Frequently Asked Questions
Frequently asked questions for the AHEAD Web site from the Mental Health Disability SIG
submitted by Linda Cooper and Barbara Blacklock, SIG Co-chairs
Q: What constitutes adequate documentation for a psychiatric disability?
A: Documentation for a psychiatric disability should include the following components:
- A diagnosis by a licensed professional, qualified in the appropriate specialty area and not related to the student; the report should be on letterhead, dated and signed.
- A clear statement of the student's illness(es), including the DSM-IV diagnosis, summary of the present symptoms and a prognosis. (Must be coded on Axis I or II)
- Documentation must be current, and describe how the student's psychiatric condition interferes with, or impacts, ability to participate in the educational process. (Generally documentation which is less than three years old is adequate, although the age of the documentation is dependent upon the psychiatric condition, the current status of the student and the student's request for accommodations.)
- Medical information relating to the impact of medication and/or treatment on the student's ability to participate in all aspects of the academic environment.
- Suggestions of academic accommodations which might be appropriate in an educational environment, supported by disability related rationale.
Q: How does Disability Services determine and communicate a student's accommodation needs to faculty?
A: Determining reasonable accommodations is an interactive process. The following questions need to be asked and answered to identify the reasonable accommodations.
- Is the individual a "person with a disability"?
- Is the individual "otherwise qualified"?
- What are the barriers resulting from the interaction between the documented disability and the campus environment?
- What are possible accommodations, modifications, or adjustments that might remove the barriers?
- Without these accommodations, would the individual still have meaningful access to the program, service, or activity?
- Would these accommodations compromise the essential elements of the curriculum?
- Would these accommodations require a fundamental alteration in the nature of the program, service, or activity?
Many Disability Services offices communicate a student's accommodation needs to faculty in writing. It is preferred that a student would directly deliver an accommodation letter to the faculty member at the beginning of the semester, or as soon as the accommodations have been determined. The letter serves as a catalyst for discussion of how the accommodations will be provided and provides information to the faculty regarding the functional limitations of the student. The letter also informs the faculty member of who to contact if they need assistance with providing accommodations or if they question the reasonableness of the accommodations.
Some classes require more creative accommodations due to the nature of the course or the complexity of the functional limitations. When this occurs, the DS provider should facilitate a dialog with the student and the faculty member to clarify the essential elements of the course and identify creative and reasonable accommodations, considering the functional limitations of the student.
It is important for the student, the faculty member and DS to be clear about their roles in the accommodation process. A summary of the roles of the key participants in the accommodation process follows:
- Provide medical and/or psychological documentation to Disability Services
- Participate in process of determining and implementing reasonable accommodations
- Inform Disability Services when accommodations are not working, need to be modified or symptoms change
- Referral to Disability Services
- Participate in process to determine and implement reasonable accommodations
- Identify essential course components for accommodations to be determined
- Request assistance (From Disability Services) with accommodation, implementation, or consultation
Disability Services Role
- Maintain medical/psychological documentation in a confidential manner
- Determine if condition(s) are a disability in accordance with state and federal laws
- Identify and assist with implementation of reasonable accommodations
- Request updated documentation when symptoms change to determine if accommodations need to be modified
- Provide information and referral to campus and community resources to resolve disability-related issues
Q: How should you respond to a faculty member who wants a disruptive student removed from his or her classroom? The faculty suspects that the student has a psychiatric disability.
A: This question can best be answered by first looking at some general principles and then addressing some specific issues. Regardless of the reason for the disruptive behavior, it is critical that the proper policies be in place to meet the needs of all students, including those with psychiatric disabilities. The following administrative supports are needed:
- A clear, behavioral definition of disruptive behavior. For example, the California Community College System Chancellor's Office Report defined a student who is disruptive as one who:
Verbally threatens or abuses college personnel, physically threatens or assaults others, willfully damages college property, misuses drugs or alcohol on college premises, habitually interferes with the learning environment by disruptive verbal expressions, or persistently makes inordinate demands for time and attention from faculty and staff (Unger, 1998).
- A well-defined code of student conduct that will provide the structure for consistent and methodical interventions.
- Judicial affairs policies and procedures
- A clear awareness of designated administrative personnel responsible for upholding the campus code of conduct
With these in place, the following approaches are suggested as methods for managing the verbally or physically aggressive student. First and foremost, it is important to maintain a calm appearance and to respond to the student calmly and quietly. It is clear that the student is feeling out of control at this moment. By presenting in a calm manner, you are modeling an example of one who is in control of his behavior.
Do not press the student for an explanation of his or her behavior. Let the student know that you are interested in allowing him or her to describe what is causing the upset but that aggressive/abusive language and behavior are not acceptable. Emphasize that only behaviors that are safe for others are acceptable. If possible, walk the student to a quieter, but public place or invite the student to discuss the matter with you after class. If this is not possible, or there is fear of being alone with the student, ask the student to make an appointment with you during your office hours when there are others in the vicinity. When meeting with the student, clearly and objectively address the specific behavior that is problematic.
Since you are the person responsible for the learning environment of all students in your class, utilize your campus resources and work to connect the student with the appropriate professional staff. If possible and, if the student agrees, walk the student to the college's counseling center where he or she can talk to a professional who may be more able to address the underlying feelings of frustration or of being out of control. In addition, if the student is not responsive to these interventions, contact campus security or campus police to remove the student from the classroom. If the student has been displaying behaviors that have been making you uneasy, speak to Security about the matter and arrange the best way for you to alert them should an emergency arise and you need to call for their assistance. In that eventuality, first inform the student of your intention and then carry it out.
In any case, it is not advisable to enlist the aid of other students to quiet the student down. Don't threaten, taunt, or touch the student or mention any action you are not prepared to take; and do not allow yourself to become physically cornered.
Adapted from Handbook on Supported Education, by Karen Unger, 1998.
Q: How should you handle requests for special residence hall assignments based upon the student's psychiatric disability?
A: Housing requests for this population surface regularly. The most frequent request is for a single room. However, before discussing the possibilities, it is important to note that the student's documentation must substantiate a disability-related need for whatever housing request is being made (see question pertaining to adequate documentation). The presentation of adequate documentation is the basis upon which a dialogue can begin with regard to the student's housing needs. Colleges can handle this request in a number of ways. The guiding principle in determining institutional responsibility should be a case-by-case consideration of the options and the requests.
The question often arises as to whether it is discriminatory to grant a disability-related request for a single room to some individuals with disabilities and not to other individuals with disabilities. For example, is it discriminatory to grant a single to a student in a wheelchair who needs attendant care and not grant a single to a student with a psychiatric disability who needs a quiet, distraction-free place to study? While it is very likely the student with the psychiatric disability can find a quiet place to study elsewhere on campus, it not at all likely that the student in need of attendant care can be afforded the privacy and dignity he or she deserves in a double room. It is within the institution's scope and authority to make such decisions about reasonable accommodation on a case-by-case basis (Jarrow, 2001).
If you are affiliated with a college with ample single rooms, this request usually does not present a problem. With the cooperation of your housing office, students with disabilities may be given priority on the single room assignment list. However most schools do not have this luxury and single rooms may be at a premium or nonexistent. If your school is inclined to convert a double room into a single room, it is generally considered appropriate and acceptable to charge the student the double room rate. This compensates the school for lost income.
In most schools not only are single rooms extremely limited but they may only be located in certain levels of housing. For example, at some colleges there are only a few single rooms available in freshman residence halls. Housing for upperclassmen consists of group living arrangements e.g. apartments or suites composed of six or more bedrooms and shared kitchen and common space. Usually the demand for this housing is great and, depending upon the size of the bedrooms, students will be doubled or tripled to accommodate the demand. In this situation, to meet the student's medical, disability-related request for a single, he or she may have to accept a single located in the freshman residence hall. It is not discriminating against the student with the disability to not offer them something that is not available to any student (single rooms in upper-class housing). While this may not be ideal from a social perspective, we must keep in mind that what we are accommodating is the disability and not the student's social needs and/or preferences.
Q: Is a reduced course load considered a reasonable and appropriate accommodation for a student with a psychiatric disability? If so, how will that affect their eligibility for such things as housing, participation in student organizations, financial aid and health insurance?
A: This question addresses the issue of saying a student is a full-time when s/he is carrying less than the requisite number of credits. For many institutions 12 credit hours is considered the minimum for full-time status. The answer to this question has two parts. The first part deals solely with your institution and the rules it sets forth. It has often been said that any rule the institution can make the institution can bend. "As such, the institution has the right to define full-time status for a PARTICULAR student at whatever level they deem to be necessary and appropriate" (Jarrow, 1998).
With that in mind, if a student presents documentation of his psychiatric disability to the Office of Disabled Student Services and it has been determined that a reduced course load is a reasonable accommodation, your institution can decide to modify its policy and state that the student should be considered "full-time". As such, the student would be entitled to on live on campus, participate in student organizations, hold office, etc. despite the reduce course load. Typically these are rights, privileges and benefits reserved for full-time students. Offices affected by this decision e.g. Housing, Dean of Students, Advisor, Registrar, etc. should be notified of this decision.
The second part deals with such things as financial aid and health care coverage. With regard to institutional aid (the college's private funds), the college can decide to do whatever it would like and could award the student with a reduced course load institutional funds that are usually reserved for full-time students. However, with regard to loans and state and federal funds, there are specific requirements set forth by those entities to which the college must adhere. In most cases, there are provisions for both part-time and full-time study and the aid is adjusted according to the number of credit hours for which the student is enrolled.
The answer becomes even trickier with regard to health insurance coverage. This is a matter that should be discussed with your Registrar as well as the Academic Dean. Most health insurance companies define "full-time" very concretely. They are "going by the book" with regard to the number of credit hours in which a student is enrolled. Typically, it is the Registrar who must verify thousands of insurance forms each semester in order for a student's health coverage to continue. If a health insurance company has questions down the pike, documentation of the student's enrollment for any or all semesters could be subpoenaed in court. For this reason, it is imperative to handle this matter with extreme caution. If the institution decides that it will report these students as "full-time" to insurance companies despite the reduced number of credit hours, it is important that the "higher ups" e.g. Academic Dean, support this decision should there be legal fallout in the future. As disabilities service providers we should work closely with the Registrar and the academic side of the house to come to a decision about this matter and to assist these departments with understanding the need for adjustments to university policy as a reasonable accommodation. If we know of other schools where this is working smoothly we should suggest that the Registrar contact the Registrar at the other school to learn more about this from a colleague Many institutions will not report these students as full-time for insurance purposes. The moral dilemma is whether the institution should report the actual number of credit hours for which the student is enrolled, knowing that by doing so the student may have to forego health insurance, even if they legitimately need to carry a lighter load.