"No obstacles are insurmountable when God commands and we obey"
- - Heber J. Grant
August 30, 2013
Academic Accommodations for People with Mental Health Concerns
by Sarah Hancock

The majority of students young and old return to school this month, leaving many people with psychiatric disorders and their loved ones scratching their heads wondering if they can really tackle school.

When I returned to school in 1998, after having been newly diagnosed and put on medication, I was stunned at the difference in my academic abilities. I just couldn’t perform as previously. Half of the problem was because I hadn’t found the right medication and other supports necessary to live successfully with my illness. The other half of the problem was that I just wasn’t used to having symptoms.

A large percentage of people who have a psychiatric diagnosis begin having symptoms in their late teens and early twenties. For that reason, it’s like having the rug ripped out from under you just as you began understanding how you do your best.

Growing up, I’d never had an individualized education plan (IEP). I wasn’t aware that there were provisions for me. With my new deficits, I thought surely it was the end of my academic career.

However, I was lucky. I had many deaf friends used to being in a “disabled” system. When I shared with them my desire to drop out due to complications with my disorder, they wisely asked if I’d spoken with my disability counselor. Of course, I hadn’t. I’d never even knew there was such a thing!

They introduced me to BYU’s Disabled Student Services (in an effort to focus on strengths rather than deficits, BYU has since changed their office’s name to the “Accessibility Center.” Other universities are following their example).

So what could an Accessibility Center possibly offer you, a loved one or someone you serve? Well, let me explain. Strictly legally speaking, every school taking federal funding of any nature must comply with section 504 of the Rehabilitation Act of 1973, the ADA of 1990 and the ADA’s amendments of 2008. Even if your college or university is a private one, chances are there are students attending the school utilizing federal funds Pell grants, requiring that school to comply.

Academic accommodations allow equal access to academia and school activities, contributing to the diverse educational experience.

Psychiatric disorders adversely affect students in two ways, the symptoms themselves and the side effects of the medications prescribed. Both need to be taken into consideration when discussing possible academic accommodations. But how do you even know what to ask for? That’s a great question!

In the kindergarten-high school arena, a parent and student sit down with the school psychologist and the special education teacher to create an IEP. When a student attends college, he must go to the equivalent of an accessibility center. (Some campuses call this the disability center or disability services, programs and support (DSPS) office.) Regardless of what they call it, you can look it up on your school’s website.

Once in that office, you will discuss possible accommodations with a disability support counselor.

At your first meeting it is good to bring a letter from your doctor on his or her letterhead stating your diagnosis and any recommended accommodations. You can also plan ahead and come to the office completely prepared if you ask for the intake forms prior to your first appointment so that you have everything all ready for your counselor the first time you sit down with him.

(As a disability counselor, it always impresses me when a student makes the effort to do this, demonstrating a desire to succeed. Sometimes university accessibility center websites have the forms to download on their website. If you have everything prepared for the first meeting, you can get your academic accommodations expedited for use immediately.)

The first meeting with the counselor is an intake session. During this meeting your counselor will discuss with you the intake forms and the letter from your doctor. In this meeting it is vital to keep in mind two things.

First, how do the symptoms of your illness affect your ability to perform academically? Second, how do your medications affect your academic ability?

Each person will answer those questions differently, regardless of the fact that they may have the same illness and the same medication. For that reason, it is vital to be able to communicate with your counselor the answers to those two questions.

When discussing possible academic accommodations it is also good to consider the following questions:

  • What is the underlying problem?

  • How does it affect your academic performance?

  • How long have you dealt with your symptoms?

  • How do you cope with your symptoms?

Rather than go into the specifics of each illness, I am going to touch on underlying problems and how to address them.

First, preferential seating can help students for a variety of reasons. Symptoms of psychiatric illnesses often affect one’s ability to filter sensory input. For example, if a person is in a classroom where multiple students are typing away on their laptops, it may be virtually impossible to filter out the tapping and focus on the material. Giving the student preferential seating allows the person to sit in the front of the room and away from the students who are typing on their laptops.

Preferential seating is also good for students with an anxiety disorder, allowing them to sit next to the door to step out, have the anxiety attack and then come back in with minimal class distraction.

Preferential seating is also appropriate for students with PTSD because it allows them to always sit where they are most comfortable so as to allow them to have a bit of control over their situation — especially for veterans who are used to keeping an eye of surveillance on their surroundings. Preferential seating is good for a person on medication that causes dry mouth because drinking lots of liquid creates a need to escape class discreetly for frequent bathroom trips.

Having a distraction-free testing environment is also vital for successful testing. Each school should have provisions for a student to take exams and quizzes in a proctored testing center. This creates a relatively distraction-free environment, allowing students to focus on their exam.

Test proctoring is also given to students with an illness or medication that slows down their processing speed. Depending on the situation, students can get adjustable time for their exams. For example, if a student with a panic disorder has a panic attack during the test, the proctor can stop the timed test, let the student have the attack, and then start the time again when the student is ready to proceed.

Some disorders or medications allow time and a half on tests due to processing issues. If this does not resolve the processing issue and additional time is needed, the student can talk to a counselor for additional provisions. (After having some neuropsych testing done, my counselor decided that having double time on tests was appropriate until my brain was able to recover from its trauma.)

Test proctoring is usually done on the same day and at the same time as the students’ class. Test proctoring is closely monitored just as a classroom or testing center would be, assuring professors they aren’t giving one student advantage over another, but merely allowing a student with psychiatric symptoms to have equal access to their exams.

Note takers or audio recording devices can be utilized to help students with psychiatric symptoms make up for what they didn’t process during the class. Processing information while trying to cope with psychiatric symptoms can be difficult for many reasons. The person may process information slowly because of the actual symptoms or might process information slowly due to the prescribed medication.

Either way, having access to another student’s notes allows the student with a psychiatric diagnosis to spend their energy focusing on the professor rather than both listening and scrambling to keep up with the notes.

Accessing notes can be discreet as well. A student can approach the professor with an accommodation letter from the accessibility center, explaining the need for a note taker. The professor can then ask for a volunteer notetaker and get the notes after class.

Some universities have the ability to pay a small gratuity to a note taker; other schools write a letter of gratitude to the note taker at the end of the semester, mentioning the amount of hours contributed for the semester by the good Samaritan. Either way, it’s a win-win situation.

Note takers do not take notes if the student they are serving is absent. Audio recording devices work much the same way, and it is solely up to the student’s preference.

Flexible attendance is also available on a limited basis from a college or university. I say limited basis because in general colleges cannot allow a student to miss more than two classes for accreditation purposes. However, if discussed in advance, a student can arrange with a teacher to access the class via Skype, Google Chat, or via another interactive media source preferred by the school.

When a student goes to register for classes, he needs to think about normal life patterns. If symptoms or medication causes difficulty getting out of bed before 11 a.m., taking a class earlier than noon isn’t advisable. Or perhaps the student needs to start taking night medication earlier (like between 7:30 and 8 p.m., rather than waiting until they are going to get in bed).

The other accommodations I would recommend are tutors and study skills classes. Since the large majority of people diagnosed with a form of schizophrenia or bipolar disorder are diagnosed in their late teens or early twenties, they are not used to pursuing education while dealing with symptoms. Attending a study skills class can teach them additional compensatory strategies circumventing symptoms, allowing them to succeed.

Course load is also vital to discuss with a disability counselor. Taking a lighter load doesn’t mean that you are weak; it means that you are smartly choosing to care for yourself by not overloading. If you know you need to take a certain number of credits to keep a scholarship or FAFSA money, your disability counselor can write a letter to the financial aid office, stating that you are being served by the accessibility office for having a verified disability and asking for an appropriate credit load given your circumstances.

It’s important to remember a couple of things about receiving services from an accessibility center. Everything you discuss with your accessibility counselor is completely confidential. Professors and other university staff do not have access to your information unless you sign a release for the counselor discuss it. You can revoke that release at any time.

Additionally, the fact that you received services from an accessibility office is not disclosed on your academic record or transcript. Please have no reservations about taping into your resources. Doing so will allow you to succeed in a way you may not have be able to do so without academic accommodations. You have the right to succeed, and you deserve it.


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About Sarah Hancock

Sarah Price Hancock, a graduate of San Diego State University's rehabilitation counseling Masters of Science program with a certificate psychiatric rehabilitation.

Having embarked on her own journey with a mental health diagnosis, she is passionate about psychiatric recovery. She enjoys working as a lector for universities, training upcoming mental health professionals. Sarah also enjoys sharing insights with peers working to strengthen their "recovery toolbox." With proper support, Sarah knows psychiatric recovery isnít just possible ó itís probable.

Born and raised in San Diego, California, Sarah served a Spanish-speaking and ASL mission for the LDS Church in the Texas Dallas Mission. She was graduated from Ricks College and BYU. Sarah currently resides in San Diego and inherited four amazing children when she married the man of her dreams in 2011. She loves writing, public speaking, ceramics, jewelry-making and kite-flying ó not necessarily in that order.

NAMI San Diego's Fall Keynote Address: Living in Recovery with Schizoaffective Disorder

Having recently moved into a new ward, she currently serves as a visiting teacher.

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