How Colleges Can Better Accommodate Students with Depression

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How Colleges Can Better Accommodate Students with
Depression

• Kim Collins, Ph.D.
• Division of Rehabilitation Education Services
• University of Illinois

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Accessibility

• Operationally, most often discussed within the
  context of actions which society MUST take in
  order to PROVIDE equal benefits, opportunities
  and access to persons with disabilities
• Legal compliance
• Compulsory
• Focuses on minimum requirements (which may meet
  the legal obligation and not serve the student,
  e.g., bus lifts)
• Reinforces an accommodation philosophy of Say NO
  when we can, and yes when we have to.

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Best Case Practice

• Pertains to actions taken by society in order to
  take full advantage of every individuals
  capacity to contribute
• Focuses upon the societal benefit of action
  rather than obligatory standards
• Reinforces an accommodation philosophy of Say
  YES when we can, and no when we have to.
• Directs attention away from stereotypical
  perceptions related to limitations and towards
  abilities

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Why UIUC is different?

• First provider of services to students with
  disabilities in the world 1948
• Already had effective system in place for
  students with physical disabilities, then
  cognitive disabilities, and now psychiatric
  disabilities
• Has an excellent reputation on campus and support
  of the Chancellors and Provosts office

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Post Secondary Disability Statistics

• In 1994, 9.2 of college freshmen reported
  disabilities, as compared to 2.6 in 1978
• Largest growth has been in the number of students
  with cognitive and psychiatric disabilities
• UIUC disability statistics
• Approximately 1 percent of the total population
• Cognitive and psychiatric disabilities comprise
  62 of the students with disabilities registered
  at DRES

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(No Transcript)
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Data by Category Fall, 2002

• Disabled Students 611
• Psychiatric Cognitive subtotal 382
• Learning Disability 159
• ADHD 119
• Acquired Brain Trauma 14
• Aspergers/Autism 5
• Depression 33
• Anxiety 25
• Bipolar Disorder 12
• Schizophrenia/Schizoaffective 15

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Post-secondary Legal Requirements

• Section 504 of the Rehabilitation Act of 1973
• No otherwise qualified person with a disability
  in the United States shall solely by reason of
  disability be excluded from the participation in,
  be denied the benefits of, or be subjected to
  discrimination under any program or activity
  receiving federal financial assistance.

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ADA Definition of Disability

• A person with a disability is anyone with a
  physical or mental impairment that substantially
  limits one or more major life activity
  including learning

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ADA definition of mental impairment

• Any mental or psychological disorder, including
  major depression, bipolar disorder, anxiety
  disorders, psychotic disorders and specific
  learning disorders (Adapted from EEOC enforcement
  guidelines)

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Disorder vs. Disability

• Many students experience psychological distress
  or have a psychological disorder (such as Major
  Depression or Panic Disorder), but do not have a
  psychiatric disability because the condition does
  not result in a substantial limitation to a major
  life activity. The disorder must also meet
  severity and duration criteria as determined by a
  medical provider.

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Post-Secondary Students Rights

• Equal access to courses, programs, services,
  activities and facilities
• Equal opportunity to learn
• Access to reasonable accommodations, academic
  adjustments and auxiliary aids
• Appropriate confidentiality

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Post-Secondary Students Responsibilities

• Meet qualifications
• Maintain essential institutional standards
• Disclose the fact that he/she has a disability
• Provide necessary documentation
• Request reasonable accommodations utilizing
  published UIUC procedures

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Accommodation Denial Criteria

• Undue Hardship
• Direct Threat
• Disability has been observed to pose a
  substantial risk of danger to individual or
  others
• Substantial or fundamental alteration of the
  content or methodology of a course or curriculum

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Mitigating Measures

• Medications do not always manage all symptoms
  therefore, accommodations are still necessary to
  address functional limitations
• If a mitigating measure such as medication does
  resolve the functional limitations, then a
  disability does not exist under the ADA and
  accommodations are no longer available.

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UIUC Disability Services for Students with
Psychiatric Disabilities

• Clinical psychologist as coordinator/case manager
• Academic accommodations
• Advocacy
• Neuropsychological Testing
• Coaching
• Support groups/Community Referrals

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Clinical Psychologist/Mental Health Service
Provider

• Better access to other mental health agencies to
  coordinate services
• Better understanding of psychiatric disabilities
• More confident/capable in interacting with
  students with psychiatric disabilities
• Ability to supervise clin psych or counseling
  psych practicum students

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Academic Accommodations

• Nonexaustive list of typical accommodations
• Priority registration
• Extended time on exams
• Take exams in a distraction-reduced environment
• Not being penalized for missing class/assignments
  due to exacerbation
• Substitutions and extensions
• Note taking assistance

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Advocacy

• Provide support to student
• Help reduce stigma on campus
• Safe place for student to discuss problems and
  make decisions

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Neuropsychological Testing

• Free to UIUC students experiencing academic
  difficulties with no prior diagnoses
• Diagnose, Refer for services
• Dramatic results, students going from probation
  to Deans list in one semester

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Academic Coaching

• Monthly, Biweekly, Weekly, Twice per week
• In-person, phone, email
• Organizational strategies, structure, short-term
  and long-range planning
• Provides external structures/supports to help
  students stay on track

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Support Groups/Referrals

• Provide support and increase social interactions
  of students with psychiatric disabilities
• Referrals to providers in the community for
  long-term individual therapy

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Barriers/Solutions

• Stigma regarding psychiatric disabilities/Advocacy
  , Education to include in-services, literature,
  one-on-one interaction, Mentality
• Overall campus philosophy of diversity/Has to
  come from the Chancellor on down, disability must
  be included in diversity issues and must be a
  priority for campus
• Counseling center supports and services/Build
  relationships, Continue to work with to seek
  answers, Creative solutions to stop gaps in
  services

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Barriers/Solutions

• Relationships between hospital psych units,
  community referrals, and disability services
  offices/Phone calls, visits, contacts, make aware
  of services
• Referral follow-up/Implement a follow-up program,
  Referral source of community providers
• Getting lost in the system/Monthly checks,
  midgrade reports for freshmen, grade reports

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Case Examples Gloria and Jack

• Academic accommodations
• Referrals community mental health agency vs.
  counseling center/campus mental health for
  psychiatrist and individual therapy
• Confidentiality regarding professors
• Atmosphere of positive regard
• Support Services