Mental Health Problems

• Introduction
• General / Legal
  • Overview
  • Definition of Disability
  • Myths and Assumptions
  • Disability Legislation
  • Key Understandings
  • Disability Action Plans
  • Disclosure and Privacy
  • Inherent Requirements - Tips
• Communication / Interaction
• Universal Design
  • Inclusive Practice / Universal Design?
  • Tips for Applying Universal Design
• Disability Information
  • Accomodations for Students with Disabilities
  • Aspergers Syndrome
    • General Information
    • Teaching Strategies
    • Assessment Strategies
  • Hearing Impairment
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
  • Learning Disability
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
  • Medical Disability
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
  • Mobility Impairment
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
  • Psychiatric Disability
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
    • Additional Information
  • Vision Impairment
    • General Information
    • Communication
    • Teaching Strategies
    • Assessment Strategies
• Alternative Assessment
  • Alternative Assessment - General
  • Alternative Assessment Strategies
• Accessible On-line Teaching
• Frequently Asked Questions
• Appendices
  • Making Print Materials more Accessible
  • Accessible Word & PDF documents
  • Working with an interpreter
  • Students in Other Learning Environments
• Acknowledgements

• Guide Home

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(Source: Adapted from information in the publication
Kitchener BA and Jorm AF. (2002) Mental Health First Aid Manual
Centre for Mental Health Research, Canberra)

Some important facts

Psychiatric illnesses can affect individuals of any age, gender, and intellectual group. The onset of these illnesses can occur at any developmental period, but the onset of many types of psychiatric illnesses most commonly occurs between the ages of 18 and 25. This is of critical importance to staff working in universities since at most institutions the majority of students fall within this age range. A psychiatric illness is considered a ‘disability’ when it results in a substantial limitation in a major life activity.

The stigma of psychiatric labels, the stereotypes that come with these labels, and concern over disruptive behaviour (generally unfounded) often result in exclusion and isolation for the student with the psychiatric disability. Recognising that disruptive behaviour is not a defining characteristic of most people with psychiatric disabilities is important. Not every student who has a psychiatric disability is disruptive. Most are not. The converse is also true: Not every student who is disruptive has a psychiatric disability.

Issues that arise for these students may be the result of the disorder itself, medication taken to control symptoms, or a combination of the two. Environmental factors may also have an impact. Functional limitations include difficulty concentrating and staying focused during stressful situations (including exams), maintaining orientation to the physical layout of the campus, and selecting appropriate courses and a workable study load. Social skills involved on one-to-one and group interactions vary widely.
Students with psychiatric disabilities have accommodation needs just as other students with disabilities do. Individual students must identify themselves and provide documentation to Disability Advisers if services are needed.

Recognising signs of psychiatric or psychological illness

Some indicators of mental illness may include:

• Impaired concentration.
• Marked decline in quality of work- when this occurs it presents a ‘way in’ for staff to enter into dialogue with the student, a reason to comment in a positive and supportive way.
• Suspicion- which may lead to inappropriate behaviour and aggression
• Depression - depression may present as a pattern of lateness, the student may express feelings of hopelessness and despair, they may appear unusually lethargic and lacking in energy.
• Anxious, tense, loss of motivation.
• Irritability, agitation or loss of emotion.
• Withdrawal or marked change in participation with peers.
• Lower attendance or changed pattern of attendance.
• Talks or writes about things that don’t make sense or are very unusual.
• Delusions or hallucinations- which can present as vagueness or absentness or a lack of engagement.

The ‘context of the behaviour’ needs to be considered. General signs indicate that ‘something is not quite right’, but there are many other factors besides mental health issues which affect students, for example:

• Physical illness
• ‘Normal’ stresses or life problems
• Educational adjustment and stress
• Family responsibilities

Nevertheless, these signs could point to the possibility of mental health issues but it is important not to make this assumption lightly. If you are unsure, suggest support anyway.

General Considerations

• The need for accommodations may vary from time to time. The student’s symptoms may vary during the semester. A student with a psychiatric disability may begin the semester in good health, but may have an episode during the semester.

• The student may have to miss classes occasionally or may have an extended absence.

• The students may have symptoms that directly affect his or her ability to perform academically. Symptoms that may have a direct impact on learning include: difficulty concentrating, fatigue, memory and recall problems, and drowsiness. These symptoms may be caused by the disability or may be the side-effects of medications.

• Psychiatric disabilities are “hidden” disabilities. Psychiatric disabilities have long carried a certain stigma. These disabilities are sometimes misunderstood or perceived in a negative light. Students with these disabilities sometimes express concerns that they will be treated differently or discriminated against once their disability is revealed. These students, therefore, may not get the accommodations that would allow them to perform at their full potential. Staff can help break this cycle by providing a safe and supportive atmosphere for students and by taking students who disclose their disabilities seriously.

• Students with psychiatric disabilities may not be aware that they qualify for services available to people with disabilities. If a student reveals to you that he or she has a psychiatric disability and the student is having difficulties in class, you may want to refer him or her to the Disability Adviser.

Information about specific mental illnesses in provided at the end of this section.

Mental health problems

Mental health problems are often referred to by a range of terms, which are frequently used inter-changeably: mental disorder, mental ill-health, mental illness, psychiatric disorder, psychological disability. These terms do not give much information about what is really wrong with the person. It is important to realise that a mental health problem, though not physically obvious, is as real as a more obvious disability such as blindness or deafness. It is not an illness that is caused or cured by will-power or intelligence, but one that may be treated and stabilized with medication and support systems.

There are different categories of mental health problems that can be identified, diagnosed, and treated. Some of these disorders are common, such as depression and anxiety disorders, and some not so common, such as schizophrenia and bipolar disorder. However, all mental health problems cause a lot of disability to the sufferer- a point often not appreciated by people who have never experienced a mental health problem.

A mental illness causes major changes in a person’s thinking, emotional state and behaviour. The person’s ability to cope with stressors is impeded and their capacity to work and carry on their usual relationships is disrupted. It is important to note that the onset of many mental health problems most commonly occurs between the ages of 18 and 25. This is of critical importance to those working in postsecondary education settings since at most institutions the majority of students fall within this age range. Still, students with a mental health disability continue to be among the most misunderstood of our student population.

For university students who are used to demonstrating a high level of cognitive capacity, the effects of a mental health problem can be especially difficult as they may experience symptoms which interfere with their educational goals. These symptoms may include, but are not limited to: increased anxieties, confused or disorganized thinking, difficulty concentrating, making decisions or remembering things, restlessness and shortened attention span and highs and lows in mood. These students are intelligent and capable of pursuing and succeeding in higher education once barriers to equal access are removed.

Disability caused by mental health problems

Mental health problems can be more disabling for the sufferer than many chronic physical illnesses. ‘Disability’ refers to the amount of disruption that a health problem causes to a person’s ability to work, study, look after themselves and carry on their relationships with their family and friends. Research in the Netherlands has looked at the amount of disability caused by a large number of both physical and mental health problems. It helps to understand the amount of disability that mental health problems can cause by comparing them to physical health problems that cause the same amount of disability. For example:

• The disability caused by moderate depression is similar to the disability from relapsing multiple sclerosis, severe asthma, chronic hepatitis B or deafness
• The disability from post-traumatic stress disorder is comparable to the disability from paraplegia
• The disability from severe schizophrenia is comparable to the disability from quadriplegia.

Although mental health problems are not major killers, they are major causes of long-term disability. The Australian Institute of Health and Welfare (2) concluded that mental health problems rank as the third biggest health problem in Australia after heart disease and cancer. Of the different mental health problems, depression is the biggest single cause of disease burden. However, with the appropriate treatments and support, stabilization of mental health problems can be accelerated.