This disability category describes a broad range of mental and emotional conditions. These are different from other mental disabilities, such as organic brain damage and specific learning disabilities. The term ‘psychiatric disability’ is used when mental illness significantly interferes with the performance of major life activities like learning, thinking, communicating and sleeping. The type, duration and symptoms vary from person to person. They do not always follow a regular pattern, making it difficult to predict when symptoms and functioning will worsen, even if treatment is followed. Although the symptoms of psychiatric illnesses often can be controlled effectively through medication and/or psychotherapy, or go into remission, for some people the illness continues to cause periodic episodes that require treatment.
Anxiety disorders are the most common group of psychiatric disabilities, characterized by severe fear or anxiety associated with particular objects and situations. Most people with anxiety disorders try to avoid exposure to the situation that causes anxiety. These conditions include:
- Panic Disorder
- Obsessive-Compulsive Disorder
- Acute Stress Disorder
- Generalized Anxiety Disorder
- Post-Traumatic Stress Disorder
Mood disorders are illnesses that share disturbances or changes in mood, usually involving either depression or mania (elation). Symptoms vary but they usually involve a pronounced change in the person’s emotional state. These conditions include:
- Major Depressive Disorder (Depression)
- Dysthymic Disorder
- Bipolar Disorder
Schizophrenia and orther psychotic disorders are psychiatric disabilities with symptoms characterized by thoughts that seem fragmented and difficulty processing information, sometimes resulting in delusions, preoccupations, hallucinations, peculiarities of mood and loss of contact with reality.
Other forms of psychiatric disability include, but are not limited to:
- Eating disorders (anorexia, bulimia, binge eating)
- Substance abuse
While a psychiatric disorder may be a source of discomfort or distress, most of the more common psychiatric disorders, such as generalized anxiety disorder and major depressive disorder, do not necessarily rise to the level of causing disability. In order to trigger consideration of accommodation, the documentation required must clearly describe how such an impact is created as to substantially limit major life activities or necessitate reasonable accommodation.
All documentation must be authoritative, comprehensive and current.
Authoritative: To be authoritative, the documentation for most psychiatric disabilities must be provided by a psychiatrist or registered psychologist. For certain conditions, such as Asperger’s Disorder or Autistic Disorder, authoritative documentation may also be provided by a neurologist. In all cases, the diagnosing professional must have established expertise in the differential diagnosis of the psychiatric disorder in adolescents and adults. Comprehensive documentation meeting all other requirements, but which is from a family physician, may be adequate to support the provision of interim accommodations for up to one semester. The purpose of this interim period of support is to allow time for a student to seek the required documentation from a qualified assessor (psychiatrist or registered psychologist).
Comprehensive: To be comprehensive, the documentation needs to verify that a DSM-5 diagnosis has been established (note that reporting the specific DSM diagnosis is optional). The documentation needs to describe the ways in which the impairment substantially limits a major life activity or necessitates reasonable accommodation. In addition, there should be information about current treatment including a description of the impact of medications on the level of impairment experienced by the student, or conversely the level of impairment associated with use of the medication. There should be a statement about the expected prognosis of the disability and whether the condition is permanent or temporary. As well, the assessor should indicate if, and when, periodic reassessment is needed.
Please note that a brief letter stating that a student has a particular psychiatric disability, takes medication to treat the condition, and needs reasonable accommodations is unlikely to meet the university’s documentation requirements.
Current: To be current, the documentation must describe the symptoms and levels of impairment presently experienced by the student. This is particularly critical due to the possible changing nature of most psychiatric conditions, and as the determination of accommodations is based on an understanding of the current impact of the disorder.