Looking back on it now, Tori Gruber ’17 doesn’t think she should’ve enrolled at Wesleyan when she did.

“I was really unhealthy,” said Gruber. “I was dealing with serious depression, serious eating disorders…there was other stuff I didn’t even realize I had to deal with.”

Eventually, she determined that she was not going to be able to return to Wesleyan during the spring semester. Instead, she decided to go on a medical leave, taking a break from the University until her health improved.

According to Michael Whaley, Vice President for Student Affairs at the University, about 40 students, or roughly 1.4 percent of the student body, take a medical leave every semester. A little over half of the people on medical leave are students like Gruber, who are dealing with mental health problems. The rest of people on leave are dealing with other types of medical conditions.

The medical leave process for students with mental health issues frequently begins when a student approaches a therapist at Counseling and Psychological Services (CAPS) asking for a leave. Gruber, for instance, requested a leave without having visited CAPS previously.

“When I went on medical leave, the University only knew that I was going to go on medical leave the moment that I said, ‘I’m going on medical leave,’” she said.

Often, according to Jennifer D’Andrea, Medical Director of CAPS, someone—typically a class dean or a friend—suggests the idea of a medical leave to a student before the student brings up the idea to someone at CAPS.

It is also common for a therapist at CAPS to suggest the leave to students. D’Andrea said that she suggests medical leaves to students about as frequently as students request leaves to her.

By contrast, the medical leave process for students with non-mental health problems almost always begins with a request from the student, according to Thomas McLarney, Medical Director of the Davidson Health Center.

“I can’t even think of a case where I say, you know, you’re pretty sick with this condition; I’d take a medical leave,” McLarney said.

Once a student requests a medical leave, D’Andrea or McLarney meets with the student before making a recommendation for or against the leave—a requirement under the University’s Medical Leave Policy. These requests are usually granted.

D’Andrea said that she would rarely, if ever, refuse to recommend a person who had requested a leave from taking a medical leave.

“We don’t tell people ‘no’ if they want a medical leave,” she said. “If a student says, ‘I really need a medical leave,’ we’re going to take them at their word.”

That recommendation then goes to the student’s class dean and to Whaley. Whaley then authorizes the forms.

“I just review what [D’Andrea or McLarney has] sent and then authorize it,” Whaley said. “In terms of people leaving, I rely on their expertise because they know a lot more about somebody’s medical condition or psychological condition than I do.”

Then, the student takes time off and seeks medical or psychological treatment. The University is unlikely to hear from the student again until that person is about to return.

At that point, the student has his or her attending physician or therapist send a letter to D’Andrea or McLarney saying that the student is prepared to return to campus.

Following a return to campus, students will sometimes communicate throughout the semester with someone from CAPS or the Davidson Health Center. Others will barely meet with them at all.

“We do require students to check in with us at least once at the beginning of the semester when they return from medical leave,” D’Andrea said. “Because returning from medical leave is stressful and particularly if the student has been out on medical leave for a long time—let’s say a year or more—they might find that return especially challenging.”

Returning to campus can be especially hard on students who leave after their first semester.

Tyla Taylor ’19, for example, got sick after her first semester during her freshman year. She said that spending so little time at Wesleyan before leaving has made being on medical leave especially difficult.

“It’s definitely challenging, especially considering I kind of had my freshman fall, and then by freshman spring I was sick, and now I’m taking off my sophomore fall,” she said in an interview in Nov. 2015. “So I feel like I haven’t really had the opportunity to fully experience everything that Wesleyan has to offer so that’s definitely challenging. It’s just hard to feel isolated in this way.”

Taylor had hoped to return to campus this semester, one year after she took her initial leave. However, she wrote in an email to The Argus that, due to health complications, she will be taking an additional semester off.

For Gruden, the transition back to Wesleyan was especially difficult, because, when she was dealing with depression and eating disorders, her ability to experience life as a college student was limited.

“I didn’t even get a chance to get an understanding for what this place was,” she said.

She returned in the fall of 2014, after a brief stint at New York University—nearly two years after she left the University.

“When I came back last fall it was sort of like, ‘Okay, let’s start doing this again,’” she said.

Following her leave, Gruden rarely communicated with people at CAPS. Instead, she began work with Wesleyan’s MINDS chapter, a student-run organization that hosts workshops and panels designed to discuss mental health issues and remove the stigma surrounding mental illness.

For some people, the decision to take a medical leave can be a way of maintaining academic standing while struggling with health issues. Many students who are struggling with health issues begin to fail classes before they take a leave of absence. Without taking a medical leave, they would be placed on strict academic probation.

For this reason, Laura Patey, Associate Dean for Student Academic Resources, views medical leave as one of many options for students who are struggling with the stress and anxiety that often come with being in college.

“[Students] may [alternatively] make an adjustment; they may withdraw from a class—either a class is particularly challenging to them at that particular time, or just reducing the stress and the amount of work that they need to do,” Patey said.

For students like Gruden, however, medical leave is a necessity. There aren’t any options–medical leave is the only choice.

“Had I not gone on medical leave, I don’t know what would’ve happened to me,” Gruden said.