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Mental health manual


An Educator’s Guide To Successfully Working With Students Who Are Recovering From Mental Illness Deborah Tull, M.S.
Mental Health Education Consortium Project Funded by Fund for Instructional Improvement Chancellor’s Office California Community Colleges The knowledge presented through this publication is designed for community college professionals to shape new attitudes about stu- dents recovering from mental illness. The increased knowledge and sensitivity will foster improved instructional delivery and service pro- vision to this segment of our college population. It will be through the combined efforts of faculty members and the Mental Health Educa- tion Consortium Project that students recovering from mental illness will have the opportunity to achieve greater success in college and in their personal lives.
The Mental Health Education Consortium Project is a collaborative effort between the Los Angeles Community College District and the Los Angeles County Department of Mental Health. The Project wishes to give a very special acknowledgement for the tremendous support that was provided by the following individuals: Sarah Minden, Bar- bara Wallace, Surrah De Almeida, Amarylles Hall, Gary Perkins, Frank Quiambao, Susan Steele, Steven Swaim, Marsha Grove, and Patricia Waldeck.
For Further Information Regarding this Project and This Publication Deborah Tull, Project Director Mental Health Education Consortium Project Los Angeles Harbor College 1111 Figueroa Place Wilmington, CA 90744 The History of Mental Illness: Myth vs. Facts. 4The Myths and Facts of Mental Illness . 5-8Prevalence of Mental Illness In Today’s World. 9Causes of Mental Illness . 10Cultural Understanding of Mental Illness . 11Basic Types of Mental Illness . 12Generalized Anxiety Disorder (GAD). 13Manic Depression (Bipolar Disorder) . 14Major Depression . 15-16Obsessive-Compulsive Disorder . 17Panic Disorder. 18Post-Traumatic Stress Disorder (PTSD) . 19Schizophrenia . 20Substance Abuse Drugs/Alcohol . 21Treatment of Mental Illness . 22Common Psychotherapeutic Drugs . 23-24The Role of Educators As Effective Change Agents . 25More Similar Than Dissimilar: A Universal Set of Needs . 26Identification of Students In Trouble . 27Functional Limitations That Recovering From MentalIllness May Experience . 28Campus Strategies And Accommodations For Access, Retention, And Student Success . 29 Faculty Interventions For Student Success . 30World Wide Web Resources . 31Mental Health Education Consortium Project Bibliography. 32-34 THE HISTORY OF MENTAL ILLNESS: MYTH VS. FACT
It has only been within the past decade that we have begun to understandthe true causations and cures of mental illness.
The understanding of mental illness has historically been clouded by ig-norance: n The mentally ill were thought to be possessed by evil sprits.
n The mentally ill were thought to be chosen by higher powers for punishment.
n The mentally ill were though to be victims of bad fate, religious and moral transgression or even witchcraft.
n The mentally ill were typically ridiculed, tormented and alien- ated from society.
The care and treatment of the mentally ill was often cruel and inhumane: n Treatment included burning at the stake, drilling a hole in the person's head to release evil spirits, dunking under water, andexorcism.
n Blood transfusions and blood letting were cures for depression n The mentally ill were often thought to act in criminal ways so they were chained in filthy cells and viewed on Sundays asentertainment.
It wasn't until the eighteenth century that mental illness became recog-nized as an illness. Sweeping reforms took place and the mentally ill wereunchained and humanly treated. Furthermore, it wasn't until the twentiethcentury that treatment modalities drastically changed and medication used.
It is now very clear that mental illnesses are diseases of the brain. Ninety-five percent of what is known about the human brain was only discov-ered during the last decade. It is now known that mental illnesses aremuch like cancers, diabetes, heart diseases and other physical illnessessince they have biochemical causes and medical treatments. If a particu-lar mental illness cannot be totally cured it can certainly be controlledthrough treatment - just like diabetes. Ninety percent of people withmental illness can be helped through therapy and medication.
THE MYTHS AND FACTS OF MENTAL ILLNESS
MYTH: People with mental illness can never be normal or productive. If hired they
would be of lower quality with little or no capacity for higher level jobs.
FACT: Many people who have experienced mental illness are highly successful and
happy. Ninety percent of these people can be helped with therapy and
medication; they can be as vital and effective as any one else. Many high level jobs
are performed by people who have experienced mental illness. Persons who have
had mental illness have excelled in many areas. Role models include: Abraham
Lincoln, Ludwig Beethoven, Edgar Allan Poe, Vincent Van Gogh, Issac Newton,
Ernest Hemingway, Winston Churchill etc.etc.etc.
MYTH: Mentally ill people are dangerous.
FACT: Mentally ill people are not typically violent or dangerous. In rare instances
when violence occurs, it is when the person is very seriously mentally ill and/or not
under treatment. Research from the National Institute for Mental Health indicates
that only 1% of mentally ill persons are potentially dangerous.
MYTH: Psychological treatment causes brain damage which can be seen by a
patient's robot-like behaviors and expressions.
FACT: Robot-like behaviors and expressions are a symptom of the illness and not
an effect of the treatment.
MYTH: People who appear to act in a functional way with a logical speech pattern
and good memory are not mentally ill.
FACT: There are many types and forms of mental illness which do not affect
memory or ability to speak appropriately. Many individuals recovering from mental
illness appear to be "normal."
THE MYTHS AND FACTS OF MENTAL ILLNESS
MYTH: Mental illness is unlike physical illness; the illness is really "all in a
person's head."
FACT: Mental illness is just like physical illness since both are biologically based.
Mental illnesses are brain disorders which alter a person's thoughts, behaviors,
and feelings.
MYTH: Mentally ill people have weak characters since they can't cope with
the world in the same way that the rest of us do.
FACT: The development of mental illness has nothing to do with a person's
character. Mental Illness strikes people with all kinds of backgrounds, beliefs,
temperaments and morals.
MYTH: Mentally ill people are unfocused, have defective thought processes
and consequently, can't really tap their intelligence or learn effectively.
FACT: Most mentally ill people have average to above average intelligence.
Studies have shown that these individuals can be quite focused and are ca-
pable of achieving very high grade point averages in school.
MYTH: Mental illness is not very widespread and health care providers
should
focus their attention other health problems.
FACT: Studies have indicated that by the year 2020 the leading cause of
disability in the world will be major depression. International studies indicate
that from 30-40% of people in any given population will experience mental
illness at some point in their lives. The National Institute of Mental Health
statistics tells us that more than 50 million people or 24% of our country's
population over the age of eighteen will experience some form of mental ill-
ness in any given year.
THE MYTHS AND FACTS OF MENTAL ILLNESS
MYTH: People with mental illness experience little difficulty with people around
them; their main struggle is with themselves.
FACT: People with mental illness frequently withdraw from society and iso-
late themselves. This is due in part to the mental illness itself, but it is also due
to the great stigma that is attached to people with mental illness. People tend to
shun the mentally ill because they don't understand behaviors that appear strange
or unusual. The rejection by society pushes the mentally ill person away and
forces them to live in isolation.
MYTH: Mental illness first appears at birth or shortly after birth.
FACT: Many forms of mental illness appear later in life. As an example,
schizophrenia occurs in the late teens or early adult years. Other mental illness
such as depression can affect people of any age. Since mental illness often
first appears during the college years it gives educators the opportunity to assistin the identification of students who might be exhibiting the signs so mentalillness. A key role for educators is to refer these students to the appropriateservice sites.
MYTH: The majority of mentally ill people live in hospitals.
FACT: The vast majority of mentally ill people live in our communities. Many
of these people have undetectable illnesses while others are rather obvious. It is
estimated that one third of the homeless population have some form of mental
illness.
THE MYTHS AND FACTS OF MENTAL ILLNESS
MYTH: The majority of Individuals with mental illness access treatment to
recover from their illness.
FACT: It is estimated that only one in five persons actually seek treatment. This
is due to a variety of reasons. Typically health insurance policies do not
provide the same coverage for mental illness as for physical illness. People with
limited incomes cannot afford to pay for treatment on their own. Some people
do not seek treatment because of the stigma attached to mental illness; they find
themselves embarrassed and unable to withstand the social consequences of
publicly declaring their illness. Some people may be unclear about exactly
what their problems are and do not realize that treatment is available. Some
people may be unaware of where to go for help.
PREVALENCE OF MENTAL ILLNESS
IN TODAY'S WORLD
There is a critical need to understand how pervasive mental illness is and howtreatable it is. The National Institute of Mental Health statistics tell us thatmore than 50 million people or 24% of our Country's population over theage of eighteen will experience some form of mental illness during any given year.
Studies have also indicated that by the year 2020 the leading cause of disability inthe world will be major depression. International studies indicate that from 30-40%of people in a given population will experience mental illness at some point duringtheir lives. The important thing to realize here is that 90% of these people can behelped with new medications and therapies.
What is the reason for the tremendous increase in mental illness? There are twobasic reasons: (1) increased life expectancy has brought an increase in the agerelated mental illness problems and (2) the worldwide increase in the depressionrate may be related to factors such as political and social violence along withcultural and economic changes. The shift of the world population from rural areato cities with overcrowding, noise, pollution, decay and social isolation) has beensited as a specific cause for higher rates of mental illness. Rapid social changethroughout the world has brought about higher rates of suicide and alcoholism.
Other facts centered on the increased prevalence of mental illness include thefollowing: n There is a higher incidence of mental illness among people living in pov- erty. A 1994 national survey indicated that individuals earning less than$19,000 annually in the United States were twice as likely to experiencean anxiety disorder than people who earned $70,000 or more.
n There is a higher incidence of mental illness during times of high unem- n There is a much higher risk of mental illness for refugees and victims of social disasters (war, genocide, domestic violence etc.). The increasewould be seen in the categories of depression, anxiety, and post-trau-matic stress disorders.
CAUSES OF MENTAL ILLNESS
A tremendous amount of research has already been done and continues to bedone on the causation of mental illness. The majority of research indicates thatthere is no single cause but rather a combination of contributing factors. Thebasic factors include the following: (1) genetic, (2) environmental and (3) organic.
GENETIC CAUSES:
There does seem to be a hereditary factor involved in developing a mental
illness. People may be born with certain personality types, predispositions
for certain illnesses or biochemical make-up. It appears that certain types of
mental illness occur with greater frequency in certain families. Research has
shown that there is a 10% greater chance that a person will develop schizophrenia
if one parent had the disorder. Research has also shown that around 20% of
patients with affective (mood) disorders had a parent with the same disorder.
It should be realized, however, that there is no clear evidence that mental illness
is entirely genetic. Environmental influences are also thought to play a role in
someone developing mental illness.
ENVIRONMENTAL CAUSES:
Many environmental factors can affect our mental health. These include the
conditions under which people are raised, economic pressures, work related
pressures, threats of unemployment, presence of any violence, family
break-ups, death of a loved one, etc. etc. It has been found that prolonged
stress of any kind can actually create biochemical changes in the brain which
could give rise to mental illness.
ORGANIC CAUSES:
Physical factors resulting from drugs, poisons, injury through accident
(especially brain injury), problems at birth, disease (such as syphilis), or
illness (such as brain tumors) can cause mental illness.
CULTURAL UNDERSTANDING OF MENTAL ILLNESS
Mental illness is not always defined in the same way throughout all cultures.
Some behaviors considered signs of mental illness in one culture may beconsidered normal in other cultures. In the western culture if someone saidthey heard voices it would be listed as a symptom of Schizophrenia. In othercultures, this symptom might be viewed as someone's special ability to per-haps hear the voices of those who have died.
There are differences in the overall prevalence of mental illness among menand women. Men have proportionately higher rates of anti-social personalitydisorders and substance abuse. Whereas women experience depression andanxiety disorders at twice the rate of men. The gender gap can change withdifferent cultures; women in China experience depression at nine times therate of men.
The majority of mental illness types are the same worldwide (depression,anxiety disorders, schizophrenia, and bipolar disorder). Others appear onlyin certain cultures. For example, eating disorders occur mostly among girlsand women in Europe, North America and Westernized areas of Asia where"thinness" is culturally viewed to be one of the most essential elements ofbeauty. In Latin America, when people undergo a frightening traumatic event,they are said to have susto (fright) which is an illness where the soul has beenfrightened away. In countries like West Africa students (and others) whoexperience trouble with focusing, pain, and fatigue are said to have brainfag.
THE BASIC TYPES OF MENTAL ILLNESS Mental illness very simply put means that a person is having problems withtheir thoughts, behaviors or feelings. The full range and degree of these prob-lems are different within the basic mental illness types. What follows is somebasic information which breaks down the major categories of mental illnessalong with specific information on several major illness types which seem toappear quite frequently on our college campuses.
Affective or Mood Disorders: Disorders that have a disturbance in mood as
the predominant feature.
Psychotic Disorders: Disorders that have psychotic symptoms as the
defining feature. Psychotic can be defined as having delusions or hallucina-
tions.
Organic Mental Disorders: Disorders which arise from or relate to certain
substances or bodily conditions.
Anxiety Disorders: Disorders which are characterized by excessive anxiety
and worry.
Other Types: Other variations of mental disorders which effect one or more
of life's essential functions. Personality disorders present thoughts and behav-
iors that deviate from cultural expectations, that are pervasive and inflexible,
occur in adolescence or early adulthood and lead to great distress or impair-
ment. Eating disorders are characterized by severe disturbances in eating be-
havior.
GENERALL ANXIETY DISORDER (GAD)
♦ This anxiety disorder is characterized by chronic excessive worry about a number of events or activities, with no obvious threat present, as well as bya variety of symptoms ranging from tension to irritability to restlessness.
♦ People suffering from this disorder perceive that the future holds doom and gloom. They are constantly "on edge" in an attempt to be ready for thepredicted upcoming negative events.
♦ People suffering from this disorder often have difficulty concentrating, mak- ing decisions and sleeping. They often complain about great muscle tensionin their bodies.
♦ The majority of these individuals feel that it is impossible to control their tendency for worrying.
♦ There is both a genetic and environmental link to developing this psycho- logical disorder. It often occurs in people that have experienced a tremen-dous number of uncontrollable and unpredictable life events.
♦ This condition is relatively common. It is currently estimated that approxi- mately 4% of the population in any one-year period will experience thiscondition.
♦ This condition is more prevalent in women than men.
♦ People with this condition respond to psychotherapy along with medica- ♦ Since people can manage to function with high levels of anxiety they are less likely to seek treatment for their psychological condition. In manyinstances they develop physical problems due to the constant tension thatthey have to live with.
MANIC DEPRESSION (BIPOLAR DISORDER)
n A biochemical brain imbalance evidenced by cyclical episodes of frantic highs (mania) and incapacitating lows (depression) best describes ManicDepression.
n During the manic phase the person's thoughts race, speech often becomes disorganized and incoherent, they become hyperactive, and overly self-confident with an inflated sense of what they can accomplish. For example,They may lose their sense of judgement and may spend thousands of dollarsirresponsibly or participate in indiscreet sexual activities.
n There is a full range of symptoms ranging from moderate to severe. The manic phase can last for up to three months. This phase can be followed bya brief period of normalcy, which is followed by eventual depression. Thesymptoms can come on suddenly. If someone has had a manic episode,they are at greater risk of repeated episodes.
n The condition continues to worsen without treatment. Untreated, it can be come more severe as a person ages.
n Manic Depression occurs equally between men and women. Approximately 1.6% of the American adult population is affected by this illness.
n The typical age of onset for Manic Depression is somewhere in the 20's, but it can also occur in the mid-teens.
n Research indicates that the transmission of Manic Depression from one generation to another is hereditary. Close relatives of people sufferingfrom either Manic Depression or Major Depression have a 10-20 timesgreater likelihood that they will also develop the illness.
n Research indicates that environmental factors may also play a role in the development of the illness since it can trigger the onset.
n Treatment usually consists of psychotherapy and medication. Lithium is a common medication that it used to help stabilize the mood swings in approximately 75% of those suffering from Manic Depression.
n Major Depression is a disease of the brain. Symptoms of the disease in- clude extreme fatigue, difficulty focusing or concentrating, little or nointerest in life's activities, or the absence of emotion or uncontrollablecrying.
n People suffering from Major Depression often experience an overwhelm- ing sense of hopelessness, sadness, and worthlessness. They are oftenpreoccupied with thoughts of suicide and death.
n Major Depression can also drastically alter a persons sleeping and eating habits. Insomnia or an increased desire to sleep and weight gain or loss iscommon.
n Major depression can be severe and disabling. During the most critical phases of the disease, people have difficulty with routine life activities.
Major Depression is more intense than situational depression or unhappi-ness that often accompanies such life events as divorce or death of aloved one.
n Research indicates that Major Depression is caused by chemical imbal- ances or biochemical changes within the brain. The condition can be ex-acerbated by stressful environmental situations.
n Research indicates that there is a genetic link. A person is three times as likely to develop Major Depression if their mother or father had the dis-ease.
n Research indicates that by the year 2020 the leading cause of disability in the world will be Major Depression.
n There are approximately 8 to 10 million people living in the United States who will suffer from Major Depression at any given time.
n Approximately 30 million adults will experience Major Depression at least once during their lifespan.
n Women experience Major Depression at twice the rate of men. The average age of onset is somewhere between the 20's and early 30's.
n Within the past decade, there has been a 300% increase in teen suicides resulting from depression. Reportedly 60% of people committing suicide doso because of depression.
n The treatment of Major Depression usually consists of medication and psy- n Anti-Depressant medication is very effective in the treatment of Majo Depres- sion. The medication can either reduce or remove all symptoms of the diseasein 80% of the cases.
n Unfortunately, less than 30% of those individuals afflicted with Major Depression seek the professional help, which would lead to their recovery.
OBSESSIVE-COMPULSIVE DISORDER (OCD)
n Persistent obsessions and compulsions that are so severe that they cause great distress and interfere with a person's ability to livenormally characterize this disorder.
n The obsessions involve recurrent and persistent thoughts or dis- tressing images. The compulsions are repetitive behaviors (hand-washing etc.) or mental acts (counting etc.) that the person feelsdriven to do in response to the obsession.
n Research indicates that this disorder has specific biological causal n OCD is becoming more prevalence and shows little gender differ- n This disorder usually begins in late adolescence or early adulthood but it also occurs in children.
n OCD often co-occurs with other disorders such as depression.
Research indicates that as many as 80% of those with OCD mayexperience major depression at some time in their life.
n Behavior therapy and medication (Prozac) are useful treatments.
n Panic Disorder is an anxiety disorder in which people feel tremendous fear and anxiety in a spontaneous manner with little or no precipitating cause.
n The anxiety state usually peaks within ten minutes and goes away within sixty n There are physical symptoms (shakiness, muscle tension, fatigue, sweating, heart palpitations etc.) and psychological symptoms (fearfulness, worry,irritability, insomnia etc).
n This disorder results from biological abnormalities in the brain. Abnormal activity of the neurotransmitter norepinephrine in the brain may play a causalrole in the actual panic attacks.
n This disorder is more common in women.
n Individual psychotherapy using behavioral techniques and participation in support groups are the most effective and common forms of treatment.
n Tranquilizers or anti-anxiety medication is often used successfully.
nBefore any treatment plan is designed a full physiological work-up is done torule out any physical illness ( many people with this disorder complain that theyfeel as if they are having a heart attack).
POST-TRAUMATIC STRESS DISORDER (PTSD)
n Post-Traumatic Stress Disorder is an anxiety disorder than stems from terri- fying, life-threatening events such as war, natural disasters, or violent crime.
n Symptoms include flashbacks to the traumatic event, feelings of detach- ment, depression, alienation, and emotional numbness.
n Post-traumatic Stress Disorder can affect a person's ability to concentrate and establish close relationships.
n People suffering from this illness often suffer depression and frequently try to self-medicate through the use of drugs and alcohol.
n This disorder results from exposure to a traumatic event such as war, natural disasters, or violent crime.
n People who have experienced prolonged physical and/or sexual abuse are more susceptible to the illness.
n Research indicates that 7% of people will experience this disorder at sometime during their lives.
n Individual psychotherapy and involvement in support group are the most common forms of treatment. Medications for depression and anxiety arealso found to be very beneficial.
n Schizophrenia is a disease of the brain that is characterized by impaired thinking, delusions, hallucinations, and drastic changes in a person's emo-tions and behavior.
n A common symptom is auditory hallucinations.
n Research indicates that the anatomy and chemistry of people with schizo- phrenia are abnormal. To date however, there is no definitive answer forexactly what causes this illness. It seems clear that it is not environmental.
It seems to run in families but is not always passed down from parents tochildren.
n Research indicates that approximately 1.2 million people will suffer from Schizophrenia at any given time.
n It affects approximately 1 out of every 100 people and commonly occurs first between the ages of 17 and 25. An age of onset after 30 is highlyirregular.
n Approximately 25-30% of the nation's homeless population suffers from n The symptoms of Schizophrenia can be controlled through the use of medi- cation but there is no cure.
n This disorder is characterized by addictive behavior that stems from the need for a substance or abuse of substances.
n This disorder is caused by both genetic and environmental factors.
n This disorder can occur at any age but is very common during adoles- cence and young adulthood. It varies according to metropolitan area, raceand ethnicity. Substance abuse problems are more common in economi-cally depressed minority communities.
n There is a higher incidence of alcoholism in men than women (5 times higher than women).
n Alcoholism in the US is a major problem. One in seven people meet the criteria for alcohol abuse. The disease cuts across all ages, educational,occupational and socioeconomic boundaries.
n Medication and therapy are useful treatments.
n Group therapy and behavioral intervention are effective treatments.
n Twelve Step programs such as Alcoholics Anonymous is extremely ben- n Successful treatment demands complete abstinence from the substances being abused.
Psychotherapeutic Drugs Controls high level anxiety. Side effects And Experiential can include drowsiness and 2. Antidepressant Controls symptoms of depression. Side effects can include dizziness, dry mouth, blurred vision, urinary There are many types: problems, constipation, drowsiness and 1. Psychoanalysis sexual dysfunction. 2. Client-Centered Therapy 3. Group Therapy 4. Family Therapy Controls mania in Bipolar Disorder. 5. Behavioral Therapy Side effects can include nausea, 6. Cognitive Therapy vertigo, increased thirst and 7. Cognitive-Behavioral Therapy 8. Humanistic Therapy 9. Existential Therapy 4. Antipsychotic 10. Play Therapy Controls hal ucinations and 11. Light Therapy delusions (common in Schizophrenia). Side effects can include blurred vision and involuntary movements of the Common Psychotherapeutic Drugs
Drug Class
Generic Name
Trade Name
Propanediol Carbanates Meprobamate Reuptake Inhibitors Selective Serotonin Monoamine Oxidase Common Psychotherapeutic Drugs
Drug Class
Generic Name
Trade Name
Lithium Carbonate Source: "Common Psychotherapeutic Drugs," Microsoft ® Encarta ® 98 En-cyclopedia. 1993/97 Microsoft Corporation. All Rights Reserved THE ROLE OF EDUCATORS AS EFFECTIVE Educators cannot ignore the fact that our colleges will continue seeing anincrease in the enrollment of students recovering from mental illness. Manystudents will experience their first psychological problems between the agesof 20 and 35 and instructors can be a student's first link to help by effectivelyreferring students to service sites for help. Many students will only undergo asingle episode of mental illness in their entire lives. We need to remember thatthe vast majority (8 out of 10 individuals) with mental illness can be cured orbrought under control with improved treatments. With an increased under-standing of mental illness faculty members can be extremely helpful in therehabilitation of these students. Increased awareness and sensitivity will allowcollege professionals to assume the role of being effective change agents inthe recovery and healing of this special group of students.
MORE SIMILAR THAN DISSIMILAR:
A UNIVERSAL SET OF NEEDS
It is important to recognize that we have more in common with people recov-ering from mental illness than differences. We all possess the following: ♦ Need to believe in ourselves.
♦ Need to be respected by others.
♦ Need to be loved and show love.
♦ Need to develop friendships.
♦ Need to belong and have a place called home.
♦ Need to be useful and productive.
IDENTIFICATION OF STUDENTS IN TROUBLE
The following warning signs can help educators identify students who arestruggling with emotional problems and are in need of potential referral tocampus service sites. Educators should look for students who: ♦ Appear sad, hopeless or fearful and appear unable to enjoy life or have a good time.
♦ Make direct reference to suicide.
♦ Appear to be suffering from the effects of drug or alcohol abuse.
♦ Are often absent from class.
♦ Seem unable to accept compliments or appear unable to feel success.
♦ Appear to have low self-esteem and view themselves as a failure.
♦ Appear to have difficulty adjusting to new situations and appear with- drawn and isolated from others.
♦ Have difficulty focusing and indicates that they can't concentrate.
♦ Appear to have difficulty sleeping or eating.
♦ Exhibit mood fluctuations.
♦ Indicate that they have recently undergone a traumatic life event or loss.
FUNCTIONAL LIMITATIONS THAT STUDENTS
RECOVERING FROM MENTAL ILLNESS MAY EXPERIENCE
Please Note: Individual students may experience some but not all of the limita-tions listed.
If a student takes medication, they may experience certain side effects. These mayinclude: Thirst or dry mouth Difficulty initiating interpersonal contact Difficulty concentrating Cognitive limitations may include: Difficulty with time management and study skills Concentration or distractibility problems Behavioral, physical, and perceptual limitations may include: Overall endurance and stamina problems Motivational problems Weak or rambling speech Feelings of fear, anxiety, sadness, or failure These limitations may impact the student's ability to successfully handle the fol-lowing: test-taking, concentration, attendance (including punctuality), meeting as-signment deadlines, responsibly arranging for and keeping appointments, criticalthinking in new settings, coping socially, registration, parking, and coping withpaperwork and the "bureaucracy." CAMPUSWIDE STRATEGIES AND ACCOMMODATIONS
FOR ACCESS, RETENTION, AND STUDENT SUCCESS

The Mental Health Education Consortium Project recommends the followingeducational strategies and accommodations. Research has proven that theseare helpful to students recovering from mental illness since they address thespecific functional limitations of the disability: n Establish a supportive learning environment where disclosure is encouraged and individual differences are respected.
n Allow for extended time on tests and assignments.
n Provide a quiet distraction free environment for test taking.
n Provide advance copies of syllabus.
n Provide alternative test formats if needed (enlarged copies etc.) n Arrange for special seating if needed.
n Provide for early registration and special orientation.
n Provide for special counseling.
n Provide assessments leading to the establishment of education goals and a Student Education Plan.
n Offer special classes (study skills, career planning, etc.).
n Provide special parking as needed.
n Provide assistance with problem solving, time management and study n Arrange for volunteer note takers and readers.
n Provide for use of tape recorders in classes.
n Provide for referrals to campus and community resources.
n Allow for "incomplete grades" and additional time to complete a course n Allow for full access to faculty during office hours.
n Provide open and honest feedback to reinforce and motivate students to do their best.
Please note: Once a community college is made aware (with appropriate verification of disability) that a student has a disability the collegeis legally obligated by State and Federal Law to ensure thatreasonable accommodations and educational services areprovided. For specific details contact your Disabled StudentProgram professionals, the College ADA Coordinator or theCollege Compliance Officers FACULTY INTERVENTIONS FOR STUDENT SUCESS
n Encourage students who seem to be emotionally upset to talk with college counselors, mental health professionals, or even their friends andfamily about their situation.
n Be sensitive to the enormous stigma surrounding mental illness and do what you can to dispel the myths! n Encourage students to keep active and involved and not withdraw or isolate themselves.
n Provide an inviting college atmosphere for all students, including indi viduals recovering from mental illness or any disability.
n Work closely with Student Services Personnel in support of professional recommendations for needed accommodations.
n Work closely with Student Services Personnel to evaluate course materi als (including curriculum, textbooks and syllabi) for potential barriers tospecial needs students and make changes that could improve studentperformance and retention.
n Attend in-service activities and conferences on successful teaching methods for special needs students.
n Increase your knowledge of mental illness and be able to distinguish between treatment issues and educational issues.
n Work closely with Student Services Personnel (Counselors, Health Center Staff, and Disabled Student Programs and Services) in the referralof students who are experiencing classroom and/or personal difficulties.
n Recognize that students recovering from Mental Illness are not necessar ily disruptive. These students are typically more withdrawn or shy. Discipline problems should not be confused with mental health issues. Referdisruptive students to the Dean of Students (or appropriate designee) fordisciplinary action. All students need to responsibly meet the Code ofStudent Conduct by adapting behaviors to the school environment.
n Utilize teaching methods which embrace positive reinforcement, open communication, and full participation of all students in classroomactivities.
WORLD WIDE WEB RESOURCES
American Psychiatric Association American Psychological Association Center for Psychiatric Rehabilitation Journal of the California Alliance for the Mentally Ill Knowledge Exchange Network, Center for Mental Health Services, Sub- stance Abuse and Mental Health Services Administration Mental Health Infosource National Alliance for the Mentally Ill (NAMI) National Institute of Mental Health National Institute on Alcohol Abuse and Alcoholism National Institute on Drug Abuse National Mental Health Association World Wide Web Mental Health Home Page MENTAL HEALTH EDUCATION CONSORTIUM
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Chancellor's Office, California Community Colleges. Resource Guide ForServing Students with Psychological Disabilities in California CommunityColleges. September, 1991.
Gitlin, M.J. Medications for Treating Mood Disorders." The Journal of theCalifornia Alliance for the Mentally Ill. Vol.1,Number 4, Summer 1990 pp. 7-8.
HMS, "Myths, Types, Causes and Treatments of Mental Illness…"http://members.tripod.com.
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Keeping UP on Diabetic Medications and Complications  Apply current clinical practice standards to optimize pharmacologic treatment outcomes and non-pharmacological management strategies for an adult patient with type 2 diabetes.  Recognize patient situations where the utilization of a new or novel pharmacological agent appropriately optimizes type 2 diabetes management.