Why do schools make it so much harder for students with mental illness and disabilities?

The first time I discussed academic accommodations with my psychiatrist, it was an intricate and unfamiliar song and dance.

He looked at me coldly, and stated, “In terms of your severity of symptoms, you and I know they are severe. However, I am going to choose “moderate” on the form so the university doesn’t put you under undue surveillance. Similarly, I am not choosing “mild” symptoms, because then you’ll have difficulty getting the accommodations you need.”

It was one of the first moments I became acutely aware of the discrimination that exists in academic systems, especially higher education. It was one of many experiences I would have with ableism.

Early on in life, I learned how to advocate for my needs. Simultaneously, I learned that more often than not, my needs could be rejected, ignored, dismissed, or violated in some capacity. Over time, I started to think: why bother? As disabled university student, Mary G. stated, “Self-advocacy, the golden ticket of access can become a trigger when every attempt to self-advocate is met with subtle or overt violence.”

During my four years at college, I was faced with many uncomfortable and discriminatory conversations with Professors and administrators who had my “best interests” in mind. My requests were often met with suspicion or insult. “I don’t think you actually need that accommodation”; “I think you just need to improve your time management skills”; Often, the responses stung. “I don’t know how to differentiate from students that really need extensions and students who just didn’t start their work on time.” “I don’t want to give you an unfair disadvantage.” These exchanges would pile up until what was once a microaggression felt overwhelmingly macro.

Receiving these accommodations, however, and having these conversations in the first place, is still an important privilege to recognize. If a student’s grades slip and they don’t receive proper support from the university, they are often presented with a “choice” between academic probation or a voluntary medical leave (a tool that has been utilized to filter out mentally ill, disabled, and neurodivergent students from higher education). And often, students who are most marginalized and struggling do not have the means or resources to professionally verify a DSM-based diagnosis, making academic accommodations almost completely inaccessible. Their voices should not be left out of this conversation.

In March 2017, The Chronicle of Higher Education published an article titled Why I Dread The Accommodations Talk. The author, Gail Hornstein, states, “Like many faculty members, I dread such moments … The reason I dread such encounters is that they have become formulaic and often defensive — distant from the actual needs and talents of the student thrusting the form at me.”

Professor Hornstein - do you know what I, and many other disabled, mentally ill, and neurodivergent students dread? Proving ourselves over and over again; Explaining every symptom or experience we have. How we’re working to address it. Wondering if not using our accommodations would make a “better” impression on our Professors; knowing that, often times, the only way to get the accommodations we need is to disclose far more information than is legally necessary; sharing intimate details about our lives to appeal to your humanity.

We dread begging for your understanding and forgiveness.

A central principle of ADA & 504 law calls for Full and Equal Opportunity (i.e. reasonable accommodations).” According to the Bazelon Mental Health Law Center, “Accommodations simply provide an alternative way to accomplish the course requirements by eliminating or reducing disability-related barriers. They provide a level playing field, not an unfair advantage”

When it comes to accommodations, it’s not just about can you do this? It’s about what do you need to be able to do this?, and what does it take out of you to do this?

As a college student, I repeatedly went through an internal process to determine my limits, and what I am able to do in any given moment. If I have a 10-page essay due in the morning, and I’m on page 2 at 3:00 AM, I can potentially finish the assignment. And I often did -- by abusing substances, inducing psychotic states through limited sleep, dissociating, numbing out, and triggering some of the worst, most severe suicidal episodes I had experienced in my life. So, what I need to be able to do this becomes: drugs that are not prescribed to me, the ability to “work” all 24 hours in a day, hyperfixation. What it takes out of me to do this becomes: my stability, health, ability to properly cope and process my emotions, ability to focus or concentrate, my hope, and desire to be alive.

Can I just get that extension?

To Those Who Teach & Support Us (Professors, Administrators), I say this with love: You are not the gatekeepers of student health and wellness. It is not your job to “teach” disabled, mentally ill, and neurodivergent students how to manage their life experiences, and to cope with crises. It is not your job, as Hornstein argues, to be “determining who actually requires assistance, and in what form, and discouraging students from defining themselves by what they can’t do.” Legally, you are responsible for responding to our needs. Legally, we do not need to respond to any inquiries about our disabilities. It is highly inappropriate to offer coping strategies and ask students personal questions about how we manage our disabilities.

Our accommodations form does not give us space to list our strengths. In fact, neither does the majority of the mental health care system -- in which we are defined by our weaknesses and our deficiencies; often pathologized for our normal reactions to abnormal situations or experiences of oppression. Disabled, mentally ill, and neurodivergent students have had to learn, from our history and our communities, what makes us strong and resilient. We have spent countless hours trying to become more “neurotypical;” wishing we could produce like you expect us to. We know ourselves better than you do and our accommodations meeting is time for you to listen.
I am here, in your office, because I have accepted my limits. That is a blessing, not a curse. I have not “given up.” There is nothing wrong with being disabled.

I am allowed to fight against the compulsory able-bodiedness and able-mindedness that force me into a box. I should not have to use all of my available energy to do what neurotypical students do, to complete assignments like neurotypical students can.

Though I have had the privilege of accessing mental health care services (often out-of-pocket), I have spent 8 years misdiagnosed. At age 22, after recently graduating from college, I was diagnosed with Autism Spectrum Disorder (ASD). Autism is not a mental illness -- it is on the spectrum of neurodivergence, a different neurological state of being, thinking, and feeling. I breathed a heavy sigh of relief upon my diagnosis -- “I wasn’t making all of this up! I couldn’t have just “worked harder!”

I think back, wondering if this new lens I am viewing myself through would have made a difference in college. I wonder if I would have stopped trying to fix myself sooner. If maybe, just maybe, the shame I felt and still feel would weigh less, be less imprinted in my memories.

What would have happened if I were given the time and space to properly focus on healing, instead of wasting my energy trying to run away from myself? If I could have explored my differences and learning styles without shame and fear, but with openness and acceptance?

As Alice Wong states, “Accessibility is more than just adherence to a law. It’s an ethos that values different ways of being in the world.” Accessibility at college requires thinking beyond the structures of the institution, and imaging a university in which all students, of all abilities and capabilities, can thrive and succeed.

One of my favorite parts of the Project LETS Peer Mental Health Advocate (PMHA) training is when we ask students to design an anti-ableist university system: what would assignments look like? How would we motivate students?

One disabled student described an experience where they knew they could complete an assignment, but it wouldn’t be their best work due to recent symptoms. The professor asked them instead to write an outline of the paper they knew they were capable of completing, and to submit it when they felt ready. A week later, when the student submitted the essay, they felt calmer, more organized and proud of their work.