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.
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
Ex.: A student may need to learn new routines, or feel unduly
stressed when requirements or instructors change, or when new expectations are
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
*Adapted from Mancuso, L.L. (1990) Reasonable accommodations for workers
with psychiatric disabilities. Psychosocial Rehabilitation Journal,
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.
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.
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
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:
|Obstacles needed to be
overcome to continue in school:
|Difficulties with memory/concentration
|Rusty academic skills
|Lack of goals
|Lack of funds
|Ongoing obstacles (No
|Lack of goals
||Lack of self confidence
||Difficulty retaining information
|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
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