Not all those who struggle show their scars.

Many students face physical and mental health challenges that can sideline their educational career, but at Illinois State University, students can access resources to help them navigate learning and succeed with a hidden illness.

A hidden illness can be any physical or mental health issue not easily seen, and include everything from irritable bowel syndrome (IBS), heart problems, post-traumatic stress disorder (PTSD), and anxiety. Tori Niestrom, a senior education major from Darien, Illinois, was diagnosed with type I diabetes when she was four years old. Throughout her K-12 days, Niestrom received accommodations that helped her complete work without risking her health.

headshot of Tori Niestrom

Tori Niestrom

“I had no idea that services I received in high school could continue in college,” said Niestrom. When she and her mother attended a college visit at Illinois State, they asked about potential support avenues. “They connected me with Student Access and Accommodation Services.”

Known as SAAS, Student Access and Accommodation Services helps students with disabilities or medical and mental health conditions find success in the classroom. Students like Niestrom who battle hidden illnesses might need more time to complete assignments, or need accommodations during testing.

“Usually students are required to stay within the testing environment during an exam,” said Director of SAAS Tammie Keney. “But a student suffering from Crohn’s disease may need to use the restroom immediately, or a student with PTSD might need a distraction-reduced environment to take an exam.”

SAAS creates an individualized plan for students who qualify for accommodations (See the SAAS request for services). They can also answer questions of faculty members to ensure accommodations fit with class needs. “We use the term ‘reasonable accommodations’,” said Keney. “It doesn’t mean you can miss half the school year and still pass, but it does carve out a path for those who need it.”

Niestrom’s accommodation plan includes a letter she can email to teachers to let them know when she cannot attend class due to high or low blood sugar, and permission to have snacks in class. “More than anything, SAAS helps my teachers be aware that I may need to miss class,” she said. Niestrom also deals with attention deficit hyperactivity disorder (ADHD), and receives in-class accommodation. SAAS assists with a note taker, extended exam times, and an app that allows for readable pdfs.

headshot of Jeremy Niestrom

Jeremy Schwartz

The first step to getting access to services is to stop by SAAS or fill out a form on the website. “They walked me through the paperwork, and even got out a map to show me where my classes would be. They went above and beyond,” said Jeremy Schwartz, a freshman communication and broadcast major from Glenview, Illinois. Diagnosed with a learning disability in fifth grade, Schwartz is allowed extra time when taking tests, and the ability to type essay tests as opposed to writing them. “I’d encourage people to contact SAAS. There’s no shame in it, only not doing anything about it.”

Keney said she has seen a greater number of people who are willing to get the help they need. “I do think things have changed over time,” said Keney, who has been working with people with medical and mental health conditions for more than 30 years. “There is not as much stigma attached, and more people are willing to self-report.” Keney added that at Illinois State, nearly 3 percent of the population self-reported an accommodation need in 2016-2017. That has increased to 4.4 percent for 2017-2018.

Of course, not all students know they might be battling a hidden illness. Other areas on campus keep an eye out for students who might need help. “It happens quite often that students do not realize the bigger picture. They see recurring complaints—aches and pains, headaches that won’t go away, not being able to get out of bed—and not know that this could be tied to something like depression,” said Assistant Director of Student Health Services (SHS) Becky Ludolph.

Ludolph said providers watch for patterns in students who are seen at SHS. If a student is identified as having an illness, such as IBS or depression, a referral to SAAS can be made as needed. “Along with physicians and nurses, SHS has a psychiatrist and a dietitian,” she said. “If the student agrees to help, SHS can refer the student to Student Counseling Services or other services on campus as needed.”

Anxiety is the number one mental health concern for college students, noted Staff Counselor Stacy Parton of Student Counseling Services, who added the condition can be debilitating. “Most students experience some anxiety around test-taking, completing projects, etc. When anxiety is severe, it can interfere with just getting to class, or being able to leave their room,” she said. “Some students experience fears of being judged or fears of crowds. There can be difficulties concentrating that can cause barriers to paying attention in class or doing homework.”

Along with the services provided by SAAS, Student Counseling Services works to encourage holistic care for students who struggle. “We work to help them build skills to increase their ability to relax and challenge anxious thoughts. Students can use our relaxation room or attend a skill-building workshop. Are they getting enough exercise, taking part in social groups?” asked Parton. “Are they happy with their major? Sometimes it’s about finding a sense of meaning and purpose, and doing things to enrich their lives.”

For Niestrom, having resources at the University provides more than a step on the path for success for students battling hidden illnesses. “Having a place like SAAS has been emotionally helpful. I feel like I’m not alone,” said Niestrom, who noted the challenges she faces have helped her become an advocate for herself and others. “I’ve had diabetes since I was four, so I know how to advocate for myself. But I’ve seen other students who receive services from SAAS who don’t know how to stand up for themselves yet, and SAAS is helping them find their voice.”

With plans to become an educator for students who are deaf or hard of hearing, Niestrom founded the ISU chapter of the College Diabetes Network with help from staff at SAAS. “I’ve never really thought of diabetes or ADHD as disabilities,” said Niestrom, “but I can see how my life has shaped me to own who I am, and I’d like to help others do the same.”

Students who believe they might qualify for accommodations, can begin the process at the SAAS office in Fell Hall, room 350, or on the SAAS website.

SAAS Steps
Request for Service
The first step is to fill out a Request for Service form in our office or online,” said Keney. “Online students can also find guidelines for determining eligibility.”

Signed documentation
Documentation includes a typed letter on letterhead signed by the student’s provider. “We will not accept pictures of documentation or documentation that is handwritten,” said Keney. Full documentation guidelines can be found on the SAAS site.

ID card
All requests for service go to a Document Review Committee. Once eligibility is determined, the student is issued an ID card that is shared with faculty members. “The card contains accommodations needed for the students,” said Keney.

“If a faculty member feels like the accommodations that we’ve outlined fundamentally alter their program in any way, or they have questions on how to implement it within a course than they typically reach out to us,” said Keney. “Our goal is to help guide and support the students and the faculty.”