Category: Leave Policies and Protocols

PROVIDE MENTAL HEALTH AND SUBSTANCE USE/MISUSE SERVICES:
LEAVE POLICIES AND PROTOCOLS

JED Recommendations: Leave Policies and Protocols 

Provide Mental Health and Substance Use Services

Last updated March 2025

Disclaimer:  These recommendations are high level in nature (not meant to be exhaustive)  and should not be construed as legal advice or guidance.  Campuses need to consult with their general counsel to determine if their policies and procedures are in alignment with rulings from the Department of Education, Office for Civil Rights, the United States Department of Justice, and/or other regulatory guidance.  

Definitions

• • Voluntary Leave of absence:  A voluntary leave of absence (LOA) is granted by the college in which a student is enrolled.  A LOA is a temporary interruption of a student’s program during which the student is considered to be enrolled.  Under most federal and state requirements an LOA cannot exceed 180 days in any 12 month period without potential implications for financial aid repayment.  Please check with your local/federal financial aid regulations surrounding this.  
    • Medical leave of absence:  A medical leave of absence (MLOA) is when a student needs to take a leave due to a mental health or physical health issue.  For more information on LOA’s see this guide here.   

• Involuntary/Mandatory Leave of Absence: When a student is unwilling to take a voluntary leave of absence and an individualized assessment based on objective evidence indicates that they pose a serious risk to the health and safety of others in the community, the school should have a process in place requiring the student to take an involuntary leave of absence.  These policies should be used rarely and be a last resort as described below.

• Withdrawal:  An official withdrawal is when an enrolled student decides to leave their college/university after their semester begins.  

JED Campus Recommendations for Leave Policies

Develop/refine a written voluntary medical leave of absence policy consistent with the following recommendations:

Establish a central office to administer and coordinate all leaves to ensure consistency and eliminate confusion for the student. In this office the students can discuss the decision to take a leave and/or consider possible accommodations that might allow them to remain in school. The central office should:

• Review reasons for the leave request
• Discuss potential accommodations to allow a student to remain in school and avert a leave of absence.
• Discuss the impact on academics
• Discuss financial considerations, including tuition insurance and tuition refunds
• Review the student’s transcript and scholarship status.
• Consider the specific issues for graduate/professional students such as, graduate assistantships, grants etc.
• Discuss visa and insurance implications for international students
• Discuss the possibility of a leave collaboratively with the student. If they decide to take a medical leave of absence, frame it as a positive step that the student is taking to support their wellbeing and overall success.

Consider reasonable accommodations to allow a student to remain on campus and avert a medical leave.

• Create virtual accommodations, where possible and reasonable, so that students can participate in social, academic, and other activities while off-campus (for example if a student is hospitalized with a mental health condition).
• Encourage faculty to implement pass/fail grading/non punitive coursework options for students to help students stay on campus during difficult periods. 
• Encourage faculty to provide flexible attendance policies.

Seek to create and maintain leave policies that are transparent and easily accessible to the campus community. 

• The policies need to be accessible via the student handbook, the faculty handbook and easily searchable. Consider disseminating the policy to parents/families, faculty, academic advisors, athletics, students, financial aid, etc. 
• The medical leave of absence policy should include clear and concise explanation of the college’s expectations for the student while they are on leave that are fully and concretely explained. This should include a description of documentation required for a medical leave.

• An individualized assessment should be done with each student to develop a wellness plan that might include clinical treatment. Work to ensure that any treatment is culturally and identity relevant.
  • Inquire about financial resources/insurance coverage to meet these goals. 
  • Encourage students to build social connections and sleep/nutrition/exercise practices into these plans.

• School policies should allow for decisions about length of time and terms of medical leaves on a case-by-case basis.
• The medical leave process should be well coordinated among relevant offices and the college should assist students in appeal processes for tuition and housing costs.
• Provide the student with a written summary letter of the details of the voluntary leave process, the details for what they need to do to return to school, and any other details to which has been agreed.

Once a student has decided to take a medical leave of absence, where possible, support for students while on leave might include: 

• The facilitation of avenues for students to access mental health resources while on leave in their communities.
• Virtual academic and community support for students while on leave.
• Campus staff who can reach out to, and support students on leave.

A return-from-leave policy should be established, and a checklist should be provided to the student. There should be clarity, education and awareness around timelines, processes, steps/stages, deadlines, and documentation for returning from leave. The return-from-leave policy should include the following:

• A requirement for the student to submit a formal written request (e.g., a standardized form) that includes:
  • Recommendations from an appropriate and licensed, credentialed treatment provider regarding the student’s readiness to return (corresponding to the nature of their medical/mental health conditions associated with their leave), including any necessary personal, health, residential, academic, and/or extracurricular accommodations to optimize success, health, and re-integration.
  • The form should specifically provide opportunities for treatment providers to list any needed accommodations, itemized in these areas and others relevant to the student’s needs and ability to thrive.
  • The form should reflect a collaborative process of agreement between the student and provider and be signed and attested by both parties. 
• A centralized support person or department (e.g., Dean of Students case manager), not connected to any academic unit, college, or department, should review the return form to ensure adherence to policies, deadlines, and completeness of information, and verify that the treatment provider is aligned with the condition in question.
• Information provided by the student as part of this process shall only be viewed, used, stored, and protected by the appropriate person(s) necessary to support the student’s reintegration. (Academic units, for example, should not have access to medical or mental health details but may need to learn about re-enrollment needs. Other units may be involved in accommodation requests. 
  • It is important that all records are kept confidential and handled according to privacy guidelines. Documentation should be routed to the appropriate office, ensuring that the external clinician’s evaluation and the student’s privacy are protected.
  • The nature (type, diagnosis, symptoms, treatment, etc) of the medical/mental health condition(s) associated with leave and return should be kept confidential, and not shared outside of the centralized support person/department unless otherwise authorized by student; specifically, academic units and support areas should not be provided medical/mental health details or information. 
• The support person/department should be able to consult with university health and wellness providers (or, when not available, externally contracted providers) as needed when there are questions or difficulties with verification. 
• University staff/clinical providers should not be expected to evaluate the clinical nature of these return requests if they were not the ones providing treatment and progress monitoring for the student requesting a return. Instead, this process shall yield to the appropriately credentialed and licensed clinical treatment provider making the recommendation, but as verified by the university’s centralized office in adherence to its process and policy. 

Upon return from leave, the college might support students in the following ways: 

• Having a designated case manager or support person who coordinates re-entry, and additional follow-up, as needed, to ensure accommodations are provided and received to be helpful related to academic, residential, extracurricular, health and wellness needs and services, among other areas of need. 
• Provide wellness coaching upon their return to the university that encourages students to adopt healthy habits, connect with their peers, set a workable schedule, and utilize mental health resources.
• Ensure financial/personnel resources to provide counseling and support for returning students.
• Incorporate treatment professionals’ recommendations (e.g., partial/full return, academic/extracurricular accommodations). This may require adapting existing policies and procedures. Standard procedures should not prevent reasonable accommodations. Flexibility and creative solutions are essential to ensure reasonable accommodations and support student reintegration and success.

There should be parity (non-discrimination) in policy/procedure for students leaving for physical and mental health issues.

Offer a tuition insurance policy that has parity between medical leaves for physical and mental health concerns. Tuition insurance protects a family’s investment and can reduce the fear of financial loss as a reason for a student to decide against getting the care they need (or medical leave).

• The school may write a letter to families that outlines the benefits of participating in a tuition reimbursement plan, specifically:
  • Very little cost for plan versus potential cost for loss of tuition
  • Covers unexpected occurrences
  • Encourages students to get the care they need when they need it without having to weigh significant financial loss as a factor in their decision

• The tuition insurance plan will offer the same reimbursement coverage for leaves due to mental health issues as for leaves due to physical health issues
  • The tuition insurance plan will provide parity in conditions for reimbursement – for example, some policies require hospitalization for mental health issues as a precondition for reimbursement, but only a note for reimbursement for medical issues – this type of inequity should be avoided.
  • The school’s tuition reimbursement policies can also be established to provide a better reimbursement schedule for students who take legitimate medical leaves.

Develop/refine a written involuntary/mandatory leave of absence policy consistent with the following recommendations:

As discussed above, on the rare occasion that a student is refusing/unwilling to take a leave of absence and poses a serious risk to others and/or is causing serious campus disruption based on their behavior, it is important for schools to have a policy in place for involuntarily withdrawing the student and for addressing the disruptive behavior. Keep in mind that in 2011 the Department of Justice stated that these types of policies should be considered when there are concerns about danger toward others only.  There is still confusion/ambiguity as to when/how/if such policies may be implemented when there are concerns about a student’s potential danger toward self.  

 A few considerations when developing these policies are below:

• Provide an individualized assessment  to evaluate whether an involuntary leave is indicated. The DOJ articulated how “direct threat standard” may apply and is central to making determinations about an involuntary leave. 
• The policy will indicate that suicidal ideation ALONE is not a justification for mandatory leave. Schools and their legal counsel should review carefully the DOJ changes from 2011 on this topic.  
• The policy should consider mandatory leave when:
  • The school has exhausted reasonable efforts and accommodations to assist a student’s ability to remain on campus
  • The student’s behavior is a material disruption of, or direct threat to the campus living and learning community and/or its members

• The school will provide a clear process for appealing a leave decision
• There will be policy in place to consider/encourage communication with families around plans for leave and return, consistent with state and federal privacy law requirements
• A mandatory leave of absence should be rare and given only after all other efforts have been applied to keep a student in school.