In keeping with its systemic mandate, the OHRC sought to spread the positive results achieved at one university to all public colleges and universities in Ontario. To that end, in 2016 the OHRC wrote to all public colleges and universities in Ontario asking them to implement six specific measures to reduce systemic barriers to post-secondary education for students with mental health disabilities (Appendix 1).
The OHRC requested that institutions ensure that the medical documentation guidelines, medical documentation forms and procedures used across all divisions and faculties do not require students to disclose their mental health disability diagnosis to register with the Office for Students with Disabilities (OSD), or to receive accommodations.
The OHRC requested this change because policies that routinely require students with a mental health disability to reveal a DSM diagnosis to access academic accommodations create barriers to equality. Requiring a DSM diagnosis can have an impact on a student’s autonomy and dignity. As well, the stigma associated with mental health disabilities can mean that a person will not come forward and request the accommodation they need, if they have to reveal information about their diagnosis.
Accommodation requires individualized assessment. The definition of disability under the Code is flexible and encompasses new and emerging disabilities and disabilities for which a precise diagnosis is unclear or has not yet been determined. Accordingly, the duty to accommodate can be triggered even when there is no specific DSM diagnosis. Furthermore, a DSM diagnosis does not necessarily help determine what accommodations need to be provided and may foster reliance on stereotypes about particular mental health disabilities.
Students may have difficulty accessing mental health services in a timely way, and reaching a conclusive diagnosis may take up to 18 months or may never be possible. In these instances, students may have functional limitations associated with mental health disabilities that require accommodation even if a DSM diagnosis has not yet been determined.
As such, academic accommodations should be determined based on functional limitations, rather than a DSM diagnosis.
The OHRC requested that institutions make it clear that students may request interim accommodations for mental health disabilities pending receipt of medical documentation.
An institution’s obligations under the Code include providing interim accommodations while waiting to receive medical documentation. Students may require accommodation for functional limitations associated with a mental health disability before they are able to obtain medical documentation. Therefore, where a student is waiting to be assessed by a health care professional, post-secondary institutions should provide interim accommodations using the best information available, including how the student identifies their own needs, pending the assessment.[9]
The OHRC requested that institutions make it clear that both temporary and permanent mental health disabilities will be accommodated. Under the Code, there is a duty to accommodate the needs of persons with disabilities to ensure equal access to education services. All disabilities, whether temporary, permanent, minor or significant, must be accommodated to the point of undue hardship.
The OHRC requested that institutions do not state or imply that requests for accommodation after a deadline, test or course completion (i.e. retroactive accommodation) will not be considered. In some cases, the nature of a mental health disability may leave a student unable to identify that they have a disability or that they have accommodation needs. In these cases, institutions should not refuse to consider accommodation requests retroactively. All requests for accommodation should be meaningfully considered on an individualized basis.
The OHRC requested that institutions not require students to reveal their private medical information to, or seek accommodation directly from, their instructors. Requiring students with mental health disabilities to establish their need for accommodation with individual instructors can create barriers for access to appropriate accommodations for some students with mental health disabilities. These barriers arise because students may find approaching individual instructors intimidating, fear stigma or a negative response from their instructor. Furthermore, instructors may not be well-positioned to respond to direct requests for accommodation.
As well, the mental health policy emphasizes the importance of maintaining confidentiality for people with mental health disabilities. Accommodation requests should be handled through an Office for Students with Disabilities. These Offices should take steps to maintain strict confidentiality and safeguard privacy, for example by keeping medical documentation in locked filing cabinets and/or in password-protected computer databases or files. A student’s involvement with the Office for Students with Disabilities, including the fact that he or she has received academic accommodations, should not be identified on test results, student records, transcripts or graduation documentation.
The OHRC requested that medical documentation guidelines, forms and procedures be clearly communicated to all students, faculty and staff. Improving awareness about available services and procedures is essential to creating meaningful access to appropriate accommodations for students with mental health disabilities. Effective training of faculty and staff about mental health and academic accommodations, including responsibilities under the Code, is also an important part of tackling the systemic challenges faced by students with mental health disabilities.
[9] The accommodation process is a shared responsibility. Everyone involved should co-operatively engage in the process, share information and consider potential accommodation solutions. Students seeking accommodations are responsible for making their accommodation needs known to the best of their ability and providing medical documentation about their functional limitations as soon as possible.