Punching Holes In The Darkness


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A workshop presentation for faculty and staff on working with college students with mental illness as a disability

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Punching Holes In The Darkness

  1. 1. Punching Holes In The Darkness: Helping Students With Psychiatric Disabilities Cope Within The College Community Presenter: Rodney E. Pennamon, M.Ed, CPDM Director Georgia State University
  2. 2. <ul><ul><li></li></ul></ul>06/08/09 Give Us A Chance <ul><li>We are almost forgotten, You know, the misbegotten, Those who see a different light, A light of darkness bright. </li></ul><ul><li>Some say we are insane, Others call us just inane. We can’t help our plight, When our days are one long night. </li></ul><ul><li>All we ask, is for a chance, Without let or hindrance, To prove that we can do Most anything just like you. </li></ul><ul><li>What we have cannot be caught, Nor is it ever actively sought, Yet society sees us as being rank, Each and everyone a raging crank. </li></ul><ul><li>  </li></ul><ul><li>  </li></ul><ul><li>Michael Mann Yellowknife, N.W.T. January 2000 </li></ul>We seek compassion and understanding, But To have a mind that’s one big knot. So lets all with one accord, And for the final human record, Not hold those with mental malady Responsible to ridicule and parody. Just think about it, you may be next When mind and reality become vexed. Generally it’s misunderstanding, That’s received with a vapid smile, And whispered sniggers full of bile. Why is mental illness so abhorred, When evil often finds its own reward? It depends upon your self-esteem And how you personify it would seem. Bad it might be, but wrong it’s not
  3. 3. Percentage of Population with Disability: <ul><li>52.6 million people (19.7%) have some level of disability . </li></ul><ul><li>33.0 million people (12.3%) have a severe disability. </li></ul><ul><li>High school dropout rate: </li></ul><ul><li>22% of students with a disability do not graduate. </li></ul><ul><li>9% of students with no disability do not graduate. </li></ul><ul><li>College graduation rates: </li></ul><ul><li>12% of students with disabilities graduate from college. </li></ul><ul><li>23% of students with no disabilities graduate from college. </li></ul>Source: Us Census Bureau Current Population Report February 2001 issue
  4. 4. Adults with Psychiatric Disabilities on Campus <ul><li>Mental illness is a widespread and debilitating illness that affects as many as 41 million people in the United States. </li></ul><ul><li>Mental or psychological disorders are second only to cardiovascular conditions worldwide in causing disability and premature death. The onset of many major psychological disabilities is in early adulthood, between the ages of 18 to 25, a critical time when young people are leaving home for the first time to attend college and graduate school . </li></ul>
  5. 5. <ul><li>There aren’t many good statistics on how many people with mental illness attend colleges, apart from suicide rates (suicide is commonly linked with mental illness) and even then, some critics charge that many campuses will not report suicides that occur when students are on leave, or living off campus. Disability Compliance for Higher Education, February 2001 </li></ul>
  6. 6. Disability Status by Sector <ul><li>Students with invisible disabilities </li></ul><ul><li>(chronic health disorders, seizures psychiatric problems or learning disabilities) make up the single largest disability category among the nation’s undergraduate college students. </li></ul>
  7. 7. <ul><li>Community colleges enroll the largest percentage of students with disabilities. </li></ul><ul><li>More than half of the students with disabilities at two-year and four- year public institutions are male. </li></ul><ul><li>Students with disabilities at community colleges are more likely to be older(age 25 and above) than those in other sectors. </li></ul><ul><li>Source: Information from HEATH. Vol. 13, No.2, June-July 1994. </li></ul>
  8. 8. Five Myths About Mental Illness <ul><li>Myth # 1 </li></ul><ul><li>Mental illness is rare on any campus. </li></ul><ul><li>Myth # 2 </li></ul><ul><li>People with mental illness are violent. </li></ul><ul><li>Myth # 3 </li></ul><ul><li>Someone who is mentally ill is just weak and can “snap out of it” and choose to be better if they want to. </li></ul>
  9. 9. <ul><li>Myth # 4 </li></ul><ul><li>Mental illness is incurable. </li></ul><ul><li>Myth # 5 </li></ul><ul><li>People with mental illness are not intelligent and should not be in college. </li></ul>
  10. 10. What is a Psychiatric Disability? <ul><li>A Psychiatric disability (i.e., mental disorder) is a clinically significant behavioral or psychological syndrome or pattern occurring in an individual that reaches a certain frequency, intensity and duration. </li></ul><ul><li>It is a disability in one or more important areas of functioning ( psychological, social ,or occupational). </li></ul>
  11. 11. Psychological Psychiatric Disabilities Could Include: Anxiety Disorders Neurosis Panic Disorder Personality Disorders Specific Phobia Paranoid Social Phobia Schizoid Obsessive-Compulsive Psychosis Acute Stress Disorder Schizophrenia Eating Disorders Sleep Disorders Emotional Disorders Mood Disorders Depressive Disorders Bipolar Disorders
  12. 12. Top Ten Problems Encountered by Students <ul><li>Relationships with family, partners, friends. </li></ul><ul><li>Anxiety </li></ul><ul><li>Academic matters </li></ul><ul><li>Depression </li></ul><ul><li>Bereavement </li></ul><ul><li>Abuse-mental , emotional, physical and sexual </li></ul><ul><li>Intra-personal, including those with low self-esteem or confidence, as well as the suicidal </li></ul><ul><li>Sexuality </li></ul><ul><li>Transitions, including difficulties adjusting to university life, or to changes such as parental divorce </li></ul><ul><li>Drugs, alcohol </li></ul>
  13. 13. Functional Limitations Due to Psychiatric Disability <ul><li>Screening out environmental stimuli. </li></ul><ul><li>Sustaining concentration. </li></ul><ul><li>Maintaining stamina. </li></ul><ul><li>Handling time pressures and multiple tasks. </li></ul><ul><li>Interacting with others. </li></ul><ul><li>Responding to negative feedback. </li></ul><ul><li>Responding to change. </li></ul><ul><li>Source: Psychosocial Rehab. Journal, 14 (2), 3-19 </li></ul>
  14. 14. Recognizing Signs of Mental Illness in the Campus Setting <ul><li>Marked personality change over time. </li></ul><ul><li>Confused thinking; strange or grandiose ideas. </li></ul><ul><li>Prolonged severe feeling of depression or apathy. </li></ul><ul><li>Feeling of extreme highs or low. </li></ul><ul><li>Heightened anxieties, fears, anger, or suspicion; blaming others. </li></ul><ul><li>Social withdrawal, diminished friendliness, increased self- centeredness. </li></ul><ul><li>Denial of obvious problems and a strong resistance to offers of help. </li></ul><ul><li>Dramatic, persistent changes in eating or sleeping habits. </li></ul><ul><li>Substance abuse. </li></ul><ul><li>Thinking or Talking about suicide. </li></ul>
  15. 15. Signs Continued <ul><li>Consistent late arrivals or frequent absences. </li></ul><ul><li>Low morale. </li></ul><ul><li>Disorganization in completing school work or in study habits. </li></ul><ul><li>Lack of cooperation or a general inability to communicate with others. </li></ul><ul><li>Increased accidents. </li></ul><ul><li>Frequent complaints or evidence of fatigue or unexplained pains. </li></ul><ul><li>Problems concentrating, making decisions or remembering things. </li></ul><ul><li>Missed deadlines, delays in completing assignments, poor exam grades. </li></ul><ul><li>Making excuses for missed deadlines, or poor quality work. </li></ul><ul><li>Decreased interest or involvement in class topics or academics in general. </li></ul><ul><li>Source: Zuckerman etal. (1993), National Mental Health Association. </li></ul>
  16. 16. Students with Psychological Disabilities Possible Conduct Issues <ul><li>Classroom disruption </li></ul><ul><li>Assault of a Faculty member </li></ul><ul><li>Manipulation and dishonesty </li></ul><ul><li>Verbally dominates classroom environment </li></ul><ul><li>Faculty biased against the student with disability </li></ul><ul><li>Attention getting behavior </li></ul><ul><li>Obsessive behavior/stalking </li></ul><ul><li>Alcohol & drug abuse issues </li></ul>
  17. 17. Possible Special Issues in the Residence Halls <ul><li>To have a roommate or not? </li></ul><ul><li>Cleanliness issues </li></ul><ul><li>Community care taking/burden on the roommate </li></ul><ul><li>Pressure on RA’s and Hall Directors to be “in loco parentis” </li></ul><ul><li>Threat of Suicide </li></ul><ul><li>Medication issues </li></ul><ul><li>Parental expectations for the Residence Life staff </li></ul><ul><li>Student isolation </li></ul><ul><li>Student disruption alienates the residence hall floor </li></ul>
  18. 18. Affect On Education <ul><li>Hospitalization usually means the individual is “out” of school for an extended period of time. </li></ul><ul><li>Misunderstandings and stereotyping make re-integration difficult. </li></ul><ul><li>Student may have a relapse which further reinforces stereotype. </li></ul><ul><li>Student must follow the same rule and limits. </li></ul>
  19. 19. The Role of the Disability Support Services Staff <ul><li>In providing services to students with psychiatric disabilities it is important for ODSS staff to separate as clearly as possible, treatment issues from educational issues. Treatment issues, such as therapeutic counseling, medication maintenance,or crisis intervention should be provided by professionals other than the ODSS staff. Campus resources may be available, mental health community resources should be sought. </li></ul>
  20. 20. Strategies for Working with Students with Psychiatric Disabilities <ul><li>Encourage early disclosure and don’t operate in a crisis mode. </li></ul><ul><li>Have releases in place so that you can be responsive when people’s conditions change. </li></ul><ul><li>Clarify with the student his support network(on-campus support group, therapist). </li></ul><ul><li>Consider offering a support group on your campus. </li></ul><ul><li>Create Liaisons with student affairs or student development offices. </li></ul><ul><li>Make sure there is a syllabus statement for faculty to use that addresses disabilities. </li></ul><ul><li>Be aware of options for programmatic accommodations (i.e. part-time status). </li></ul><ul><li>Source: Barbara Blacklock, University of Minnesota </li></ul>
  21. 21. Instructional Program for Faculty in Dealing with Psychiatric Disorders in the Classroom <ul><li>Review the code of conduct. </li></ul><ul><li>Discuss what constitutes disruptive conduct in the classroom. </li></ul><ul><li>Define inappropriate classroom behavior for use in the faculty member’s syllabus. </li></ul><ul><li>Give examples of inappropriate classroom behavior. </li></ul>
  22. 22. Faculty Continued <ul><li>Use several case studies of actual problems that have occurred in the classroom. </li></ul><ul><li>Explain the student disciplinary process. </li></ul><ul><li>Describe types of behavior that might be indicators of psychiatric problems. </li></ul><ul><li>Describe resources to assist the faculty including the Dean of Students Office, the Counseling Center, Psychiatric Services, and the Student Health Service. </li></ul>
  23. 23. Typical Documentation Sources <ul><li>Psychiatrist </li></ul><ul><li>Clinical Psychologist </li></ul><ul><li>Clinical Mental Health Counselor </li></ul><ul><li>Clinical Social Worker </li></ul><ul><li>Psychiatric Nurses </li></ul><ul><li>Marriage, Family, Child Therapists </li></ul>
  24. 24. Documentation <ul><li>When documentation for a disability is requested </li></ul><ul><li>there are several areas which need to be addressed </li></ul><ul><li>for the college student. </li></ul><ul><li>Documentation of individual’s psychiatric condition (DSM IV-TR diagnosis with Axis). </li></ul><ul><li>Dates of registration or treatment (from__to__). </li></ul><ul><li>How the individual’s condition may affect him/ her in the academic setting. </li></ul><ul><li>Recommendations for academic accommodations. </li></ul><ul><li>Is the students currently in treatment or activity working with a counselor? </li></ul>
  25. 25. Guidelines <ul><li>The following questions can guide service providers in assessing the needs of students with Psychiatric Disabilities. </li></ul><ul><ul><li>What reasonable accommodations need to be made? </li></ul></ul><ul><ul><li>Is this an educational problem or a treatment problem? </li></ul></ul><ul><ul><li>Do I need to make a referral to a community or campus resource? </li></ul></ul><ul><ul><li>How would I solve this problem if the person had a physical disability? </li></ul></ul><ul><ul><li>Has there been a violation of student conduct? </li></ul></ul><ul><ul><li>Am I working harder on this problem than the student who presented the problem? </li></ul></ul><ul><ul><li>Source: Roth, Patricia. Virginia Tech. PD Newsletter, Winter 1996. </li></ul></ul>
  26. 26. Functional Domains <ul><li>Cognitive </li></ul><ul><li>Behavior </li></ul><ul><li> Communication </li></ul><ul><li>Emotion </li></ul><ul><li>Motor </li></ul><ul><li>Sensory Perceptual </li></ul><ul><li>Biological Needs </li></ul><ul><li>Psychosocial Needs </li></ul>
  27. 27. Reasonable Accommodations for Students with Psychiatric Disabilities <ul><li>Assistance with registration/financial aid </li></ul><ul><li>Extended time for exams </li></ul><ul><li>Change of location for exams </li></ul><ul><li>Priority parking </li></ul><ul><li>Note taking, tape recorders </li></ul><ul><li>Seating arrangement modifications </li></ul><ul><li>Beverages allowed in class ( i.e.,for thirst resulting from medication) </li></ul>
  28. 28. Accommodations Continued <ul><li>Peer support </li></ul><ul><li>Identified place to meet on campus that is non-threatening before or after class </li></ul><ul><li>Incompletes rather than failures if relapse occurs </li></ul><ul><li>Training in time management </li></ul><ul><li>Training in study skills </li></ul><ul><li>Special topic courses( college survival, personal psychology) </li></ul><ul><li>Early registration </li></ul>
  29. 29. Accommodations Continued <ul><li>Incompletes </li></ul><ul><li>Provide honest feedback when behavior is inappropriate </li></ul><ul><li>Orientation to campus </li></ul><ul><li>Assistance with class selection and class load </li></ul><ul><li>Allow less than full time involvement in program </li></ul><ul><li>Referrals to campus and community resources </li></ul><ul><li>Use the university conduct code when appropriate </li></ul><ul><li>Source: Adults with Psychiatric Disabilities on Campus. (1996) HEATH. </li></ul>
  30. 30. Accommodations <ul><li>Myth </li></ul><ul><li>My therapist said that I need these things so you must provide them. </li></ul><ul><li>Reality </li></ul><ul><li>Accommodations need to be directly linked to the underlying disorder </li></ul><ul><li>Is an accommodations reasonable? Ask: </li></ul><ul><li>Is it necessary in order for the student to enjoy equal opportunity? </li></ul><ul><li>Is it reasonable in the context of the student’s course of study? </li></ul>
  31. 31. Defenses <ul><li>Primary defenses available: </li></ul><ul><li>Not otherwise qualified </li></ul><ul><li>Fundamental alteration </li></ul><ul><li>Personal services </li></ul><ul><li>Direct threat </li></ul>
  32. 32. Helpful Resources <ul><li>The Dismissal of Students with Mental Disorders by Gary Pavela, J.D. </li></ul><ul><li>Legal Issues </li></ul><ul><li>Policy Considerations </li></ul><ul><li>Alternative Responses </li></ul><ul><li>Coping with the Disruptive College Student: </li></ul><ul><li>A Practical Model </li></ul><ul><li>by Gerald Amada, Ph.D </li></ul><ul><li>Source: The Higher Education Administration Series </li></ul><ul><li>College Administration Publications, Inc. </li></ul>
  33. 33. Envisioning Best Practices for Students with Psychiatric Disabilities <ul><li>Higher Education reaches out to people with psychiatric disabilities </li></ul><ul><li>Schools provide information on accessibility for student/consumers </li></ul><ul><li>Higher education is available to all on the basis of the ability to learn, not the ability to pay </li></ul><ul><li>Students have the right to withdraw from studies because of mental health problems without financial penalty </li></ul>
  34. 34. Best Practices Continued <ul><li>Scholarships exist for students with psychiatric disabilities </li></ul><ul><li>Orientation is accessible to student/consumers </li></ul><ul><li>Mental health issues are included in orientation events </li></ul><ul><li>Access to voluntary early intervention exists for students experiencing their first mental health crisis </li></ul>
  35. 35. Best Practices Continued <ul><li>Staff in all offices of the institution have access to information about services and supports for students/consumers </li></ul><ul><li>Residence is accessible for students with psychiatric disabilities </li></ul><ul><li>Students with psychiatric disabilities have access to accommodations </li></ul><ul><li>Students with psychiatric disabilities are aware of academic accommodations </li></ul>
  36. 36. Best Practices Continued <ul><li>Student representatives include the issues of students with psychiatric disabilities </li></ul><ul><li>Voluntary, free access to a variety of mental health services, both on-campus and in the community, is available </li></ul><ul><li>Support for students experiencing crisis is available </li></ul><ul><li>Student status is not conditional upon mandatory withdrawal for students with psychiatric disabilities </li></ul>
  37. 37. Best Practices: Model Programs for Students with Mental Illness <ul><li>State University of New York at Buffalo </li></ul><ul><li>http://ub-counseling.buffalo.edu/ccv.html </li></ul><ul><li>University of Michigan </li></ul><ul><li>www.ssw.umich.edu/sed/about.html </li></ul><ul><li>University of Illinois www.psych.uic.edu/UICNRTC/project_12.htm . </li></ul>
  38. 38. Best Models Continued <ul><li>University of Chicago </li></ul><ul><li>http://counseling.uchicago.edu/vpc/virtulets.html </li></ul><ul><li>Harvard-Radcliffe </li></ul><ul><li>http://www.hcs.harvard.edu/~mhaag/ </li></ul><ul><li>York University </li></ul><ul><li>wysiwyg//78http://www.yorku.ca/cdc/pdp/index.htm </li></ul>
  39. 39. Case Vignettes <ul><li>Student A: ADHD/Psychiatric Disorders </li></ul><ul><li>Student B: Bipolar Disorder/ Depression </li></ul><ul><li>Student C: Schizophrenia/Paranoid Type </li></ul><ul><li>Student D: Medication side-effect(s) </li></ul>
  40. 40. Suggestions for Students with Mental Illness <ul><li>Get an accommodation plan </li></ul><ul><li>Talk with teachers </li></ul><ul><li>Take a break </li></ul><ul><li>Ask for reassurance </li></ul><ul><li>Gain allies </li></ul><ul><li>Be aware of medication side effects </li></ul>
  41. 41. Suggestions Continued <ul><li>Try to let things go </li></ul><ul><li>Make goals </li></ul><ul><li>Try to have some fun </li></ul><ul><li>Try something new in or outside of school </li></ul><ul><li>Ask for exactly what you need </li></ul><ul><li>Source: Elizabeth Drucker. (2001), Suite 101. </li></ul>