Accommodating Children with Mental Health Disabilities

One thing that struck me about the recent college admissions scandal is the way that the parents abused disability laws to get more time for standardized tests or a specific test center for their children. Most mental health professionals are people of integrity, but many mental health diagnoses depend entirely on subjective criteria. It is hard for honest patients and professionals alike to know what diagnosis is the correct one, much less what accommodations actually will help a patient. It also is difficult to know when accommodation of a child’s psychological disability requires giving him or her a pass and when it requires encouraging the child to push their limitations.

Youth-serving organizations cannot second-guess the diagnoses that we receive. Both the ADA and Section 504 require us to work with parents to accommodate diagnosed mental health problems. Most of the time we will see behavior disorders, such as younger children being unable to control their temper. In older children and teenagers, we are seeing an increased number of diagnoses of anxiety and depression.

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.

The third exception comes into play more often with psychological disabilities than physical, and that 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, your decision will depend on the specific facts of the situation. In the child care setting, 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 disorders in a canoe or on the archery range. The physical world is not forgiving, and in some situations our good intentions are not enough to protect children. If a child’s mental health disabilities prevent them from following safety protocols, then safety concerns may require that you limit a child to low-risk activities.

Most psychological disabilities, however, 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.