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May 7, 1999
BY LIZ LIPTON
By age 35, George L. Argento of Kingston, N.Y., had spent almost a year in jail. Prior to that, Argento, a former trucker, had been an addict for many years and suffered from undiagnosed depression.
Now at 39, Argento, a recovered addict, is graduating this spring from Ulster County Community College (UCCC) in Stone Ridge, N.Y., where he studied full time and worked as a student aide in the computer lab. With a 3.3 grade point average, Argento is applying to four-year colleges and plans on earning his master's degree in graphic design.
While there were several catalysts that enabled him to make this transformation (including receiving medication and counseling), one key factor was the supported education program at UCCC that assists students with psychiatric disorders.
"Without this program, I probably would not have stayed in school," Argento said. "I have to work doubly as hard as other students because it's more difficult for me to concentrate and retain information. Also, I have slight dyslexia."
He continued, "I go to the program about three times a week. Sandra [Bollin, the director] teaches me ways to study and tutors me."
Argento is one of 72 students benefiting from this program, called ACES: Academic Coaching for Educational Success. As the ACES coordinator and only employee besides the program's administrator, Bollin assists students with depression, bipolar disorder, anxiety, personality disorders, schizophrenia, and other psychiatric disorders. Bollin works with students individually and in groups to provide a wide range of services including tutoring, management of stress and time, counseling, referrals, enhancement of communication skills, and orientation to the college environment.
What makes this seven-year-old program unusual is its impressive success rate and small budget-less than $50,000 a year, said Bollin, who suffers from posttraumatic stress disorder. The 49-year-old participated in the ACES program seven years ago when she attended UCCC.
Of the 72 participants, 15 are doing so well they no longer require assistance, but may resume the program at any time. Of the 25 students who graduated last year, only one stopped attending college; 14 went on to study at four-year colleges, and 10 are working. This spring, of the seven graduates, four will be attending a four-year university, and three are looking for jobs.
Graduates hold positions as computer programmers, accountants, and graphic designers. Some go on to graduate school, including law school.
These statistics are especially impressive because "about three-quarters of the participants had been on Social Security or disability," according to Bollin, who has a bachelor's degree in psychology and sociology and is completing her master's degree.
"The program has allowed people who normally would not have the emotional resources to go to college to attend," said David Jutton, who refers clients to Bollin. "It's a very effective program. She [Bollin] has a good understanding of the needs of people with disabilities, and she has the big advantage of being nice."
Jutton works as a vocation rehabilitation counselor for the New York State Education Department's Vocational and Educational Services for Individuals with Disabilities (VESID) in Kingston, N.Y.
Beyond knowing the age range of participants (19 to 58), there are no data available on participants. However, Bollin estimated the following: the average age is 30, three-quarters are taking medication, almost all are seeing a psychiatrist, and most are facing financial difficulties. When asked whether there are students whose diagnosis would be too severe for her to accept, Bollin, whose caseload includes about six or seven participants with schizophrenia, replied, "Absolutely not. If they're willing to come here and study, I'm willing to work with them."
"The secret of the program is having [the participants] redefine themselves as students rather than [think of themselves as] patients. This is key because when they can focus on their role as a student, they can drop their label as a mental health patient and get on with their lives," said ACES administrator Martha Steuding, M.P.S. (master's in professional studies).
She added that ACES was replicated from the supported education program model developed at Boston University's Center for Psychiatric Rehabilitation. This program model, based on the Choose-Get-Keep approach, is an application of the psychiatric rehabilitation approach developed by the center's director, William Anthony, Ph.D., and his colleagues over the last two decades. This program model is one that has been widely implemented in a variety of settings from four-year colleges to community mental health centers, according to Anne Sullivan Soydan, Sc.D., the center's supported education program manager at BU's Center.
Besides helping redefine their self-assessment, Bollin assists students with immediate needs. This may include such activities as driving them to a dental appointment and referring them to a housing specialist or other community services.
She even helps the students during episodes of increased stress. Among the techniques she uses are talking, walking outside, taking slow, deep breaths, visualization, muscle relaxation exercises, and kite flying. For example, to help a participant who has posttraumatic stress disorder and experiencing difficulty, Bollin might bring him outside for a walk and instruct him to take deep, slow breaths. She also might accompany him while kite flying, which Bollin says distracts participants from their problems while also forcing them to change their posture from being hunched over to more erect. This change in posture, Bollin said, helps them think more positively.
Do such techniques work? Argento talked about his own experience: "Sometimes I would get so down and depressed that I would think, 'How can I do this? I'm not as good as these people.' And she'll help me see the reality of the situation. She's very supportive and points out every little positive thing. Also, she'll bring me to fly kites. That doesn't sound like the way to help someone, but it works, the spontaneity breaks from the norm of feeling like failing. Once she breaks [me] from the stress, I feel more relaxed and open to new ideas."
Bollin's services, however, do not venture into the realm of treatment. Each student meets with his or her psychiatrist for medication reviews and receives counseling on a regular basis from a psychotherapist. If the psychiatrist becomes aware that the student is having particular difficulties affecting school work, he or she calls the student's therapist, who contacts Bollin. However, since the goal of the program is to foster the participants' roles as "students" rather than "patients," she doesn't directly involve psychiatrists and other mental health personnel in her work with the students.
Helping students cope with basic immediate needs is only one service Bollin provides; she also teaches social and academic skills.
To help students prepare for their first semester, she starts working with some as early as June before the fall semester; however, most attend her intensive three-day orientation session in August.
The main teaching technique she employs is "processing," in which participants explain how they felt in that experience, followed by Bollin's making suggestions that will lead them to self-discovery.
Throughout the semester, Bollin offers workshops on decreasing anxiety, improving coping skills, and other relevant topics. She provides help with admission and financial aid forms, mediating difficulties with students and professors, scheduling, registration, academic advisement, and social skills.
"Many of these students have been isolated much of their lives, so communication skills are very important," said Bollin.
In addition, her work involves tutoring students and teaching academic skills such as mnemonics devices to aid in memorization, test-taking strategies, and note-taking skills.
The program operates with an annual budget of less than $50,000, all of which is used for staffing. UCCC donates the office space and computer. Most of the program's funding is provided by the Mental Health Association (MHA) in Ulster County Inc. in Kingston, explained Steuding, the director of education and advocacy for the MHA. In addition, the program receives funding from the United Way of Ulster County and from VESID, which pays a fee for each student it refers to the program.
Currently there is no nationwide listing of supported education programs; however, the University of Hawaii's Center on Disability Studies will be formulating one soon. For further information, contact the center's director, Robert A. Stodden, Ph.D., at (808) 956-9199.
Below is a partial listing of supported education programs for patients with mental illness provided by Anne Sullivan Soydan, Sc.D., and Karen Unger, M.S.W., Ed.D., at the Center for Psychiatric Rehabilitation Sciences at Boston University.
Boston University Center for Psychiatric Rehabilitation, Boston: Anne Sullivan Soydan, (617) 353-3549
College of San Mateo, San Mateo, Calif.: Tim Stringari, (650) 574-6193; Dee Howard (650) 574-6487
Laurel House, Psychosocial Clubhouse, Stanford, Conn.: Steve Dougherty, (203) 324-1816
Northeast Career Planning, Troy, N.Y.: Maureen Melia and Kiki Garg (518) 273-0818; Cristin Sullivan (518) 438-3445.
Pierce Community College, Tacoma, Wash.: Deanne Gilmur, (253) 756-2767; Lynn Braedt (253) 756-2344.
Quincy Mental Health Center, Quincy, Mass.: Elsa Eckblaw, (617) 770-4000
Thresholds Psychiatric Rehabilitation Centers, Chicago: Joe Kerouac, (312) 337-4258
Ulster County Community College, Stone Ridge, N.Y.: Sandra Bollin, (914) 687-5073