Documentation Guidelines - Mental Health Disabilities



DOCUMENTATION INFORMATION: MENTAL HEALTH DISABILITIESThe following information is intended to provide information for students who wish to register their diagnosis of a Mental Health Disability with the DRC: DefinitionsThe Americans with Disabilities Act, as amended (ADAAA) and Section 504 of the Rehabilitation Act define a disability as a physical or mental condition that substantially limits a major life activity, such as learning, working and communicating, among others. Mental health disabilities refers here to a broad range of mental and emotional conditions, and is different from other covered mental impairments such as intellectual disability, organic brain damage, and learning disabilities. The irregular nature of mental illness may create problems in establishing or maintaining consistent work or school patterns. Some individuals may need time off for medical appointments or to recuperate. The irregular nature of mental illness might also impair an individual’s performance. Persons with mental health disabilities may experience difficulties with remembering, learning, reading, concentrating and/or thinking, socially interacting and/or communicating, which may interfere directly with their ability to function in a university setting. The source for understanding the diagnostic criteria of these conditions is typically the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases: Classification of Mental and Behavioural Disorders (ICD). However, not all clinical diagnoses included in the DSM and/or ICD are included in the legal definition of a disability. For example, Substance-Related Disorders, when it involves the current or ongoing use of illegal drugs, is specifically excluded from the definition of a disability. ?Some clinical diagnoses that the ADA recognizes as potentially disabling include, but are not limited to: Obsessive-Compulsive, Bipolar, Generalized Anxiety, Mood, and Post-Traumatic Stress Disorders.The evaluation must be conducted by a qualified evaluator. Qualified evaluators are defined as those licensed individuals who are have the education and training to evaluate and diagnose mental health disorders, and have relevant expertise in differential diagnosis of mental health disorders. These may include: licensed social workers, professional counselors, psychologists, psychiatrists, neurologists, or other mental health specialists with experience and expertise in the area for which accommodations are being requested. The name, title, and professional credentials of the evaluator should be clearly stated in the documentation. It is not considered appropriate for professionals to evaluate members of their family.Documentation to Support the Diagnosis and Accommodations Must be Recent. Due to the changing nature of mental health conditions, an individual’s presentation and functional impacts of the diagnosis may vary over time even if the diagnosis remains the same. It is difficult to provide hard-and-fast rules regarding the currency of psychiatric documentation, but the DRC endeavors to be reasonable when reviewing the totality of information provided. In most instances, we require that an evaluation has been conducted within one year of the requested accommodations. However, there is room for flexibility, depending on the following variables: nature and type of disability, including its stated or implied course; severity of the disability; history of onset and/or duration of the disability; treatment status; and stability of functioning.Documentation to Support the Diagnosis and Accommodations Must be Comprehensive. A school plan such as an IEP is insufficient documentation by itself, but can be included as part of a more comprehensive report. In most cases, documentation should be based on a comprehensive diagnostic/clinical evaluation and include the following components:Clear Statement of the Diagnosis. A specific diagnosis must be based on current DSM or ICD diagnostic criteria. Citing the specific objective measures used to help substantiate the diagnosis, along with scores, can be quite helpful in documenting a reasonable need for accommodations. The evaluator should use definitive language in the diagnosis of a psychiatric disorder, avoiding such wording as “is consistent with,” “has problems with,” or “may indicate emotional problems.” Given that many individuals benefit from prescribed medications and therapies, a positive response to medication in and of itself does not confirm a diagnosis, nor does the use of medication in and of itself either support or negate the need for accommodations.History of Present IllnessCurrent symptoms, including level of severityOnset and time course of the disorder, including previous episodes of mental illness, suicidality, and/or aggressive behaviorsTreatment history (type, frequency, duration, adherence), including any previous psychiatric hospitalizations and/or outpatient treatment and medication response/efficacy/side effectsDevelopmental, educational, and psychosocial history, including established eligibility for special education, social services, and/or prior academic accommodations; coping strategies successfully used; capacity to maintain interpersonal relationships; sociocultural supportsDates and results of previous psychodiagnostic/psychoeducational/neuropsychological assessments, including rule-outs of other potential diagnoses involving neurological and/or medical conditions (including substance abuse), as well as educational, linguistic, and cross-cultural factors that may result in symptomsCurrent Level of Functioning. Reasonable accommodations are based upon the current impact of the disability, with the understanding that a psychological disorder usually presents itself across a variety of settings beyond the academic domain and its expression is often influenced by context-specific variables (e.g., school-based performance, work or job performance). The documentation must address:Present level of functioning across multiple settings, taking into account the impact of any medication treatment regimenResponse to medication treatment (efficacy, side effects) and anticipated impact to functioning in the academic setting Expected progression or stability of the impact of the diagnosed condition over timeNote: Achievement measures that substantiate the ongoing impact of the disorder on postsecondary academic performance may be necessary. If a formal psychological assessment is undertaken to help document the presence of functional limitations, it is important that the test-taker undergo such clinical testing while taking the medication. Although the ADAAA prevents considering a therapeutic response to medication to deny the presence of a disabling condition, taking into account the impact of the treatment regimen is relevant to the granting of appropriate accommodations for this population.Provide Rationale for Each Requested Accommodation. Each accommodation recommended by the evaluator must include a rationale. A link must be established between the requested accommodation(s) and the manifested symptomatology of the disorder that is pertinent to the postsecondary education setting. A diagnosis by itself does not automatically warrant accommodations. For example, “test anxiety” is not a sufficient diagnosis and would not support a request for testing accommodations. Given that many individuals may believe that they would benefit from extended time in testing situations, evaluators must provide specific rationales and justifications for the recommended accommodation. A prior history of accommodations, without demonstration of current need, does not in and of itself warrant the provision of accommodations. Accommodations can be provided only when a convincing rationale is made for their necessity to create a “level playing field.” Documentation must support the need for reasonable accommodations that allow equal access to the postsecondary academic environment without fundamentally altering essential curriculum or course requirements. Psychoeducational or neuropsychological testing is often necessary to support the need for academic accommodations based on the potential for mental health disorders to interfere with cognitive performance. Obtaining standardized measures of performance on a range of academically relevant tasks can guide the accommodation-granting process by objectively demonstrating the need for accommodations and identifying the type and extent of formal assistance that is likely to be effective. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download