Increasing numbers of students are enrolling in postsecondary institutions who report having a mental illness. Recent increases in the size of this group are due in part to improved medications that result in symptoms mild enough for them to enjoy the benefits and meet the challenges of postsecondary education. Students with psychiatric disabilities are entitled to reasonable academic accommodations as provided by the American Disabilities Act (ADA) of 1990 and 2008 amendments. Providing effective accommodations allows students equal access to academic courses and activities.
"Mental illness" refers to the collection of all diagnosable mental disorders causing severe disturbances in thinking, feeling, relating, and functional behaviors. It can result in a substantially diminished capacity to cope with the demands of daily life.
A mental illness is a hidden disability; it is rarely apparent to others. However, students with mental illness may experience symptoms that interfere with their educational goals and that create a "psychiatric disability." These symptoms may include, yet are not limited to:
A student with a mental illness may have one or more of the following psychiatric diagnoses (American Psychiatric Association, 1994).
Depression. This is a mood disorder that can begin at any age. Major depression may be characterized by a depressed mood most of each day, a lack of pleasure in previously enjoyed activities, thoughts of suicide, insomnia, and consistent feelings of worthlessness or guilt.
Bipolar affective disorder (BAD, previously called manic depressive disorder). BAD is a mood disorder with revolving periods of mania and depression. In the manic phase, a person might experience inflated self-esteem, high work and creative productivity, and decreased need to sleep. In the depressed phase, the person would experience the symptoms of depression (see above).
Borderline personality disorder (BPD). BPD is a personality disorder which includes both mood disorder and thought disorder symptoms. This diagnosis has both biological and environmental determinants. Individuals diagnosed with BPD may have experienced childhood abuse and family dysfunction. They may experience mood fluctuations, insecurities and mistrust, distortion of perceptions, dissociations, difficulty with interpersonal relationships, and limited coping skills.
Schizophrenia. This is a mental disorder that can cause a person to experience difficulty with activities of daily living and possibly delusions, hallucinations, and paranoia. Schizophrenic individuals typically demonstrate concrete thought processing and appreciate structure and routines.
Anxiety disorders. These are mood disorders in which the individual responds to thoughts, situations, environments, or people with fear and anxiety. Anxiety symptoms can disrupt a person's ability to concentrate and focus on tasks at hand. Symptoms may be in response to real or imagined fears. Specific anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, social and specific phobias, and post-traumatic stress disorder (PTSD).
Autism Spectrum Disorders (ASD). Autism is a Pervasive Developmental Disorder. Pervasive Developmental Disorders are characterized by severe and pervasive impairments in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities (DSM-IV-TR, p. 69)
Autism is a “spectrum” and individuals who fall within this label range in abilities as well as in presentation of stereotypical behaviors (Rogers, 2005). Individuals with Asperger's Syndrome are typically considered “high-functioning” on the spectrum.
Examples of stereotypical characteristics of Autism may include:
The Tips for Working with Students with Autism Spectrum Disorder (ASD) document provides specific strategies and suggestions for working with this population of students.
The following functional limitations related to psychiatric disabilities may affect academic performance and may require accommodations (Center for Psychiatric Rehabilitation, 1997).
Students with a history of psychiatric disabilities can be intelligent, sensitive, creative, and interesting. Many will share their background, challenges, and experiences freely and comfortably. For others, disclosure of highly personal information will be more difficult. It is essential that all conversations be kept highly confidential at all times. The following are other strategies that will help in promoting student success:
Some students with mental illness may require accommodations to allow them equal access to classes, programs, and coursework. Students are encouraged to register with the DSS office in order to receive accommodations. The following are typical accommodations and/or strategies that may be helpful for a student with a psychiatric disability.
Source: Adapted from "Academic Accommodations for Students with Psychiatric Disabilities," University of Washington (DO-IT), Seattle, Washington.