Charting the Course: Accommodating Students with Psychiatric Disabilities

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Charting the Course Accommodating Students with
Psychiatric Disabilities

• Pat Bunge, LPC
• disAbility Access Services
• Guilford Technical Community College

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Postsecondary Students with Disabilities

• In a survey of 423,470 postsecondary education
  students, 38,410 identified themselves as having
  a mental illness (National Center for Education
  Statistics, 1999)

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Laws Requiring Reasonable Accommodations

• 1973 Rehabilitation Act, Section 504
• 1990 Americans with Disabilities Act

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What is a Mental Illness?

• Mental illness is a term that refers collectively
  to all diagnosable mental conditions causing
  severe disturbances in thinking, feeling,
  relating, and functional behaviors. These
  conditions result in substantially diminished
  capacity for coping with the ordinary demands of
  life.

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How One Might Recognize Signs of Mental Illness
on Campus

• While a single symptom or isolated event is
  rarely a sign of mental illness, a symptom that
  occurs frequently, lasts for several weeks, or
  becomes a general pattern of an individuals
  behavior may indicate the onset of a more serious
  mental health problem that requires treatment.

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Symptoms of a Mental Health Problem

• Chronically missing class
• Assignments consistently late
• Extreme highs or lows in mood
• Anxieties
• Problem concentrating or remembering
• Marked personality change
• Confused or disorganized thinking
• Thinking or talking about suicide
• Denial of obvious problems

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Major Depression

• Mood disorder
• Depressed mood over long period of time
• Lack of pleasure in activities
• Thoughts of suicide
• Sleep and appetite changes
• Low self- esteem
• Feeling guilty and/or worthless

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Bipolar Affective Disorder

• Previously known as Manic Depressive Disorder
• Mood disorder
• Revolving periods of mania and depression
• Either grandiose, euphoric, highly
  productive/creative, or depressed, withdrawn,
  hopeless

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Posttraumatic Stress Disorder

• Anxiety Disorder
• Exposure to traumatic event
• Flashbacks
• Dissociation

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Borderline Personality Disorder

• Combined mood and thought disorder
• Biological and environmental factors
• Mood fluctuations
• Low self- esteem, insecurities, distrust
• Perceptual distortions, dissociations
• Difficulty with relationships
• Limited coping skills

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Schizophrenia

• Thought Disorder
• Delusions, hallucinations, paranoia
• Difficulty with daily functional tasks
• Poor interpersonal relationships
• Concrete thought processing
• Need for structured routine

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Anxiety Disorders

• Generalized Anxiety Disorder
• Excessive worry in general
• Obsessive-Compulsive Disorder
• Consuming fixation and ritualistic behaviors
• Panic Disorder
• Overwhelming physiological event
• Social Phobias
• Incapacitating fear of social interactions
• Specific Phobias
• Intense fear of specific object event

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• For more information about specific disabilities,
  contact
• NC Alliance for the Mentally Ill
• 4904 Waters Edge Drive, Suite 152
• Raleigh, NC 27606
• 800-451-9682

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Conditions excluded from coverage under ADA

• Transvestism
• Transexualism
• Pedophilia
• Voyeurism
• Gender identity disorders
• Compulsive gambling
• Kleptomania
• Pyromania

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Medication Side Effects

• Drowsiness
• Fatigue
• Excessive thirst
• Blurred vision
• Hand tremors
• Initiating interpersonal contact
• Concentration

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Functional Limitations

• Screening out environmental stimuli
• Sustaining concentration
• Maintaining stamina
• Handling time pressures and multi-tasks
• Interacting with others
• Fear of authority figures
• Responding to negative feedback
• Responding to change
• Severe test anxiety

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Strategies for Inclusion in College

• Teach to various learning styles--visual,
  auditory, kinesthetic
• Increase experiential learning activities
• Increase knowledge and acceptance of mental
  illness
• Be prepared to set behavioral limits
• Know campus mental health resources
• Work cooperatively with students
• Assist students with time management

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• Reasonable accommodation by definition is the
  removal of barriers to participation .

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Principles of Accommodation

• Address individual needs
• Respect students desire for confidentiality
• Engage in joint problem solving
• Make all accommodations voluntary
• Review accommodations periodically
• Be flexible in enforcing policies
• Identify accommodations clearly

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Accommodations are NOT Reasonable if they...

• Pose a direct threat to the health or safety of
  others
• Make substantial change in essential elements of
  the curriculum
• Require substantial alteration in educational
  opportunities or course objectives
• Pose undue financial or administrative burden

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Possible Classroom Accommodations

• Preferential seating, near door
• Beverages permitted
• Prearranged or frequent breaks
• Tape recorder, note taker
• Early availability of syllabus, text
• Text, assignments in alternate formats
• Personal and private feedback

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Possible Examination Accommodations

• Change in test format
• (Written to oral and vise versa, dictation,
  scripted, typed)
• Permit use of computer software
• Exams in alternate format portfolio,
  demonstations
• Extended test taking time
• Individual proctoring
• Separate, quiet room for testing
• Increased test frequency

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Possible Assignment Accommodations

• Substitute assignments in specific circumstances
• Advance notice of assignments
• Allow assignments hand -written
• Written rather than oral, or vise versa
• Change format drama, role-play, sculpture
• Assignment assistance--ask
• Extensions on assignments

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The Myths of Mental Illness

• People with mental illness are dangerous
• People with psychiatric disabilities are
  unpredictable, and can go berserk at any time
• People recovering from mental illness can work at
  low level jobs, but are not suited to be in
  college, and probably will never hold responsible
  positions

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The Myths of Mental Illness cont..

• When you learn that a person has a mental
  illness, you have learned the most significant
  thing about his or her personality

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Create an environment of trust and
confidentiality that allows the person to feel
comfortable discussing his or her condition.
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Resources

• American Psychiatric Association
• American Psychological Association
• Mental health info Source
• National Alliance for the Mentally ill (NAMI)
• National Institute of Mental Health
• National Mental Health Association
• Washington Advocates for the Mentally Ill (WAMI)

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• Mental Illness. The Way We Treat It Is Insane.