Journal of Community Medicine & Health Education
Open Access

The increasing recognition of mental health as a core component of student well-being and professional competency has prompted many academic institutions to reevaluate their policies, especially within the structure of experiential education programs. These programs integral to fields such as pharmacy, medicine, social work and allied health immerse students in real-world practice environments, demanding high levels of responsibility, consistency and resilience. Yet, when students face mental health challenges that necessitate absences from these placements, institutional policies often fall short of providing the same flexibility, understanding and legitimacy granted to physical health issues. The absence of clear, equitable and compassionate policies for mental health leave in experiential education is both a systemic gap and an ethical concern that merits critical attention.

Experiential learning is designed to bridge theory with practice, equipping students with the confidence, clinical skills and professional behaviors necessary for licensure and employment. However, the demanding nature of these placements—long hours, emotionally intense patient interactions and often high-stakes performance evaluations—can significantly impact a student’s mental health, particularly when layered on top of pre-existing conditions, financial stress, or lack of support. Unfortunately, many absence policies in experiential education are rigid, often allowing limited excused days for illness and rarely addressing mental health explicitly. In some cases, students are even discouraged from disclosing mental health issues for fear of academic penalization or professional stigma.

This lack of clarity or acknowledgment forces students into a difficult position—choosing between their mental well-being and the risk of academic or professional consequences. For students experiencing depression, anxiety, panic attacks, or trauma-related responses, the pressure to "push through" placements may worsen their condition and undermine both patient safety and the student’s learning experience. Conversely, taking unexcused absences can delay graduation, necessitate repetition of rotations, or result in negative evaluations, all of which can further compound stress and mental health deterioration.

Institutions often cite consistency, accreditation requirements and fairness to preceptors and peers as justifications for maintaining strict absence policies. While these are legitimate concerns, they should not come at the expense of student health. There is a growing body of literature supporting the integration of mental health accommodations into academic policy frameworks, particularly under disability law and human rights standards. Yet experiential education, which operates in a hybrid academic-clinical space, frequently falls into a grey area where neither academic accommodations offices nor clinical sites fully take responsibility. This jurisdictional ambiguity creates confusion and results in inconsistent handling of mental health-related absences.

A major point of contention lies in the documentation and validation of mental health absences. Whereas a doctor’s note for a physical illness is generally accepted without question, students with mental health needs may be subjected to more scrutiny. The requirement for formal psychiatric documentation, often within tight deadlines and from licensed mental health professionals, may be unrealistic given the access barriers and stigma that prevent timely treatment. Institutions must consider whether their documentation demands create unnecessary obstacles or disincentivize students from seeking help.

There is also a growing recognition that mental health challenges are not always episodic or discrete events, but rather chronic conditions that may require ongoing flexibility and support. Policies that define absence allowances as “one-off” exceptions fail to account for students who may require regular time for therapy, medication management, or recovery from intermittent flare-ups. Experiential education programs should therefore explore more nuanced and tiered absence policies that reflect the diverse nature of mental health conditions.

The impact on preceptors and clinical sites also needs to be addressed. Concerns about student reliability and team coverage are valid, but can be mitigated through transparent communication, advance planning and the inclusion of mental health education in preceptor training. Preceptors who understand the importance of mental health and are supported by clear institutional guidelines are more likely to respond with empathy and flexibility rather than frustration. Importantly, fostering this understanding also sets a standard for future healthcare professionals about the importance of mental health in workplace culture.

In conclusion, the absence of clear mental health policies in experiential education undermines the well-being of students and contradicts the broader commitment of health professions to compassionate, patient-centered care. Institutions must recognize that students are not immune to the very conditions they are being trained to treat in others. Mental health must be centered as a legitimate and non-stigmatized reason for absence and policies must be rewritten to reflect this reality. Doing so not only supports student success but also models the values of empathy, resilience and equity that the healthcare professions strive to uphold.