The Mentally Ill: New Population on Campus

Andrew Posner has been in and out of psychiatric hospitals, lived in special homes for the mentally ill, and undergone every imaginable type of psychotherapy. Still, doctors could offer no explanation for the deep depression that had cast a shadow on his life since the age of 9.

Five years ago, though, Posner, had his first glimmer of hope. A doctor discovered a chemical imbalance in his brain and told him the condition was controllable with a drug called lithium. Soon after he started taking the drug, Posner’s emotional state had improved enough to try something unthinkable only a few months before: He enrolled in college.

“I didn’t just immediately get well. But I was well enough to realize how much time I had lost,” said Posner, now 35 and the director of BACUP, a nonprofit agency in Los Angeles that helps mentally ill clients obtain Social Security and disability benefits. “I knew I had a lot of catching up to do.”

Posner’s story isn’t unique. As more mental-health facilities close their doors and advances in psychotropic drugs help many patients adapt socially, an increasing number of people with diagnosed mental illnesses are attending college.

California classrooms now regularly include thousands of students with conditions that range from mild depression and anxiety to multiple personality disorder and schizophrenia.

“This is the emerging issue for colleges and universities in California and nationwide,” said Catherine Johns, chairman of a California Community College Chancellor’s Office task force designed to serve students with psychological disabilities.

“Suddenly, colleges are being asked to provide services for a population they’ve never served before,” she said.

In most schools that provide those new services, college counselors try to find ways to reduce the emotional stress--whether by asking teachers to make special arrangements, waiving lengthy registration lines or having the student accompanied to class. However, since the range of emotional disorders is so great, colleges report that each case often requires an individual solution.

Posner said he relied heavily on college counselors during his first two semesters at Los Angeles Valley College to “walk him through” the daily anxieties about being on campus and his struggle to fit in. “There is so much stress when you take your first step back into the world,” he said. “Without help I know I would have dropped out.”

Unlike mental retardation, psychologists say that mental illness often affects people who are average or above in intelligence. Several recent studies have shown that if given a supportive environment, many people with psychological problems can benefit significantly by going to college. According to a report published in the Journal of American College Health, students not only experience increased self-esteem, but also are far less likely to fall into the 70% of mentally ill adults who are unemployed.

“People equate mental illness with mental retardation, which is an absolute myth,” said Dennis Laurents, clinical director of the Help Group, a Van Nuys treatment and educational center for psychologically disabled teen-agers. “Many emotionally disturbed people are highly intelligent.”

Another commonly held misconception, Laurents said, is that mentally ill people have a greater propensity for violence and are thus likely to be dangerous. That view has been found false by several studies--including a report published in the American Journal of Psychiatry--that show the rate of crime among mentally ill people is no higher than in the general population.

There also is concern among educators and special service coordinators about the lack of guidelines for determining which students will benefit from going to college.

“The range of disorders is unbelievable--from students with mild emotional problems to those with such severe impairments that there is a question whether college is an appropriate place for them,” said Ken Ortiz, associate dean of special services at Orange Coast College in Costa Mesa. “Even with information, a lot of people don’t know how to deal with that.”

Janine, a student at Los Angeles Valley College with a diagnosed post-traumatic stress disorder, said she experiences frequent flashbacks of the abuse she received as a child from family members. The flashbacks come without warning--several times, she said, she has experienced them during class--and leave her emotionally incapacitated for days afterward.

Janine, who asked that her last name not be used, said college coordinators have helped her by explaining her condition to instructors, who in turn have been understanding of her frequent absences. They also have allowed her to take tests outside class. Because of that assistance, she said, she has earned B’s and hopes to transfer to a four-year university next year.

A student at Moorpark College in Thousand Oaks who suffers from manic depression and agoraphobia became emotionally distraught when she had to drive around the campus parking lot looking for a vacant space. “She couldn’t handle that part of it, so I gave her a spot in the disabled students lot,” said Jan Zaboski, coordinator of special education at Moorpark College. “That got her to class.”

Other times, however, colleges may have a more difficult time meeting a student’s special emotional needs. Many disabled-student service coordinators say that arranging for special tutoring, or note-taking or other special services can create a departmental strain.

“A lot of colleges are already having a hard time stretching their budgets to make certain that the physically disabled population gets an education,” said Robert Scott, director of the disabled-student service program at Los Angeles Valley College, and also a clinical psychologist. “Now, this is a new disability group for them.”

Under federal law, chronic mental illness is listed among those conditions protected from discrimination and requiring accommodation by colleges. But California does not now provide money specifically for that purpose. Community colleges receive state funds for special service programs based on the number of students served, Scott said. But psychologically handicapped students are not included in that financial formula.

For special service coordinators, that legal discrepancy puts them between a rock and a hard place. “According to the state, I’m not supposed to work with these people. But according to the federal government I must,” Zaboski said.

Although four-year universities with selective admission policies are less likely to be faced with the issue, officials say community colleges are hard-pressed to find solutions because of their open admissions policies. Last September, the California Community Colleges Chancellor’s Office submitted a budget proposal to the state Department of Finance, which would have allocated $260,000 for 10 community colleges throughout the state to develop model programs to address the needs of mentally handicapped students, according to Johns. That proposal was turned down.

While special service coordinators grapple with a shortage of funds, many teachers struggle with what they say is a lack of information. If the student doesn’t give permission, instructors are told nothing about his or her emotional background. As a result, situations arise that many teachers feel ill-equipped or unwilling to handle.

One teacher at Valley College, for example, said he was uncertain what to do when a Vietnam veteran, whom he later discovered suffered from post-traumatic stress disorder, suddenly stood up in class and announced in a threatening voice that he was capable of hurting everyone in the room. Another teacher said she felt “completely at a loss” when a young woman began hyperventilating during a panic attack in the back of the room.

Then there are cases in which an instructor may be informed of a student’s condition, but fellow classmates are told nothing. In some cases, instructors say students have become frightened or bewildered when they witnessed bizarre behavior; other times, teachers say they have acted unkindly or antagonistically.

David, a 31-year-old paranoid schizophrenic who asked that his last name not be used, said that other students at Valley College “sometimes make me feel like I shouldn’t even try to be here, like what they are doing is just tolerating me.” One of his instructors, though, said it sometimes gets more pointed.

“They pick on him,” said Bill Edler, professor of broadcasting at Valley College. “The rest of the class hasn’t been told he is paranoid schizophrenic.”

The complexity of the issue and the need to consider all of its facets has not escaped the attention of educators.

“Right now, there are all these issues that haven’t been properly addressed, like what rights do these students actually have? Or, what about the rights of other students?” said Rhona Hartman, director of Higher Education and the Handicapped, a nonprofit organization in Washington, D.C. “There is no consensus.”

Hartman recalled one meeting of 23 disabled-student service coordinators recently in Washington. At the meeting, she said, they discussed several incidents involving a local psychiatric hospital that had been sending many of its patients to community colleges in the area.

“One psychiatric student had threatened a teacher with a knife, and it later came to pass that the Disabled Student Service Program had known that the student had a history of dangerous actions. But confidentiality prohibited discussion of that fact with the teacher without the student’s approval,” Hartman said.

Another issue arose, she said, when a student informed a teacher she was considering suicide. “We all agreed that it was the responsibility of the teacher to inform someone about the suicidal student, but there was no agreement about a student who is potentially dangerous to others,” she said. “Most people felt that confidentiality about a disability should be maintained, but they also wanted some protection.”

In a report issued last year, the 25-member California Community College task force on psychological disabilities acknowledged the wide scope of problems, and said there is a “urgent need” for colleges to address both the “needs and rights of their student population.”

Barbara Priddy, an instructor at Orange Coast College in Costa Mesa and the mother of a schizophrenic son, said she joined the Sacramento-based task force when she got a firsthand view of the problems psychologically disabled students encounter without support services.

Priddy said her son didn’t exhibit any emotional problems until after he graduated from high school. Seven years ago, though, he was diagnosed as schizophrenic at age 25. He has been living at home with her ever since. Although she believes he is intelligent enough to benefit from an education, Priddy said the lack of any coordinated services at Orange Coast College makes it impossible for him to attend classes.

“He’s tried, but each time he goes on campus, he’s gotten too scared and overwhelmed. Those lines for registration alone can be scary,” she said. “He’s like a lot of other emotionally disturbed students who come here and then disappear because they are too fragile to handle it on their own.”

Ortiz, associate dean of special services at Orange Coast, acknowledged that the services the college provides for psychologically disabled students “aren’t extensive.”

For Janine, though, who someday hopes to earn a master’s degree in psychology, the issue of getting an education boils down to a change in social attitudes.

“Sometimes I think it would be easier if I had a physical disability that people could see at least. Then you don’t get blamed for bringing it on yourself, for not exercising self-control or for not wanting to get better,” she said. “I have this horrible thing that happened to me, and I have been disabled as a result of it. A lot of people have a hard time accepting that.”

Janine wrapped her arms tightly around her books, her eyes darting away from a visitor sitting beside her. “I saw that picture of that paralyzed man who climbed in Yosemite with his friend, and it really moved me,” she said quietly.

“I thought, ‘OK, so I’m disabled. But I could climb a mountain too, if someone gave me the support.’ ”

Posner, who now works as an advocate for mentally ill people, shares that belief. “Medically, this country is coming out of the dark ages when it comes to mental illness. Socially, I think we have a long way to go.”