How Colleges Can Better Accommodate Students with Depression

Kim Collins, Ph.D.Division of Rehabilitation

Education Services University of Illinois

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.”

Best Case Practice Pertains to actions taken by society in

order to take full advantage of every individual’s 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

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 Chancellor’s and Provost’s office

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

Students Registered with DRES by Disability Type (1966-2001) Data Series 1

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Year

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PsychTBIADHDLDDeaf/HOHBlind/Low VisionMobility/Systemic

Data by Category: Fall, 2002 Disabled Students 611

Psychiatric Cognitive subtotal 382 Learning Disability 159 ADHD 119 Acquired Brain Trauma 14 Asperger’s/Autism 5 Depression 33 Anxiety 25 Bipolar Disorder 12 Schizophrenia/Schizoaffective 15

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.

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”

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)

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.

Post-Secondary Student’s 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

Post-Secondary Student’s 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

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

“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.

UIUC Disability Services for Students with Psychiatric Disabilities Clinical psychologist as

coordinator/case manager Academic accommodations Advocacy Neuropsychological Testing Coaching Support groups/Community Referrals

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

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

Advocacy Provide support to student Help reduce stigma on campus Safe place for student to discuss

problems and make decisions

Neuropsychological Testing Free to UIUC students experiencing

academic difficulties with no prior diagnoses

Diagnose, Refer for services Dramatic results, students going

from probation to Dean’s list in one semester

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

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

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

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

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