UP CLOSE | Pressure to project growth

UP CLOSE | Pressure to project growth

The struggle to package mental illness in a college application

Published on April 25, 2023

Gabriella Gutierrez ’23 has just completed her senior thesis — a research project exploring behavior in different subtypes of schizophrenia — and is rapidly approaching commencement, when she will officially receive her Yale College degree in psychology.

About four and a half years ago, Gutierrez’s life looked very different. Then a high school senior in California, she wrote her Common Application essay about an intense “mental battle” that she experienced that year while playing competitive tennis.

During one particular championship match, the team’s first-ranked singles player chose to compete in the doubles round. Gutierrez — then the second-ranked singles player — had to fill her shoes, amounting to a “deeply stressful mental battle” as Gutierrez fought with herself to be able to perform. In the essay, Gutierrez called this moment a “turning point” in her mental health, noting that this one match marked tremendous personal growth for her.

Gutierrez is part of a growing pool of high school students who write their college essays about suffering through and overcoming mental health struggles, in an effort to craft personal testimonials that speak to strength of character. 

“There is a lot of pressure to write an admissions essay that [shows] you’ve grown from a certain experience, that you have finished growing, and you learn some big life lesson from it,” Gutierrez, who now is an advocate with the Yale Student Mental Health Association, told the News. “But the issue with mental health is that it’s reoccurring. It’s something that doesn’t go away.”

Gabriella Gutierrez wrote her college admissions essay about an intense “mental battle” that she experienced while playing competitive tennis in high school. (Courtesy of Gabriella Gutierrez)

Highly selective universities like Yale consider an applicant’s potential to succeed within the college community. The Yale Office of Undergraduate Admissions states on its website that they seek out “students who will make the most of Yale and the most of their talents” and that they consider how a prospective Yalie would, if admitted, “engage the resources” that the University has to offer.

This framework of potential success at the University is further complicated by the persistent nature of mental illness that Gutierrez notes. For students with chronic mental health conditions, or whose past experiences may have yielded permanent psychological consequences, the question of what to disclose or not disclose in a college application is a complex one, as they seek to find the mix of poignant and palatable that will make an application successful.

Yale’s admissions office told the News that it does not discriminate against applications on the basis of any kind of health condition, including mental illness. In fact, Dean of Undergraduate Admissions and Financial Aid Jeremiah Quinlan wrote in a statement that an applicant’s choice to share details about any sort of health issue can provide further insight on challenging circumstances that a student has had to navigate. 

“In some instances, [these insights] can provide helpful context for reviewing other parts of the application, such as the transcript or activities list, but the admissions office does not advise students to either disclose or conceal personal health information in their applications,” Quinlan said. “That choice lies with each applicant and their own understanding of how they would like to present their candidacy to the admissions committee.”

But making that decision is exactly what can be challenging. 

Independent college counselor Christine Chu ’01, who was a Yale admissions officer from 2001 to 2003 and now works for New York-based educational consulting firm IvyWise, told the News that the students she advises are often concerned with how disclosures about mental health will be perceived. 

“How do you want to tell your story to show that you would thrive in a college community, that you can come and take advantage of everything that a school like Yale has to offer and be a contributing member as well?” Chu said. 

What it means to be a “contributing member” of the Yale community

Gutierrez told a story of growth in her college application, looking to show that she could — and ultimately did — arrive at Yale with skills that would enable her to bounce back from periods of mental stress.

But when journalist and software engineer Emi Nietfeld applied to Yale in 2009 as part of the early action program, with an application package that shared sensitive details of homelessness, residential psychiatric treatment and other trauma-related circumstances, she was rejected. 

Nietfeld’s high school guidance counselor called the University and relayed to Nietfeld that it did not look like she had “overcome enough,” Nietfeld told the News.

In the 2009 email from Nietfeld’s high school counselor, which the News obtained a copy of, her counselor wrote specifically that the list of “past issues [was] daunting” and that the readers did not perceive a “sense of reflection or [Nietfeld’s] ‘success story.’” 

Courtesy of Zoe Prinds-Flash (Emi Nietfeld discussed her experience with homelessness and psychiatric treatment in her Yale application, which was rejected.)

After removing any mention of her post-traumatic stress disorder, hospitalization and residential treatments, Nietfeld submitted a new application to schools other than Yale in the 2010 regular decision cycle and received vastly different outcomes.

“I really interpreted this as [meaning] that I cannot talk about mental health stuff, like I had to write the parts of my story that are going to look attractive and make me look like an overcomer,” Nietfeld said. “But I cannot mention this mental health stuff, even if I’m saying I’ve overcome it and I have people who can attest to the fact that I’m relatively stable and functioning. It was going to make me too much of a liability. So I ended up cutting every single mention of anything mental health-related, and focused my application on my parents struggles and being in foster care and being homeless.”

Ultimately, with her newly-sanitized application package, Nietfeld was admitted to Harvard University, the University of Pennsylvania and a slew of other highly selective colleges. She went on to matriculate at Harvard and graduated in 2015. 

Yale employs a system of holistic review. Under this model, mental health is — like all other elements of an application package — one factor about an applicant, not their whole story. In his statement to the News, Quinlan wrote that admissions officers review applications from students who disclose information about their mental health status the same way as they review all other applications.  

But the admissions process is a black box. It is impossible to know whether Nietfeld would have definitively gotten into Yale with the same sanitized application that she submitted to Harvard, UPenn and the other selective schools to which she was admitted. Plenty of students submit the same application to similarly selective universities and end up with vastly different verdicts — such is the nature of schools with admissions rates that lie under 5 percent and are continually decreasing.

In Nietfeld’s admissions cycle, 25,869 students applied to Yale. 23,929 were rejected. 

But Nietfeld finds this line of argumentation “convenient” and worries that it may enable “systemic discrimination” against mentally ill applicants to persist, whether at Yale or other college campuses. 

“I do have empathy for admissions officers, and I think it’s a really tough job, and, obviously, most people are not going to get in,” Nietfeld said. “But I also think that mental health impacts people from different backgrounds so differently, and if colleges are not really careful, they will end up unfairly rejecting applicants with fewer advantages since that’s one of [the] ways that mental health manifests.”

Admissions officers review applications from students who disclose information about their mental health status the same way as they review all other applications, Dean of Undergraduate Admissions and Financial Aid Jeremiah Quinlan said. (Tim Tai, Photography Editor)

What happens after arriving on campus?

Some applicants hope that the decision to disclose or not to disclose their mental health struggles will conclude after receiving an offer of admission — that matriculation will resolve consequences wrought by the pressure to gain admission to a selective university as well as the potential stigmas attached to discussing mental health challenges in their application.

For Gutierrez, this was true. The story she recounted in her college admissions essay was one of genuine growth, and she told the News her mental health has improved tremendously since when she applied to the University. 

“I had full-on gotten screamed at by some of the parents in tennis during my matches, and there was all this pressure in these moments, but eventually, I learned to block it all out,” Gutierrez told the News. “Now, with college, I’m very happy. … Everything that I learned back from that tennis match in high school [made me] really grow as a person and learn how to manage stress and high-pressure situations.”

For Nietfeld, though, matriculating to Harvard came nowhere close to solving her mental health struggles. 

Nietfeld told the News that while she was an undergraduate, she felt “overwhelming” pressure to model a “perfect person” who had not been marred by trauma and mental illness — a pressure intensified by her belief that she would not have been admitted had she told her full story in her application.

“It’s kind of like being asked to lie, or maybe not to lie, but to tell a very, very narrow version of the truth,” Nietfeld said. “And [within] that there’s that message of, ‘You are not acceptable unless you are this healed person or a person who was never sick at all.’”

“Symptoms” (Jessai Flores, Illustrations Editor)

At the end of November, mental health advocacy group Elis for Rachael and two current undergraduates sued the University on the basis of alleged discrimination against students with mental illnesses. The plaintiffs argued specifically that Yale’s previous policies around medical withdrawal and reinstatement placed undue burden on mentally ill students, giving them no other choice than to withdraw from the University if faced with a serious bout of mental illness and placing unreasonable requirements on those seeking reinstatement.

Representatives of Eli for Rachael declined to comment due to ongoing legal negotiations

Since the lawsuit was filed, the University updated its reinstatement policies dramatically, changing the title of “medical withdrawal” to “medical leave of absence” to lessen the sense of permanence attached to choosing to take semesters off from school and relaxing the reinstatement requirements. 

While reinstatement policies at the University are handled separately from the general undergraduate admissions process, the themes that underscore class-action lawsuits like the one currently pending against Yale and a similar suit that hit Stanford University in 2018 can reinforce feelings of exclusion or fears of retribution like those that Nietfeld experienced. 

These feelings can bleed into the application process, prompting applicants to further agonize over how to distill their personal experiences into an application portfolio that they can successfully market to selective universities. And they also can make it harder to ask for help upon matriculation.

“I felt like colleges wanted somebody who had been through these bad things, but they didn’t want somebody who had been affected by them,” Nietfeld said. “I tried to get counseling, but I was too afraid to say, ‘Hey, here’s what’s going on for me,’ because I worried that my admission would be rescinded or I was going to get in trouble.”

A Yale-affiliated chaplain with experience in New Haven mental health programs wrote in the email to the News that due to stigma surrounding mental health, she would not advise students to disclose diagnosis of a chronic mental illness — like Nietfeld’s post-traumatic stress disorder — unless they could meaningfully show how they had dealt with the condition.

However, the chaplain added that the context of disclosure changes after matriculation, when seeking help is “one of the many responsibilities of adulthood.”

Nietfeld wishes she had been better able to understand that distinction while an undergraduate.

“I just wish that I had realized that my application was not a promise, that it was not a binding commitment, but it was the way in the door,” Nietfeld said. “And then once I was in college, I could talk about things as freely as I wanted. “

The high-intensity environment at Yale and peer institutions can exacerbate mental stressors. (Tim Tai, Photography Editor)

The way forward

Nietfeld applied to college in the 2009-2010 cycle, about nine years before Gutierrez would apply and 13 before the incoming first-year class

Last December, she wrote an opinion column for the New York Times about erasing her mental illness from her college application. Nietfeld told the News that she wrote the piece, which includes interviews with 11 other students and several college counselors, in part because she was curious about how much had changed in the admissions process since she was rejected from Yale. 

Her verdict? Not much.

“Even though Gen Z is much more open with discussing mental health, if anything, colleges are more afraid now,” Nietfeld told the News. “And in part, it’s because there aren’t a lot of resources. There’s a nationwide therapist shortage that has made its way onto campus. Colleges generally … [think], ‘If I accept this student, I have to be able to take care of them,’ and, in part, this is what people demand of colleges; it’s their substitute parents. And that can turn into basically discrimination, where they don’t want to take people because they don’t think they’ll be able to meet your needs.”

The college mental health crisis, of course, extends beyond the University. A 2014 survey by the Association for University and College Counseling Center Directors found that about half of students served at college counseling centers around the country had attended counseling for mental health concerns. A 2019 research paper out of Harvard Medical School found that suicide rates are currently at their highest levels in a century, with the adolescent age group particularly at risk. In his State of the Union speech this February, United States President Joe Biden named rising rates of anxiety and depression among teenagers as a top concern for the nation. 

The high-intensity environment that characterizes Yale and peer institutions can further exacerbate mental stressors. 

Emerging research finds that adolescents enrolled at high-achieving schools, such as those in the Ivy League, can suffer significantly higher rates of anxiety, depression, substance abuse and delinquent behaviors — at least two to three times the national average. 

“I felt like colleges wanted somebody who had been through these bad things, but they didn’t want somebody who had been affected by them”

—Emi Nietfeld

But the impact of the Ivy League on youth mental health comes into play long before matriculation, as the sociocultural value placed on Ivy League admission — and fear of disclosing mental health status in an application — can contribute to stigma around mental illness, Nietfeld noted. 

“In our society as a whole, getting into an Ivy League college is one of the most impressive things that you can do,” she told the News. “So if you obscure your mental health, and you can get into an Ivy League, that is a very powerful incentive, telling you that is the right thing to do. You should not talk about it, you shouldn’t be honest about it.”

Dean of Yale College Pericles Lewis spoke to the News about the general stress that exists within the current culture, especially for young people applying to college.

Low admissions rates, Lewis said, contribute to the problem. 

“One of the things I am looking for is ways to reduce stress and encourage mental health and, more broadly, emotional well-being, and I think we can look at admissions as part of that broader thing,” Lewis said. “Obviously it’s stressful when only 4.35 [percent] of the students are admitted, but maybe taking a little pressure off of that and remind[ing] people that most of the other 95 percent of students will get into excellent colleges somewhere [would] take off some of the pressure related to the whole process.” 

Nietfeld and Gutierrez both agree that the admissions process is not solely to blame for the biases and discrimination that surround mental illness — “the whole world,” Gutierrez said, is stigmatized against mental health.

According to Gutierrez, a long-term solution must lie with broader destigmatization that goes beyond admissions on its own, especially because mental health affects everyone.

“Treatment should not be stigmatized, and it should be accessible,” Gutierrez said. “I think that those are probably the first steps — the major steps, at least — in addressing these types of issues and normalizing discussion around mental health. It’s just something that you experience, something that all of us experience. Everybody, at least once in their life, has experienced some sort of mental health struggle.”

Yale College admitted 2,275 of its 52,250 applicants to the class of 2027. 


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