Medically Confirmed Functional Impairment as Proof of Accommodation Need in Postsecondary Education - Are Ontario's Campuses the Bellwether of an Inequitable Decison-Making Paradigm?

Oct 15, 2026

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Historically, Canadian postsecondary students with disabilities have relied on comprehensive documentation of diagnoses and functional impairments to obtain appropriate academic accommodations. Increasingly, some provinces allow students with mental health disabilities to avoid disclosing diagnoses; a clinician may confirm disability, enumerate functional impairments, and specify accommodations. Disability Services Offices then often depend on physicians for this information. A census of Ontario medical training programs assessed how well residents are trained to determine functional impairments; most received no such training.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Introduction

Trends in mental health accommodations

Documentation and disclosure policy shifts

Role of health professionals and decision-making equity

Medically Confirmed Functional Impairment as Proof of Accommodation Need in Postsecondary Education: Are Ontario's Campuses the Bellwether of an Inequitable Decison-Making Paradigm? Allyson Harrisona, Alana Holmesb, & Kathleen Harrisona Queen's Universitya, Cambrian Collegeb Abstract Historically, students with disabilities in Canada provided comprehensive and objective documentation of their diagnosis and related functional impairments to access appropriate accommodations at the postsecondary level. Recently, some Canadian provinces have adopted an approach whereby students with mental health disabilities need not reveal their diagnosis; a healthcare professional may simply verify that a disability exists, enumerate the functional impairments, and detail the accommodations to be provided. Without transparent documentation, Disability Services Offices frequently rely upon physicians for this information. We completed a census of all medical training programs in Ontario to evaluate the extent to which medical professionals receive training in determining functional impairments in postsecondary students with mental health conditions. Our findings demonstrated that the vast majority of medical residents receive no such training. Two programs report offering limited training in subjective methods such as self-report or the wishes of the client. Implications and recommended best practice are discussed. Keywords: disability policy, academic accommodation, functional impairment, decision making, human rights Introduction The number of students with mental health complaints enrolled in Canadian postsecondary institutions has grown markedly (American College Health Association, 2017a, 2017b; American College Health Organization, 2011) and is now in contention with learning disabilities (LD) to be the disability most commonly seen by Disability Services Offices (DSO) (Nadira Ramkissoon, Ministry of Advanced Education and Skills Development, personal communication, March 13, 2017) . In community colleges in Ontario there was a 110% increase in mental health disabilities requiring accommodation between 2009 and 2015 as compared to a 25% increase in LD and a 71% increase in Attention Deficit Hyperactivity Disorder (ADHD) (Deloitte Canada, 2017) . Postsecondary institutions in the United States are reporting similar increases in accommodation requests, with mental health diagnoses eclipsing all other disability groups over the past few years as the main justification for required supports (Belkin, 2018) . The accommodations needed to level the playing field for students with mental health challenges may be quite different from those needed by students with other non-evident disabilities already served by DSOs, as symptoms may be transient, curable, or cyclical throughout the school year. A provincially funded research survey investigating appropriate accommodations practices for students with mental health challenges (Condra & Condra, 2015) concluded, based primarily on the opinions of the students polled by the researchers, that students need not disclose their mental health condition in order to receive academic accommodations in postsecondary settings. Instead of documentation describing objective, evidence-based procedures, the report recommended that students provide only information regarding the functional limitations experienced as a result of their mental health issues in order to obtain academic accommodations in college or university. These recommendations mirror current accommodation trends in both the United States (Lovett, Nelson, & Lindstrom, 2015) and other Canadian provinces such as Manitoba (Glowacki, 2018) . Taking their cue from the conclusions ofthis report, the Ontario Human Rights Commission (OHRC) issued a statement to all Ontario postsecondary institutions that students with mental health diagnoses need not disclose the specifics of their disability to educators when seeking accommodations (OHRC,

FAQs

What change in accommodation documentation policies is discussed for students with mental health disabilities?

Some provinces have adopted an approach where students need not disclose their diagnosis; instead, a qualified healthcare professional verifies that a disability exists and provides details on functional impairments and needed accommodations.

How did the authors evaluate medical training in Ontario?

They completed a census of all medical training programs in Ontario to assess the extent to which medical professionals receive training in determining functional impairments for postsecondary students with mental health conditions.

What did the study find about training for determining functional impairments?

The vast majority of medical residents received no such training, with only two programs reporting limited training using subjective methods such as self-report or the wishes of the client.

Oct 15, 2026

Uploaded by Muffet