Comparing Disclosure and Supports used by Higher-Education Students with Neurodivergent or Mental Health Conditions

Abstract

Background:

Retention and academic success are associated with accessing supports for students with disabilities and/or mental health conditions (MHCs); however, many students do not disclose to their institution. While disclosure and supports use have been investigated for Autistic students, less is known about other neurodivergent students, those with multiple minority identities, and whether this differs from the experiences of non-neurodivergent students with MHCs (NND-MHCs).

Methods:

Using the bioecological framework, we investigated disclosure experiences and supports use for neurodivergent and NND-MHC students via an anonymous online survey capturing diagnoses, disclosure experiences, supports usage, and new supports wanted from 131 neurodivergent and 42 NND-MHC Australian and New Zealand higher education (HE) students. Kruskal–Wallis, Chi-square, and Fisher’s Exact tests were used to compare neuro groups.

Results:

Neurodivergent participants were grouped into Autistic, Attention Deficity/Hyperactivity Disorder (ADHD), Autistic-and-ADHD (AuDHD), and ND-other. More AuDHD students disclosed to their institution than NND-MHC (83%–19%, p < 0.001). Similar proportions of neurodivergent and NND-MHC students found disclosure helpful and intended to disclose in the future. Minority-identity scores differed significantly, but did not affect disclosure. More AuDHD students (74%) accessed supports than the other groups (38%–58%), but this was not significant (p = 0.074). There were significant group differences in use of note-takers, extended time for examinations/assignments, computer use in examinations, group project alternatives, and modified orientation. NND-MHC students reported lower overall supports use than the neurodivergent groups, p = 0.028. Support helpfulness ratings were similar for neurodivergent (95%) and NND-MHC (96%) students. Neurodivergent groups (77%–87%) wanted new neurodivergent-specific supports in both structured and unstructured formats, with neurodivergent mentors/facilitators preferred by the Autistic, ADHD, and AuDHD groups, 50%–71%.

Conclusion:

Apart from the AuDHD group, less than half of eligible students disclose to their institution or use supports, but when they do, they find them helpful. A more nuanced understanding of neurodivergent students’ support needs is required to improve their HE experience and completion rates.

Community Brief

Why is this an important issue?

For students with disabilities or a mental health condition (MHC), success in higher education (HE) is linked to accessing supports. But the majority of eligible students do not disclose, that is, register for support with their HE institution. We need to increase our understanding of the disclosure and supports experiences of students with neurodivergent and MHCs so that institutions can improve their processes and support offerings, and thus, help more students complete their studies.

What was the purpose of this study?

We wanted to discover if neurodivergent students and students with MHCs differ in their disclosure and supports decisions.

What did the researchers do?

We recruited Australian and New Zealand HE students with neurodivergent (131) and mental health (42) conditions to complete an anonymous online survey. We asked questions about their conditions and minority identities (neurotype, gender identity, and ancestry) and whether they had disclosed to their HE institution. We asked if they had used supports at school or in HE and whether they were helpful. We also asked neurodivergent students questions about new neurodivergent-specific supports they might want.

What were the results of the study?

Neurodivergent students were grouped into Autistic, Autistic-and-ADHD (AuDHD), ADHD, and ND-other neuro groups. More AuDHD students (83%) disclosed to their institution than non-neurodivergent students (19%). While the neurodivergent students had more minority identities than the non-neurodivergent students, this did not affect disclosure. More AuDHD students (74%) accessed supports than the other groups, and there were group differences in which supports they used. Non-neurodivergent students used fewer supports than students in the neurodivergent groups, but similar proportions of neurodivergent (95%) and non-neurodivergent students (96%) rated supports as helpful overall. The neurodivergent students used more staff-led than peer-focused non-academic supports compared with the non-neurodivergent students. Neurodivergent students want new neurodivergent-specific supports such as unstructured social/support groups and structured mentoring programs to be led by neurodivergent facilitators.

What do these findings add to what was already known?

This is the first study to find differences in disclosure rates and supports use between neurodivergent and non-neurodivergent students with mental health conditions. Neurodivergent students also differ in new supports wanted. Students with AuDHD are most likely to disclose their conditions and use supports and non-neurodivergent students are the least likely. Disclosure processes could be made easier by removing the requirement for documentation to be recent.

What are potential weaknesses in the study?

Limitations of the study included having small and uneven group sizes, and most (67%–82%) of the participants were female. Future studies could address these issues by recruiting more participants and more men and gender-diverse people.

How will these findings help Autistic adults now or in the future?

Understanding the differences in disclosure rates, supports use, and what new supports students want will help HE institutions improve their processes and make it easier for students with neurodivergent and MHCs to access supports. Institutions must involve neurodivergent students in co-designing new supports to improve supports access and usage, which will help more neurodivergent students complete their studies.