The other side of the room

Objective: When college students return to campus housing following psychiatric hospitalization, institutional policies appropriately focus on the returning student, but one stakeholder is systematically overlooked: the roommate. This review examines the evidence gap surrounding roommate impact, analyzes the ethical tensions in current approaches, and proposes policy recommendations. Methods: A scoping review conducted in accordance with PRISMA-ScR. Searches of PubMed, PsycINFO, ERIC, Google Scholar, and ProQuest Dissertations & Theses Global (2000 to 2025) were supplemented by gray literature from professional and advocacy organizations, two litigation settlement agreements, and medical leave of absence policies at six U.S. research universities. Evidence was synthesized narratively across four domains: clinical and post-discharge risk, institutional policy, legal and ethical frameworks, and secondary traumatic stress. Results: No published research examines the psychological, academic, or safety implications for roommates. Current legal frameworks and all reviewed institutional policies prioritize privacy protection and disability accommodation for the returning student while treating the roommate as an externality; no policy contains any roommate provision. Adjacent evidence on secondary traumatic stress in resident assistants and student affairs professionals suggests plausible harm to roommates. Conclusions: Truly student-centered policies must acknowledge that both students have needs and that the roommate relationship is a clinical variable affecting recovery, academic performance, and retention for both. Recommendations address proactive roommate support, functional information sharing within privacy constraints, genuine choice architecture for housing decisions, and institutional acknowledgment of the burden placed on uninvolved roommates.