Reasonable Accommodations: How does mental illness interfere with functioning at school?

How does mental illness interfere with functioning at school?

Mental illnesses may interfere with functioning in different ways. Many of the illnesses affect a student’s ability to do certain things, such as thinking or communicating with others. Often, the person themselves or the professionals working with them can describe the functional limitations that are specific to your student. Please remember that since there are a lot of different types of mental illnesses, that this is not a complete list, nor do these limitations apply to everyone who has a mental illness.

Functional limitations due to psychiatric disability

The following is a list* of some of the activities that people with psychiatric disabilities may have trouble doing:

Screening out environmental stimuli - an inability to block out sounds, sights, or odors which interfere with focusing on tasks
Ex.: A student may not be able to attend to a lecture while sitting near a loud fan or focus on studying in a high traffic area.
Possible solutions: Move student away from fan area, turn off fan during lecture, identify quiet study area for student.
Sustaining concentration - restlessness, shortened attention span, easily distracted, remembering verbal directions
Ex.: A student may have trouble focusing on one task for extended periods, difficulty reading and retaining course material, or trouble remembering instructions during an exam or a classroom exercise.
Possible solutions: Break large projects into smaller tasks, allow brief but more frequent breaks to stretch, walk around, get fresh air, refer student to a tutor to help with study skills and information retention, assign tasks one at a time, write out instructions on board.
Maintaining stamina - having energy to spend a whole day of classes on campus, combating drowsiness due to medications
Ex.: A student my not be able to carry a full-time course load, or take a lengthy exam at one sitting.
Possible solutions: Encourage part-time enrollment; segment an exam so that student can take one part in morning, another in the afternoon.
Handling time pressures and multiple tasks - managing assignments & meeting deadlines, prioritizing tasks
Ex.: A student may not know how to decide which assignments should be done first, or be able to complete assigned tasks by the due date.
Possible solutions: Break larger assignments and projects down into manageable tasks; distribute a course syllabus of the class topics, assignments, and due dates for the entire semester to help students to plan and prioritize workload.
Interacting with others - getting along, fitting in, chatting with fellow students, reading social cues
Ex.: A student may have difficulty talking to other students, getting notes or discussing assignments, participating in class, meeting students outside of class, chatting with other students at class breaks.
Possible solutions: Establish a mentor or “buddy system” relationship to introduce the student to others or to show the student “ ropes”.
Responding to negative feedback - understanding and interpreting criticism or poor grades, difficulty knowing what to do to improve, or how to initiate changes because of low self esteem
Ex.: A student may not seem to understand the feedback given, becomes upset when criticism is given on an assignment, or wants to withdraw from class because of a poor grade on an exam.
Possible solutions: Use a feedback loop (ask student’s perspective of performance, describe both strengths and weaknesses, suggest specific ways to improve); give student the chance to read written feedback privately, and then discuss; make alternative assignments or “extra credit” options available to all students, thus giving them the opportunity to make up for a poor grade; if necessary, arrange a three-way meeting with the student and the disability services counselor to facilitate feedback.
Responding to change - coping with unexpected changes in coursework, such as changes in the assignments or exam due dates, or changes in instructors.
Ex.: A student may need to learn new routines, or feel unduly stressed when requirements or instructors change, or when new expectations are introduced midsemester.
Possible solutions: Prepare students when possible for changes that will be happening, explain any new course requirements, make a special effort to introduce any new instructors and orient the new instructor to student’s needs.

*Adapted from Mancuso, L.L. (1990) Reasonable accommodations for workers with psychiatric disabilities. Psychosocial Rehabilitation Journal, 14(2), 3-19.

Please be aware that any special strategies that are considered should be discussed with the student in advance, identifying the particular areas of difficulty for that person and individualizing possible solutions that may work for him or her.

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Why I need to know about functional limitations?

Both Section 504 of the Rehabilitation Act and the ADA state that educational personnel only need to provide accommodations to the known mental or physical limitations of someone with a disability that can be attributed to that disability. School administrators, faculty, and staff are not required to accommodate limitations due to other characteristics, such as poor literacy skills (that are not due to learning disabilities), low educational levels, inability to meet the minimum entrance requirements of the learning environment, or lack of credentials. You can ask the student to document the types of functional limitations due to the disability that lead to the need for academic adjustments for that person.

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How I might recognize signs of mental illness in the campus setting*

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 individual's behavior, may indicate the onset of a more serious mental health problem that requires treatment. Some of the most significant indications of a possible mental illness include:

marked personality change over time,
confused thinking; strange or grandiose ideas,
prolonged severe feelings of depression or apathy,
feelings of extreme highs or lows,
heightened anxieties, fears, anger or suspicion; blaming others,
social withdrawal, diminished friendliness, increased self-centeredness,
denial of obvious problems and a strong resistance to offers of help,
dramatic, persistent changes in eating or sleeping habits,
substance abuse,
thinking or talking about suicide.

In reality, these symptoms are not always readily apparent. Educators and support staff may, however, be able to notice significant changes in their student’s work habits, behaviors, performance, and attendance, such as:

consistent late arrivals or frequent absences,
low morale,
disorganization in completing school work or in study habits
lack of cooperation or a general inability to communicate with others,
increased accidents,
frequent complaints or evidence of fatigue or unexplained pains,
problems concentrating, making decisions, or remembering things,
missed deadlines, delays in completing assignments, poor exam grades,
making excuses for missed deadlines, or poor quality work,
decreased interest or involvement in class topics or academics in general.

People who experience problems such as those listed above may simply be having a bad day or week, or may be working through a difficult time in their lives. A pattern that continues for a long period may, however, indicate an underlying mental health problem.

* Adapted from: Zuckerman, D., Debenham, K. & Moore, K. (1993) The ADA and People with Mental Illness: A Resource Manual for Employers. Available from the National Mental Health Association, 1021 Prince Street, Alexandria, VA 22314-2971

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Some research findings on types of functional limitations

A recent program review conducted by the Center for Psychiatric Rehabilitation involved interviews of 25 students attending a community college in Worcester, Massachusetts. The findings identified several critical functional limitations which were accommodated in a variety of ways. Supported education service providers were often very helpful to educators and administrators in identifying the limitations and suggesting effective academic adjustments.

Educational Skills for Which Assistance Was Needed:

None 30%

Content comprehension 30%

Writing/grammar 26%

Mathematics 26%

Time management/organizing 17%

Stress management 14%

Notetaking 9%

Obstacles needed to be overcome to continue in school:

Difficulties with memory/concentration 69%

Rusty academic skills 61%

Lack of goals 22%

Non-accommodating instructors 30%

Lack of funds 22%

Difficulty w/peers 30%

Transportation 35%

Ongoing obstacles (No common responses):

Lack of goals Lack of self confidence

Difficulty walking Difficulty retaining information

Non-accommodating instructors Panic attacks

Low self esteem Skill deficits in the areas of time management, concentration, & writing

Source: Sullivan, A. & Sharac, J. (1997) Post-secondary education for individuals with disabilities: Supported education project for people with psychiatric disabilities. Final report to the U.S. Department of Education. Boston, MA: Center for Psychiatric Rehabilitation, Boston University.

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The facts on this website are believed to be correct at the time of publication but cannot be guaranteed.
© 1997, Center for Psychiatric Rehabilitation, Boston University

Educational Skills for Which Assistance Was Needed:
None	30%
Content comprehension	30%
Writing/grammar	26%
Mathematics	26%
Time management/organizing	17%
Stress management	14%
Notetaking	9%
Obstacles needed to be overcome to continue in school:
Difficulties with memory/concentration	69%
Rusty academic skills	61%
Lack of goals	22%
Non-accommodating instructors	30%
Lack of funds	22%
Difficulty w/peers	30%
Transportation	35%
Ongoing obstacles (No common responses):
Lack of goals	Lack of self confidence
Difficulty walking	Difficulty retaining information
Non-accommodating instructors	Panic attacks
Low self esteem	Skill deficits in the areas of time management, concentration, & writing