service provision for students with mental health conditions: the ds perspective anna barrafato and...
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Service Provision for Students with Mental Health Conditions:
The DS Perspective
Anna Barrafato and Gordon DionneAccess 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
Medical Social
Legal/Political Cultural
Individual
Campus Culture and Values
Policies & Codes
Interactions and Environment
Models of Disability Translation to Campus
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
AnxietyCommon 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 DisorderCommon 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 disorderCommon 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
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
PTSDCommon 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
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Anxiety DisordersDepressiveBipolar and Related Disorders
Academic Accommodation
Perc
ent
of D
SOs
Most Common General Academic Accommodations:
Anxiety, Depressive, and Bipolar Disorders
0%10%20%30%40%50%60%70%
OCDTrauma and Stressor RelatedPersonalitySubstance RelatedEating DisorderSchizophrenia
Most Common General Academic Accommodations:
OCD, Trauma and Stressor, Personality, Substance, Eating Disorders, and Schizophrenia
Extra Time as an Exam Accommodation
Anxiety, Depressive, and Bipolar Disorders
25% more
time offered
33% more
time offered
50% more
time offered
75% more
time offered
100% more
time offered
Unlimite
d exam time
Other exa
m timing0%
10%
20%
30%
40%
50%
60%
70%
80%
AnxietyDepressiveBipolar and Related
Amount of Extra Time
Perc
ent
of D
SO
Extra Time as an Exam Accommodation:
OCD, Trauma and Stressor, Personality, Substance, Eating Disorders, and Schizophrenia
0%
10%
20%
30%
40%
50%
60%
70%
OCD
Trauma and Stressor Related
Personality
Substance Related
Eating
Schizophrenia
Amount of Extra Time
Perc
ent
of D
SOs
Most Common Exam Accommodations:Anxiety, Depression, and Bipolar Disorders
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
AnxietyDepressiveBipolar and Related
Most Common Exam Accommodations:OCD, Trauma and Stressor, Personality, Substance, Eating
Disorders, and Schizophrenia
Computer to ty
pe
Noise ca
ncelin
g headphones
Breaks
during exa
m offered
Altern
ate room (m
ore th
an 6 students)
Permitt
ed to lis
ten to m
usic
Room alone (single ro
om)
Small r
oom (less
than 6 students)
0%
10%
20%
30%
40%
50%
60%
OCDTrauma and Stressor RelatedPersonalitySubstance RelatedEatingSchizophrenia
Let’s Practise:Case Studies