Teaching & Student Expectations Around Mental Illness?

[foreverbull]

For all of the teachers out there, I've been pondering this awhile so I thought I'd put this out there to see if I"m alone in this. I think that an unintended consequence of destigmatizing mental illness in college populations has perhaps been to set up increased expectations around what instructors should do for students with mental health concerns, and I feel very conflicted and ambivalent about this as a psychologist and instructor. For example, several students I've taught in the past few years have cited vague mental health concerns as the reasons they can't complete assignments on time, and other students have asked for extensions due to mental health difficulties (without providing any documentation). Some students have also felt particularly bitter toward me when I did not change my policies when they asked to turn assignments in late (they claimed that they had certain disorders or mental health issues). I've also noticed that there are now mental health accommodations that allow students to miss extra classes above and beyond what instructors allow for mental health reasons.

When I was an undergrad student, these things were not discussed with teachers, that I can recall, and while it's better that we're now discussing mental health openly, I also feel ambivalent about the expectations that may be arising from this openness. I do find it concerning that some students seem to expect more leeway due to mental health concerns. My personal belief is that if mental health issues are preventing folks from coming to class regularly and turning in assignments, they probably need to withdraw from the class because they aren't able to function in a major domain of living. Other students face mental health challenges yet don't ask for extensions, and I wouldn't even know they struggle with mental illness because they manage it effectively and attend class regularly. Once students graduate, the job world will be much less accommodating, for sure, so I also feel ambivalent about this because after graduation, employers are not going to hold their hands if they claim vague mental health issues and decide they can't go to work or do their jobs, and if students are protected from real world consequences such that they experience a shock when they start working full-time, are we really preparing them for their careers? Here's where I'm not sure if I'm being too harsh about this.

Is anyone else seeing this? What are your thoughts? Is this generational? My thoughts are a bit rambly, but I'm trying to work through it and think your input in this is valuable.

---

Members don't see this ad.

 

[MCParent]

I've always required documentation. I say in the syllabus and on the first day (which is also recorded and posted online for people who add my course late), that as much as I find it distasteful to require things like a death certificate, funeral notice, or letter that the student is under duress, there is a long history of exam season being deadly for grandmas. Same deal with this, I'd assume--you can't assess them as their instructor so they need a note like any other medical absence or extension.

 

[WisNeuro]

Been a while, but when I taught, I also required documentation. I had several students every semester with accommodations from the Student Services center for ADHD/LD. We always met prior to start of class and laid down expectations and such.

As for other stuff, everyone is held to the same standards. Things do indeed come up, and they are taken on a case-by-case basis. As MCP laid out, my syllabus was pretty clear that some verification would be needed for extended absences, missed exams, and the like. As for MH concerns aside from the cases with pre-existing accommodations, if it's causing significant disruption in being able to meet with class demands, that person should probably be taking time off or a reduced class load to help deal with things.

 

[PhDenial]

Other students face mental health challenges yet don't ask for extensions, and I wouldn't even know they struggle with mental illness because they manage it effectively and attend class regularly.

I've been a TA for some semesters, and even though I have the same ambivalence you do regarding providing extensions/allowances for mental health issues, I find issue with this statement. We should know that mental health challenges present differently for different individuals, and just because one student can pull it together doesn't mean we should hold every student to that same standard. I get what you're saying- I'm one of those people who struggle with ADHD and anxiety but manage to keep it together, for the most part- but I wouldn't expect everyone to be able to deal with mental health issues in the same way I do. It's that whole equity vs. equality thing. Different students/individuals just need more support/assistance than others.

 

[Ollie123]

Been a while since I've taught, but I treated it the same way I did medical illness. Bring me documentation and I will provide reasonable accommodations in line with what our disability services office recommends. If your issues (however defined) prevent you from attending class regularly, I will be happy to sign documentation so you can withdraw. Don't want to withdraw, but can't make it to class regularly? That sounds like a tough situation. Might want to talk to your provider about whether it is better to risk the F or move forward with withdrawing.

I've made minor exceptions for people - I did have one student who was either particularly unfortunate or particularly devious who missed an exam and "couldn't afford to go to the doctor" (wasn't covered by student health services). Gave them one make-up time the next day and told them to be there.

 

[foreverbull]

I've been a TA for some semesters, and even though I have the same ambivalence you do regarding providing extensions/allowances for mental health issues, I find issue with this statement. We should know that mental health challenges present differently for different individuals, and just because one student can pull it together doesn't mean we should hold every student to that same standard. I get what you're saying- I'm one of those people who struggle with ADHD and anxiety but manage to keep it together, for the most part- but I wouldn't expect everyone to be able to deal with mental health issues in the same way I do. It's that whole equity vs. equality thing. Different students/individuals just need more support/assistance than others.

I hear what you're saying, and I do assess on a case-by-case basis (individual differences), as you mention.
But the main issue I'm speaking to is that students tend to claim mental illness or mental health challenges with no documentation whatsoever, and this is where the struggle is. I tend to treat mental illness the same as medical concerns (documentation required), as others have mentioned. However, there's been a noticeable uptick in students requesting leeway without any documentation, and sometimes bitterness and resentment when I don't change my policies without documentation.

Maybe I'm just finding that students without mental illness are using mental illness as an excuse more these days?

 

[PhDenial]

I hear what you're saying, and I do assess on a case-by-case basis (individual differences), as you mention.
But the main issue I'm speaking to is that students tend to claim mental illness or mental health challenges with no documentation whatsoever, and this is where the struggle is. I tend to treat mental illness the same as medical concerns (documentation required), as others have mentioned. However, there's been a noticeable uptick in students requesting leeway without any documentation, and sometimes bitterness and resentment when I don't change my policies without documentation.

Maybe I'm just finding that students without mental illness are using mental illness as an excuse more these days?

Thanks for the clarification! I can definitely see that, and perhaps there is a lack of differentiation between legitimate mental health concerns and the occasional "feeling down/feeling like you can't get out of bed this morning." To make a medical comparison, it would be the difference between having a concussion and having a mild headache (with the former, a student would reasonably be expected to miss class, whereas with the latter, a student would reasonably be expected to just suck it up and attend class).

It's unfortunate because I can see this issue potentially making it difficult for students with actual mental health concerns to be taken seriously and provided the supports they need. I completely understand your feelings of frustration/confusion about the issue. I think you're doing the right thing by asking for documentation, though, even if students' bitterness makes it difficult to do so.

 

[PsyDr]

In disability the person must request reasonable accommodations prior to the problem. It's an issue of access, not performance.

 

[erg923]

I once dedicated an entire class to final exam prep, review, and overall Q&A. When one student asked if I was going to give them a hard-copy study guide too, I said "uh, no." You might have thought I just shot a puppy or something. I haven't taught a full class for 2 years now. I do miss it, but not all that much.

I really rejected any push for "attendance" for regular classes during the term. In-class quizzes were weighted so little (compared to projects, papers, and exams), nobody could really fight me on it even if they missed a few classes. I had a couple major exam make-up days built-in to office hours.

 

[futureapppsy2]

Man, there's a lot of misinformation in this thread:
-Reasonable accommodations are decided in an "interactive process" between the student, disability services office, and the instructor. This includes deciding to what degree attendance or on-deadline assignment submission is an "essential function" to the course and at what point the requested flexibility alters that function or becomes an undue burden.

-You cannot legally request documentation of a students's disability beyond a letter stating that they have one and have been approved from X accommodations by the disability services office. You cannot legally ask for a specific diagnosis or category of diagnosis, treatment notes, diagnostic reports, etc.

-Short-term illnesses (say, colds) are not legally considered disabilities.

-You do not have to provide any accommodations for students who don't go through the disability services office.

-Legally, you can change the rules for any student, but going around the disability services office opens you to potential legal liability.

-You have to provide all accommodations approved by the disability services office. If you disagree with them, you have to go through the interactive process.

-Flexibility with deadlines on long-term assignments is very rarely offered as an accommodation, FWIW.

 

[Ollie123]

erg brings up a good point - I also shied away from any formal attendance points or things of that nature. Only time I required it was one upper-level seminar that was more discussion-focused and MUCH smaller so we kinda needed people in the room. Would occasionally give small "bonuses" (extra credit quizzes, one semester I would end random classes with hints on specific exam questions that I deliberately did not put on slides).

I always found it odd when faculty both require attendance and get upset when people don't seem to be paying attention. My (personal) view is at the college level you need to pick between those two. As an undergrad I was usually the kid who never showed up and still aced everything, so I felt like it would be a bit hypocritical if I didn't let autonomous learners do their thing. Again - obvious exception for discussion-focused classes. Also saved me a lot of unnecessary back and forth about that nonsense and it does help the responsible students who may have health issues (or other legit reasons) for attendance problems. If they know the material at the end of the semester, I could care less about the process through which they got there.

 

[erg923]

erg brings up a good point - I also shied away from any formal attendance points or things of that nature. Only time I required it was one upper-level seminar that was more discussion-focused and MUCH smaller so we kinda needed people in the room. Would occasionally give small "bonuses" (extra credit quizzes, one semester I would end random classes with hints on specific exam questions that I deliberately did not put on slides).

I always found it odd when faculty both require attendance and get upset when people don't seem to be paying attention. My (personal) view is at the college level you need to pick between those two. As an undergrad I was usually the kid who never showed up and still aced everything, so I felt like it would be a bit hypocritical if I didn't let autonomous learners do their thing. Again - obvious exception for discussion-focused classes. Also saved me a lot of unnecessary back and forth about that nonsense and it does help the responsible students who may have health issues (or other legit reasons) for attendance problems. If they know the material at the end of the semester, I could care less about the process through which they got there.

It is a smallish college, and there was a big push for this from the Dean, apparently.

Fortunately, I was familiar with the Psychology Department Chair peripherally for years, so I was able to bluntly tell him that I thought this was stupid. He said there was no way he could really enforce it (and that my teaching reviews would probably go better without it). That was the end of taking "attendance" for Dr. erg923.

 

[futureapppsy2]

erg brings up a good point - I also shied away from any formal attendance points or things of that nature. Only time I required it was one upper-level seminar that was more discussion-focused and MUCH smaller so we kinda needed people in the room. Would occasionally give small "bonuses" (extra credit quizzes, one semester I would end random classes with hints on specific exam questions that I deliberately did not put on slides).

I always found it odd when faculty both require attendance and get upset when people don't seem to be paying attention. My (personal) view is at the college level you need to pick between those two. As an undergrad I was usually the kid who never showed up and still aced everything, so I felt like it would be a bit hypocritical if I didn't let autonomous learners do their thing. Again - obvious exception for discussion-focused classes. Also saved me a lot of unnecessary back and forth about that nonsense and it does help the responsible students who may have health issues (or other legit reasons) for attendance problems. If they know the material at the end of the semester, I could care less about the process through which they got there.

Some of the focus on attendance has to do with federal financial aid requirements where we have to document the "last day attended" for students who fail the course.

 

[WisNeuro]

-You cannot legally request documentation of a students's disability beyond a letter stating that they have one and have been approved from X accommodations by the disability services office. You cannot legally ask for a specific diagnosis or category of diagnosis, treatment notes, diagnostic reports, etc.

At least from MCPs and my comments, our request for documentation was centered around acute issues that students claimed to miss exams and such (e.g., family death, sudden Dr's apt, etc).

 

[futureapppsy2]

At least from MCPs and my comments, our request for documentation was centered around acute issues that students claimed to miss exams and such (e.g., family death, sudden Dr's apt, etc).

Yep. That’s why I made a bulletin point addressing that. But I’ve seen a lot of psych professors especially ask students for diagnostic reports, and that’ll get you sued.

 

[foreverbull]

Man, there's a lot of misinformation in this thread:
-Reasonable accommodations are decided in an "interactive process" between the student, disability services office, and the instructor. This includes deciding to what degree attendance or on-deadline assignment submission is an "essential function" to the course and at what point the requested flexibility alters that function or becomes an undue burden.

-You cannot legally request documentation of a students's disability beyond a letter stating that they have one and have been approved from X accommodations by the disability services office. You cannot legally ask for a specific diagnosis or category of diagnosis, treatment notes, diagnostic reports, etc.

-Short-term illnesses (say, colds) are not legally considered disabilities.

-You do not have to provide any accommodations for students who don't go through the disability services office.

-Legally, you can change the rules for any student, but going around the disability services office opens you to potential legal liability.

-You have to provide all accommodations approved by the disability services office. If you disagree with them, you have to go through the interactive process.

-Flexibility with deadlines on long-term assignments is very rarely offered as an accommodation, FWIW.

This comes up most often outside of the realm of disability services, with students requesting lenience due to mental health challenges without disability status (disability status is a separate issue, and teachers know to honor them without seeking further detail).

For example, a student reports that a family member has passed away, causing distress, but provides no documentation to support it and stops attending class and/or turning in assignments. Another example would be a student saying he/she/they have panic attacks and need an extension on an assignment. Sometimes there is an acute event claimed, other times, students just vaguely say they have mental health issues and have been triggered by different things (or perhaps claim a diagnosis) and request more flexible deadlines or more flexible attendance. There's variability in the way these concerns are presented.

 

[futureapppsy2]

This comes up most often outside of the realm of disability services, with students requesting lenience due to mental health challenges without disability status (disability status is a separate issue, and teachers know to honor them without seeking further detail).

For example, a student reports that a family member has passed away, causing distress, but provides no documentation to support it and stops attending class and/or turning in assignments. Another example would be a student saying he/she/they have panic attacks and need an extension on an assignment. Sometimes there is an acute event claimed, other times, students just vaguely say they have mental health issues (or perhaps claim a diagnosis) and request more flexible deadlines or more flexible attendance. There's variability in the way these concerns are presented.

For things like funerals, that's not disability-related (may go through your student affairs people depending on the campus). For the other situations, refer students to your student disability services office (panic disorders are disabilities, depression is a disability, etc). I mean, honestly, a lot of them can kind of suck, but it's the only way both you and the student are legally protected and it keeps you out of the decision-making role as well. Not doing so opens you up to the possibility of disparate treatment legal liability.

 

[Ollie123]

I'm actually not sure I saw much disagreement between what you posted and what people had said. Maybe I'm wrong, but at least I was referring to disability services documentation for things where that is appropriate (i.e. not the one-off acute issues). I can't fathom asking for a diagnostic report or anything along those lines, though I don't doubt it happens. Providing actual disability accommodations was remarkably straightforward/simple at every institution I've worked in because there is invariably a disability services office who handles everything. In my experience, they are usually quite conservative in what sort of accommodations they request for people and are usually happy to do the heavy-lifting (i.e. if student gets extended time they will administer the exam in their office so I don't have to figure out how the heck to find a 4 hour block of time to proctor). The students who used them were also usually quite content using the accommodations they got and I can think of only one time they attempted to backchannel additional accommodations, in which case it was very easy to punt the matter to disability services who were quite content to tell them to suck it up. These were by far the easiest cases I got teaching, though maybe I was just lucky enough to have good support.

I think its what to do about the "I'm super-stressed about my other exams. Can I take yours at another time?" that cause issues. Actually that one doesn't cause issues because I just tell them no, but you get the point. Or my personal favorite, when ROTC tried to tell me I had to schedule their students a separate exam two days early because they needed to know if they could walk in their separate graduation ceremony that took place before the end of exams. No. Reschedule your graduation ceremony to align with the school calendar if you want, like you should have done in the first place.

RE: attendance - we always said it could just be the last date some documentation of class participation happened (last exam, last assignment turned in, etc.). It seems outlandish to take attendance for just that reason, though I don't doubt it happens.

 

[foreverbull]

For things like funerals, that's not disability-related (may go through your student affairs people depending on the campus). For the other situations, refer students to your student disability services office (panic disorders are disabilities, depression is a disability, etc). I mean, honestly, a lot of them can kind of suck, but it's the only way both you and the student are legally protected and it keeps you out of the decision-making role as well. Not doing so opens you up to the possibility of disparate treatment legal liability.

This is fair, but I’ve never seen assignment extensions as part of disability accommodations in my experience, and this is the request I get most often. Is that what you’re suggesting—let student disability services be the entity that says “no, extensions are not part of accommodations?”

 

[futureapppsy2]

This is fair, but I’ve never seen assignment extensions as part of disability accommodations in my experience, and this is the request I get most often. Is that what you’re suggesting—let student disability services be the entity that says “no, extensions are not part of accommodations?”

Yep, exactly! Not only is it the most legally and procedurally safe route, it also protects you from being seen as the "bad guy."

 

[ExploringOptions]

I’ve definitely seen assignment extensions as part of a disability accommodation. Had a student with one in my TA last year. He was entitled to turn things in two days late with two days notice ahead. He began abusing it and tried to not count weekends or days he didn’t have class as one of the two days he has to turn things in late. (This kid was always trying to work the system.) we had to crack down and repeatedly point out what his DSS memo said and didn’t say. Eventually, he decided to audit the class and even then he asked if he could take the final and if I could still grade his assignments so he would have practice before he took it again. We said no. Having the DSS memo was exactly what we needed to keep him from abusing the system.

 

[Fan_of_Meehl]

For all of the teachers out there, I've been pondering this awhile so I thought I'd put this out there to see if I"m alone in this. I think that an unintended consequence of destigmatizing mental illness in college populations has perhaps been to set up increased expectations around what instructors should do for students with mental health concerns, and I feel very conflicted and ambivalent about this as a psychologist and instructor. For example, several students I've taught in the past few years have cited vague mental health concerns as the reasons they can't complete assignments on time, and other students have asked for extensions due to mental health difficulties (without providing any documentation). Some students have also felt particularly bitter toward me when I did not change my policies when they asked to turn assignments in late (they claimed that they had certain disorders or mental health issues). I've also noticed that there are now mental health accommodations that allow students to miss extra classes above and beyond what instructors allow for mental health reasons.

When I was an undergrad student, these things were not discussed with teachers, that I can recall, and while it's better that we're now discussing mental health openly, I also feel ambivalent about the expectations that may be arising from this openness. I do find it concerning that some students seem to expect more leeway due to mental health concerns. My personal belief is that if mental health issues are preventing folks from coming to class regularly and turning in assignments, they probably need to withdraw from the class because they aren't able to function in a major domain of living. Other students face mental health challenges yet don't ask for extensions, and I wouldn't even know they struggle with mental illness because they manage it effectively and attend class regularly. Once students graduate, the job world will be much less accommodating, for sure, so I also feel ambivalent about this because after graduation, employers are not going to hold their hands if they claim vague mental health issues and decide they can't go to work or do their jobs, and if students are protected from real world consequences such that they experience a shock when they start working full-time, are we really preparing them for their careers? Here's where I'm not sure if I'm being too harsh about this.

Is anyone else seeing this? What are your thoughts? Is this generational? My thoughts are a bit rambly, but I'm trying to work through it and think your input in this is valuable.

Thank you for being so open about this. I think it's a real problem.

I think it is generational and I don't think this perspective comes from a position of hate but one of truth.

One of the things I have tried to do is 'not lie' when it comes to veterans (or any clients).

"Doc, do you think that my problems with being irritated with my spouse or having problems sleeping are due to brain damage from my concussion 8 years ago?"

(me, not lying) "No, I have no reason, considering the scientific/clinical literature on mTBI, to strongly suspect that your concussion from 8 years ago is a potent cause of these difficulties...let's talk about your sleep hygiene, sleep apnea, drinking 10 standard drinks per night, and lack of assertive communication strategies as possible contributors to these problems."

Notice, I don't claim the 'truth' that 'your head injury is not a cause of your problems' (****, I don't know that, who could?). What I do is 'not lie.' Honestly, I have no compelling scientific or clinical reason to believe a concussion 8 years ago is causing these issues. But I do have good reason to suspect poor sleep hygiene, depression, anxiety/avoidance, etc. as contributors to the problem.

Fark! It is a sign of the times that simply 'not lying' on the part of providers is so violently persecuted by patients/administrators/excellentologists.

LOL, best wishes to you.

 

[Fan_of_Meehl]

I hear what you're saying, and I do assess on a case-by-case basis (individual differences), as you mention.
But the main issue I'm speaking to is that students tend to claim mental illness or mental health challenges with no documentation whatsoever, and this is where the struggle is. I tend to treat mental illness the same as medical concerns (documentation required), as others have mentioned. However, there's been a noticeable uptick in students requesting leeway without any documentation, and sometimes bitterness and resentment when I don't change my policies without documentation.

Maybe I'm just finding that students without mental illness are using mental illness as an excuse more these days?

Please stick with your gut on this. It is probably correct. No one helps another by colluding with them to avoid the truths about their lives or their relationship with their suffering.

 

[foreverbull]

Everyone in here has given me a lot of good input, and a new tactic (refer students to SDS more when some of these concerns arise). I will continue to reflect on everyone’s perspectives. My current policy is fair but can certainly be tweaked as I go. I’m sure I’ll get better at balancing sensitivity to mental health concerns with consistency and equity, I just don’t want to end up at either extreme.

 

[Fan_of_Meehl]

Everyone in here has given me a lot of good input, and a new tactic (refer students to SDS more when some of these concerns arise). I will continue to reflect on everyone’s perspectives. My current policy is fair but can certainly be tweaked as I go. I’m sure I’ll get better at balancing sensitivity to mental health concerns with consistency and equity, I just don’t want to end up at either extreme.

You're a good person/professional. The self-questioning is the key.

 

[Fan_of_Meehl]

self-doubt is the hobgoblin of the honest conscience

 

[ExecutiveDysfunction]

Somewhat related topic.

My spouse teaches an online course and, for one of her exams, students with and without disabilities have traditionally completed the exam in well under an hour (maximum 50 minutes), for both people with and without time and a half accommodations.

Given that a number of students in her classes have extra time accommodations, she gave all of the students 2 hours maximum to complete the exam. It’s an online class, so it needs a maximum for the exam anyway, and 2 hours is well beyond what anyone will need.

A concern was raised by a student that he/she has as not receiving extra time relative to other students, and for the disability office involved. My spouse is obviously going to comply, but we’re curious about the accommodation required here. In other words, does she need to give time and half relative to what the typical student should need (1.5 hours) or time and a half relative to what every student is otherwise getting (3 hours total). Just curious if anyone’s thoughts if they have more experience, as any teaching I’ve done myself has not run into this issue.

 

[foreverbull]

I think it’d be 3 hours based on what everyone is getting as “standard time.” I ran into this issue with an online exam and thought about giving everyone more time than they needed as well, but figured there’d be an issue since some students get 1.5x the standard test time. Because of the accommodation, some will see it as unfair regardless of whether two hours should be enough time for everyone. Allowing everyone the same “extended” time is a good idea in theory, but not in practice because it can look like the teacher isn’t honoring the accommodation.

Figuring out just how to allow just a certain subset of students on one’s platform to have extra time on the online test (and privately so as not to breach confidentiality) is another matter entirely, however!

 

[PsyDr]

Upon reflection, it may be the case that there is some opportunity to educate students about the differences between lay descriptions of "depressed" and diagnosable things like Major Depressive Disorder.

 

[WisNeuro]

Upon reflection, it may be the case that there is some opportunity to educate students about the differences between lay descriptions of "depressed" and diagnosable things like Major Depressive Disorder.

These students have taken intro to psych, they're like, experts, now.

 

[PsyDr]

These students have taken intro to psych, they're like, experts, now.

They have read a LOT of stuff about serial killers. They want to be like Silence of the Lambs. Or a profiler. And their aunt is a psychologist, but she didn't need a doctorate. And she makes $400k/year.

And no one knows how hard it is, because they have anxiety or depression. Can't everyone just do what they say?! GAWD!

 

[futureapppsy2]

Somewhat related topic.

My spouse teaches an online course and, for one of her exams, students with and without disabilities have traditionally completed the exam in well under an hour (maximum 50 minutes), for both people with and without time and a half accommodations.

Given that a number of students in her classes have extra time accommodations, she gave all of the students 2 hours maximum to complete the exam. It’s an online class, so it needs a maximum for the exam anyway, and 2 hours is well beyond what anyone will need.

A concern was raised by a student that he/she has as not receiving extra time relative to other students, and for the disability office involved. My spouse is obviously going to comply, but we’re curious about the accommodation required here. In other words, does she need to give time and half relative to what the typical student should need (1.5 hours) or time and a half relative to what every student is otherwise getting (3 hours total). Just curious if anyone’s thoughts if they have more experience, as any teaching I’ve done myself has not run into this issue.

There was actually a federal case on this. Extended time as a disability accommodation is always the time given times the extension (so, 3 hours x 1.5=4.5 hours, for example), NOT the time the instructors thinks the exam "should" take. This does not apply to things like take home exams where the students are given multiple days to complete the exam at their leisure.

 

[ExecutiveDysfunction]

As always, the collective knowledge of the board is much appreciated! Good to know, despite good intentions it’s easy to mess up these things.