For new college students, adjusting to academic demands and new social situations can be difficult. For those with serious mental illness, however, these aspects of undergraduate life can seem like insurmountable obstacles.

They're not. That is the philosophy behind Education Plus, a supported-education program designed to help people with serious mental illness earn associate's, bachelor's, and master's degrees by providing them with psychosocial and academic support.

Education Plus is a program of Horizon House, a Philadelphia mental health agency that operates a variety of psychiatric rehabilitation programs, including a supported-employment program (see story above and in June 3 issue).

"Education Plus is helping people to bypass entry-level jobs so that they can embark on successful careers," the program's director, Arlene Solomon, M.S., told Psychiatric News.

Education Plus was established in 2002 with funding from the Pew Charitable Trust and the Philadelphia Office of Mental Health. Services are free to people with mental illness who live in Philadelphia. Students come to Education Plus through referrals from one of the Horizon House rehabilitation programs, local psychiatrists and mental health professionals, college disability offices, and other sources. The majority of students in the program have schizophrenia, schizoaffective disorder, bipolar disorder, or major depression, Solomon noted.

Students are assigned to one of two educational specialists who meet with them once every week or two during the semester, usually on the student's campus. Together they discuss the student's educational goals and begin to tackle issues that may hamper his or her ability to meet those goals.

GinaMarie Centanni, an educational specialist and Education Plus coordinator, helps students manage their time effectively, communicate with their instructors, and cope with anxiety around exam time, she said.

"Procrastination is a big problem with our students," she acknowledged.

Whether in high school, college, or graduate school, most people can recall waiting until the last minute to begin an assignment and pull an" all-nighter" to hand it in on time, but these tactics can exacerbate psychiatric symptoms, Centanni noted.

"Our students can make themselves sick by placing extra pressure on themselves, and when they don't get the assignment done, some students slip into depression and stop going to class."

Part of Centanni's job involves helping students to cope with psychiatric and other medical problems, medication side effects, and problems that arise with housing or family members.

Students are faced with formidable challenges. "We had one woman who was living in a homeless shelter with her two children while attending classes," Solomon recalled.

Mornings are the worst time of day for some Education Plus students, Centanni noted, because that is when they most often hear voices or feel fatigued from their medications. In these cases, Centanni advises them to register for afternoon and evening classes.

The majority of Education Plus students need special accommodations to succeed in their courses.

This may, for example, mean having a classmate take notes for them during a brief psychiatric hospitalization, providing them with extra time to finish an exam, or allowing them to take a test in a room by themselves to concentrate better. Some must bring fluids in class to alleviate dry mouth.

Centanni said she regularly refers students to the campus disability office, which offers services such as career or course-selection advice. It is through the disability office that many accommodations can be made for Education Plus students, she added.

"I've seen students' self-esteem improve a great deal" since starting with Education Plus, Centanni said.

Students in the program have met requirements for honor roll and the dean's list, she noted. After graduating, some have become emergency medical technicians, insurance agents, and personal trainers, for instance.

Some students may have trouble forming friendships on campus or feel as though they can't fit in with their classmates, Centanni said.

They and others are encouraged to attend a peer support group for Education Plus students held each week during the school year. "It's not a therapy group," Centanni emphasized, but "a place where students can meet others who face similar difficulties.... It's also a friendship network."

The majority of Education Plus students are in their late 20s, but the age range is wide.

Since the program began 2002, more than 60 students have received supported-education services, and about 30 are currently participating.

Most are seeking associate degrees from the Community College of Philadelphia. Other students have enrolled at Temple University, Drexel University, DeVry University, LaSalle University, and career institutes in the Philadelphia area.

Solomon described supported education as a "burgeoning" field and said she knew of only about 30 across the country. "It was once thought that people with mental illness were incapable of holding down a job," a notion that proved incorrect with the advent of supported-employment programs. "Supported education is the next step," she said.

Mark Selzer, Ph.D., who helped develop Education Plus with Solomon, said he believes that supported-education programs are essential to professional advancement for those with serious mental illness.

Selzer is director of the UPenn Collaborative on Community Integration, which promotes community integration for people with mental illness, and an assistant professor of psychiatry at the University of Pennsylvania School of Medicine.

"Instead of viewing mental illness as the primary source" of problems with job attainment and/or career advancement, he said, "we need to look at other things that may hamper professional success."

Selzer noted that research has demonstrated that people with serious mental illness have lower educational levels than the general population, and" we know that education is probably the number-one factor in obtaining employment for anyone."

"A good number of people with serious mental illness do have the ability to return to college and reach their educational goals with the right supports," he said.

Information about Horizon House and its programs is posted online at<www.hhinc.org>.▪