In December 2023, a first-year sat on a Zoom meeting with her parents, and University administrators including her deans of college, weighing a hefty decision. She was given a choice: Complete her end-of-term assignments in the remaining two days before Dean’s Date, Princeton’s deadline for all end-of-term work, or take a leave of absence from the University.
Blaire, who requested this pseudonym and, like the other students in this story, spoke under the condition of anonymity to discuss sensitive health information, had experienced a mental health emergency on campus earlier in the semester. As a result, she spent eight nights in Penn Medicine’s Princeton House Behavioral Health (not affiliated with Princeton University), sandwiched on both ends by an overnight stay in McCosh Health Center. In total, she missed 11 days of school, including the last few days of class and almost all of reading week, the period of time between the end of classes and Dean’s Date, the due date for all written work.
On the Zoom call, Blaire was still reeling from the ordeal which landed her at Princeton House, an experience that she said left her “emotionally wrecked.” She was not given the option for coursework extensions, as Dean’s Date offered limited flexibility.
“They said I had to do all of my work in the next two days if I wanted to finish the term and still be a Princeton student,” she recalled. Feeling caught between her academic and mental well-being, Blaire decided to stick it out and finish her assignments.
“I made the choice to just continue and try to finish everything up as fast as I could,” she said. And she did, submitting everything in time, despite the guidance she said she received from a Princeton House social worker to slowly reintegrate into campus and academic life. She passed her classes and returned in the spring to continue her studies.
Still, the experience made her lose trust in University Health Services and question whether she belonged at Princeton.
“I felt so alienated from my community,” she explained. “It didn’t make me feel good about being a Princeton student.”
Blaire is not alone. She is one of about 30 undergraduate and graduate students each year who experience severe mental health crises that escalate to the point of inpatient hospitalization, according to Director of CPS Dr. Calvin Chin. On a campus where resources for students are remarkably abundant, and where around 35 percent of the student body seeks mental health care each year, many students expect that the University’s mental health system can and should meet every student’s needs.
But in cases that challenge that system, both students and administrators are confronted with a difficult bind: how to balance the uninterrupted high achievement Princeton expects with the often disruptive mental health care some students need. Over the course of a year, in dozens of interviews with The Daily Princetonian, students, professors, mental health professionals, and administrators provided a window into the difficult decisions at the heart of that balancing act, one where each student’s case may be different and challenge the system in new ways.
And while each case is different, Princeton is not alone — it is just one institution of many navigating the nationwide mental health crisis among college-aged students.
“Adolescents in general are experiencing much more stress, anxiety, and depression across the country,” said Dr. Jerome Miller, a clinical psychologist and lecturer emeritus in psychology at the University of Michigan. “Health centers everywhere are feeling overwhelmed, [because] there are so many more students asking for resources.”
Dr. Zainab Okolo, Senior Vice President of Policy, Advocacy, and Government Relations at the Jed Foundation — which is working with Princeton to help it meet its mental health goals — echoed this. “Princeton is absolutely and unfortunately not alone. We as a nation are facing a national youth mental health crisis,” she said.
Conversations around mental health on campus invariably return to the fact that Princeton has confronted seven undergraduate student deaths due to suicide and mental health struggles in the last four years, most recently that of Lauren Blackburn ’26. It can be difficult to wrap one’s head around the fact that even a campus as well-resourced as Princeton still struggles. University President Christopher Eisgruber ’83 nodded to this during a public forum in early 2024, days after the death of James Li ’27.
“There are tragedies that take place, even when people do all the things that they should be doing,” Eisgruber said in the meeting, while citing the University’s investments in CPS and the new Frist Health Center.
Each of these deaths has left its mark on the Princeton community, often launching new conversations around mental health on campus in their aftermath. In this regard, too, Princeton represents a microcosm of a nationwide crisis, in which suicide is now the second leading cause of death for individuals aged 10–34.
At the same time, though addressing suicide remains an open question, Princeton has made extraordinary investments in mental health resources. Students can make CPS appointments for free without a formal limit. While there is often a long wait time for these appointments, and CPS is designed to be a short-term resource, Princeton also connects students with a robust network of outside providers. And after years of student advocacy work, students on the Student Health Plan can now see those outside practitioners for only a $10 copay, less than many peer institutions.
Students have also seen an increased emphasis on wellness in daily life, especially since the COVID-19 pandemic. From community care days packed with plant-potting and yoga to emotional support puppies visiting the residential colleges during exam season, from wellness programming grants to an easily-navigable resources website, from a 24/7 emergency care line to mental health training for first-years during orientation, Princeton has made a significant effort to address both everyday wellness and more serious mental health issues.
Yet every semester, some students are hospitalized for mental health emergencies. Some have difficulty paying the bills for their short- and long-term treatment. And some feel like CPS isn’t working for them.
With students in crisis and colleges and universities across the country seeking solutions, Princeton is a resource-rich and expert-laden campus that has the opportunity to lead by example. Can it?
‘The whole student’: The evolution of mental health care on American campuses
Mental health care at Princeton was first conceived with academic achievement in mind.
In 1910, Princeton became the first college in the United States to establish a mental health-specific service for students, in response to a psychiatrist’s observation that students were dropping out due to “emotional and personality issues.” The goal of the service was to help students remain at Princeton while dealing with these concerns. Other schools followed suit over the next decade — University of Wisconsin in 1914, Dartmouth in 1921, Yale in 1925.
Intense moments of national trauma have brought significant changes to the system since its inception. In the 1940s, largely driven by the psychological weight of World War II, the University started including CPS as part of its healthcare plan. After disagreements between students and administrators in the 1980s about the level of access students should have to counseling on campus, University administrators approved expansion of the student health plan to include mental health coverage in 1992.
The pandemic inundated the mental health system, forcing it to significantly transform. At Princeton, the number of students seeking care at CPS had already been steadily increasing before the pandemic — it reached an all-time high in the spring of 2021. Following a student referendum, a sweeping report from the Undergraduate Student Government (USG) recommended the University implement 24/7 on-demand CPS counseling and fund transportation to off-campus care, among other changes.
Some, but not all, of the recommendations from the report have been implemented. Still, the mental health ecosystem on campus today would be unrecognizable to a student 15 years ago. There are more resources, clearer websites, reduced copays for outside providers, and a more open administrative approach to suggesting leaves of absences. And this spring, the University will be required to start providing annual suicide prevention training for all faculty and staff by a New Jersey law passed in 2023.
Still, these changes have only gone so far in individual cases, and each student’s experience differs vastly from the next. Though Blaire got the care she needed — she was taken into CPS, received treatment at Princeton House that she later reflected positively on, and regained her footing at Princeton in the aftermath — the experience itself was wracked with anxiety and confusion.
If Blaire took a leave, her return would not be automatically guaranteed: According to Princeton’s guidelines for Academic Standing, Leaves of Absence, and Reinstatement, it might be contingent on evidence of her mental rehabilitation from a provider. For health-related leaves of absence, the guidelines state, “Careful consideration will be given to the opinions and recommendations of the student’s treating physician or mental health professional, if available.”
Leaves of absence have long been a point of contention for universities in the United States. In the 2010s, reports circulated of students in mental health crises being forced to take mandatory leave from colleges, in some cases because universities feared that these students were a liability. This changed when students and their parents began filing lawsuits claiming that these forced leaves disrupted students’ studies and induced deeper depression, including a suit filed against Yale in 2022.
Such a lawsuit was filed against Princeton in 2014, when a student alleged that Princeton had discriminated against him in the wake of his suicide attempt. The student claimed that forcing him to withdraw likely exacerbated his condition and caused him emotional distress. The student and the University settled the case in 2019 after five years of litigation.
The ‘Prince’ reported in 2023 that CPS requiring a student to take a leave of absence is now incredibly rare.
According to Chin and Associate Dean of Students Mellisa Thompson, who regularly handles cases that might involve a leave of absence, administrators try to work with students to choose the best path for them when considering a leave of absence.
When she meets with students, Thompson emphasizes that Princeton is not going anywhere. “Students should not try to struggle through this place, when students are at a point when the type of treatment that they need to engage in doesn’t feel like it’s compatible with the academic rigor and the demands,” she said. “Mental and physical health — we treat both of those the same, because they’re both just as important.”
According to Chin, more than 2,000 students seek CPS care each year. In Fiscal Year 2024, CPS had contact with 2,300 students, with 1,500 total sessions. With just 14 psychologists, nine social workers, two psychiatrists, and two psychiatric nurse practitioners, that’s around 85 students per every professional on staff.
Many mental health professionals associate the spike in seeking care with the pandemic, and though numbers continued to climb in the post-COVID-19 years, the 2025 senior survey conducted by the ‘Prince’ revealed a decrease in the amount of students who sought mental health care in the Class of 2025 over their four years at Princeton. This coincides with the 44 percent of the recently graduated class who expressed dissatisfaction with the mental health resources Princeton offers.
Chin explained how CPS handles this level of demand. “We have to be thoughtful about the students we keep and the students we connect to community providers who can provide weekly treatment,” he explained. For its part, according to Chin, CPS typically meets with students every other week, though other arrangements can be made on a case-by-case basis.
“The question of resources is a challenging one,” Chin said. While Chin welcomes more resources, he said that Princeton has more therapists than is typical of peer institutions. Additionally, CPS never turns a student away, he said; if the center lacks capacity to take a student on, the student is referred to an outside provider. “The bottom line is to make sure anyone who needs mental health care has access to it,” said Chin.
In keeping with this promise, many students are referred by CPS to outside providers or, in more severe situations, sent to Princeton House, an inpatient and outpatient mental and behavioral health facility focused on supporting recovery from mental health, substance use, or co-occurring disorders and affiliated with Penn Medicine, the hospital closest to Princeton. Princeton House declined to respond to a list of questions, instead telling the ‘Prince’ in a written statement, “We are committed to providing every patient with respectful and compassionate treatment according to their clinical needs and our professional standards of care.”
‘Everything is piling up’: Leaning on CPS during stressful times
The transition to college as a first-year can be extremely challenging for anyone, anywhere. But for students with mental health needs at Princeton, it can be a particularly vulnerable time.
Okolo, from the JED Foundation, explained that students often discover their mental health issues for the first time when they arrive on campus. Part of this is simply a matter of being in a new setting. “It’s the first time that you’re out of your safety context, and on top of that, there are the academic stressors and other challenges that come along with growing into yourself,” she explained.
She added that mental health is often particularly stigmatized in high-pressure environments like Princeton. “That means competition is high. It’s the first time a lot of folks have not been the smartest person in the room.”
Former chair of the USG Mental Health Committee Meera Kochhar ’25 was inspired to take on that role after becoming a Residential College Advisor (RCA) in her junior year and being reminded of her own difficulties as a first-year.
“I just feel like it’s so difficult for anybody to go into college — throughout the whole country, the whole world,” she said. “In most cases, this is a very different environment for students than what they grew up [with] in high school.”
Blaire described the start of her first semester at Princeton as “really rough.” She was facing many pressures common to first-years: moving far away from home for the first time, friction with roommates, and adjusting to academics after coming from an under-resourced public school. On top of this, she had a parent sick with a terminal illness at home.
Blaire began seeing a counselor through drop-in appointments at CPS. However, she said she could only see a counselor once every 2–3 weeks.
Another first-year, who asked to be identified by one of his initials, M, was able to see a CPS therapist more frequently. These appointments helped him contend with both past issues and his academic adjustment to Princeton, he said, “to an extent.”
But CPS’s care could only go so far during a particularly intense academic week. “I didn’t really have the opportunity to sleep. I had so much work; I was just really stressed. Everything was piling up,” M explained.
One night, fearful that he was going to hurt himself, M called the 24-hour care line. M remembers the care line provider asking him to walk to McCosh. After being promised he could spend the night there, he complied. But when he arrived, he says he was immediately told he would be sent to Princeton House.
The psychiatrist on call that night was the same person M had been seeing regularly for months. M said that he told her, “I just need one night to cool down, just one night to be in a safe environment.”
The psychiatrist cleared M to spend the night in McCosh and be released back to his dorm the next day, without being sent to Princeton House. She also told M that if he ever needed to stay overnight at McCosh again, he could email her. He ended up doing so when he faced another mental health emergency later that year, and he was able to spend the night again with no trouble.
“She’s really great,” M said of his CPS psychiatrist. “She’s going way beyond her commitments.”
Still, M believes that if any other psychiatrist had been on call that day, he would have been sent to Princeton House and would likely have missed multiple days of school.
“After that whole experience, now I trust CPS a lot less, and it’s taken a long time for many people to gain my trust back,” he said.
‘Penn Medicine was kind of like the calm before the storm of being discharged’
Of course, mental health emergencies are not limited to first-years. After experiencing a personal tragedy her sophomore year, N, a member of the Class of 2025 who asked to be identified by her first initial, said she did not feel that CPS would be enough to meet her needs.
“By that time, there were three students who had already committed suicide on campus, and I had some pretty down thoughts at that time, but I didn’t feel like CPS was helpful enough, especially the psychiatrists,” she explained.
That year, N scheduled an appointment with her dean, who she said recommended that she take a leave of absence. The suggestion to step away from campus altogether was difficult for her to take, she said.
“It made me feel like garbage,” N said. “Initially, I felt like I needed just some encouragement, or some mentorship of some sort.” From her perspective, N had been seeking increased support at Princeton — and the suggestion that she take a break from Princeton entirely felt to her like the opposite of that.
As a senior, N reflected on how her first three years at Princeton were affected by student death. Kevin Chang ’23, Jazz Chang ’23, and Justin Lim ’25 in her first year. Misrach Ewunetie ’24 in her second. Sophia Jones ’27 and James Li ’27 in her third.
N and Li were in a class together, so his death had a particularly lasting impact on her. “I wouldn’t say I was that close to James, but I saw him every single day,” she said. “When you see someone every single day, you kind of get used to seeing them. So that was Friday, and when I went to class Monday, I just looked at where he usually sits, to the left in the front, and he wasn’t there, and Tuesday, he wasn’t there. He wasn’t ever there.”
For some students, depression and suicidal thoughts require more intensive interventions.
Blaire said Jones’ death contributed to her own spiral. The day after the tragedy, Blaire felt stunned to see classes continue as normal. “At the time, walking around on campus, it was lively and bustling. Everything was moving. It just made me feel so sick,” she said.
The next night, Blaire called the campus mental health hotline, Princeton Peer Nightline, sobbing. She said she found the call, which was answered by another student, unhelpful and began to feel worse. Her friend called Public Safety (PSafe) and explained the situation. Blaire was then picked up by PSafe and transported first to CPS, then to Princeton House.
Though she felt in the dark during the process of getting to the hospital, Blaire was pleasantly surprised by the care she received there. “The actual facility was honestly helpful, to an extent,” she said. “Princeton House is a lovely place, and I think that the University using that as their facility is good because they were very nice to talk to.” According to Thompson, Princeton House is the most common example of multiple facilities to which Princeton sends students in crisis.
According to Blaire, her Princeton House social worker was understanding and provided good assistance. “She was the first person I talked to that made me feel human,” Blaire said.
After her eight days in Princeton House, Blaire arrived back on campus to what felt like the edge of an academic cliff.
Blaire said that her professors didn’t know she was sent to Princeton House. Without access to her computer or phone, Blaire herself was not able to send them an email. And the University cannot inform professors when students miss class due to stays in Princeton House, or other medical reasons, without written permission from the student.
According to Chin, staff from CPS meet regularly with the staff at Princeton House and the staff at the Penn Medicine emergency room to ensure “clear channels of communication” between them. This is meant to help the process of sending a student to the hospital — and the process of the student’s return — to go smoothly.
However, “Penn Medicine was kind of like the calm before the storm of being discharged,” Blaire said. She said she was required by the University to spend another night in McCosh on the backend. This was followed by a formal meeting with her parents and University administrators.
After the meeting, Blaire received an email signed by her residential college deans and the assistant dean for student life outlining her options clearly, described as “action items” she would need to take.
“Consider the possibility of taking some time off to prioritize managing your health without the academic pressures of Princeton. Time away could provide you with an increased period of stability to ensure that you are stable and healthy enough to continue your studies,” read the first bullet point.
The email continued, “Should you elect not to take a voluntary leave of absence and decide to continue your enrollment this semester and in the spring term, you will be accountable for your conduct and academic requirements, as are all Princeton students.”
Thompson, who manages crisis intervention efforts and emergencies involving undergraduates, said the University views time off as a way to grow and reach a point where they can return and make use of all Princeton has to offer.
“I think sometimes students think they’re the only ones that have been in this situation, and I like to dispel that myth,” she said. “We’ll talk through all the realities, and we have conversations where it really is a choice.”
After weighing the decision, Blaire made her choice to stay, although she found it “jarring” to throw herself back into her studies so soon after being in a “very surreal and vulnerable place.”
Still, she stayed because she was scared of the possibility of no longer being a Princeton student. She stayed because her parents could not afford to pay for an extra semester, even with financial aid. And she stayed because when she finally was able to email professors and let them know what had happened, she found that they were compassionate.
“Professors are pretty wonderful about mental health,” she said. “I ended up staying because of professors who were genuinely kind and understanding.”
Blaire said that by her sophomore year, she had better safety nets. “First year, you don’t know who your people are,” she said. Now, she describes feeling more hopeful. “I think the biggest thing was [discovering] that Princeton is a lovely campus, as long as you’re getting your support from the right places and finding external therapists and psychiatrists.”
Struggling in Princeton’s safety net
For all the swipes students take at Community Care Day and the constant list of study breaks, Princeton’s mental health resources are substantial.
The Jed Foundation, which Princeton contracted last spring to assess student mental health. produced a preliminary assessment last spring finding that the University gets a lot of things right. Most categories in the strategic plan for FY 2025 were marked as “Meets Requirements” or “In Progress.” The categories ranged from social connectedness to clinical services and included specifics like training students “to identify, reach out to, and refer their friends/peers who may be struggling with mental health or substance issues,” and developing “proactive Action Steps to help identify disconnected/isolated students.”
There is an extensive web of resources, for instance, to cover various expenses for mental health emergencies. The TigerLife website, launched in 2024, helps students navigate these resources and offers guided walkthroughs to determine which services will most benefit a student at the moment. These include the Dean’s Emergency Fund, which typically has a $500 cap, the University Health Services Special Needs Fund, with a $300 cap, the University Safety-Net Fund, also capped at $500, and the Aryeh Stein-Azen Memorial fund.
There is also a Mental Health Loan, in which graduate and undergraduate students “may apply for a loan of mental health expenses not covered by insurance up to $1250 per semester to cover off-campus psychological services,” as explained on a University website. The loan does not accrue interest until after a student graduates.
Even then, the financial safety net doesn’t always catch everyone.
Financial consequences weighed on Blaire’s decision to seek mental health care in the first place and continued to pose concerns for her after the fact.
She had a copay of $3,000 for the hospital visit that she described as “entirely unfeasible” for her family. Blaire was not on the University Health Plan, but rather on her own Aetna health plan, which required the copay. When she consented to be admitted to Princeton House, Blaire does not remember being informed of the cost at the time.
Blaire applied to a number of University crisis funds for help with the cost, and was initially denied from all of them. Though Blaire received partial financial aid, she was shocked to discover that she originally did not have “high enough financial need to qualify [for the funds].”
Ultimately, Blaire qualified for a $1,000 reimbursement from the Dean’s Emergency Fund, according to documents reviewed by the ‘Prince.’ Blaire said that she was reimbursed the $1,000, but did not hear back from any of the other student emergency funds to which she applied to cover the rest of the cost, leaving her with an outstanding balance of $2,000 to cover on her own.
N has also had difficulties getting reimbursements for mental health expenses from University sources. When she was prescribed medication for a mental health disorder her freshman year, she was able to receive funds from the McCosh Health Services Center Fund. “But it’s only $300 per academic year, not enough if I want to get off campus health,” she said.
“That can be a really complicated and unnerving process, but we try to sort of give students advice around how to navigate that,” Chin said. “We typically advise people to never let financial concerns get in the way of getting the kind of care they need.”
Faculty and administrators seek the ‘human response’
While administrators play a crucial role in supporting students, the adults to whom students form their closest connections are often professors.
The University recently rolled out suicide prevention training which all faculty and staff are expected to complete on an annual basis as part of a new requirement for colleges in New Jersey. Still, not everyone knows what to do when a student comes to them in distress.
Nine years ago, Professor Ilya Vinitsky came to Princeton from the University of Pennsylvania, where he had participated in a round table on mental health for students. He described this as a “revelatory experience” because it helped him understand that the issues students had already been talking to him about for years were more widespread. “The absolute majority of students experience these problems and they want to talk about this,” he said.
As Vinitsky sees it, one problem is that professors are not trained to speak about mental health issues with their students. Professors are not taught what to do when a student bursts into tears during class. They are not given a template for responding to a student who opens up about their mental health during office hours.
“There really is a moment where you want to do something as a human being, but you cannot, because you do not know how to do this,” Vinitsky said. “And it just contributes to your own psychological uncertainties. What to do?”
In 2023, New Jersey passed a law requiring all colleges in the state to provide mandatory suicide prevention training for faculty and staff. Until recently, training has mostly taken the shape of an optional Princeton Disaster Awareness Response partnership.
The new training, launched this summer, uses a software called MindWise SOS. According to its website, the program combines educational videos, discussion guides, advice, and interactive scenarios related to suicide prevention.
For Vinitsky, training faculty on protocol is significant, but it must be paired with advice for what professors can say in the moment.
“I need some kind of concrete human recommendation, suggesting what is to be done in accordance with University policy but also with normal human behavior as someone who wants to help.”
The faculty-only view also has its limitations, Head of Yeh College Yair Mintzker said.
“The residential colleges are a place where you can see much more obviously than professors [who] see students in a classroom environment,” said Mintzker, who is also a full-time professor in the Department of History. “We have a more holistic view of what happens.”
He now has a deeper understanding of certain challenges students face: competitiveness, high expectations from both outside and within, and imposter syndrome.
“People should realize they’re not alone, that it happens to everyone,” Mintzker said, emphasizing that he and the other residential college heads want to support students.
That’s why Mintzker encourages students to be open about their experiences and failures with one another. He also encourages professors to learn about what happens in the residential colleges and how many resources there are to help students.
“We’re really eager to talk,” Mintzker said. “They don’t bother us, we’re eager to see them.”
If professors and residential college staff can provide holistic support, there are also systemic practices universities can implement to help students who face severe mental health crises, experts say.
Brian Ahmedani, who authored a 2025 paper about a set of guidelines called the “Zero Suicide Approach,” said that screening was a particularly useful tool.
“The most important thing to start with is asking people if they’re at risk,” he said. “There are some screening tools that work as well as those for cholesterol do.”
The Zero Suicide Model offers a systemic approach to improving suicide prevention in healthcare systems based on the core “belief and commitment that suicide can be eliminated in a population,” via seven elements (Lead, Train, Identify, Engage, Treat, Transition, Improve).
Ahmedani’s paper, published in the journal the Jama Network, argued that implementing the model is “associated with a reduction in suicide attempt rates among patients accessing outpatient mental health care at most study sites,” that it might be able to eliminate suicide entirely in well-resourced institutional settings.
‘Not turning a blind eye’ on mental health
How does an administration design a mental health care system that can work for young, ambitious students facing a host of academic and social pressures? How do professors respond to students who come to their doors asking for help? And how does a campus respond to the tragedy of a student suicide?
Okolo discussed the importance of talking about mental health, including suicide, while resisting normalization. “When it comes to mental health, having these conversations and not turning a blind eye is very important,” she said.
“Sometimes we conflate the fact that it’s happening everywhere with thinking that it’s normal having several suicides on a campus or within a state,” she said. “It’s not normal.”
Chin acknowledged the tough balancing act of experiencing mental health concerns while at Princeton. “It definitely is really hard to be a Princeton student when you’re also struggling with a serious mental health issue,” Chin said.
He also emphasized that CPS’s goal is to focus on the whole student.
“You have options. You can make choices. We want to take away any kind of internal or external pressure you feel to have to do Princeton in any particular way,” he said.
But for some students, there’s still lingering resentment and distrust in the system.
“I understand that not everything happens overnight,” said M, who said he was still frustrated and disillusioned after his first experience staying overnight at McCosh.
“First, address that there’s an issue, address the problems with mental health care by making it accessible and not a financial burden. And while we’re addressing these surface issues, the long term always needs to be, how do we make Princeton’s environment better?” he said. “We need to reflect.”
Raphaela Gold is a head Features editor for the ‘Prince.’
Please send any corrections to corrections[at]dailyprincetonian.com.