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Instructor's Handbook: Accommodating Students with Disabilities
7.8 Students With Psychiatric Disorders
Psychiatric impairments result in several symptoms which require accommodation in academics. The most frequently occurring impairments are affective disorders (depression, anxiety, bipolar disorders), personality disorders (obsessive compulsive disorder especially), schizophrenia, and dissociative identity disorders. Psychiatric impairments are present in about 18-20% of students with disabilities seen by Disability Services personnel each year.
Personal psychiatric disorders interfere with a student's ability to concentrate at various times. This may be due to primary symptoms of fatigue, limited ability to focus and sustain attention, internal events such as disturbing or obsessive thoughts, or medication side effects.
Productivity is also affected with psychiatric conditions as the ability to consistently engage in studies and attend class varies with the course of the condition. In some cases, the very nature of the material covered in class may have a profound effect on the student's ability to participate, as certain subjects trigger difficult emotional responses. The work may be very good when the student is able to participate, and careful pacing with flexible deadlines may be required when the condition worsens.
It is important to note that an anxiety disorder in this context is distinctly different from the "anxiety" experienced by most students at exam time. Anxiety disorder may include panic attacks with difficulty breathing, rapid heart rate, sweating, and a profound fear of impending disaster. Students with anxiety disorders may actually lose consciousness in exam settings. It is an ongoing, long-term condition not easily remediated with strategies such as study and exam-writing skills, relaxation techniques, or improved confidence; it is probably being treated with psychotherapy and medication as well as lifestyle management.
Similarly, depression as a primary impairment is distinct from "the blues", situational depression, or bereavement and grief reactions. The latter occur in the normal range of human experience, and are more readily addressed with supportive counselling, changes in the situation, the passage of time, or a combination thereof. Clinical depression, on the other hand, can be very persistent, lasting months or years, affecting the student's appetite, sleep pattern, engagement in activities, concentration and productivity. There is often a biochemical imbalance which requires a combination of medication and therapy before improvement is seen.
An excellent resource regarding students with psychiatric illness in post-secondary education is the Canadian Mental Health Association's publication Your Education, available online. Another excellent book for help in understanding these conditions is College Students in Distress: A Resource Guide for Faculty, Staff and Campus Community by Bruce S. Sharkin.
- Note-takers and taping of lecture material may be helpful in ensuring the student does not miss information when attendance, attention and concentration are affected.
- Hard copies of notes, overheads, and handouts are useful in reinforcing ideas covered in class.
- Awareness of material that may be emotionally evocative for the student and a sensitive approach, including some explanation of topics to be addressed, may help the student deal more effectively with the information.
- Privacy and an absence of background noise are helpful in communicating with students with psychiatric impairments.
- Providing information in writing for future reference may help compensate for limited short-term memory and attention.
- Students with psychiatric impairments benefit from using computers and on-line services from home for research and obtaining notes whenever possible, as this allows for more individualized pacing of work, a less stressful environment, and fewer intrusions from other people, which may be anxiety-inducing.
- Flexibility in deadlines is important in helping students with psychiatric impairments to do their best work.
- Awareness in dealing with emotionally sensitive course material is helpful in facilitating the student's successful participation in class and in assignments.
- Extra time on exams and tests allows students with psychiatric impairments to compensate for time lost to intrusive thoughts, lack of focus, slowed mental processing or medication side effects.
- Separate space for writing exams, either privately or semi-privately, is helpful in reducing the stress of the exam environment and reducing the potential for reaction to being in a highly controlled setting with many other people, which is aversive to many students with these conditions.
- Computers may help students organize and re-organize work more efficiently when thought processes are disrupted frequently in an exam period.