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Comment by wting | Hacker News Reader

It's a combination of multiple factors.

I go to UT Austin, which has a population size of 75,000 and basically its own city. An on site clinic is a practical measure since it's convenient and handles the simple stuff[1] for the campus body while deferring to specialists or hospitals for more complex procedures.

The clinic is paid through mandatory fees and thus "free". By comparison, visiting another clinic or doctor is less convenient and has a $10-25 copay (more if you don't have insurance).

> Sexual harassment is indeed a problem, here as well, but again I wonder why not go to the police? At least here, it's a criminal offense.

It is a criminal offense, but there is a lot of emotional fallout that the police aren't prepared to handle. Mental health and counseling services are supposed to help victims in these situations, not push them out.

[1]: List of services on page 4 (PDF): http://healthyhorns.utexas.edu/IMAGES/pdf/UHS%20Information%...

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Thank you for the response. Your comment and other ones indeed explain the matter - some colleges are basically their own cities, located near a small town.

My own conclusions from this appalling story are:

1. If you're at a U.S. university and are experiencing mental difficulties - just pay the 25$ copay and see someone outside the university. Had the OP done that, Yale would have probably had no clue what was going on. Maybe someone would notice she's missing classes, maybe not even that.

2. Don't get committed. If you need to, see a therapist on your time and on your own dime. They likely won't order you to take off your underwear, spread your legs, then hop up and down to make sure nothing was hidden “up there".

To not get committed, one would have to lie about hurting oneself (which might not have been possible in this case given the visible injury). Not foolproof, but to not get committed, one should keep these thoughts to oneself. Even a trusted doctor is likely to commit one. This decision still lies purely with the doctor. The _only_ surefire way to not get committed is to not see anyone who doesn't have your best interests in mind and that includes all medical and social professions. Sad indeed.

Yes, sounds like a serious dilemma - try to get help, and you risk being committed. I have a feeling that private psychiatrists know they face a repeat game with a patient they shipped to such horrendous treatment at a ward, and thus have their finger resting much easier on the trigger. But as you said, nothing here is foolproof.

I wouldn't doubt that. Psychiatrists play some horrific games with their patients that border on criminal (and likely should be criminal). These days, a patient that is difficult is simply dealt with in the simplest possible way: drugs. If that one size fits all solution should cause problems or not work, I wouldn't put it past any psychiatrist to commit their difficult patients, especially ones with a history of problems. Most of the time, they won't even bother with a diagnosis, even after years of prescribing medicine. In many ways, it's quite scary, and undoubtedly people that need the help are not getting it while people that don't are being drugged and strung on for the psychiatrist's profit.

Depends on the institution. MIT is incredibly committed to trying to get anyone admitted to graduate, and apparently that includes a lot of free psych services. I know students who dropped out for years and subsequently continued by simply registering and paying tuition.

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