College in Mind: A Mixed-Methods Study of How Emerging Adults with Psychiatric Disabilities Prepare for and Transition to and through Higher Education

This dissertation study employs an exploratory sequential mixed methods design to investigate how emerging adults with psychiatric disabilities plan for and transition to and through college. Special attention is paid to how disclosure of disability status in educational contexts can influence both educational and recovery outcomes. Though more students with psychiatric disabilities attend American colleges and universities than ever before (Gallagher, 2014), little is known about their educational experiences prior to arrival in higher education or the strategies they employ to navigate college once there. Taking a strengths-based approach grounded in disability theory, the study conceives of college as a realistic goal for many, as well as a potentially powerful context for continued recovery and optimal development. The study investigates how students with mood, anxiety, and psychotic disorders matriculate into college and persist in pursuing educational and personal goals. Qualitative data consists of multiple semi-structured interviews with each of 26 participants, and quantitative data consists of surveys completed by 22 of these participants, as well as 56 additional anonymous respondents (total n = 78). Interviews were analyzed through a process informed by grounded theory (Glaser & Strauss, 1967), leading to the emergence of three key theoretical constructs representing essential processes in successful college transitions for students with psychiatric disabilities: (1) Strategically Disclosing Aspects of Mental Health; (2) Constructing a Recovery Identity; and (3) Participating in College and Experiencing Social and Academic Integration on Campus. An over-arching grounded theory of Education for Rehabilitation, is then proposed, marrying the above individual-level findings with institutional-level recommendations to better support students’ recovery and educational journeys. Next, an online survey informed by the above qualitative findings was developed to further investigate college transition experiences with a larger sample. Items address respondents’ diagnoses and treatment histories; high school experiences; choices surrounding mental health disclosures in educational contexts; college planning and application activities; and use of academic accommodations in higher education. The survey also includes measures of institutional integration in college (IIS, French & Oakes, 2004), self-perceived recovery (RAS, Corrigan et al., 1999; Corrigan et al., 2004), and a new pilot measure of disclosure . Over-all level of mental health disclosure in college is significantly greater than over-all level of disclosure in high school. In addition, disclosure in college is significantly and positively correlated with IIS and RAS total scores, as well as with use of on-campus counseling services. Implications for supporting students’ “strategic disclosures” in order to promote recovery as well as social and academic integration in educational contexts are explored. Ultimately, qualitative themes are merged with select quantitative findings to paint a nuanced picture of the experience of college preparation, transition, and ongoing recovery for students. Recommendations to inform policy and practice at both the individual and institutional levels are proposed, and a call for change, or rehabilitating higher education to better support integrated learning and recovery for students with psychiatric disabilities is made