Mental Illness in the School System
ON THE SIXTH of November, Matthew Cohen, partner in the law firm of Monahan-Cohen,
pointed out that mental disorders cause problems for children that adults don’t face: mental illness in children may be dismissed as “just kids being kids,” not a real illness; parents may not want their child to see a psychiatrist or to take psychotropic meds; or they may expect drugs alone to solve all problems. The child’s school may share the last expectation. In any case, school systems operate from a diagnostic model for mental illness so different from the medical community’s as to seem at times insane to frustrated parents.
A child whose needs cannot be met by the standard school curriculum may qualify for special help under any or all of three different sets of rules:
1. Special Education and related services (mandated by the IDEA, the Individuals with Disabilities Education Act)
2. Section 504 of the Rehabilitation Act of 1973
3. Department of Human Services
Special Education
To qualify for Special Ed, a child must fit into one its 13 categories of disability, some of which are the following: 1) retardation, 2) vision or hearing impairments, 3) autism, 4) various physical disabilities, 5) certain serious emotional disturbances, and 6) other defined health impairments. The child must also have his education adversely affected by the disability and must need Special Education.
Children with unipolar or bipolar disorder are most likely to qualify for Special Ed under either of two categories. One is emotional disturbance. Eligibility in this category is not based upon medical diagnosis but upon the presence or absence of specified behaviors, including inappropriate thoughts or behavior under normal circumstances, school-phobia, and inappropriate relationships with peers and adults. A unipolar or bipolar child not manifesting these behaviors does not qualify for Special Ed.
The second likely category is “other health impairment,” a catch-all for many miscellaneous illnesses (e.g., asthma, epilepsy, diabetes). Qualifying for this category entails “limited strength, vitality or alertness.”
Special Ed and related services are a service, not a place. They may be provided within a “regular” classroom or as resource services, or as discrete classes in therapeutic day school or in residential service. Most kids who need special Ed services do not need to be removed from the “regular” classroom.
Theoretically, no particular category of disorder is more eligible for Special Ed than another; eligibility depends upon the severity of the disorder. In practice, though, some school districts provide better for some disorders than for others. A child with different needs may be dumped in with children he doesn’t fit in with---in which case, he may be better off without Special Ed.
Schools tend to worry about children whose academic performance is below average. A child of superior intelligence whose grades are merely average might benefit from Special Ed services but may have difficulty qualifying for them.
Once a child qualifies for Special Ed, the school works up an Individualized Education Program (IEP)---an evaluation of the child’s needs and the objectives for meeting them. Having an IEP is beneficial for two reasons;
· The school must provide positive behavior intervention for behavior problems, not just punishment.
· Accommodations, modifications and supports must be specified; teachers must be informed of them.
Section 504
Section 504 of 1973's Rehabilitation Act prohibits discrimination on the basis of disability and also requires accommodation by all schools. Its options differ from Special Ed’s.
ELIGIBILITY FOR SECTION 504:
· Must have an impairment (e.g., unipolar or bipolar)
· The impairment substantially limits a major life activity (e.g., learning)
· The impairment makes Special Ed or related services necessary. (If medication enables a mood-disordered child to function normally at school, he does NOT qualify for Section 504 UNLESS he requires medication while at school.)
Federal law does not define how help is to be provided under Section 504, so it varies from one school district to another. Many school districts assume that their responsibility is limited to minimal classroom accommodation. Parents can demand more but may not get it. Section 504 offers less protection in case of behavioral problems than Special Ed.
Department of Human
Services
The DHS may help in any of three ways:
1. It funds the community mental health system, making services available on a sliding fee scale.
2. For children who qualify, it offers an Individual Care Grant. A major advantage of the ICG is that parents can determine how it is used, including choice of respite care or residential care. It is used mostly for kids with severe psychiatric disorders---with thought disorders such as hallucinations, paranoia, grandiosity, and/or psychosis---who have been, or are at risk of being, removed from the home to institutional care. A big disadvantage is that parents must complete a very intrusive questionnaire.
3. The DHS networks local services together---school districts, mental health facilities, hospitals, etc.---to help parents locate all the services to which their child is entitled.
SPECTRUM January-February 2003 Volume 17, Number 1
For More Information:
The National Alliance on Mental Illness
NAMI of Greater
Chicago
1536 West Chicago Ave
Chicago, IL
60642
312-563-0445