office of Equal Opportunity, Residential Life and Student Accessibility Services. 

Perez, who convenes the HAMLC, added that the committee meets several times during the semester to review and decide on each student’s "reapplication" to Tufts. She said approximately 15 students take a medical leave of absence at a given time, but the committee always reviews every application received.

Director of CMHS Julie Ross discussed the role of clinicians from Health and Wellness in the reapplication process for medical leaves of absence. According to Ross, outside providers whom the student has seen while on leave must submit records to the appropriate Tufts clinician during all cases of medical leave.

When that appropriate clinician is a health clinician, the health clinician will then submit this documentation to the Medical Director of the Health Service. When it is a mental health clinician, they will submit documentation to CMHS, according to the student affairs website.

Ross said this process keeps the records confidential and separate from students’ educational records.

“These confidential records typically summarize the care the student has received while on leave and the provider’s judgment regarding their readiness to return," she said. "We review these records, meet individually with the student and then present a brief summary to the committee (with the student’s written consent, of course).”

In addition to submitting medical documentation, Perez said that students are often required to submit a personal statement describing their time on leave. For medical leaves of absence that address mental illness, Perez reviews these documents looking for changes in the way the student handles the issues that led to the leave.

“I like to know [not] as much what they have done, but what has changed, what perspectives they have,” Perez said. 

Rossi added that he and Perez do not always require the application and the interview depending on the circumstances surrounding the student's leave, but that these reentry steps are almost almost always necessary for students leaving Tufts due to mental illness.

Upon returning from a medical leave of absence after a physical injury, junior Kevin Lovaincy said his reentry process to Tufts was fairly simple.

Lovaincy took a medical leave of absence in fall 2015 after he tore his ACL, LCL and hamstring during football practice. He said most of his semester on leave was spent focusing on intense physical therapy that continued through the end of the semester.

He explained that it was clear to him and to the associate dean dealing with his case at the start of the leave that he would return to campus next semester.

“It wasn’t like I had to reapply,” Lovaincy said. “It was just a pause.”

Griego went through the full reapplication process, and was approved to return to Tufts this semester. Nandagopal, on the other hand, said he was denied reentry to Tufts when he first applied to come back after one year of medical leave.

“In the beginning, I was a little surprised,” Nandagopal said. “I asked my dean if there was something [different] I could have done.”

He said that Perez reassured him that the committee simply believed he needed more time.

As this semester’s students return from medical leave, Perez and Rossi plan to meet with each returning student regularly. According to Rossi, this is crucial for maintaining and advancing the progress students have made during their leave.

“It's for us to map out a follow-up plan for them if they need additional supports here at Tufts — things that are helpful to them, things that need to be put in place,” Rossi said. 

Rossi and Perez both said that they hope more students recognize medical leave of absence as an option to support their own health and well-being.

Nandagopal, who spent both years of his medical leave in Bangalore, India, said the second summer of his medical leave gave him the opportunity to resolve his issues with BDD, to explore his passion for classical Indian music and dance and to gain the motivation to start a new organization about body positivity on campus, called Jumbodies.

“In hindsight, I could never imagine a better decision," he said. "For some reason, they kind of figured out that I needed more time not just to stabilize, but to stay stable."