Academic Accommodations for Students with Psychiatric Disabilities

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Achieving equal access through accommodations and universal design

By Alfred Souma, Nancy Rickerson, and Sheryl Burgstahler

Tens of thousands of students enrolled in American postsecondary institutions report having a mental illness. Recent increases in the size of this group are due in part to improved medications that result in symptoms mild enough for them to enjoy the benefits and meet the challenges of postsecondary education. Students with psychiatric disabilities are entitled to reasonable academic accommodations as provided by the American Disabilities Act (ADA) of 1990 and 2008 amendments. Providing effective accommodations allows students equal access to academic courses and activities. The presence of students with disabilities also contributes to the diversity of the student population.

What is a Mental Illness?

"Mental illness" refers to the collection of all diagnosable mental disorders causing severe disturbances in thinking, feeling, relating, and functional behaviors. It can result in a substantially diminished capacity to cope with the demands of daily life.

A mental illness is a hidden disability; it is rarely apparent to others. However, students with mental illness may experience symptoms that interfere with their educational goals and that create a "psychiatric disability." These symptoms may include, yet are not limited to:

Psychiatric Diagnoses

A student with a mental illness may have one or more of the following psychiatric diagnoses (American Psychiatric Association, 1994).

Depression. This is a mood disorder that can begin at any age. Major depression may be characterized by a depressed mood most of each day, a lack of pleasure in previously enjoyed activities, thoughts of suicide, insomnia, and consistent feelings of worthlessness or guilt.

Bipolar affective disorder (BAD, previously called manic depressive disorder). BAD is a mood disorder with revolving periods of mania and depression. In the manic phase, a person might experience inflated self-esteem, high work and creative productivity, and decreased need to sleep. In the depressed phase, the person would experience the symptoms of depression (see above).

Borderline personality disorder (BPD). BPD is a personality disorder which includes both mood disorder and thought disorder symptoms. This diagnosis has both biological and environmental determinants. Individuals diagnosed with BPD may have experienced childhood abuse and family dysfunction. They may experience mood fluctuations, insecurities and mistrust, distortion of perceptions, dissociations, difficulty with interpersonal relationships, and limited coping skills.

Schizophrenia. This is a mental disorder that can cause a person to experience difficulty with activities of daily living and possibly delusions, hallucinations, and paranoia. Schizophrenic individuals typically demonstrate concrete thought processing and appreciate structure and routines.

Anxiety disorders. These are mood disorders in which the individual responds to thoughts, situations, environments, or people with fear and anxiety. Anxiety symptoms can disrupt a person's ability to concentrate and focus on tasks at hand. Symptoms may be in response to real or imagined fears. Specific anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, social and specific phobias, and post-traumatic stress disorder (PTSD).

The following conditions are behavior or personality disorders excluded from coverage under the ADA: transvestitism, transsexualism, pedophilia, voyeurism, gender identity disorders, compulsive gambling, kleptomania, and pyromania (Blacklock, 2001).

Functional Limitations

The following functional limitations related to psychiatric disabilities may affect academic performance and may require accommodations (Center for Psychiatric Rehabilitation, 1997).

Instructional Strategies

Students with a history of psychiatric disabilities can be intelligent, sensitive, creative, and interesting. You can employ strategies that will promote their success in your class. For example:


Some students with mental illness may require accommodations to allow them equal access to classes, programs, and coursework. An accommodation is the removal of a barrier to full participation and learning. The emphasis is on access, not outcome. This is done by providing the student with a disability equal access to the content and activities of a course, but not necessarily assuring their success.

Each student with a disability is encouraged to register with the office that supports students with disabilities in order to receive accommodations. Personnel from this office typically send instructors a letter documenting specific accommodations required for the student with the disability. It is the responsibility of the instructor to provide the accommodations. It is the student's responsibility to fulfill the academic requirements of the course. The best solutions result when the instructor, student, and disability support service professional work cooperatively. Meeting as a group may facilitate problem-solving alternatives. Respecting the privacy of the student by not discussing his or her disability or accommodations with others outside of this meeting is essential. Review accommodations periodically with the student to assess effectiveness and adjust to changing needs.

The following are typical classroom, exam, and assignment accommodations that may be recommended by the disability student service professional for a student with a psychiatric disability.

Classroom Accommodations

Examination Accommodations

Assignment Accommodations

Not all requested accommodations are "reasonable." An accommodation is not reasonable if:


American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: Author.

Center for Psychiatric Rehabilitation. (1997). How does mental illness affect the way I function at school? Boston University.

Additional Resources

DO-IT has created a collection of videos that can be freely viewed at Of particular relevance are the following titles: Building the Team: Faculty, Staff and Students Working Together, Equal Access: Universal Design of Instruction, and Invisible Disabilities and Postsecondary Education. You may also find the following resources useful as you explore this topic further.

American Academy of Psychiatry and the Law

American Psychiatric Association

American Psychological Association

Anxiety Disorder Association of America (ADAA)

The Center for Universal Design in Education

National Mental Health Association

National Alliance on Mental Illness (NAMI)

National Institute of Mental Health (NIMH)

About DO-IT

DO-IT (Disabilities, Opportunities, Internetworking, and Technology) serves to increase the successful participation of individuals with disabilities in challenging academic programs such as those in science, engineering, mathematics, and technology. Primary funding for DO-IT is provided by the National Science Foundation, the State of Washington, and the U.S. Department of Education. DO-IT is a collaboration of UW Information Technology and the Colleges of Engineering and Education at the University of Washington.

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This publication was developed under a grant from the U.S. Department of Education, #P33A990042. However, these contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the federal government.

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