1. Charting the Course: Accommodating Students with Psychiatric Disabilities Pat Bunge, LPC disAbility Access Services Guilford Technical Community College

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

3. Laws Requiring Reasonable Accommodations 1973 Rehabilitation Act, Section 504 1973 Rehabilitation Act, Section 504 1990 Americans with Disabilities Act 1990 Americans with Disabilities Act

4. 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. 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.

5. 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. 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.

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

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

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Revolving periods of mania and depression Either grandiose, euphoric, highly productive/creative, or depressed, withdrawn, hopeless Either grandiose, euphoric, highly productive/creative, or depressed, withdrawn, hopeless

9. Posttraumatic Stress Disorder Anxiety Disorder Anxiety Disorder Exposure to traumatic event Exposure to traumatic event Flashbacks Flashbacks Dissociation Dissociation

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

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

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

13. 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

14. Conditions excluded from coverage under ADA Transvestism Transvestism Transexualism Transexualism Pedophilia Pedophilia Voyeurism Voyeurism Gender identity disorders Gender identity disorders Compulsive gambling Compulsive gambling Kleptomania Kleptomania Pyromania Pyromania

15. Medication Side Effects Drowsiness Drowsiness Fatigue Fatigue Excessive thirst Excessive thirst Blurred vision Blurred vision Hand tremors Hand tremors Initiating interpersonal contact Initiating interpersonal contact Concentration Concentration

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

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

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

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

20. Accommodations are NOT Reasonable if they... Pose a direct threat to the health or safety of others Pose a direct threat to the health or safety of others Make substantial change in essential elements of the curriculum Make substantial change in essential elements of the curriculum Require substantial alteration in educational opportunities or course objectives Require substantial alteration in educational opportunities or course objectives Pose undue financial or administrative burden Pose undue financial or administrative burden

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

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

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

24. The Myths of Mental Illness People with mental illness are dangerous People with mental illness are dangerous People with psychiatric disabilities are unpredictable, and can go berserk at any time 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 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

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

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

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

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