I Edited Mental Illness Out of My College Applications. I’m Not Alone.

When I applied to college in the 2009-10 school year, I wasn’t worried about my grades or extracurriculars. Instead, I agonized over a dilemma that’s familiar to more students than ever as the Common Application deadline looms: What should I disclose about my mental health?

As I wrote my applications, my past was both my greatest asset and my biggest liability. I’d spent time in foster care and homeless, circumstances that made me attractive to the handful of selective universities that offered full scholarships to low-income students — my only hope at avoiding crushing loans. In an applicant pool filled with squash champions, concert organists and third-generation double legacies, I had my story.

But my experiences also affected me and my academic record in ways that weren’t so appealing: Like approximately 80 percent of current foster youth and many former, I had serious mental health diagnoses, including post-traumatic stress disorder, depression, anxiety and disordered eating. Between ages 13 and 15, I was hospitalized repeatedly. Before being placed in a foster home, I spent nine months in a locked treatment center. I’d attended between four and eight high schools, depending on how you counted. How could I possibly explain all that?

Officially, colleges say that students can share as much about their mental health as feels comfortable. But in practice, it seems clear that schools are nervous about accepting adolescents who divulge psychiatric histories. That perception is reinforced by high-profile lawsuits alleging discrimination against students with mental health disabilities, including an ongoing suit against Yale University and a similar one settled by Stanford University in 2019.

“We have all read the headlines of students on college campuses who have either harmed others or harmed themselves,” said Kat Cohen, a private admissions consultant who helped me, pro bono, with my applications. “These are the things that colleges worry about if they admit someone who is not stable.”

These mixed messages are forcing more and more students to make impossible choices amid a teenage mental health crisis. Should applicants play it safe and conceal their emotional troubles — even when it means leaving low grades and gaps in transcripts unexplained? Or should they tell the truth and risk getting flagged as a liability?

For those with mental health conditions, college admissions are unfairly arduous, an injustice that has long-lasting ramifications for both students and society. Many teenagers with psychological disorders end up at lower-quality schools than they could have attended otherwise, affecting their career options and earning potential. And since elite universities produce a disproportionate number of politicians and managers, society loses out by having fewer people in power who deeply understand mental illness and how it intersects with almost every major issue.

“In the age of Instagram activists, I thought it wouldn’t be as bad,” Jia Suo, a high school senior from Sugarland, Texas, told me about the stigma of mental illness. “But when I got out of my treatment center my junior year, it’s not an exaggeration to say that I lost every single one of my friends.”

After an inpatient program for suicidal ideation (a diagnosis Ms. Suo attributes to normal angst misinterpreted by doctors), she did not receive credit for the classwork she did there. Looking at her grades — C’s and incompletes in a transcript filled with A’s — she figured they must have given her a zero for every missed assignment. She said she reached out to her guidance counselor and homebound teacher but was told it was too late and there was nothing they could do.

Initially, Ms. Suo wanted to explain herself in her college application essay. She wrote a personal statement about how her institutionalization motivated her to study law after meeting girls who had been sex trafficked and boys who languished in the facility for months waiting for foster homes.

But sharing her struggles was risky. A family friend who worked in admissions advised her, “Say you slacked off junior year.” Ms. Suo crossed her dream school, Cornell, off her list and has instead applied to 17 colleges without any explanation for the sudden drop in G.P.A. She resents that her brush with psychiatry will shape what college she attends, but it feels safer to talk about her institutionalization in The New York Times than in her applications. “I’m OK with the whole world knowing about it, but at the same time I just know the stigma they’re going to have at colleges about this.” In three months, when Ms. Suo gets the final acceptances and rejection letters, she’ll know the true impact.

When I applied to college, Ms. Cohen — Dr. Kat, as I and her other clients call her — advised the opposite approach at first. “You have to be extremely explicit,” I remember her warning me. “Otherwise they’ll have no idea how bad things were.” This surprised me. Until that point, the adults around me made me feel like my symptoms were evidence of what was wrong with me, not evidence of what was wrong with my circumstances. Though I was deeply ashamed, when I applied to Yale early I attached a timeline detailing my mom’s hoarding and my overmedication, culminating with me regaining my emotional stability as a scholarship student at boarding school.

I was rejected. My school guidance counselor called Yale’s admissions office and relayed to me that though my grades and test scores were similar to other applicants’, as she put it in an email to me, “regarding the past issues, the list was daunting.” Dr. Kat also queried her network and surmised that Yale wanted to minimize its risk after several high-profile on-campus suicides of college students around the country. “It was just TMI,” she told me — too much information.

A spokeswoman for Yale this month said that she could not discuss my case because admission files are confidential. But she did say, “This account of an admissions decision from over a decade ago is at odds with our admissions practices and philosophy,” adding that Yale’s admissions process is “holistic.”

She continued, “The admissions committee does not discriminate against any applicant for health reasons.”

For my next round of applications, I wrote a simple explanation for why I had changed schools, and thereby excised three years of my life: the diagnoses, the drugs, the self-inflicted scars. I became a parallel person who’d gone through the same things but come out unscathed. I hit “submit,” applying to 10 schools, including Harvard.

While I waited, I lived in fear of being found out. In my dreams, admissions officers interrogated me. They called me a liar and a cheater.

But after three months of nightmares, on April 1, 2010, I got into Harvard.

I screamed when I opened the email; I danced in the rain. Then guilt fogged the world. Harvard accepted 7 percent of applicants that spring. I felt alternate versions of myself trailing me, fates in which I hadn’t been able to hide my past and it haunted me into adulthood.

I spoke to current and former admissions officers this fall, seeking answers to the question that had mystified me a teenager: How much should students talk about mental health on their college applications? Echoing the advice of other professionals, Claudia Marroquin, dean of admissions at Bowdoin College,implied that applicants should not feel pressure to disclose. Pressed for more specifics, Ms. Marroquin told me that students “have to feel comfortable with what they’re sharing.” This platitude made me seethe with frustration: Even if I was comfortable sharing everything, I suspected that the colleges were not comfortable hearing it. The students I interviewed all sensed there was a line, but few of us were lucky enough to know where it lay.

Only Dr. Kat was willing to speak candidly. In the years since she initially advised me to discuss my struggles in detail, she has realized that this approach may be unwise.

“Without exception,” she said, “reading a personal statement about the applicant’s mental health struggles, that’s going to immediately raise a red flag unless it can really be contextualized as something that the student has triumphed over.”

She emphasized that mental health had to be handled on “a case-by-case basis,” ideally in close consultation with the student’s school guidance counselor.

But that, too, is fraught. At 16, I sought out Dr. Kat’s help because even at a private boarding school, my counselor didn’t have the bandwidth to give me the personal attention I needed. The pro bono services I received would’ve cost more than $16,000 in 2009 dollars. When I spoke to students about their experiences, far greater than the variety of emotional issues was the range in support. Even at Ms. Suo’s affluent suburban school, a single counselor could juggle more than 400 students at a time. Students with less help turn to YouTube gurus and Discord servers where peers workshop their essays.

Favour Osisioma, who immigrated from Nigeria to rural Tennessee at 13, started 2020 on track to attend an elite school. Then Covid hit. She found herself caretaker for her two younger siblings — the three of them remote-learning on one computer while their mom worked 100-hour weeks and Ms. Osisioma worked part-time at McDonald’s. “I felt that it was my job to bring my family out of poverty,” she says. Her grades fell, escalating the anxiety she’d had before the pandemic into paralyzing panic attacks. She remembers an adviser saying, “‘I never expected you to disappoint me in this way.’”

Ms. Osisioma agonized over how to explain this to colleges. “I was trying to get the perfect words,” she says. “But I wasn’t sure anyone would see me and think, ‘This is an attractive package.’” In her senior year, she won a number of accolades, including a prestigious Coca-Cola scholarship. A video crew surprised her at school with a jumbo-size check.

“I remember coming home and putting it down in my room and still crying, because I didn’t know what to say in my applications about the anxiety.” At the time, a single guidance counselor was assisting 800 students with everything from class scheduling to college counseling. Staring at her Yale application, Ms. Osisioma watched the deadline tick past and became so overwhelmed that she couldn’t walk, and felt herself going in and out of consciousness. She had to see a neurologist to rule out seizures. She ended up attending college a year later than planned at the University of Tennessee at Martin. She’s a university scholar there and enjoys her classes but feels a long way from where she hoped she’d be.

Meanwhile, prep schools often employ former admissions officers as counselors, with caseloads closer to 30 students. Jessica Smith, director of college counseling at Westtown School in Pennsylvania, takes pains to protect “students’ private business”: “Even when a psychiatric crisis affects a transcript, there’s a lot I can control about how much it shows up.”

Jaimi Salone, now in their final quarter at Stanford, benefited from this kind of advice while a student at The Blake School in Minneapolis, which they attended on scholarship. In their essay, they wrote frankly about depression, anxiety and shame following their mom’s cancer diagnosis and eventual death — providing context for why they “did not look like what was expected of a Stanford admit,” with a 3.06 G.P.A. and many absences. But at the suggestion of their college counselor, they omitted their sophomore-year hospitalization. “Is it lying to not include?” they wondered. “What is considered an accurate representation of me as a student when I actually do have mental health issues?”

Even after they got in, the stress stayed. “I was worried my admissions would be revoked if other information came out.”

My Harvard application taught me what was acceptable to share and what was not. I sensed that colleges wanted a pristine survivor who was not marred by trauma. At 16, I didn’t realize that it is impossible to emerge from certain hardships unscathed; the perfect overcomer is a fantasy that some young people are coached into creating. This illusion can do great damage: I saw that I was not that person, which caused me deep shame.

Effective admissions policies require grasping how mental illness manifests in different students’ lives. The same crisis that leads to an outpouring of support for a wealthy child might cause a foster youth to be sent to a locked facility, prescribed antipsychotics and forced to change schools. Stigma varies widely across communities, affecting how teenagers view their struggles and what leeway they get from adults. Some kids are far less likely to be diagnosed and treated; others receive superfluous labels and get overmedicated. Understanding these disparities is crucial in the face of worsening adolescent mental health and ever more competitive standards at the colleges that produce an outsize share of leaders.

For a decade, I believed my story was an anomaly, but every year that seems less and less true. There are so many young people unable to hide their crises. We all lose out if this disqualifies them from a better future.

Emi Nietfeld @eminietfeld is the author of a memoir, “Acceptance.”

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: [email protected].

Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.