Service Provision for Students with Mental Health Conditions: The DS Perspective

1. 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

2. 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

3. Setting the Frame Social Model of Disability Medical Model

4. Interactional Model Models of Disability Translation to Campus Interactions and Environment Medical Social Individual Policies & Codes Campus Culture and Values Legal/ Political Cultural

5. 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

6. Mental Health Conditions: Common Symptoms, Diagnostic Features and Academic Accommodations

7. Common Mental Health Conditions • Depression • Anxiety • Bipolar Disorder • Obsessive Compulsive Disorder (OCD) • Schizophrenia • Borderline personality disorder • Eating disorders • PTSD • Addictions

8. 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

9. 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

10. 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

11. 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

12. 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

13. Borderline personality disorder Common Symptoms and Diagnostic Features • Pattern of instability in interpersonal relationships, self-image, 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

14. 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

15. 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

16. 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

17. Most Common General Academic Accommodations: Anxiety, Depressive, and Bipolar Disorders

18. Most Common General Academic Accommodations:OCD, Trauma and Stressor, Personality, Substance, Eating Disorders, and Schizophrenia

19. Extra Time as an Exam AccommodationAnxiety, Depressive, and Bipolar Disorders

20. Extra Time as an Exam Accommodation:OCD, Trauma and Stressor, Personality, Substance, Eating Disorders, and Schizophrenia

21. Most Common Exam Accommodations:Anxiety, Depression, and Bipolar Disorders

22. Most Common Exam Accommodations:OCD, Trauma and Stressor, Personality, Substance, Eating Disorders, and Schizophrenia

23. Let’s Practise:Case Studies