Massachusetts Court Holds That Harvard College Satisfied Its Duty To Prevent A Student's Suicide
Student mental health continues to be a “top-of-mind” issue on campuses across the country. As a critical step in risk management, educational institutions are advised to consider carefully their evolving legal responsibility with respect to supporting students with mental health issues. A recent Massachusetts court decision provides insight into the obligation of educational institutions to prevent student suicide and the limits of this obligation.
On December 20, 2022, in Tang v. Harvard College, a Massachusetts judge granted Harvard’s motion for summary judgment and dismissed the plaintiff’s claims that Harvard and its employees were negligent in failing to prevent a student suicide. By doing so, the trial court found that Harvard satisfied its limited duty to take “reasonable measures” to prevent the suicide.
Background: Supreme Judicial Court Decision In Nguyen v. MIT
In the landmark 2018 decision, Nguyen v. MIT, the Massachusetts Supreme Judicial Court (“SJC”) held that universities have a special relationship with their students such that when a university (1) has “actual knowledge” of a student’s suicide attempt that occurred while the student is enrolled at the university or recently before matriculation, or (2) is aware of a student’s stated plans or intention to complete suicide, the university has a duty to take “reasonable measures to protect the student from self-harm.” The Nguyen decision further stated that a university may satisfy this legal duty of care by (1) initiating the university’s suicide prevention protocol; (2) if the university has no such protocol, arranging for clinical care by trained medical professionals; or (3) if such care is refused, alerting the student’s emergency contact. In reaching this decision, the SJC noted that universities are “not responsible for monitoring and controlling all aspects of [graduate] students’ lives,” and the “modern university-student relationship is respectful of student autonomy and privacy.” In this sense, Nguyen found that the relationship between a university and a young adult student is not akin to an in loco parentis relationship (i.e., the relationship between a parent and a child). Therefore, while a university owes a duty of care to its students, the duty is a more limited than the duty a parent owes to a child.
Ruling In Tang v. Harvard College
In 2018, the estate of a deceased student who died by suicide brought suit against Harvard, two of its employees, and one former employee, alleging that the defendants were negligent in failing to prevent the student’s suicide. After discovery, the defendants filed a motion for summary judgment, which the trial court ultimately granted.
According to the undisputed statement of facts, Luke Tang (“Tang”), the deceased former student, enrolled in Harvard as a first-year student in September 2014. In his Initial Medical Questionnaire, completed prior to his enrollment, the student did not indicate that he suffered from any mental health condition. The student’s father, who was a licensed physician and completed the physician portion of the questionnaire for his child, indicated that his son did not have a history of mental health conditions.
In early spring 2015, Tang informed a licensed psychologist at Harvard University Health Services (“HUHS”) that he had attempted suicide two weeks before. However, Tang did not report any then-current suicidal ideations. The next day, Tang told an HUHS licensed social worker that he had, in fact, attempted suicide on two separate occasions on the same day. In response to this report, HUHS arranged for Tang to be admitted to a hospital and informed his father of this decision. During his one-week hospital stay, Tang regularly met with a social worker and his treating psychiatrist. Tang consistently denied that he was suicidal to these medical professionals. Meanwhile, a Resident Dean of Freshmen and a case manager closely monitored Tang’s progress at the hospital. After a one-week hospital stay, Tang was cleared to return to school and released from care. At that time, Tang did not report any signs or symptoms of major depression and affirmed that he was no longer suicidal.
Following his release from in-patient treatment, Tang agreed to be placed on a “care contract,” which conditioned his continued enrollment at Harvard and residence on campus on Tang agreeing to seek outside psychiatric therapy. Harvard also assigned a case manager to meet with Tang to provide access to resources, discuss his discharge plan, and be a point of contact for the university. During the remainder of the 2014-2015 academic year, Tang met separately with both the Resident Dean of Freshmen and the case manager on three separate occasions. During these meetings, Tang shared that he was continuing to attend his outside therapy sessions, but that he did not feel a connection with his therapist. He finished the academic year with strong grades and spent the summer in China.
In late August 2015, Tang returned to Harvard, where he resumed his participation in various academic and volunteer activities. The Resident Dean of Tang’s new residence hall had previously been made aware of Tang’s prior suicide attempts and the care contract. As such, the Resident Dean took steps to monitor Tang. In early September 2015, the Resident Dean reminded Tang of his continued obligation to engage in outside therapy and of the possible consequences for failing to do so. The student told the Resident Dean that his suicide attempts were an aberration and that he would obtain a new outside therapist. Approximately one week later, Tang took his own life in his residence hall.
The Court’s Grant Of Summary Judgment
The Massachusetts court granted summary judgment for the defendants because Harvard proffered facts showing that it satisfied the duty it owed to the student.
The court found that Harvard owed a limited duty of care to Tang because he disclosed his attempted suicide to an HUHS psychologist in April 2015. Furthermore, the court found that Harvard satisfied its narrow duty to take “reasonable measures to protect the student from self-harm.” In reaching this conclusion, the court acknowledged the following steps the defendants had taken to protect Tang:
- After the student’s disclosure about his suicide attempt, the HUHS’s licensed psychiatrist confirmed with the student that he did not have any future suicidal plans and made arrangements for him to be seen by HUHS’s staff;
- A licensed social worker spoke with the student and arranged for the student’s admission to a hospital for an intensive evaluation in a secure setting; and
- After the student’s release from the hospital, Harvard made efforts to get the student to follow his treating physician’s recommendation to seek outside therapy, including requiring the student to enter into a “care contract.”
The court further noted that the social worker notified Tang’s father of Tang’s suicide attempt and hospital admission. The court deemed these measures to be “precisely what the Court in Nguyen described as [‘]reasonable measures[’] by which [‘]a university satisfies its duty.[’]”
Significantly, the court emphasized that a university’s limited duty “in this context is time-bound.” In particular, after the student’s release from the hospital in April 2015, Tang did not report any new suicide attempts or suicidal ideations and no third parties (including his medical providers) reported any suicide-related concerns about Tang to the university. Therefore, the court found that Harvard did not have a newly triggered duty to undertake the measures required by Nguyen.
The court expressly rejected the plaintiff’s assertion that the limited duty in Nguyen continues until either (1) a student no longer needs clinical care according to a qualified medical professional or (2) a student graduates. In doing so, the court reiterated the SJC’s holding in Nguyen that universities must respect an adult student’s privacy and autonomy in most circumstances and “rely in all but emergency situations on the student’s own capacity and desire to seek professional help.” The court further held that universities do not have an ongoing duty to monitor a student and determine what course of care may be needed to guard against a future suicide. Moreover, the court held that the “care contract” entered into between the student and Harvard did not impose an obligation on the university to render any services to the student, but rather set forth the ground rules that the student was required to follow in order to remain enrolled at the university. Therefore, the court found that Harvard did not have an indefinite duty to prevent a student’s suicide.
Implications For Independent Schools
The Tang and Nguyen decisions consider the nature of the duty owed to university students who are or may be at risk of suicide. However, these decisions offer insight into how courts may define the duty other types of educational institutions may owe to students.
Specifically, in analyzing the limited nature of the duty owed in the post-secondary context, both decisions reference the fact that the students involved are adults. By contrast, the overwhelming majority of independent school students are minors, typically considered to be a more vulnerable population. So it is very well possible that courts would hold that independent schools to a heightened duty of care as compared to the duty outlined in Tang and Nguyen. In addition, courts might also consider the type of program offered by the school and whether the school is a residential or day school. The more an educational institution is serving in loco parentis, the more likely a court may be to find that the school owes a heightened duty of care owed to its students.
Given the evolving legal responsibility and the primary goal of protecting students, we recommend independent schools and other educational institutions consider auditing their policies and practices regarding the following issues, involving experienced legal and mental health professionals, as appropriate:
- Student medical leaves.
- Counseling services (including identifying mental health resources available on and off campus and advising students and their families of these resources).
- Privacy policies and policies regarding how health information is shared among employees responsible for supporting students emotionally and socially.
- Health forms, including any questions about suicide and self-harm risk and policies about the type of medical providers who can complete these forms (e.g., whether to allow forms to be signed by a physician who is also an immediate family member (as in Tang)).
- Suicide prevention and response protocols.
- Protocol for a return to school from a mental health leave.
- Protocols for communicating with outside professionals regarding mental health issues.
- Health and wellness curricula for students.
- Professional development programming for school employees, including student care teams and residential life staff.
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Please contact a member of the Firm’s education practice group if you have questions about any of these issues or if we can be of assistance.