What is it? The concept of “mental illness” has long aroused perceptions of fear and negativity. From the Middle Ages, where mental illness was seen as a sign of possession by evil spirits, to the more recent warehousing of individuals with mental illness in asylums, mental hospitals, or institutions, it is clear that our history of dealing with people with psychiatric disabilities is marked by ignorance and insensitivity.

Unfortunately, despite considerable advances in our ability to effectively identify, diagnose, and treat various forms of mental illness, ignorance and insensitivity continue to haunt the lives of  people with psychiatric disabilities.  Even on university campuses, where great pride is taken in efforts to promote an atmosphere of accessibility, acceptance, and celebration of diversity, students with psychiatric disabilities are prone to feel marginalized, disempowered, and misunderstood.

Psychiatric disability can be defined in many ways.  It is roughly synonymous with mental illness, but some clarification may aid understanding.  Mental illness can be understood as a broad term describing any of the hundreds of mental disorders listed in the American Psychiatric Association’s (1994) Diagnostic and Statistical Manual of Mental Disorders – 4^th edition (DSM-IV).  According to the DSM-IV, a mental disorder “is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.  In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one” (p. xxi).

As is clear from this definition, a mental disorder may or may not reflect a disability, depending on how it is manifest. That is, two students with similar diagnoses may present different symptom profiles and levels of functioning, thereby necessitating examination of needs on a case by case basis. For this reason,  a diagnosis alone does not constitute a psychiatric disability; there must also be evidence of functional impairment in an important area of daily life, such as academics.

Because of concerns about stigmatization and other negative reactions, students with psychiatric disabilities are often afraid to disclose their mental health status to service providers on campus.  As a consequence, there is no way to reliably estimate the number of such students in higher education today. If we extrapolate from samples in the wider community, however, where prevalence estimates of  5-10% of the population are often reported, it is clear that there could be a very large number of students with psychiatric disabilities on campus.  What is also clear is that today there is increased awareness of the unique needs of these students and how they must be supported if they are to succeed in higher education (see Web Resources).

Since the needs of students with psychiatric disabilities can vary widely, depending on the condition they have, their degree of disability, the amount of community support they receive, and other factors, a multidisciplinary approach is most beneficial.   A coordinated effort among various health care professionals and service providers, including psychologists, physicians, counsellors, disability service providers, and student advocates, seems to offer the best potential for satisfactory outcomes.  In addition, partnerships with community agencies, mental health consumer advocacy organizations, and groups of students with psychiatric disabilities can also be beneficial.  Finally, efforts to promote awareness of accessibility, educational, and clinical needs for students with psychiatric disabilities among faculty, administration, and support staff can also help to facilitate the success of these students in higher education.

Some concrete steps that can be taken to promote the success of students with psychiatric disabilities in higher education include: (a) confirming formal recognition of psychiatric disabilities as a qualifying condition for academic accommodations (e.g., private space for exams for students with anxiety disorders who may be easily distracted by others; extended time on exams for students who may process information more slowly because of depression or the side effects of medication); (b) providing on-campus therapeutic services, including psychological and medical services accessible on a drop-in or crisis basis as well as for longer-term support; (c) promoting advocacy efforts around campus to help raise awareness of the needs and issues confronting students with psychiatric disabilities; (d) accessing community resources, such as the Canadian Mental Health Association (www.cmha.ca), information and other supports; and (e) striving to destigmatize psychiatric disabilities through workshops, networking, and other educational endeavors.

Finally, it is important to realize that the vast majority of individuals with mental illness, including students with psychiatric disabilities, do not constitute any sort of threat or safety concern.  Popular media stereotypes to the contrary, there is no evidence that persons with mental illness are generally any more violent or dangerous than anybody else.  Moreover, by working to overcome the marginalization of these individuals, through increasing accessibility to higher education, their contributions to society may be maximized, and all will be enriched.