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Full text of "ERIC EJ1083849: Academic Accommodations for Postsecondary Students with Mental Health Disabilities in Ontario, Canada: A Review of the Literature and Reflections on Emerging Issues"

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Journal of Postsecondary Education and Disability, 28(3), 277-291 277 

Academic Accommodations for Postsecondary Students 
with Mental Health Disabilities in Ontario, Canada: 

A Review of the Literature and Reflections 
on Emerging Issues 

Mike Condra 
Mira Dineen 
Sarah Gauthier 
Helen Gills 
Anita Jack-Davies 

Queen's University (Ontario, Canada) 

Eleanor Condra 
St. Lawrence College 


An increasing number of students with mental health disabilities (MHDs) are enrolling at Canadian colleges and 
universities. This review examines the challenges and complexities of meeting the unique needs of these students at 
Ontario’s postsecondary institutions, with a specific focus on the issue of academic accommodations. These com¬ 
plexities include: delays in receiving a diagnosis, the episodic nature of MHD-related symptoms, and challenges 
in determining functional impairments. The present review highlights the current factors influencing the integra¬ 
tion and academic success of this population of students, the importance of faculty education, stigma-reduction 
programs and the development of a “welcoming culture” on campus. Accommodation issues are also discussed 
such as the need for retroactive accommodations, which are more likely to be required by this population because 
of the intermittent and episodic nature of many MHDs. Retroactive accommodations are not currently included 
in the typical formal academic accommodation procedures used in Ontario. The authors conclude by pointing to 
the need for the development of documentation practices and effective policies to assist postsecondary institutions 
in designing the most appropriate academic accommodations for in-class and fieldwork essential requirements. 

Keywords: Mental health, postsecondary education, academic accommodations, stigma, equity in education, 
retroactive accommodations 

There has been a well-documented increase in 
the number of students with mental health disabilities 
(MHD) who are involved in postsecondary educa¬ 
tion. For example, the number of students with MHD 
registered with Offices for Students with Disabilities 
(OSD) at colleges and universities in Ontario, Canada, 
increased by 67% in the five years between 2006 and 
2011. Over the same period, the overall number of 
students with disabilities in the postsecondary system 
in Ontario increased by 31.5%' (J. Pyett, personal com- 

1 These data are not audited and are based on informa¬ 
tion provided by college and university OSDs in their 
annual report under the Accessibility Fund for Students 
with Disabilities (AFSD), to the Ministry of Training, 

munication, June, 2013). This pattern is not limited to 
Canada; it has been noted also in the United States (e.g., 
Castillo & Schwartz, 2013), the United Kingdom (e.g., 
Quinn, Wilson, MacIntyre, & Tinklin, 2009; Tinklin, 
Riddell, & Wilson, 2005), and Australia (e.g., Manalo, 
Ede, & Wong-Toi, 2010). A similar trend has been 
reported in campus health and counselling services in 

Colleges and Universities of Ontario. In this report OSDs 
summarize the number of students registered with their 
offices and who are receiving accommodations or services 
during that year. This does not reflect the total number of 
disability categories receiving services or accommodation 
because students with more than one disability may be 
accessing several services from OSDs. 

278 Journal of Postsecondary Education and Disability, 28(3) 

the United States where the phrase a “rising tide” was 
used in 2002 to describe the increase in the number 
of students with mental illnesses who were seeking 
services (Eudaly, 2002, p. 1). 

A number of factors may account for this develop¬ 
ment. Student enrollment in postsecondary education 
has steadily increased from decade to decade. As 
well, access to education for persons with disabilities 
is now protected by human rights law; the relevant 
legislation in Ontario is the provincial Human Rights 
Code. Finally, Castillo and Schwartz (2013) suggest 
that the availability of increasingly effective psycho- 
pharmacological and psychotherapeutic treatments 
has facilitated access to postsecondary education for 
students with MHD. 

The substantial increase in the number of students 
with MHD has resulted in significant systemic and 
administrative challenges for postsecondary institu¬ 
tions. For example, it has underscored the need for 
postsecondary institutions to develop a more sophis¬ 
ticated and comprehensive awareness of mental health 
and an understanding of how problems in this area 
may affect academic performance. As this review will 
demonstrate, faculty and staff express a strong interest 
in increasing their understanding of mental health and 
how to best support students with MHD (Brockelman, 
2011; Collins & Mowbray, 2005). There are apparent 
benefits to providing such education; students report 
that a lack of awareness on the part of faculty and staff 
can pose a significant barrier to their success and can 
deter help-seeking behaviour. 

Postsecondary institutions are also challenged in 
the provision of academic accommodations for stu¬ 
dents with MHD. The Ontario Human Rights Code 
requires that universities and colleges accommodate 
students with disabilities, including those with MHD. 
While there is substantial accumulated research, 
clinical expertise and experience in accommodating 
students with other disability types, those with MHD 
comprise a relatively new and under-served group. 
As a result, for the postsecondary sector there is still a 
great deal to learn in this area. The upsurge in students 
with MHD has put pressure on institutions to develop 
effective strategies, policies, and guidelines to accom¬ 
modate this population. 

This review will outline the specific challenges 
involved in responding to these needs. We begin with 
a description of the legal context for academic accom¬ 
modations. Following this, we outline the complexities 
involved in the academic accommodations process 
from the perspective of students, faculty, and admin¬ 
istrators. We conclude by providing some direction 
for further investigation and development in order to 

bring consistency and fairness to the accommodations 
process for students with MHD. 

The Legal Context for Academic Accommodations 

The Canadian Charter of Rights and Freedom guar¬ 
antees persons with disabilities the right of freedom 
from discrimination at the federal level (Department 
of Justice, 1982). At the provincial level, the Ontario 
Human Rights Code (1990) outlines an accommoda¬ 
tion provider’s responsibility to ensure that persons 
with disabilities receive appropriate accommodations. 
The Code focuses on the need to accommodate on 
the basis of functional impairments (disturbances in 
performance as a result of a disability), whether these 
are permanent or temporary. As well, to provide guid¬ 
ance in the area of mental health, the Ontario Human 
Rights Commission recently introduced A Policy on 
Preventing Discrimination Based on Mental Health 
Disabilities and Addictions (OHRC, 2014). 

Although the Code does not distinguish between 
permanent and temporary disabilities with regard to 
the duty to accommodate, this distinction does play an 
important role in the scope of activities undertaken by 
OSDs and postsecondary institutions. For this reason, a 
clarification of these terms is merited. An MHD is con¬ 
sidered to be permanent if it involves ongoing symp¬ 
toms (which may be chronic/continuing or episodic). 
The designation of a disability as permanent follows 
a thorough assessment of the person by a health care 
professional (physician, psychiatrist or psychologist), 
with findings that show that the condition is ongoing 
and that the functional limitations are likely to be con¬ 
tinue indefinitely. An MHD is considered temporary 
if (1) the symptoms and the impairments are likely to 
be time-limited, or (2) the disability is currently being 
investigated and there is not yet sufficient information 
to determine conclusively if the symptoms are likely 
to be permanent. 

Students are entitled to receive accommodations 
if their disability results in a functional impairment 
that impacts their ability to participate in academics, 
regardless of whether the disability is permanent or 
temporary. The distinction being made here relates to 
the likely duration of the difficulty and points to the fact 
that “not all forms of mental illness represent lifelong 
conditions” (Fiebert, 2003, pg. 1). 

While the Ontario Human Rights Code does not 
make a distinction between temporary and perma¬ 
nent disabilities and instead focuses on functional 
impairment(s) as the basis for determining appropri¬ 
ate accommodations, most OSDs in Ontario require 
documentation substantiating a formal diagnosis of a 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 279 

permanent disability. Students who experience symp¬ 
toms of MHDs for the first time and who have not 
received a formal diagnosis may request accommoda¬ 
tions directly from their professors or from on-campus 
health or counselling services. This process may result 
in inconsistencies in the provision of accommodations 
across the institution. Irrespective of whether the 
impairments are considered permanent or temporary, 
there are concerns about determining how to identify 
and provide the most appropriate academic accom¬ 
modations in relation to the functional impairment(s) 
that directly affect academic functioning. Added to this 
dilemma is the fact that “the term impairment is used 
differently by medical, mental health and educational 
professionals” (Goldstein & Naglieri, 2009, p. 2), 
which may make the evaluation of impairment in the 
context of academic functioning difficult. 

Mental Health and the Postsecondary Student 

In A Report on Mental Illness in Canada, Health 
Canada (2002) reports that youth (ages 15-24) are the 
most likely demographic to experience certain MHD 
or substance abuse/dependency problems (e.g., Belch, 
2011; Health Canada, 2002; Rae, 2009; Reavley, Ross, 
Killackey, & Jorm, 2013; Shaddock, 2004; Storrie, 
Ahem, & Tuckett, 2010). This is the stage of life when 
many young people participate in postsecondary educa¬ 
tion. The most common MHDs in this group are depres¬ 
sion, anxiety disorders, and eating disorders (Eisenberg, 
Golberstein, & Hunt, 2009). The joint incidence of these 
three disorders greatly exceeds that of all other MHDs 
combined (Kessler et al., 2005). This age of onset pattern 
is also documented in a study by Megivem, Pellerito, 
and Mowbray (2003), who found that 49% of students 
with an MHD experienced onset while participating in 
postsecondary education. Although symptoms of MHD 
often emerge during this time, there is sometimes a 
delay in obtaining a formal diagnosis or access to treat¬ 
ment and supports (Shaddock, 2004). Students may be 
unaware that the changes in their health are due to a 
mental health condition. As well, some mental health 
conditions develop slowly, and it may take a year or 
more to reach a conclusive diagnosis. 

While these statistics illustrate that the numbers of 
students with MHD registered with OSDs in Ontario 
are increasing, this is not an accurate measure of the 
total number of students with MHD attending postsec¬ 
ondary education because some choose not to disclose 
their MHD to the institution (Gallagher, 2012). One 
possible reason that students make this decision may be 
that they see the transition to postsecondary education 
as a new beginning, one free of their disability identity 

(Getzel & Briel, 2006). Among those who develop a 
MHD while attending college or university, there may 
be a reluctance to acknowledge mental health concerns 
because of fear of the implications of doing so, thus 
leading to a delay in diagnosis. 

The Ontario Postsecondary Accommodations 

The established accommodation practice at all 
Ontario postsecondary institutions is that the OSD 
processes requests for academic accommodations 
from students with documented disabilities. Col¬ 
leges and universities have established protocols and 
documentation requirements that guide the process. 
Some postsecondary institutions have separate pro¬ 
cedures for accommodating students with temporary 
disabilities. Students requesting academic accommo¬ 
dations for an MHD must first register with the OSD 
and provide documentation from a qualified mental 
health professional (such as a physician, psychiatrist, 
or psychologist). The documentation must include a 
diagnostic statement and a description of the functional 
impairment(s) resulting from the disorder that interfere 
with academic functioning. By itself, the documented 
diagnosis of an MHD does not necessarily establish 
the need for accommodation or identify the most ap¬ 
propriate accommodations in an academic environment 
(Rae, 2009). Accommodation planning involves an 
appraisal of the extent of the functional impairment 
associated with the diagnosed disorder and how it 
impacts academic functioning. 

Determining the degree of functional impairment 
caused by an MHD is challenging since often there 
are no objective measures of impairment. The current 
accommodation model works most effectively for 
students who need consistent and continual accom¬ 
modations, such as those with sensory or learning 
disabilities. The present process also facilitates accom¬ 
modation planning for all parties involved; students 
are aware of their accommodations entitlements and 
professors are usually informed of these needs early 
in the term. In addition, sufficient notice is provided to 
arrange and administer accommodated examinations. 
However, this process may not be as effective for stu¬ 
dents with MHDs, where fluctuation in symptoms and 
functional impairment is likely to occur. 

There is no uniform process for granting academic 
accommodations for temporary disabilities in Ontario; 
each institution typically follows its own guidelines or 
processes. Symptoms of MHDs may emerge acutely 
as the result of an incapacitating crisis. Consequently, 
there may not be sufficient time to access mental 

280 Journal of Postsecondary Education and Disability, 28(3) 

health services prior to needing academic accommo¬ 
dations. The requirement to obtain a diagnosis before 
academic accommodations are implemented may pres¬ 
ent difficulties due to long waiting lists for service in 
some regions and the lack of available psychiatric or 
psychological services in others. As a result, students 
may need accommodations for temporary disabilities 
that may or may not meet the criteria for a permanent 
disability at a later date. 

Rae (2009) reports that there are currently no 
standardized guidelines for providing academic ac¬ 
commodations to students with MHD, nor is there a 
framework for determining which accommodations are 
the most appropriate and effective. The focus of any 
accommodation should not be on trying to ensure that 
the student is successful but instead on “[determining] 
which accommodation would correct or circumvent 
functional impairments that might otherwise preclude 
a fair opportunity to access a course or a test” (Lovett, 
Gordon & Lewandowski, 2009, p. 99). This approach 
is taken in arranging accommodations for permanent 
MHDs and should also be considered a key ingredient 
in accommodating students with temporary MHDs. 

Challenges for Postsecondary Students with MHD 

The transition from high school and life at home 
to postsecondary education presents adjustment stresses 
for all students. These stresses are magnified for stu¬ 
dents with MHD who may experience a unique set of 
challenges in accomplishing their academic goals in a 
new academic environment. Effective functioning in 
a postsecondary environment requires a high level of 
cognitive, behavioural, and affective self-regulation 
(Medalia and Revheim, 2002). Disruption in these 
functions (e.g., problems in attention and concentra¬ 
tion, emotional regulation, and motivation) may cause 
significant difficulties in learning. These disruptions may 
result in difficulties fulfilling academic requirements 
such as reliably attending classes/labs/tutorials, adhering 
to deadlines, and working effectively with peers. 

The complexities of effective treatment for MHD 
may also raise barriers for these students. The need 
for some experimentation with medications in order 
to find the most effective treatment may mean that 
students are temporarily unable to function at their best 
academically. As well, many psychotropic medications 
have unpleasant and disruptive side effects (Megivem 
et al., 2003) that affect skills such as concentration 
and motivation which underlie successful academic 
functioning. The varying level of support (practical and 
academic) that students with MHD may receive from 
postsecondary institutions is also a potential barrier to 

equal access. This is in part a reflection of the challenge 
that institutions face in dealing with a relatively new 
phenomenon (the increase in the number of students 
with MHDs) for which many academic institutions are 
often ill prepared. 

Students who experience symptoms of a mental 
health problem for the first time while attending post¬ 
secondary education initially fall into the temporary ac¬ 
commodation category because it may not be possible 
to determine the permanence of their symptoms. At this 
stage, there may be no clear evidence of the prognosis 
or the potential resulting functional impairment(s). 
Current accommodation practices do not take into 
account the episodic nature of some MHDs, the sud¬ 
den onset of symptoms, and the barriers preventing 
certain students from following established academic 
accommodations policies and procedures. One such 
policy is that institutions expect students to inform their 
professors before an examination or an assignment due 
date if they are unable to write a test or hand in an as¬ 
signment. Due to the episodic nature of many MHDs, 
a student may be incapable of predicting when and if 
they require an extension or alternative arrangements. 

The discrepancy between the accommodation 
needs of students with MHD and current academic 
accommodations policies and procedures administered 
by the majority of Ontario postsecondary institutions 
suggests that alternatives for this group of students 
need to be considered. Collins and Mowbray (2005) 
argue that accommodations for students with MHD are 
low-cost and straightforward and could include flex¬ 
ible course loads and timing, alternative ways to meet 
degree requirements, or additional time to complete 
assignments. In a study examining the perspectives of 
faculty members (n=107) regarding the effectiveness of 
accommodations for students with MHD, Brockelman 
(2011) reported that extended deadlines, extra time to 
write exams, approved class absences, and a private 
testing room were the most frequently used strategies. 

According to Getzel (2008), underuse of academic 
accommodations seriously impacts the persistence 
of students with MHD in their studies. Studies have 
shown that students with MHD were less likely to 
graduate than those in other disability classification 
(e.g., Cavallaro, Foley, Saunders, & Bowman, 2005; 
McEwan & Downie, 2013; Moisey, 2004). Overcom¬ 
ing both the challenges that inhibit institutions from 
providing appropriate academic accommodations for 
this population of students, and the barriers to receiv¬ 
ing such accommodations, will be important to ensure 
that these students have opportunities to participate 
equitably in academic activities. 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 281 

Many students with MHDs are not aware of the 
on-campus resources that are available to them. This 
lack of information and awareness of available services 
is a barrier that prevents the use of available acces¬ 
sibility resources (e.g., Megivem, 2002; Milligan, 
2010; Mowbray et al., 2006; Quinn et al., 2009; Salzer, 
Wick, & Rogers, 2008). Students report that they do 
not know how to access these services (Quinn et al., 
2009). Importantly, students may not understand that 
they are legally entitled to accommodations under the 
Ontario Human Rights Code and the Canadian Charter 
of Rights and Freedoms (Milligan, 2010). Students also 
report that a lack of mental health resources prevents 
them from receiving the services they need (Mowbray 
et al., 2006). 

Stigma - “The Hidden Burden” 

An examination of the barriers that prevent stu¬ 
dents from seeking existing support points to access 
issues beyond the actual accommodation process or 
underlying formal policies. Broader societal values re¬ 
garding mental health, and how people internalize these 
values, play a significant role in determining the aca¬ 
demic success of these students. The literature indicates 
that stigma is a significant factor affecting whether a 
student will seek support (Belch, 2011; Quinn et al., 
2009; Stevenson, 2010; Storrie et al., 2010). 

Two forms of stigma have been identified: social 
stigma and self-stigma. “Social stigma is characterized 
by prejudicial attitudes and discriminating behaviour 
directed towards individuals with MHD as a result of 
the psychiatric label they have been given” (Davey, 
2013, p. 1). Social stigma originates from sources 
outside the individual, such as friends, family, insti¬ 
tutions and the media. Self-stigma “is a belief in or 
personal acceptance of negative stereotypes about a 
group to which one belongs and then applying this 
belief to oneself’ (Patterson, Barnes, & Duncan, 2008, 
p. 132). Self-stigma can have far more destructive 
consequences for people with MHD than the experi¬ 
ence of social stigma alone (Ritsher & Phelan, 2004). 
The internalization of stigma results in feelings of fear, 
shame, and fatigue, all of which can exacerbate the 
MHD (Stevenson, 2010). Many of those with MHD 
also report that self-stigmatization and shame can be 
worse than the most extreme symptoms of the disability 
(Stevenson, 2010; Stuart & Arboleda-Florez, 2012). 

Students may self-stigmatize and feel that they 
do not belong in advanced degree programs (Getzel, 
2008). These students fear experiencing a lack of 
understanding along with stigma from staff, faculty, 
friends, and family (Quinn et al., 2009; Storrie et 

al., 2010). Salzer et al. (2008) found that 30% of the 
students in their study did not request accommoda¬ 
tions due to the fear of disclosing their disability to 
instructors and 20% feared stigmatization by their 
peers. Stigma remains a major factor that prevents 
this population from disclosing their disability, even if 
doing so will provide access to support and academic 
accommodations (e.g., Belch & Marshak, 2006; Brock- 
elman, Chadsey, & Loeb, 2006; Brockelman, 2011; 
Collins & Mowbray, 2005; Megivem, 2002; Mowbray 
et al., 2006; Quinn et al., 2009; Rae, 2009; Shaddock, 
2004; Stevenson, 2010; Storrie et al., 2010). 

While some students have had positive outcomes 
after disclosing their MHD, negative responses are 
not uncommon, including the trivialization of their 
illness, accusations of faking or “scamming,” feel¬ 
ings of unworthiness, and discrimination (Collins & 
Mowbray, 2005). Mowbray et al. (2006) explain that 
the “stigma associated with mental health produces 
shame, fear, and guilt on the part of individuals who 
have these diagnoses” (p. 233). In a study by Quinn 
et al. (2009), participants expressed concerns about 
stigma as a barrier to accessing accommodations due 
to the fear that disclosing a MHD could negatively 
affect future career prospects. 

Stigma Reduction on Campus 

On-campus stigma reduction and awareness cam¬ 
paigns can help demystify and normalize MHD while 
also educating the campus population about mental 
health (Belch, 2011; Mowbray et al., 2006; Quinn et 
al., 2009; Rae, 2009). Rae (2009) argued that “aware¬ 
ness campaigns can assist in promoting a culture of 
acknowledgement and trust on campus, and encour¬ 
age more students, faculty, and staff to seek treatment 
if they are experiencing symptoms of mental illness” 
(p. 99). Likewise, Stuart and Arboleda-Florez (2012) 
cited the success of “contact-based education” as a 
stigma reduction initiative in schools. This approach 
involves the delivery of training/workshop sessions 
by speakers who have recovered from a MHD. These 
types of stigma reduction strategies can provide per¬ 
sonal models of effective recovery for students and 
help normalize help-seeking behaviour. Direct contact, 
in the form of an interaction or a relationship with a 
person who has a MHD, is an effective method of 
combatting stigma because individuals are confronted 
with the incongruence between their own beliefs and 
fears on the one hand, and the experience that occurs 
via direct contact on the other. 

General mental health awareness on campus is 
another component in reducing the stigmatization of 

282 Journal of Postsecondary Education and Disability, 28(3) 

students with MHD. In a qualitative study conducted in 
the United Kingdom, Quinn et al. (2009) interviewed 
students with MHD (n=12) to understand their per¬ 
spectives and experiences related to university student 
health services. Participants identified the importance 
of increased mental health awareness initiatives to 
provide students with the opportunity to share their 
experiences more easily with the university commu¬ 
nity. In addition, some respondents expressed a belief 
that creating a “culture of openness” will acknowledge 
the experiences of students with MHD. Such a culture 
is characterized by widely disseminated information 
about mental health, encouragement of help-seeking 
behaviour and support for the provision of services. 
This culture would help to achieve other highly desir¬ 
able goals including normalizing help-seeking, as well 
as guiding students towards mental health services in 
a supportive and inclusive environment. 

Academic Accommodation Challenges for Institutions 

Many MHDs emerge gradually; this pattern can 
add to the complexity of determining appropriate 
accommodations. Specific changes in levels of func¬ 
tioning associated with the onset of a MHD may be 
subtle, or difficult for the individual to discern, until 
the cumulative effect results in a significant, marked 
disruption. This is particularly the case for the first 
episodes of an MHD. The pervasive stigma surround¬ 
ing mental health makes it more difficult to attribute 
these changes to the presence of a MHD. Consistent 
with this pattern, students in a study by Quinn et al. 
(2009) reported that they often did not recognize their 
symptoms as MHDs and some did not identify with 
having a disability. This speaks to the importance of 
education and outreach to enable all members of the 
campus community to recognize the signs of poor 
mental health in themselves and in others. 

As the number of postsecondary students with 
MHD has increased, a number of institutional chal¬ 
lenges have arisen regarding how to determine and 
provide appropriate academic accommodations for this 
population (see Milligan, 2010; Mowbray et al., 2006; 
Quinn et al., 2009; Reavley et al., 2013; Salzer et al., 
2008; Stevenson, 2010; Storrie et al., 2010). Currently, 
Ontario’s postsecondary sector requires that students 
provide documentation to the OSD prior to receiving 
an academic accommodation. This approach is ef¬ 
fective when the functional impairment is relatively 
stable. However, it presents challenges for some MHDs 
where symptoms and the resulting functional impair¬ 
ments may fluctuate over time. The gradual onset of 
symptoms may mean that a student will seek an accom¬ 

modation prior to having a formal diagnosis; in effect, 
an accommodation without documentation. As well, 
many MHDs are episodic in nature; symptoms, and 
the associated disruption, may vary over time. When 
symptoms worsen students may be unable to conform 
to the expected institutional practices as a result of 
disruption in their functional ability. 

Since a diagnosis and a statement of functional 
limitations are typically required for students to gain 
access to continuing academic accommodations, those 
in the early stages of developing an MHD may be 
unable to access these supports. Students without a 
diagnosis, or those who have been recently diagnosed, 
may have limited awareness and understanding of their 
MHD and how this will impact their academic perfor¬ 
mance (Belch & Marshak, 2006). Consequently, these 
students may be unable to self-advocate for appropri¬ 
ate accommodations (Shaddock, 2004). Undiagnosed 
disorders present challenges to campus staff, students, 
and families when symptoms become evident in the 
form of behavioural crises such as acute suicidality or 
acting-out behaviour. 

Students with an MHD without a formal diag¬ 
nosis or appropriate treatments and supports are at a 
greater risk for episodes of acute illness and worsening 
behavioural problems (Rae, 2009). As a result, such 
students may be unable to access accommodations 
at the time when they most need help. For instance, 
individuals with first-episode psychosis may often go 
undiagnosed for a year or more (Shaddock, 2004). In 
the interim, symptoms may interfere with a student’s 
ability to concentrate and process information, attend 
class, meet assignment deadlines, and generally fulfill 
the academic and social demands of student life. 

Some students seek academic accommodations 
directly from their professors without contacting the 
OSD. In these situations, many professors struggle 
with deciding if they should provide the academic 
accommodation based on the student’s self-report or 
seek assistance from the OSD. Documentation of an 
approved accommodation plan from the OSD provides 
professors with reassurance that such requests have 
legitimacy. Most often, professors have the discretion 
to grant temporary academic accommodations based on 
their own best judgment. Faculty need specific support 
and education about managing accommodations for 
MHDs, especially when they fall outside the institu¬ 
tion’s formal accommodations process. 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 283 

Retroactive Accommodations 

There are circumstances in which students seek 
accommodations outside the typical framework of the 
OSD. Perhaps the most challenging example of these 
is requests for retroactive accommodations. This term 
refers to accommodations sought “after the fact,” such 
as after an examination has taken place or the deadline 
for an assignment has passed. This type of accommoda¬ 
tion may be requested where the unexpected, sudden 
emergence or re-emergence of symptoms disrupts 
the student’s functioning. For instance, students may 
develop an MFID for which they have never sought 
professional help; they may not attribute changes in 
functioning to changes in their mental health. As a re¬ 
sult, they may delay seeking help until their symptoms 
are quite disruptive to their academic and personal 
functioning; they may be quite incapacitated by the 
time they seek help and request academic accommoda¬ 
tion (Quinn et al., 2009). 

Very little information is available on the concept 
of “retroactive accommodation” in the literature. In fact 
most institutions in the province and in other jurisdic¬ 
tions indicate that they do not grant accommodations 
of this type. However, for this group of students, it may 
be important to reconsider this position. Retroactive 
accommodations, while they might not be labelled as 
such, are provided in cases of other disability types in 
instances where a disruption of functioning has oc¬ 
curred. For example, a student whose work is disrupted 
by an unexpected “flare up” of their Irritable Bowel 
Syndrome symptoms or a student who is injured in a 
car accident and is unable to meet academic deadlines 
both have a basis for requesting retroactive accom¬ 
modations and are likely to receive these. In the case 
of mental health disabilities, an acute emergence of 
disruptive symptoms may result in the same need for 
retroactive accommodations. In this case, the difficulty 
is compounded by the fact that students may not be 
in a position to think clearly and plan ahead making 
it difficult to provide advance notice of their accom¬ 
modation needs. 

A major concern regarding the provision of retro¬ 
active accommodations is the amount of time that has 
elapsed between a missed deadline and the request for 
accommodation. This is an issue that merits discus¬ 
sion at both the administration level, since any change 
would impact current policies, and within OSDs, as 
any change would impact current practices. Whether 
retroactive accommodations become part of accepted 
policy or are provided on a case-by-case basis will 
likely hinge on issues such as the amount of time that 
has elapsed and the extent to which the student’s func¬ 

tioning was disrupted in the interim and in what way, 
if any, this can be documented or verified. 

Based on interviews with mental health service 
providers at Ontario universities («=26), Rae (2009) 
found that students with MHD often seek assistance 
late in the semester after a long period of feeling over¬ 
whelmed or after a crisis. The participants, who were 
disability service providers, reported that if a student 
does not have an accommodation plan in place in the 
event of a crisis, accommodation may be needed retro¬ 
actively after an episode of acute illness (Rae, 2009). 
In a U.S. study, Collins and Mowbray (2005) examined 
the practices among staff at OSDs at universities in 
10 states (n= 275). Respondents felt these institutions 
should be more flexible in accommodating students 
with MHD and called for “academic forgiveness” and 
transcript adjustments when academic performance 
could be shown to have been disrupted by a MHD 
(Collins & Mowbray, 2005). 

In all jurisdictions in North America qualified 
postsecondary students with MHDs have access and 
participation rights to educational opportunities that 
are protected by human rights legislation. In Ontario, 
the Human Rights Commission does not identify 
retroactive accommodations as a separate category; it 
regards all requests for accommodation as requiring 
due consideration irrespective of when the request is 
made (C. Robertson, personal communication, July 
2014). Where the request is made only on the basis of 
the student’s self-report after the fact, the Commission 
recommends the exercise of “good faith” in determin¬ 
ing whether or not to accommodate. 

When considering retroactive accommodations, it 
is worth reviewing the parameters within which accom¬ 
modations must be provided. As outlined in the On¬ 
tario Human Rights Code and in similar human rights 
legislation across Canada, postsecondary educational 
institutions have a duty to accommodate to the point 
of undue hardship. According to the Code, “undue 
hardship” is evaluated based on three factors: cost, ex¬ 
ternal funding, and health and safety (Ontario Human 
Rights Commission, 2014). Based on a comprehensive 
website search in 2013, no Ontario postsecondary 
institution has a formal policy for granting retroactive 
accommodations; in fact, most state that they do not 
grant such accommodations. Among those institutions 
surveyed, only McMaster University identifies the need 
for retroactive accommodations and acknowledges that 
determining the appropriateness of these “is challeng¬ 
ing and highly fact-specific” (McMaster University, 
2012, p. 1). A number of postsecondary institutions 
have policies permitting make-up examinations and 
deadline extensions that apply to all students. These 

284 Journal of Postsecondary Education and Disability, 28(3) 

requests are often related to sudden crises (e.g., death 
of a family member). The grounds for granting these 
accommodations fall outside the human rights require¬ 
ment of “duty to accommodate” and are largely based 
on institutional willingness to make these adjustments. 

The provision of retroactive accommodations is 
challenging for educational institutions. Concerns 
centre on issues such as determining the credibility 
of student self-reports, procedural fairness, academic 
integrity, and the administrative and workload chal¬ 
lenges of providing these accommodations. In these 
situations, institutions endeavour to balance the 
rights of students where circumstances have made 
pre-arrangement of academic accommodations not 
possible, with the need to satisfy academic integrity 
requirements. This is an area where a “case by case” 
approach to granting retroactive accommodations is 
likely to be required. 

Faculty Understanding of Mental Health 

Faculty attitudes have been shown to be a key 
determinant of the sense of inclusion experienced by 
students with disabilities (Milligan, 2010). Students 
often receive a significant amount of informal support 
from professors without contacting the OSD (Salzer et 
al., 2008). Research examining the attitudes of faculty 
to MHD shows mixed findings. In a study of faculty 
members (n= 107) at a university in the United States, 
Brockelman et al. (2006) found that faculty perceptions 
of students with MHD are generally positive. However, 
many faculty reported that they felt uncomfortable 
interacting with these students. Faculty and staff some¬ 
times hold negative attitudes towards postsecondary 
students with MHDs (Hindes & Mather, 2007; Mil¬ 
ligan, 2010; Quinn et al., 2009; Rae, 2009; Shaddock, 
2004). In some cases, these negative attitudes are 
based on a lack of awareness about how to provide 
appropriate accommodations for students with MHD 
(Milligan, 2010). Some faculty may believe “mental 
illnesses necessarily produce cognitive deficits and/ 
or disruptive behaviours” (Mowbray et al., 2006, p. 
232). Students report that some postsecondary staff 
members hold more negative attitudes about students 
with MHD than about those with learning or physical 
disabilities (Quinn et al., 2009). 

In a study of professors («=83) at a Canadian 
university conducted by Hindes and Mather (2007), 
many participants expressed the belief that postsec¬ 
ondary education is not an appropriate environment 
for individuals with MHD and indicated that they 
are less willing to provide accommodations to these 
students. Faculty also expressed a number of concerns 

about teaching these students including maintaining 
academic standards, the extra workload involved in ac¬ 
commodating this group, students’ capacity to succeed 
academically, and the negative consequences of per¬ 
ceived differential treatment (Shaddock, 2004). 

The literature suggests that faculty and staff 
report a strong desire for increased awareness and 
understanding of mental health and the accommoda¬ 
tions process (Collins & Mowbray, 2008; Milligan, 
2010; Mowbray et al., 2006; Reavley et al., 2013; 
Stevenson, 2010; Storrie et al., 2010). They also re¬ 
port that they are ill-equipped to respond effectively 
to students with MHD (Collins & Mowbray, 2005). 
Faculty and staff are also challenged by the need to 
provide equal educational access while ensuring that 
academic integrity is maintained (Storrie et al., 2010). 
Like many in the broader society, faculty and staff 
members may experience fears of students with MHD. 
Many authors link these fears to misunderstandings 
and misperceptions about MHD and accompanying 
behaviours (Angermeyer, 2000; Link, Phelan, Bres- 
nahan, Stueve, & Pescosolido, 1999). 

The fears experienced by faculty members are 
often compounded by their lack of knowledge about 
the rights of students with MHD, the services available 
to them, and appropriate accommodations (Mowbray 
et al., 2006). Faculty are unsure about their roles in 
supporting students with MHD; they feel they are not 
qualified to counsel students and are not comfortable 
assuming such a responsibility. They express concerns 
that by intervening they may worsen the student’s 
problem. Many faculty are unfamiliar with how to 
respond to at-risk students and feel unable to assist 
them in seeking additional support. It is important for 
institutions to support faculty and staff in broadening 
and deepening their understanding of mental health 
because of their role in the academic development of 
students with MHD (Stevenson, 2010). 

There is evidence to suggest that mental health ed¬ 
ucation and training for postsecondary faculty and staff 
contributes to the success of students with MHD (see 
Brockelman et al., 2006; Brockelman, 2011; Collins 
& Mowbray, 2008; Hindes & Mather, 2007; Milligan, 
2010; Mowbray et al., 2006; Rae, 2009; Reavley et al., 
2013; Shaddock, 2004; Stevenson, 2010; Storrie et al., 
2010). Providing general information about students 
with MHD can help faculty and staff develop adequate 
knowledge and resources for providing academic ac¬ 
commodations. Individuals with knowledge about the 
academic accommodations process are more likely to 
provide students with the accommodations that they 
need (Milligan, 2010). 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 285 

Training is an important aspect of accommodating 
students, since a lack of knowledge about and fear of 
MHDs can be significant barriers to student success 
(Stevenson, 2010). To make training successful and 
sustainable, mental health education for faculty and 
staff should be designed to address their particular 
interests and concerns. Since students have contact 
with professors on a weekly basis, any training for 
professors should include: (a) concrete examples of 
the types of behaviours students with MHD may ex¬ 
hibit, (b) specific information on how best to support 
students in distress and in crisis, (c) confidentiality 
policies, (d) contact information if they have a question 
or a concern about a student, (e) contact information 
for emergency situations, (f) the process for granting 
temporary accommodations, and (g) which campus 
resources are available to them for guidance and as¬ 
sistance (Mowbray et al., 2006; Rae, 2009). 

Storrie et al. (2010) suggest that “staff with mental 
health skills and interest could provide one-to-one 
support to students, rather than leaving academic staff 
with little interest or expertise to cope on their own 
with students’ behavioural manifestations of emotional 
distress” (p. 6). To improve communication and foster 
closer relationships with student services, a number 
of postsecondary institutions have delegated a “de¬ 
partmental liaison” to campus mental health services. 
In this approach, a member of the academic depart¬ 
ment facilitates referrals, collects information and is 
responsible for relaying this to others in the depart¬ 
ment (Mowbray et al., 2006). Mental health training 
provides faculty and staff with knowledge and resource 
information and increases their confidence in working 
with students with MHD. As well, it demonstrates an 
institutional commitment to supporting students (Col¬ 
lins & Mowbray, 2008). 

Emerging Themes 

Safeguarding privacy and confidentiality and the 
need for policies to support students with MHD have 
emerged as areas of concern in the literature (Belch, 
2011; Belch & Marshak, 2006; Collins & Mowbray, 
2005; Quinn et al., 2009; Rae, 2009). Due to the stig¬ 
ma experienced by persons with MHD, an assurance 
of privacy and confidentiality is critical to students 
who are seeking professional help and/or requesting 
academic accommodations (Rae, 2009). Aside from 
emergency situations, OSDs are prohibited from 
sharing personal or health-related information about 
a student without the student’s expressed consent. In 
communicating with faculty members, OSDs relay 
only information about the approved accommoda¬ 

tions. Other personal or health-related information, 
including the diagnosis, is not disclosed. 

The concept of the circle of care is applicable 
to providing services to, and sharing personal/health 
information about, students with disabilities. This 
term is used to describe the capacity of certain health 
information custodians to assume an individual’s 
implied consent to collect, use or disclose personal 
health information for the purpose of providing care. 
The circle involves those individuals who are providing 
services to the student. Faculty and most general staff 
members are not a part of a student’s circle of care and 
therefore do not know, or need to know, information 
about the specifics of a student’s mental health status. 
However, as described above, they do need information 
about accommodations and support (e.g., guidelines) 
on how to handle specific mental health-related issues/ 
situations that may arise in the classroom, laboratory 
or fieldwork setting. 

With respect to policy development and imple¬ 
mentation, institutions need a formal process for 
establishing and reviewing policies and procedures 
related to supporting students with MHD (Belch, 
2011). Policies and procedures should be established 
for all students, including those with MHD, regarding 
appropriate accommodations, medical leave, voluntary 
and involuntary withdrawal, retum-to-class, training 
for staff and faculty, and circumstances in which paren¬ 
tal notification of mental health concerns is permitted 
(Belch, 2011; Quinn et al., 2009). 

Another emerging area of concern relates to 
fieldwork accommodations. Fieldwork encompasses 
clinical experience, internships, and work placements 
and is a component of many professional programs. 
It requires different behaviours and skills than those 
needed for success in the classroom; as a result, a stu¬ 
dent’s functional impairments may be location- and 
task- dependent. The student completes fieldwork with 
either direct supervision from agency staff or with 
oversight from the educational institution. In either 
circumstance, the student is vulnerable if effective 
communication and supports are not in place between 
the institution and the placement site. 

Managing accommodations in fieldwork requires 
a thorough understanding of the program’s “bona fide” 
essential requirements by disability advisors and by the 
on-site fieldwork personnel. It also may be an iterative 
process, calling for effective communication between the 
institution’s OSDs, supervising faculty and the placement 
site, an understanding of the need for accommodations 
and flexibility in their implementation. On-site profes¬ 
sional staff may be uncomfortable with the perception 
that students are receiving “special treatment” and may 

286 Journal of Postsecondary Education and Disability, 28(3) 

need information about the site’s duty to accommodate 
under the Ontario Human Rights Code and other relevant 
legislation without disclosure of the student’s confidential 
information. Certain programs of study, such as Medicine, 
Nursing, Education, Occupational Therapy and Early 
Childhood Education, all require that students complete 
fieldwork in “safety sensitive” settings (hospitals, long¬ 
term care facilities, prisons, forensic units, schools, 
daycare centres). In these circumstances, the level of 
scrutiny is increased and the careful design of appropriate 
accommodations is essential. 

In circumstances where fieldwork involves contact 
with vulnerable populations such as children, persons 
with disabilities, and older adults, students are required 
to provide a clear vulnerable sector police record check. 
For students with MHD, in some jurisdictions in On¬ 
tario, this may pose a problem since these police checks 
may include mental health-related information such as 
contact with emergency services. Such incidents typi¬ 
cally do not involve criminal charges. This requirement 
represents another bander for some students with MHD 
who in the past have accessed support from emergency 
services through a 911 call or during a crisis situation 
where ambulance and police support were needed. 


The increasing number of students with MHD in 
postsecondary education has exposed some challenges 
for institutions in the provision of equitable educational 
opportunities. These students encounter a number of 
barriers in accessing their education that are not faced 
by their peers or those in other disability groups. Aca¬ 
demic institutions may not be fully prepared to meet 
this group’s academic and support needs. This review 
focused primarily on concerns related to academic 
accommodations; however, it is clear that there are 
other areas that underpin the equitable treatment of 
this population and require attention. For example, 
there is a need for faculty and staff training aimed at 
raising awareness of mental health and the needs of this 
population of students. This training should also cover 
appropriate academic accommodation for students 
with MHD in the classroom and in fieldwork. Both of 
these are components of an “accessible and welcoming 
campus” where all members of staff are aware of and 
responsive to the circumstances of students with MHD. 

This review highlights a number of specific chal¬ 
lenges that arise in accommodating this group of 
students. Table 1 provides an overview of the issues, 
implications and considerations. 

An overarching theme relates to the mapping of this 
population’s needs onto models previously developed 

for students with other types of disabilities, where the 
functional impairments are more stable and where altera¬ 
tions to academic accommodations may not be required 
for the duration of the study period. By contrast, MHD, 
both permanent and temporary, may emerge acutely and 
result in sudden and significant functional disruption. 
MHD-related symptoms and functional impairment may 
be intermittent and fluctuate over time. For instance, 
the need for medication adjustment(s) may temporar¬ 
ily and negatively affect a student’s functional level. In 
these circumstances, accommodation planning is more 
challenging and requires both flexibility and a sound 
awareness of the complexities of mental health. Our 
review also indicates that, in some instances, students 
may be unaware of the availability of accommodation 
services on campuses. They may also be reluctant to 
disclose the presence of a MHD and to obtain support 
as a result of self-stigma. 

David Turpin, President of the University of 
Victoria, has predicted that by 2020, “mental health 
issues are going to be the leading cause of disability 
at Canadian universities” (cited in Hanlon, 2012, p. 
1). The increase in the number of students with MHD 
in postsecondary settings over the last five years sug¬ 
gests that we may reach this situation much sooner 
than Turpin suggests. Additionally, changes to the 
diagnostic system outlined in the revised Diagnostic 
and Statistical Manual of Mental Disorders (5th ed.; 
DSM-5; American Psychiatric Association, 2013) 
may also contribute to the pace of change. A number 
of new diagnoses appear for the first time in DSM-5; 
as a result, more postsecondary students may become 
eligible to apply for academic accommodations. It is 
clear that the “rising tide” referred to by Eudaly (2002) 
is well on its way to becoming a “tidal wave.” 

Since the introduction of accessibility funding in 
Ontario in the late 1980’s, the postsecondary sector has 
adjusted to be inclusive to each new group of students 
with disabilities as they gained access to postsecondary 
education. How the sector shifts to a new paradigm 
to provide support to students with temporary and 
permanent MHD will influence and determine this 
group’s integration into the campus community and 
ultimately their opportunities for success. All stake¬ 
holders, faculty, staff, students and administrators have 
a role to play in this process. To transform the current 
system from one focused on compliance with human 
rights regulations to one of full access and integration 
requires a significant cultural shift. The ultimate goal 
is that each institution is welcoming to all students and 
access for students with MHD is part of each institu¬ 
tion’s mission, strategic plan, and core values. 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 287 

Table 1 

Challenges in Accommodating Students with MHD 




Increasing number 
of students with 
mental health 
disabilities attending 

Increased need for effective faculty 
and staff education on mental health, 
academic accommodations, and how to 
respond to students in distress 

Need for effective stigma-reduction 

Challenges to the existing academic 
accommodations model because of the 
fluctuating nature of some mental health 

Temporary versus The requirement for documentation 
permanent mental of a permanent disability based 

health disabilities on a diagnosis in order to obtain 

accommodations does not reflect the 
reality of mental health conditions. In 
some instances, there are good reasons to 
believe that the impairment is temporary; 
in others, it may take months to arrive at 
a conclusive diagnosis. 

Effective education and stigma-reduction 
programs ensure increased student 
support and retention 

Availability of services and reluctance 
of students to seek help may delay the 
process of receiving a diagnosis for a 
mental health disability. 

Students may experience mental health 
symptoms for the first time while at 
college or university. Their symptoms 
may preclude them from following 
established accommodation procedures 
(i.e. making arrangements in advance of 
not meeting an academic requirement) 

What types of documentation should 
be considered suitable for students with 
temporary mental health disabilities? 

How should professors respond when 
students seek acco mm odation relating 
to a mental health disability directly 
from the professor? Often professors 
struggle with the decision to grant 
accommodations in these situations 
because of concerns about fairness to 
other students. 

the nature of 
the functional 
impairment resulting 
from a mental 
health disability 

Identifying specific impairments can be a 
challenge since this is mostly done on the 
basis of self-report. 

The term “impairment” is used 
differently by mental health and 
education professionals. 

Determining the boundary between 
“predictable and normal” anxiety/mental 
health problems that are commonly 
experienced by the general population 
and a mental health disability resulting 
in a functional impairment requiring 
accommodation can be difficult. 

Medications used to treat mental health What impairments need to be 
symptoms may impact concentration and accommodated and how? 
motivation which in turn compound the 
functional impairment. 

Social and Self- 

Both Social Stigma and Self-Stigma are 
relevant to students’ experiences and can 
delay help-seeking, diagnosis, increase 
fatigue and decrease motivation. 

Reduce social stigma within the 
academic environment by offering on¬ 
going and effective stigma-reduction 

288 Journal of Postsecondary Education and Disability, 28(3) 

(Table 1, continued) 

It may take months for a student to 
receive a formal diagnosis. In the 
meantime, there is significant functional 
impairment and often a severe disruption 
in academic functioning 

A need for increased flexibility regarding 
requirements needed for progress in a 
specific program of study, withdrawal 
and retum-to-class policies in order 
to fairly accommodate this group of 

Retroactive How to accommodate students when they Administrative challenges in providing 

Accommodations are not able to provide documentation, or such accommodations, 

notification, in advance of missing tests 
or assignments. 

Issues such as the credibility of a 
student’s self-report, procedural fairness, 
academic integrity. 

Faculty play a key role in supporting a Determining the type of education and 
student’s sense of inclusion and creating training that would be beneficial to 
a welcoming environment. Fear and faculty 
ignorance can be a significant barrier to 
student success 

Policy Development Policies and procedures need to be in Policies and procedures should be 

and Implementation place to manage the needs of students established that cover areas such as: 

with mental health disabilities and medical leave, voluntary and involuntary 

to ensure that they receive equitable withdrawal, retum-to class, training for 

accommodations. staff and faculty and parental notification 

in emergency situations 

Fieldwork Accommodation requirements in In “safety sensitive” environments, 

fieldwork are often different than those the careful design of appropriate 
required for classroom or laboratory accommodation is essential. This may 

participation. have to be an iterative process, requiring 

effective communication between the 
Determining “bona fide” essential institution and placement site, 

requirements of fieldwork is an important 


understanding of 
Mental Health 

First Episode Psychotic symptoms may severely 

Psychosis disrupt a student’s academic 

performance/progress and require their 
withdrawal from studies for a period of 

Condra, Condra, Dineen, Gauthier, Gills, & Jack-Davies; Academic Accommodations, Mental Health 289 


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British Journal of Guidance and Counselling, 
55(4), 495-512. 

About the Authors 

Mike Condra received a B.A from the National 
University of Ireland, and a M.A. and Ph.D. from 
Queen’s University in Kingston, Ontario, Canada. He 
is currently the Director of the Department of Health, 
Counselling and Disability Services, and an Adjunct 
Assistant Professor in the Department of Psychology 
at Queen’s University. He can be reached by email at 

Eleanor Condra received her Diploma in Early Child¬ 
hood Education from St. Lawrence College, and her 
B.A in Sociology, her B.Ed. and M.Ed. from Queen’s 
University. Her experience includes working as a 
professor in Early Childhood Education and as a fac¬ 
ulty liaison to Disability Services. She is currently a 
research consultant on an academic accommodations 
project for students with mental health disabilities 
which is funded by the Ministry of Training, Col¬ 
leges and Universities of Ontario, Canada. She can be 
reached by email at 

Mira Dineen received her BA degree in global devel¬ 
opment studies and human geography from Queen’s 
University. She has worked as a Research Assistant for 
a poverty-reduction organization and is co-author of 
Persistent Poverty: Voices from the Margins (Between 
the Lines: Toronto, ON). She is currently the Coordi¬ 
nator of the M 2 Peer Mentoring program for students 
with mental health issues at Queen’s University. She 
can be reached by email at: 

Sarah Gauthier received her Bachelor of Social Sci¬ 
ences in sociology from the University of Ottawa. 
Her experience includes working as a Junior Policy 
Analyst for the federal government. She is currently a 
research assistant working on the Academic Accom¬ 
modations Research Project and the M 2 Peer Mentor¬ 
ing program for students with mental health issues at 
Queen’s University. She can be reached by email at: 

Helen Gillis, M.A. (Carleton University), M.Sc. 
(Queen’s University) is a Research Assistant on the 
Academic Accommodations Research Team. She has 
been the primary project assistant for the preparation 
of a handbook on the academic accommodations pro¬ 
cess for post-secondary students with mental health 
disabilities. She can be reached by email at helen. 

Anita Jack-Davies received her PhD from Queen's 
University. Her experience includes working as a 
university Human Rights Advisor and an Educational 
Developer. She is currently Adjunct Assistant Professor 
in the Department of Geography, Queen's University. 
Her research interests includes the areas of urban 
teacher education and inner city schooling. She can be 
reached by email at: