Service Provision for Students with
Mental Health Conditions:
The DS Perspective
Anna Barrafato and Gordon Dionne
Access Centre for Students with Disabilities
July 18, 2014 2:30-4:30pm
Room: CC203
Agenda
 Introduction
 DS Models: Setting the Frame
 Mental Health Conditions: Common
Symptoms and Diagnostic Features
 Academic Accommodations for Students
with Mental Health Conditions
 Case Studies
Setting the Frame
Social Model of Disability
Medical Model
Interactional Model
Models of Disability
Medical
Legal/
Political
Social
Cultural
Translation to Campus
Individual
Interactions
and
Environment
Policies
&
Codes
Campus
Culture and
Values
The Art of Disability
“Disability is not a brave struggle or
‘courage in the face of adversity.’
Disability is an art. It’s an ingenious way
to live."
- Neil Marcus
Mental Health Conditions:
Common Symptoms, Diagnostic
Features and Academic
Accommodations
Common Mental Health
Conditions









Depression
Anxiety
Bipolar Disorder
Obsessive Compulsive Disorder (OCD)
Schizophrenia
Borderline personality disorder
Eating disorders
PTSD
Addictions
Depression
Common Symptoms and Diagnostic Features
 Depressed mood, diminished interest or pleasure
in activities, change of appetite, changes to sleep
patterns, lack of concentration, fatigue, difficulty
making decisions, suicidal ideation
What does it look like on campus?
 Appear dishevelled, miss appointments, tearful,
difficulty voicing their needs, late assignments,
absences, long emails to professors, difficulty
finishing exams on time, difficulty reading and
following instructions, little class participation
Anxiety
Common Symptoms and Diagnostic Features
 Excessive anxiety and worry, difficulty controlling
worry/thoughts, feeling restless or on edge, easily
fatigued, difficulty concentrating, irritability,
muscle tension, sleep disturbance, physiological
symptoms
What does it look like on campus?
 Speak excessively fast, complain of physical
symptoms, complain that mind goes blank on
tests, miss classes, avoid oral presentations,
difficulty participating in class discussion,
lateness, anxious around people
Bipolar Disorder
Common Symptoms and Diagnostic Features
 Cycling mood changes, manic symptoms: inflated
self- esteem or grandiosity, decreased need for
sleep, more talkative than usual, flights of ideas,
thoughts racing, distractibility, dangerous activities
(i.e., shopping sprees, sexual indiscretions etc.)
What does it look like on campus?
 Stay up all night to study, speak excessively fast,
monopolize class discussion, difficulty paying
attention in class, fidgety, impulsive responses in
class, miss classes or appointments, sense that
they have all the answers, drink lots of caffeine
Obsessive-Compulsive Disorder
Common Symptoms and Diagnostic Features
 Presence of obsessions, compulsions or both; recurrent,
persistent thoughts, urges or images (suppressed with
some other thought or action); Compulsions are
repetitive behaviors (i.e., hand washing) or mental acts
(i.e., praying, counting) used in response to an obsession
What does it look like on campus?
 Difficulty getting to class as a result of performing many
rituals before leaving the home, absences, lining up
objects on table before an exam, fear of interacting with
classmates, repeated checking with professors about
criteria for evaluation
Schizophrenia
Common Symptoms and Diagnostic Features
 Delusions, hallucinations, disorganized speech, grossly
disorganized or catatonic behavior, negative symptoms
(i.e., diminished emotional expressions or diminished
motivation in self-initiated purposeful activities)
What does it look like on campus?
 Disorganized, aloof in conversation, appear
preoccupied during conversations, may be late to
appointments or class, appear dishevelled, frequent
absences, may hand in assignments late, difficulty
getting motivated, may get distracted easily during
lectures, require handholding, difficulty making simple
decisions
Borderline personality disorder
Common Symptoms and Diagnostic Features
 Pattern of instability in interpersonal relationships, selfimage, and affect, and marked impulsivity; avoid real or
imagined abandonment, impulsivity, recurrent suicidal
behavior, threats; mood swings; chronic feelings of
emptiness
What does it look like on campus?
 Persistent lateness and absences; missed and late
assignments; inconsistent grades and academic
performance; difficulty getting along in groups;
inappropriate relationship with staff and/or faculty (i.e.,
saviour vs. aggressor “complex”); long-winded, highly
emotional emails; sudden shifts in mood
Eating Disorders
Common Symptoms and Diagnostic Features
 Anorexia Nervosa: restriction of food, fear of
gaining weight, disturbance in self-perceived
weight/body image; Bulimia Nervosa: binge
eating, compensatory behaviors to prevent weight
gain; Binge Eating Disorder: recurrent episodes of
binge eating
What does it look like on campus?
 Lack of energy, depressed mood, difficulty with
focus, missed classes, lateness, late assignments,
perfectionistic tendencies, difficulty completing
assignments
PTSD
Common Symptoms and Diagnostic Features
 Recurrent, involuntary and intrusive distressing
memories, dreams, flashbacks of the traumatic
event; intense psychological distress when
triggered; changes in cognitions and/or mood;
irritable behavior; self-destructive behavior,
exaggerated startle response
What does it look like on campus?
 Persistent lateness and absences; missed and late
assignments; variability of grades on transcript ;
dropped classes; difficulty in large groups and oral
presentations; “triggers” can appear out of the blue
Addictions
Common Symptoms and Diagnostic Features
 Unsuccessful efforts to cut down or control
drug/alcohol use; time spent on obtaining
alcohol/drugs; cravings or strong desire or urge to use;
recurrent use resulting in failure to fulfill major work,
home, or school obligations; continued use despite
social or interpersonal problems
What does it look like on campus?
 Lateness and absences; missed and late
assignments; variability of grades on transcript;
dropped classes; memory, concentration, or
attentional problems; using drugs/alcohol prior to an
exam or class
Most Common General Academic
Accommodations:
Anxiety, Depressive, and Bipolar Disorders
90%
Percent of DSOs
80%
70%
60%
50%
40%
30%
20%
Anxiety Disorders
10%
Depressive
Bipolar and Related Disorders
0%
Academic Accommodation
Most Common General Academic
Accommodations:
OCD, Trauma and Stressor, Personality, Substance, Eating Disorders,
and Schizophrenia
70%
60%
50%
40%
OCD
30%
Trauma and Stressor Related
Personality
20%
Substance Related
10%
Eating Disorder
Schizophrenia
0%
Tutoring
Access to
Use of
Access to Ability to
individual
laptop
Learning
record
supportive computer
Skills
lectures
counselling
in
Specialist
within DSO classroom within the
DSO
Access to Recognized
lecture internally
slides as full-time
student
even if only
registered
part-time
Extra Time as an Exam
Accommodation
80%
Anxiety, Depressive, and Bipolar Disorders
70%
Percent of DSO
60%
50%
40%
Anxiety
Depressive
30%
Bipolar and Related
20%
10%
0%
25% more 33% more 50% more 75% more 100% more Unlimited
time offered time offered time offered time offered time offered exam time
Amount of Extra Time
Other exam
timing
Extra Time as an Exam
Accommodation:
OCD, Trauma and Stressor, Personality, Substance,
Eating Disorders, and Schizophrenia
70%
60%
OCD
Percent of DSOs
50%
Trauma and Stressor Related
Personality
40%
Substance Related
30%
Eating
20%
Schizophrenia
10%
0%
25% more 33% more 50% more 75% more 100% more Unlimited Other exam
time offered time offered time offered time offered time offered exam time
timing
Amount of Extra Time
Most Common Exam Accommodations:
Anxiety, Depression, and Bipolar Disorders
90%
80%
70%
60%
50%
Anxiety
40%
Depressive
30%
Bipolar and Related
20%
10%
0%
Use of noise Breaks
Food and Permitted Room alone Small room Alternate Computer
canceling during exam
drink
to listen to
(less than 6 room (more to type
headphones offered
allowed
music
students)
than 6
permitted
students)
Most Common Exam Accommodations:
OCD, Trauma and Stressor, Personality, Substance, Eating
Disorders, and Schizophrenia
60%
50%
40%
30%
20%
10%
OCD
Trauma and Stressor Related
Personality
Substance Related
0%
Eating
Schizophrenia
Let’s Practise:
Case Studies