Charting the Course: Charting the Course: Accommodating Students Accommodating Students

with Psychiatric with Psychiatric DisabilitiesDisabilities

Pat Bunge, LPCPat Bunge, LPC

disAbility Access ServicesdisAbility Access Services

Guilford Technical Community Guilford Technical Community CollegeCollege

Postsecondary Students Postsecondary Students with Disabilitieswith Disabilities

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

Laws Requiring Reasonable Laws Requiring Reasonable AccommodationsAccommodations

• 1973 Rehabilitation Act, Section 5041973 Rehabilitation Act, Section 504

• 1990 Americans with Disabilities Act 1990 Americans with Disabilities Act

What is a Mental Illness?What is a Mental Illness?

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

How One Might Recognize How One Might Recognize Signs of Mental Illness on Signs of Mental Illness on CampusCampus

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

Symptoms of a Mental Symptoms of a Mental Health ProblemHealth Problem

• Chronically missing classChronically missing class

• Assignments consistently lateAssignments consistently late

• Extreme highs or lows in moodExtreme highs or lows in mood

• AnxietiesAnxieties

• Problem concentrating or rememberingProblem concentrating or remembering

• Marked personality changeMarked personality change

• Confused or disorganized thinkingConfused or disorganized thinking

• Thinking or talking about suicideThinking or talking about suicide

• Denial of obvious problemsDenial of obvious problems

Major DepressionMajor Depression

• Mood disorder Mood disorder

• Depressed mood over long period of Depressed mood over long period of timetime

• Lack of pleasure in activitiesLack of pleasure in activities

• Thoughts of suicideThoughts of suicide

• Sleep and appetite changesSleep and appetite changes

• Low self- esteemLow self- esteem

• Feeling guilty and/or worthlessFeeling guilty and/or worthless

Bipolar Affective DisorderBipolar Affective Disorder

• Previously known as Manic Previously known as Manic Depressive DisorderDepressive Disorder

• Mood disorderMood disorder• Revolving periods of mania and Revolving periods of mania and

depressiondepression• Either grandiose, euphoric, highly Either grandiose, euphoric, highly

productive/creative, or depressed, productive/creative, or depressed, withdrawn, hopelesswithdrawn, hopeless

Posttraumatic Stress Posttraumatic Stress DisorderDisorder

• Anxiety DisorderAnxiety Disorder

• Exposure to traumatic eventExposure to traumatic event

• FlashbacksFlashbacks

• DissociationDissociation

Borderline Personality Borderline Personality DisorderDisorder

• Combined mood and thought disorderCombined mood and thought disorder

• Biological and environmental factorsBiological and environmental factors

• Mood fluctuationsMood fluctuations

• Low self- esteem, insecurities, distrustLow self- esteem, insecurities, distrust

• Perceptual distortions, dissociationsPerceptual distortions, dissociations

• Difficulty with relationshipsDifficulty with relationships

• Limited coping skillsLimited coping skills

SchizophreniaSchizophrenia

• Thought DisorderThought Disorder

• Delusions, hallucinations, paranoiaDelusions, hallucinations, paranoia

• Difficulty with daily functional tasksDifficulty with daily functional tasks

• Poor interpersonal relationshipsPoor interpersonal relationships

• Concrete thought processing Concrete thought processing

• Need for structured routineNeed for structured routine

Anxiety DisordersAnxiety Disorders• Generalized Anxiety DisorderGeneralized Anxiety Disorder

– Excessive worry in generalExcessive worry in general

• Obsessive-Compulsive DisorderObsessive-Compulsive Disorder– Consuming fixation and ritualistic Consuming fixation and ritualistic

behaviorsbehaviors

• Panic DisorderPanic Disorder– Overwhelming physiological eventOverwhelming physiological event

•Social PhobiasSocial Phobias– Incapacitating fear of social Incapacitating fear of social

interactionsinteractions

•Specific PhobiasSpecific Phobias– Intense fear of specific object ; eventIntense fear of specific object ; event

For more information about specific For more information about specific disabilities, contact:disabilities, contact:

NC Alliance for the Mentally IllNC Alliance for the Mentally Ill

4904 Waters Edge Drive, Suite 1524904 Waters Edge Drive, Suite 152

Raleigh, NC 27606Raleigh, NC 27606

800-451-9682800-451-9682

Conditions excluded from Conditions excluded from coverage under ADAcoverage under ADA

• TransvestismTransvestism• TransexualismTransexualism• PedophiliaPedophilia• VoyeurismVoyeurism• Gender identity disordersGender identity disorders• Compulsive gamblingCompulsive gambling• KleptomaniaKleptomania• PyromaniaPyromania

Medication Side EffectsMedication Side Effects

• DrowsinessDrowsiness

• FatigueFatigue

• Excessive thirstExcessive thirst

• Blurred visionBlurred vision

• Hand tremorsHand tremors

• Initiating interpersonal contactInitiating interpersonal contact

• ConcentrationConcentration

Functional LimitationsFunctional Limitations

• Screening out environmental stimuliScreening out environmental stimuli

• Sustaining concentrationSustaining concentration

• Maintaining staminaMaintaining stamina

• Handling time pressures and multi-Handling time pressures and multi-taskstasks

• Interacting with othersInteracting with others

• Fear of authority figuresFear of authority figures

• Responding to negative feedbackResponding to negative feedback

• Responding to changeResponding to change

• Severe test anxietySevere test anxiety

Strategies for Inclusion in Strategies for Inclusion in CollegeCollege

• Teach to various learning styles--Teach to various learning styles--visual, visual, auditory, kinestheticauditory, kinesthetic

• Increase experiential learning activitiesIncrease experiential learning activities

• Increase knowledge and acceptance of Increase knowledge and acceptance of mental illnessmental illness

• Be prepared to set behavioral limitsBe prepared to set behavioral limits

• Know campus mental health resourcesKnow campus mental health resources

• Work cooperatively with studentsWork cooperatively with students

• Assist students with time managementAssist students with time management

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

Principles of Principles of AccommodationAccommodation

• Address individual needsAddress individual needs

• Respect student’s desire for Respect student’s desire for confidentialityconfidentiality

• Engage in joint problem solvingEngage in joint problem solving

• Make all accommodations voluntaryMake all accommodations voluntary

• Review accommodations periodicallyReview accommodations periodically

• Be flexible in enforcing policiesBe flexible in enforcing policies

• Identify accommodations clearlyIdentify accommodations clearly

Accommodations are NOT Accommodations are NOT Reasonable if they...Reasonable if they...

• Pose a direct threat to the health or Pose a direct threat to the health or safety of otherssafety of others

• Make substantial change in essential Make substantial change in essential elements of the curriculumelements of the curriculum

• Require substantial alteration in Require substantial alteration in educational opportunities or course educational opportunities or course objectivesobjectives

• Pose undue financial or administrative Pose undue financial or administrative burdenburden

Possible Classroom Possible Classroom AccommodationsAccommodations

• Preferential seating, near doorPreferential seating, near door

• Beverages permittedBeverages permitted

• Prearranged or frequent breaksPrearranged or frequent breaks

• Tape recorder, note takerTape recorder, note taker

• Early availability of syllabus, textEarly availability of syllabus, text

• Text, assignments in alternate Text, assignments in alternate formatsformats

• Personal and private feedbackPersonal and private feedback

Possible Examination Possible Examination AccommodationsAccommodations

• Change in test format Change in test format – (Written to oral and vise versa, dictation, (Written to oral and vise versa, dictation,

scripted, typed)scripted, typed)

• Permit use of computer software Permit use of computer software

• Exams in alternate format; portfolio, Exams in alternate format; portfolio, demonstationsdemonstations

• Extended test taking timeExtended test taking time

• Individual proctoringIndividual proctoring

• Separate, quiet room for testingSeparate, quiet room for testing

• Increased test frequencyIncreased test frequency

Possible Assignment Possible Assignment AccommodationsAccommodations

• Substitute assignments in specific Substitute assignments in specific circumstancescircumstances

• Advance notice of assignmentsAdvance notice of assignments

• Allow assignments hand -writtenAllow assignments hand -written

• Written rather than oral, or vise versaWritten rather than oral, or vise versa

• Change format: drama, role-play, Change format: drama, role-play, sculpturesculpture

• Assignment assistance--askAssignment assistance--ask

• Extensions on assignmentsExtensions on assignments

The Myths of Mental IllnessThe Myths of Mental Illness

• People with mental illness are dangerousPeople with mental illness are dangerous

• People with psychiatric disabilities are People with psychiatric disabilities are unpredictable, and can go “berserk” at unpredictable, and can go “berserk” at any timeany time

• People recovering from mental illness People recovering from mental illness can work at low level jobs, but are not can work at low level jobs, but are not suited to be in college, and probably will suited to be in college, and probably will never hold responsible positionsnever hold responsible positions

The Myths of Mental Illness The Myths of Mental Illness cont..cont..

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

Create an environment of Create an environment of trust and confidentiality trust and confidentiality that allows the person to that allows the person to

feel comfortable feel comfortable discussing his or her discussing his or her

condition.condition.

ResourcesResources

• American Psychiatric AssociationAmerican Psychiatric Association

• American Psychological AssociationAmerican Psychological Association

• Mental health info SourceMental health info Source

• National Alliance for the Mentally ill National Alliance for the Mentally ill (NAMI)(NAMI)

• National Institute of Mental HealthNational Institute of Mental Health

• National Mental Health AssociationNational Mental Health Association

• Washington Advocates for the Washington Advocates for the Mentally Ill (WAMI)Mentally Ill (WAMI)

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