How Colleges Can Better Accommodate Students with Depression

1. How Colleges Can Better Accommodate Students with Depression Kim Collins, Ph.D. Division of Rehabilitation Education Services University of Illinois

2. 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.”

3. 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

4. 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

5. 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

7. 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

8. 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.

9. 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”

10. 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)

11. 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.

12. 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

13. 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

14. 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

15. “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.

16. UIUC Disability Services for Students with Psychiatric Disabilities • Clinical psychologist as coordinator/case manager • Academic accommodations • Advocacy • Neuropsychological Testing • Coaching • Support groups/Community Referrals

17. 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

18. 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

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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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