Accommodating Children with Mental Health Problems

One thing that has become clear during the pandemic is that rates of mental health problems and suicide among our children have skyrocketed. As youth organizations open back up, we are likely to encounter quite a few children whose anxiety and depression reach levels that, in the words of federal nondiscrimination law, “limit one or more major life activities.” We undoubtedly will find ourselves having to work with parents to accommodate diagnosed mental health problems.

Accommodating these disorders follows the same principles as physical disabilities. You must make reasonable accommodations but need not make changes that fundamentally alter your program or pose an undue burden. For example, if you have a child whose behavior requires a one-on-one caregiver, then you need not bear that cost. You can either require the parents to pay for the caregiver or disenroll the child.

An exception that comes into play more often with psychological disabilities than physical is that you need not accommodate a child who poses a direct threat to the health or safety of others. As with the other exceptions, you cannot simply assume that the child’s condition poses a danger. You must assess the specific facts of the situation. For example, in a childcare center, a child with an uncontrollable temper may directly threaten the safety of other children in the classroom. Camps may find it dangerous to allow a child with impulse control on the archery range. The physical world is not forgiving, and our good intentions often are not enough to protect children. If a child’s mental health disabilities prevent him or her from following safety protocols, then safety concerns may require that you limit that child to low-risk activities.

You also are not required to make accommodations that pose an undue burden to your program. Some parents, for example, will say that children who have anxiety attacks need to move to a quiet area to collect themselves and calm down. Your program, however, still needs to supervise that child and monitor his or her well-being. If you do not have enough staff to provide one-on-one supervision while the child calms down, you can require that the child report to the camp nurse or someone else who can keep an eye on them. The child may prefer to be alone, but you do not have to accommodate that preference.

Most psychological disabilities can be accommodated. Work with the child, their parents, and available mental health professionals to determine what the child needs and what your program can provide within the bounds of safety, physics, and economics.