education policy analysis Applying a Socio-Ecological Model to Understand the Psychosocial Support Services Available to Students with Disabilities in Universities

: The importance of psychosocial support for students with disabilities to participate effectively in universities cannot be overemphasized. As an essential aspect of inclusive practice, psychosocial supports empower students with disabilities and improve their accessibility to and belongingness in higher education. In the Ghanaian context, some attention has been given to challenges students with disabilities encounter during their university education, while less attention has been paid to the types of support they receive. Using Bronfenbrenner’s socio -ecological model as a theoretical framework, this study conducted qualitative semi-structured interviews with 11 participants with a disability, made up of 10 undergraduate students and one lecturer (physical disability: n =8 and visual impairment: n =3), to understand the nature and extent of psychosocial supports institutionalized for students with disabilities in universities in Ghana. The participants were recruited using purposive and snowball sampling approaches from one of the largest public universities in Ghana. The interview data were transcribed verbatim, and theoretical thematic analysis was performed. The psychosocial supports received by the students with disabilities that enable them to maintain their status at the university were presented and discussed around three levels: micro-system, meso-system, and exo-system. The result showed that students with disabilities received most of their psychological support from the micro-system. The study concludes with a call to policymakers to consider the important role of stakeholders such as family and peers as well improve support services to enhance the retention of students with disabilities. psychosocial


Applying Socio-Ecological Model to Understand the Psychosocial Support Services Available to Students with Disabilities in Universities
Globally, vulnerable groups such as persons with disabilities, refugees, migrants, and individuals with HIV/AIDS require "tailored support" to enable them to adjust to life or access basic services in society (Amzel et al., 2013;Anderson et al., 2013;Speigel, 1994;Tol et al., 2011;Wessells, 2019). One such humanitarian service is psychosocial support, which refers to interventions put in place to address the social and psychological problems of vulnerable groups (Anderson et al., 2013;Suzuki & Kato, 2003;Tol et al., 2011;Wessells, 2019;Zebrack et al., 2007). The interventions are integrated into key domains that might impact the development of individuals at risk of exclusion in societies. The rationale is that the development of psychosocial support would lessen the burden on minorities and facilitate their inclusion and participation in a particular domain (Gupta & Singhai, 2005;Speigel, 1994). In relation to persons with disabilities, there is an ongoing discussion on the best ways to promote their inclusion especially in higher education (also referred to as "universities" in this study). For example, the development of psychosocial support for students with disabilities is vital because of the enormous challenges they face in higher education (Elliot & Wilson, 2008;Fuller et al., 2004;Harnett, 2016;Jacklin et al., 2007;Odame et al., 2021aOdame et al., , 2021b. Psychosocial support may be required to enhance their retention and effective participation in school. However, the nature and extent of psychosocial supports available to students with disabilities enrolled in inclusive higher education are unknown. In countries across the globe, there is an advocacy toward achieving inclusive education across all education levels for all students with disabilities owing to concerns about the effectiveness of segregated special education programs. Within this discourse, the designs of educational facilities, public spaces, and services are expected to be barrier-free for individuals with disabilities who are at risk of exclusion in societies (United Nations, 2007;World Health Organization [WHO], 2011). For example, public services such as education, healthcare, employment, and physical buildings have been found to be inaccessible to individuals with disabilities (Naami et al., 2012;Tudzi et al., 2017;WHO, 2011). To promote the inclusion of persons with disabilities in societies, promoting their participation in regular schools has been noted as a starting point for bridging the gap in societies. Consequently, there is a clamor for inclusive education due to the issue of fundamental human rights and social justice, particularly for persons with disabilities (Cardona, 2011;De Becco, 2014). In this study, inclusive education is narrowly defined as creating opportunities for persons with disabilities to rightly participate in educational programs and be able to use all the available educational facilities and services (Ainscow & Sandill, 2010). Promoting these rights means that mainstream education must reform its cultures, policies, curricula, pedagogies, physical structures, and environments so that students with disabilities will be able to access and effectively participate. This inclusive approach has been found to be an effective strategy to combat discrimination, marginalization, and stigmatization of persons with disabilities (Ainscow & Sandill, 2010;Hutchinson & Martin, 2012).
Contemporary discussions in inclusive education have focused on the effective participation of students with disabilities. Access to higher education is, therefore, more than just accepting students with disabilities into higher education institutions. The key issue is to engender a sense of belongingness, which transcends the mere acceptance or admission of higher numbers of these students (Beauchamp-Pryor, 2013). Emphasizing excellence in the social and learning experiences of these students once they are accepted into higher education is paramount (Fuller et al., 2004;Gibson, 2015;Jacklin et al., 2007;Morina, 2017;Quinn, 2013;Thomas, 2016;Wilson et al., 2016). Such acceptance and belongingness promote a feeling of satisfaction as well as the realization that students with disabilities truly belong in institutions of higher education and their presence is valued (Beauchamp-Pryor, 2013;Greyling & Sawart, 2011). While some researchers call for inclusive education to be designed and tailored for persons with disabilities (Gibson, 2012;Liasidou, 2014), others argue that this would be a challenge in higher education (Morina, 2017;Mufambisi, 2018).
In the efforts to promote equitable access to higher education, psychosocial support has been noted to be an important element that aids the accessibility, belongingness, and effective participation of students with disabilities in higher education, and is thus an important aspect of the inclusive practice (Wray, 2013). The effective implementation of support services in higher education has positive effects on the experiences of students with disabilities (Elliot & Wilson, 2008;Holloway, 2001;Wray, 2013). It assists in removing challenges and allows for an inclusive environment (Fuller et al., 2009;Redpath et al., 2013). Similarly, the provision of support services in higher education provides students with disabilities equitable opportunities that enhance their academic achievements (Madriaga et al., 2011;Morina et al., 2017;Piggot & Houghton, 2007). The provision of requisite support is also seen as a source of empowerment for students with disabilities because it reduces their dependence on students without disabilities (Beauchamp-Pryor, 2013;Vickerman & Blundell, 2010).
As part of large projects, there have been discussions on some of the psychosocial services received by students with disabilities and their associated challenges. The challenge, however, is that students with hidden disabilities are usually unaware of the existence of disability support services (Elliot & Wilson, 2008;Sanderson, 2001). This lack of awareness may be due to the ineffective communication and promotion of disability support services at the institutions of higher education (Vickerman & Blundell, 2010). Furthermore, it has been recognized that poor support (those that do not meet the diverse needs of students) negatively affects the experiences of students with disabilities in higher education (Redpath et al., 2013). It does not only affect the social life of these students but also leads to personal frustrations . In the absence of formal institutional support, informal processes, such as the interaction between students with disabilities, peers, and lecturers, have been noted as an essential gateway through which these students can receive support in institutions of higher learning . The academic achievements of students with disabilities are enhanced when there is a good association with students without disabilities, a situation that makes the former feel a sense of belongingness in higher education (Roberts, 2009). However, in sub-Saharan Africa where issues with disabilities are linked to spirits and evil (e.g., Avoke, 2002;Kassah et al., 2012), associating with students with disabilities is challenging because of the myths surrounding disability. It is unclear what psychosocial supports students with disabilities receive and what systems are available to promote their wellbeing. Therefore, the aim of this qualitative study was to develop an in-depth understanding of the psychosocial support institutionalized for students with disabilities in universities in Ghana.

Theoretical Framework: Socio-Ecological Model
Individuals are in a nested system where different parts play significant roles in their development (Kamenopoulou, 2016;Onwuegbuzie et al., 2013). In studying the development of individuals within a society, there is a need for a broader look at situations in the society that could enhance one's growth in the society. In the study reported here, the complexity surrounding disability issues informed the use of the socio-ecological model as a framework to study the psychosocial support services accessible to university students with disabilities. This theory has been described as a person-process and context model. According to Bronfenbrenner (1976), individuals are caught in a nested system where different parts play significant roles in their development. Bronfenbrenner (1976) developed the socio-ecological model to explain the role of the interaction between human beings and their environment on development. Although the child is an active player in society, the environment within which they find themselves defines how well they would develop. Bronfenbrenner (1992) later revised the socio-ecological model and added the concept of "development-in-context" to make it more applicable to the development of students in a school. The expanded development of the socio-ecological model reinforced the interaction between homeschool-community in an effort toward practicing inclusive education. Inclusive education requires support from home, school environment, teachers, policymakers, and society before students with disabilities could learn in the same classroom with their peers (Ainscow & Sandill. 2010). Bronfenbrenner (1992) outlines five components that could work together to enhance human development: micro-system, meso-system, exo-system, macro-system, and chrono-system.
For the purpose of this study, only three levels were adopted, namely, micro-system, mesosystem, and exo-system. These three levels were selected because they relate to an interplay between the individual and the environment, whereas the other two (macro-system and chrono-system) focused on the influence of historical antecedents or practices on one's development (Härkönen, 2007). The micro-system assesses the impact of the immediate environment on the development of students with disabilities. The micro-level, described as the propeller of development, is a single unit within the system where the development of students with disabilities takes place (Härkönen, 2007). This is an interaction between the students with disabilities and members of their immediate environment. The relationship between the individual and the immediate environment is bidirectional. Although the immediate surrounding could influence the individual's development, the behavior or capabilities of the individual could define the direction or extent of support they would receive from the surroundings (Härkönen, 2007). In the present study, attention was given to the relationship between students with disabilities and their families toward supporting the education of the former. The synergy between the students with disabilities and their immediate environment can give a prediction of what would happen in the future. In assessing the outcome of the interactions, if it is favorable, then the student will likely feel supported and focused on completing their studies. The meso-system outlines the relationship between various settings within which the development of an individual takes place. It refers to the relationship between different layers within the system (Härkönen, 2007). For example, the relationship a family forms with the school and the connection between the individual, school, and other stakeholders within the school environment are utmost priorities. In most instances, schools do not have effective measures to promote the development of students with disabilities (Anthony, 2011;Botts & Owusu, 2013;Greyling & Swart, 2011;Harnett, 2016;Mamah et al., 2011). In most instances, teachers are not well trained, and there is poor collaboration between home and school in the efforts to optimize the learning of students with disabilities (Gregorius, 2016;Holloway, 2001;Mamah et al., 2011). Thus, in the absence of formal structures, the support offered by peers could go a long way to enhance the learning experiences of students with disabilities (Heward, 2013). Peer-to-peer interaction is vital (Heward, 2013), and thus the existence of a cordial relationship between students with disabilities and peers could ensure the benefits for the former. The exo-system outlines the events that occur in a given environment that has an influence on or may affect the development of individuals (Härkönen, 2007). Although the individual is not directly involved in the process, events unfolding have repercussions on their development. For instance, in the event where community perceptions are negative about students with disabilities, there would not be much support available in the society to facilitate their inclusion in the education system (Gregorius, 2016;Kassah et al., 2012). Indeed, the individual with disability does not have any control over the development that happens within the environment. However, such disposition could affect their development or learning experiences (Härkönen, 2007), for example, in the form of ineffective or a lack of policies or support services available to promote the education of students with disabilities. Specifically, the existence of support services for students with disabilities would suggest the preparedness of the school environment to facilitate their development.
In this study, the three lenses (micro-system, meso-system, and exo-system) were applied to understand the level of extent of psychosocial support given to students with disabilities in higher education in a low-income context.

Research Context
Education is identified as a major pillar in the development of the country (Ministry of Education, 2016). Since Ghana's independence in 1957, the government has developed policies and educational reforms to expand access to all. Education in Ghana has a three-tier structure consisting of basic education (two years of pre-school, six years of primary, and three years of junior secondary education), three years of senior secondary school, and tertiary education (university, nursing training college, and college of education; ranging from one to four years) (Ministry of Education, 2013). Free compulsory education is provided from the age of 6 to senior secondary level. Owing to the scarcity of resources, private individuals are encouraged to set up schools to enhance accessible education to all. Parents have the option of educating their children in private schools, which are envisioned as epitomizing quality education.
In 2018, there were 437,576 students enrolled in tertiary institutions, of which 244,079 were enrolled in public universities (Ministry of Education, 2018). Unfortunately, the number of students with disabilities who were enrolled is unreported. In terms of funding, parents are expected to cover the cost of education for their children. However, there are financial schemes set up by the government to cover tuition fees for vulnerable groups, such as gifted students from poor backgrounds and persons with disabilities. Students could also apply for a loan from a government agency, the Social Security and National Insurance Trust, to cover living allowances and reading materials (Ministry of Education, 2018). All these initiatives are aimed toward eliminating financial barriers to education and promoting the participation of all persons in the education system.
In Ghana, there is an intersection between culture and disability (Baffoe, 2013). For example, persons with disabilities are stigmatized, oppressed, and marginalized due to the dominant understanding of disability from traditional and religious, medical, and charity models (Anthony, 2011;Avoke, 2002;Baffoe, 2013). Traditionally and religiously, the majority of Ghanaians believe that disability is caused by a direct curse or punishment from certain external forces (e.g., God, lesser gods, magic, witchcraft, and sorceries) as a result of offenses and sins committed by the persons with impairments or their relatives (Avoke, 2002;Baffoe, 2013;Botts & Evans, 2010;Naami et al., 2012). These prevalent perceptions of disability in Ghana locate disability within persons with impairments and treat them as objects who are labeled and defined by their impairments (Anthony, 2011;Baffoe, 2013;Goodley, 2011). Over the years, these conjectural cultural and traditional beliefs have erected formidable institutional, physical and attitudinal barriers that prevent persons with disabilities from accessing education and gaining employment, rendering them dependent on their family and friends for survival or engaging in menial jobs and begging for survival (Botts & Owusu, 2013;Dako-Gyeke & Asumang, 2013;Kassah et al., 2012). The contextual understanding of disability places a huge load on persons with disabilities who may need psychosocial support to overcome these stereotypes.
The global advocacy toward promoting inclusive education has swept through Ghana. During the 2003/4 academic year, the government formally announced the implementation of inclusive education in selected schools. The implementation was geared toward addressing barriers and creating opportunities for persons with disabilities to acquire skills for independent living. The passage of the Persons with Disability Act 715 (Republic of Ghana, 2006) and ratification of the Convention on the Rights of Persons with Disabilities in 2012 was heralded as a key milestone to opening up spaces for persons with disabilities. In nearly two decades, giant steps have been taken to ensure that all persons are able to participate in all levels of education. In 2015, Ghana developed an inclusive education policy that provided directions of practices. For instance, the policy encourages both public and private educational institutions at all levels to admit and make reasonable accommodations to ensure the right of everyone to full access and participation in education. Disability Act 715 and the Inclusive Education Policy both advocate that access to education at all levels is a fundamental human right for all Ghanaians, including persons with disabilities, and espouse educational institutions to offer barrier-free access to encourage the access and participation of all students (Republic of Ghana, 2015). These policies indicate that requisite supports would be provided by the educational institutions to ensure their rights to educational access. Although the government has led the way with the formulation of policies, it has failed to show leadership in terms of supporting practices in schools.
Moreover, the University Corporate Strategic Plan that sets out the strategic plan for universities places emphasis on increasing the access and participation of all persons, including those with disabilities. To ensure the increased access and participation of students with disabilities, the Strategic Plan indicates that higher education institutions must make all academic and non-academic facilities and equipment accessible for persons with disabilities by providing assistive technologies, ramps, and escalators. To improve the provision of student support services, the University Corporate Strategic Plan (2014) emphasizes the establishment of a student services center to provide support services such as scholarship schemes, assistive technologies, and course materials in alternative formats, including Braille, audiobooks, and electronic text, for persons with disabilities. However, it is not clear the extent to which these supports lessen the burden on students with disabilities to ensure their access and participation in the universities in Ghana.
Despite the giant steps taken to enact inclusive education, Ghana's progress toward the implementation of quality inclusive education in higher education institutions has been hindered by several challenges. These challenges include lack of teaching and learning materials, lack of resources, lack of funds, inaccessible physical buildings, and lack of skills of the teaching staff to teach students with disabilities (Mamah et al., 2011;Nketsia et al., 2013;Opoku et al., 2017;Tudzi et al., 2017). Although the Ghanaian government provides some financial assistance to all students with disabilities enrolled in universities, a recent study has found that the assistance is not enough to cater their basic needs because of the rising cost of university education (Odame et al., 2021b). Other studies have likewise reported that university programs for students with visual impairment are limited to education, social sciences, and languages. Meanwhile, most university lecturers lack the requisite resources to make accommodations and adjustments to cater to the needs of students with disabilities (Mamah et al., 2011;Odame et al., 2021aOdame et al., , 2021b. For instance, reading materials are sold to students only in print, institutions lack the resources to record lectures, university programs are examination oriented, and lecture halls are overcrowded and lack adequate lighting systems (Mamah et al., 2011;Odame et al., 2021b). These studies further found that university lecturers are intolerant and demonstrate negative attitudes toward students with disabilities by preventing students from recording during lectures (Mamah et al., 2011;Odame et al., 2021b).
Given the unsupportive social and cultural environment that students with disabilities find themselves in universities, attention must be paid to what enhances their well-being. While the challenges faced by students with disabilities are known, what enhances the agency of these students to access higher education requires scholarly insight. The central question answered in this study is as follows: What are the sources of psychosocial support for students with disabilities enrolled in universities in Ghana?

Method
This study forms part of a larger study which attempted to understand the motivation (Akoto, 2021;Akoto et al., 2022) and support services provided to students with disabilities. The study reported here covered the support services available to students with disabilities enrolled in university in Ghana.

Study Participants
A qualitative research design was adopted for this study to enable the researchers to have indepth understanding and insight and explore the participants' experiences regarding the psychosocial supports students with disabilities receive during their university education (Marshall & Rossman, 2011;Mills & Birk, 2014). Purposive and snowball sampling approaches were used to select the participants for the study. The study targeted students with disabilities. After each interview, participants were asked if they could direct the research to other persons with disabilities who may be willing to participate in the study. These non-probabilistic sampling techniques allowed the researcher to select participants with characteristics that are of great importance to the study (Etikan & Bela, 2017). Table 1 presents the characteristics of the participants who participated in the study. Eleven participants with disabilities were recruited from one of the largest universities in Ghana. Of this number, eight were students with physical disabilities and three were students with visual impairments; nine were males and two were females; five were level 400 students (4th year), three were level 300 students (3rd year), two were level 200 students (2nd year), and one was a lecturer ( Table 1). The lecturer with a disability was recruited in order to gather heterogeneous data and compare the responses of diverse participants (Creswell & Miller, 2000).

Instruments
To explore the participants' experiences about the psychosocial supports students with disabilities receive during their university education, one-on-one semi-structured interviews were conducted with them. This approach allows for more probing and clarifications regarding the experiences, perceptions, feelings, and emotions of the participants (Gray, 2009;Hennick et al., 2011;Newby, 2010). The interview guide was developed from the main research objectives and review of the literature (see, e.g., Fuller et al., 2004;Gibson, 2015;Holloway, 2001;Jack & Robinson, 2007;Jacklin et al., 2007). The main area covered in the interview guide was the support students with disabilities receive to enable them to access and participate in higher education. A draft of the interview guide was developed and shared with two academics who are experts in qualitative research. The feedback provided was used to evaluate and improve the final draft for data collection. Moreover, pilot study interviews were conducted involving two students with disabilities: a female level 200 student with visual impairment who was studying disability and rehabilitation and a male visual art master's student with a physical disability. The pilot interviews were recorded and discussed with the supervisors and then final changes were made before data collection.

Data Collection Procedures
The study and its protocols were reviewed and approved by the Human Ethics Committee of the University of Canterbury, New Zealand. Following the approval, the Special Education Department of the University Q was contacted to support us in locating students with disabilities. The department contacted one of the students with disabilities to assist the first author in locating other students with disabilities in the university. The first student then identified other students with disabilities and invited them to take part in the study. Out of the 20 students invited, which included students with hearing impairments (n=4), only 10 agreed to participate in the study and left their contact details with the informant. Attempts were also made to get the views of some of the lecturers with disabilities regarding the support available in the university for students with disabilities.
Thus, invitations were sent to three lecturers with disabilities in the Special Education Department. However, only one agreed to participate in the study. Information sheets and consent forms explaining the objectives of the study were provided to all the participants to read and sign before participating in the study. All the participants were assured in the consent form that their names and university would be replaced with pseudonyms, and their information would be stored securely and kept strictly confidential. The participants were thus assigned codes based on their gender, current level in the university, diagnosed disability, and the order in which the interview took place. For instance, the first person interviewed was a male level 400 student with a physical disability to whom we assigned the code "male level 400 with physical disability A." Thereafter, arrangements were made for face-to-face interviews with those who agreed to be interviewed. To ensure easy accessibility to where the interviews would be conducted, the participants chose their own venues that are easily accessible to them. The interviews were conducted in English, and participants were reminded that their participation in the study was voluntary and that they were free to withdraw at any stage.

Researcher as Instrument
It is important to note both our positionality and reflexivity given the qualitative nature of this study (Trainor & Graue, 2014). As we identify our positionality and reflexive practices, others can then make decisions regarding researchers' biases that may have influenced the presentation of findings. We are academics who studied in universities in Ghana, and some have worked as classroom teachers. We also had the opportunity to work and study in different universities in Australia, Finland, and New Zealand. Our understanding of the western context and structures put in place may influence our approach or understanding of the services required to facilitate the learning of students with disabilities.

Data Analysis
The interviews were audio-recorded and the recorded data were transcribed verbatim by the first author, who is proficient in the English language. Permission was granted by all the participants for the recorded data to be used for publication. The first author entered the transcribed data of the first three participants on a Microsoft Word document. Thereafter, two of the research team members with great proficiency in the English language went through the transcriptions. Areas were then discussed for improvement. The remaining eight interviews were transcribed by the first author. The transcribed interview data were returned to all participants to determine if their voices and contributions were accurately recorded (Creswell & Miller, 2000). Out of the 11 participants, only 4 responded to the emails to request that some changes be made to the transcribed data and then the changes were made.
The transcribed data were subjected to thematic qualitative data analysis. In the analysis, patterns (themes) within the transcribed data were identified, analyzed, and reported ( Table 2). The analysis was driven by the theoretical or analytic interest of the researchers in the area; specifically, preliminary research questions and the related literature-supports students with disabilities receive in the university-were used as the guideline (Braun & Clarke, 2006;Marshall & Rossman, 2011). To become familiar with the transcribed interview data, the first author read and re-read the data to obtain an in-depth understanding of the patterns and meanings. In this process, attention-grabbing ideas were noted and subsequently used to make the initial codes. The key emerging codes were discussed with the two research team members and were adopted as priori codes. The codes were matched with corresponding text. This was followed by the generation of themes and sub-themes from the codes which were later reviewed. The first author then wrote the storyline, which was shared with all the authors for their contribution and inputs. A summary associated with each theme was written by the first author and accepted by the research team for the final write-up of the research.

Results
Obtaining admission to a university is not enough to guarantee that students with disabilities can effectively participate in the appropriate learning experiences, courses, or programs without discrimination, harassment, and victimization. Reasonable measures must be put in place by higher education stakeholders to enable the adequate provision of support services for the students with disabilities to go through their studies successfully at the university. The findings of the present study showed that participants were able to maintain their status as university students owing to some support they received at the micro-system, meso-system, and exo-system. Guidance and counseling services, teaching assistants, support from certain lecturers, governmental loan, financial help

Micro-System
Family Support Family encouragement was cited as a critical support for students with disabilities to access and participate in university education. Some of the participants reported that although their parents were less educated or completely illiterate, their parents encouraged them to access and participate in university education. For some participants, the encouragement they received from their parents enabled them to persevere in the midst of difficult situations, such as discrimination, marginalization, and stigmatization. The students further explained that without the positive attitude, advice, and willingness of their parents, they would not have been able to maintain and sustain their studies at the university. Some of the participants also reported that their parents motivated them to set difficult but achievable objectives to guide their education. For some, their parents have always instilled a positive and optimistic attitude that they have tapped into to succeed. They were therefore encouraged to study hard in order to achieve this objective. For example, the encouragement from their parents assisted some participants to overcome the psychological trauma and physical challenges they experienced daily at the university. A female level 400 student with physical disability reported her experience as follows: My parents made me to understand that higher education is significant in sustaining my life in Ghana. My parents encouraged me that a person could acquire money and properties but they could come to an end but education has no end and could support me for the rest of my life as no one can take it from me. As a result, my parents encouraged and sometimes persuaded me to pursue university education so as to widen my options in life.
Some of the participants reported that their parents supported them to persevere in their studies even though their parents were less educated or completely illiterate. A male level 200 student with physical disability, male level 300 with physical disability, and another male level 400 with physical disability indicated that even though their parents were peasants and subsistence farmers, they nevertheless supported them in every way possible to access and participate in university education. The support from the family came in the form of financial and material resources, such as tape recorders, Braille papers, and laptops. The students indicated that since they did not receive materials such as laptops and recorders from the university, it would have been difficult for them without the support of their families. On participant (Male level 400 student with visual impairment I) shared his experience as follows: "My parents are very supportive of my education; they provide all my educational needs, including tape recorder and laptop. They also cater to all my financial needs." Married participants, including two male level 400 students with visual impairment, a male level 200 student with physical disability, and a male level 300 student with physical disability, maintained that their wives were their inspiration for their academic achievements. To them, their wives provided psychological, moral, and material support while at the same time encouraging them to work hard and succeed. A participant (Male level 400 student with visual impairment I) reported that his main source of support came from his wife who is visually impaired and had completed her master's degree in disability studies. He reiterated that the understanding and awareness of his partner regarding the challenges associated with the education of visually impaired students meant that he received the requisite support which lessened his stressful experiences. He further indicated that his wife provided useful information that has been beneficial to him. He shared his experience as follows: At first, I was worried about the conditions at the institutions of learning in Ghana so I decided not to continue my education anymore after sixth-form, but my wife encouraged me, bought the application form for me, and has been supporting me all the time. (Male level 400 student with visual impairment I) The comment of the male level 400 student with visual impairment shows that his partner motivated him to access and maintain university education. It is therefore plausible to state that without the support from partners, some participants would not have been able to cope with the pressure that comes with higher education. The participants' stories also indicate that those who have experienced university education could provide information that would support their partners to enroll in university education because they have walked the path.

Meso-System
Peer Support Support from peers with and without disabilities was important for the participants. Friendship with students without disabilities was a source of support for the participants of this study. The participants explained that students with disabilities cannot feel comfortable without assistance from their peers and emphasized that socializing with students without disabilities was essential. Some participants stated that they were assisted in both academic and non-academic tasks by students without disabilities. For example, students with visual impairments indicated that they were not given a disability-specific orientation when they arrived at the university. Hence, they relied on their peers to orient them within the university campus by showing them some important areas on the campus. "In this university my closest friends are everything for me, they are my sight, light, teacher …, we were friends before my impairment so they understand me better and are ready to help me all the time" (Female level 200 student with visual impairment B). A male level 300 student with a physical disability who uses a manual wheelchair reported that he relies on other students every day to get his wheelchair to lecture theaters located on the top floors of buildings as there are no elevators in a number of campus buildings.
Each time I go for lectures in this university, I need to crawl and beg other people to assist me in carrying my wheelchair to the lecture hall; other than that, I drag my wheelchair by myself along as I crawl… Also, my peers normally assist me in fetching water and carrying it to the bathroom for me when the tap is not flowing.
(Male level 300 student with a physical disability) Participants' experiences underscore the relevance of peer support received at the university. Their experiences show that some of their peers who understand students with disabilities empathize with them and are ready to assist them to overcome some of the challenges they face at the university. Hence, without peer support, students with disabilities would find university life more challenging.
This finding suggests that aside from their own academic pursuits, peers sometimes perform extra roles of caregiving to students with disabilities, a responsibility the university should carry out. Participants also experienced peer support through collaboration among themselves. This support comes in the form of sharing of information, materials, and lecture notes among students with disabilities themselves. For example, participants with visual impairments stated that sometimes they share the same recorder, transcribe lecture notes together, and distribute these among themselves. They further emphasized that they collaborated well with their course mates because they cooperate with one another through notes sharing.
In this university most of the time we move in groups, and those of us with visual impairments are always together at the basement of the department; we share almost everything, including listening to recorded lectures, transcriptions, and food. Besides, the nature of the university is such that I cannot live independently, so I share with students without disabilities peers what I think they may need from me, for example, soft copies of notes I receive from some of the lecturers. (Male level 400 student with visual impairment I) Support sometimes comes in a specific form of peer tutoring, which involves students without disabilities serving as a guide to students with disabilities in their academic activities. To some participants, their peers acted as campus tutors and supported them in different ways as well as provided them with the latest academic information at the university. For example, a female level 200 student with visual impairment and a male level 400 student with visual impairment indicated that without their sighted peers it would be difficult for them to know the happenings in the university. This support becomes even more crucial during examinations because they depend on their peers for all information and directives relating to assessments and tests. They stated that time tables for examinations and assessment results are displayed on the notice boards at the university. Therefore, they rely on their peer tutors for such information. It was reported that institutional provision for peer tutoring was absent in the university for all the participants. Hence, we depended on our peers' voluntary support for information. The university did not give us peer tutors. Some of my peers have sacrificed to be my peer tutors. They provide me with the information at the university; without them it will be difficult to obtain information on test and examination schedules. (Female level 200 student with visual impairment B) Findings from the study clearly show the importance of peer tutoring. The willingness of some students without disabilities to support their peers with disabilities could mean that a perceived understanding exists between the students. This arrangement is important as it creates a free and conducive environment in which they could express their feelings and challenges.

Institutional Support
Participants in this study discussed the influence of institutional support (support from the university and other government agencies) in their academic achievements at the university. They were disappointed that the university did not do much to lead awareness campaigns aimed toward educating the university community about their strengths and capabilities. The majority of participants indicated that institutional support, or the lack of it, has a major impact on their studies. According to the findings, some academic and non-academic staff provide support to students with disabilities in several ways. The support services discussed by participants included psychological, academic, and financial.
Psychological Support. Psychological support is provided for students with disabilities through the guidance and counseling services unit. The visually impaired participants indicated that the university assigned them to counselors to aid their psychological well-being. Contrarily, students with physical disabilities decried the poor and infrequent guidance and counseling service provided by the university, suggesting that some of the participants have misgivings about the guidance services in the university. Participants stated that their daily experiences at the university mean that they need guidance and counseling services frequently, as they have to go through a daily ordeal of provocation and hurtful comments from students without disabilities. The psychological challenges are usually compounded by the debilitating physical and teaching environment of the university, a scenario that underscores the urgent need for frequent guidance and counseling services. Probing further, the students with physical disabilities stated that the counseling unit does not have enough staff, with the limited personnel concentrating more on teaching. As a result, appointments are always delayed, which puts students off from accessing counseling services.
I would say the students with disabilities do not obtain the needed counseling support they require. This department does not have enough experts in guidance and counseling so it is always difficult to find people to assist students, particularly students with disabilities. Nevertheless, some lecturers assist some of the students who request for counseling. The university counseling unit lacks personnel to cater to the students' needs. At the moment, we do not have a program that is focused on students with disabilities. The department is working on operational plans that would apply directly to students. (A male lecturer with physical disability K) The infrequent use of counseling services at the university by the students is an indication that the students either are unsatisfied with the delayed appointments or do not recognize the significance of the counseling services in helping them manage their challenges. Academic Support. Academic support was provided through the voluntary assistance received from university staff, especially the teaching assistants. The intent was to assist students to access information from the Internet for their assignments, tests, and examinations. In addition, visually impaired participants stated that the resource assistants usually read examination questions for them to convert to Braille before they could answer, especially when the only embosser in the university develops a mechanical fault. Participants with visual impairment further stated that they sometimes receive support from certain lecturers who give them lecture notes and resources to support their studies. Support sometimes comes from non-academic staff as well. For example, some students who were able to access the library specified that they received support from the librarians in finding information they needed.
The resource persons are always ready to offer me any assistance I need. Right now one of them has installed software on my laptop that allows me to edit my assignment and other works before submission. I have software that translates text into audio through the assistance of these resource persons. Sometimes they also provide extra tutorials for some of us free of charge. In fact, without their assistance, my life at the university would be more challenging and complicated. (Male level 400 student with visual impairment E) Students' experiences of academic support show that there are some people in the university who are ready to support them to succeed and that there is some access to technological support.
Although the participants did not experience support all the time, they considered the limited support valuable because it facilitated their learning and reduced their dependency on their peers. Financial Support. Although participants indicated family support was important in assisting them in their university education, seven students suggested that their financial standing could be better if they are able to obtain a government loan to supplement the assistance they receive from their family. Participants stated that although all students have the opportunity to access government loans, the processes involved are laborious and challenging. They explained that applicants for the loan need to obtain three guarantors who are contributors to the fund so that in case of default, the sponsored institution could deduct the money from the guarantors' contributions. The problem is that people are hesitant to act as guarantors for students with disabilities who they least trust to pay back their loans on time after graduation. Consequently, most of the students with disabilities are unable to access these loans. A participant shared his experience as follows: For two years I have tried to find three guarantors so that I can obtain the student loan to support myself but I have not gotten anyone. If your family members are not contributors to the Social Security and National Insurance Trust fund, nobody wants to guarantee for you. (Male level 200 student with physical disability C) The unwillingness of the fund contributors to guarantee for these students and the refusal of the loan institution to make requirements flexible leave students with disabilities with limited funding options. It can therefore be said that while an avenue for obtaining loan concessions does exist, the procedures governing such funds prevent some students who need these loans the most from accessing them. Institutional support also comes in the form of financial help that some of the participants received from the university and external sources. A participant (Female level 200 student with visual impairment B) said she once obtained financial support from the university, though this does not happen with any regularity. Two participants, a male level 300 with physical disability and a male level 200 with physical disability, indicated having received financial support from the local government at the initial stages of their university education. However, this ceased after a couple of months. Other students indicated not receiving any form of assistance from either the university or external institutions. "I once received financial support from the university through the assistance of one of my lecturers. Although it was not much, it assisted me in paying my tuition fees" (Female level 200 student with visual impairment B).
The findings of the current study show that institutional financial support is not reliable, given that only one student has experienced this support. The indication is that students cannot rely entirely on such sources of funding for their upkeep in the university. However, there are no established scholarships or hardship grants that could support students with disabilities in their daily activities, with the exception of the vice chancellor's scholarship, which is given to the best student in each year group.

Discussion
The purpose of this study was to understand the psychosocial support given to some students with disabilities in universities in Ghana. Bronfenbrenner's (1976) socio-ecological lens was used to understand the psychosocial support received by students with disabilities at three levels: micro-system, meso-system, and exo-system. The micro-level appears to be the most reliable avenue where participants received psychosocial support.
Participants in this study received financial and emotional support from their families, and this enabled them to participate and maintain their status as university students. Since there are no established mechanisms to provide financial support for the education of students with disabilities in Ghana, the family unit becomes the main pivot around which such commitments revolve (Kassah et al., 2012). Studies have found that in families where the education of students with disabilities are valued and given equal opportunities as that of siblings without disabilities, the student with disabilities are able or more likely to excel (Beauchamp-Pryor, 2007;. A case in point is in Tanzania, where Macha (2002) reported that the positive perceptions of family members urged the government to provide financial support for students with disabilities. This initiative, however, is an aberration because the most dominant societal belief in sub-Saharan Africa is that persons with disabilities are unable to cope with the pressures of higher education; hence, the education of such persons is often neglected (Opini, 2012;Rugoho & Siziba, 2014). Families do not consider the education of students with disabilities as a priority in sub-Saharan Africa because of the belief that there may not be any returns on such investments (Botts & Evans, 2010;Gregorius, 2016;Author et al., 2015). Therefore, it could be argued that families who understand the importance of higher education defy the dominant belief that persons with disabilities are incapable of participating in higher education by supporting the education of students with disabilities. The differences in perceptions may be attributed to the experiences and socio-cultural and economic backgrounds of the families involved.
At the meso-level, peers of the study participants were found to play critical role in their ability to adjust and follow the school curriculum. Within the university community, peers were noted to play crucial roles in making the study participants feel that they belonged (or not). Studies have identified social networking and confidence building as important consequences of peer support. Harnett (2016) indicated that peer role is significant because it builds the confidence levels of students with disabilities and engenders a sense of unity among them. Other studies have confirmed the importance of peer support in higher education for students with disabilities and its influence on inclusive education (e.g., . The implication is that the positive attitude of one's peers is significant in developing trust and respect for students with disabilities. Participants of the current study appreciated the effort of the few students who understood them through the support they offered, stating that without the support of their peers, the examination dates would elude them. This finding probably lends support to the need to intensify public education among other peers at school communities. This is due to the fact that schools lack basic resources to accommodate the learning needs of students with disabilities. Thus, the support from the meso-level is fundamental in the efforts toward practicing inclusive education. Gaps appear in the psychosocial support received by participants at the exo-system. It was noted that when higher educational institutions provide a supportive psychological environment where care, worth, and acceptance are experienced by students with disabilities, the students feel secure and have a sense of belonging (O'Keeffe, 2013). Access to guidance and counseling services is critical for the retention of students with disabilities as it has proven to be a good source of inspiration and care for all students (Simpson & Ferguson, 2012). Notwithstanding the importance of counseling services, there were limitations in the present study as services were available only to visually impaired participants. Inadequate psychological support means that the emotional stress and difficulties the students with physical disabilities who took part in this study experienced at the university remained unattended to, and this could make them drop out of the university. In remedying this situation, a cue can be taken from Cyprus, where the Education and Training of People with Special Needs Policy mandates the employment of professionals such as psychologists and speech therapists to support students with disabilities (Jones & Symeonidou, 2017). However, there are some complexities in the Ghanaian context, as the present study showed that the university is constrained by inadequate resources, making it difficult to achieve the counseling needs of participants. This situation notwithstanding, Mosia (2017) argued that setting the needs of students with disabilities as a priority and the efficient use of resources could make this achievable.
At the exo-system, an important element of inclusion gleaned from my findings was related to the support participants received from instructors in the learning process. The role of instructors who appreciate and support students with disabilities in the classroom is critical to the concept of inclusion (Mamah et al., 2011). In the current study, participants were not satisfied with the support they obtained from the majority of university staff. They perceived this shortcoming as caused by the poor knowledge of disability issues among university staff. Harnett (2016) observed that the academic success of students with disabilities partly depends on the support they receive from their instructors, adding that staff who are aware of disability issues are able to provide the support required by students with disabilities in the teaching and learning process. With reference to this discussion, some researchers have pointed to the ingenuity of instructors in sub-Saharan Africa as key, stating that because of resource constraints, students with disabilities are dependent on sympathetic staff to feel that they belong in higher education (Greyling & Swart, 2011). Holloway (2001) put this in perspective, indicating that the insensitivity of staff toward the needs of students with disabilities may be due to a lack of awareness of disability issues. Consequently, there is more potential for growth in terms of staff support in the understanding of students with disabilities from instructors. Apart from training university instructors to appreciate the diverse needs of students, it is possible to use the few university staff who understand these issues as change agents among their colleagues.

Study Limitations
The results of this study must be interpreted with caution owing to a number of limitations. First, the sample size is small because the participants were recruited from only one of the public higher education institutions in Ghana. Other students with disabilities in other universities might have different experiences from those reported in this study. The second limitation is the manner in which the participants were recruited. The study used two non-probabilistic sampling techniques to recruit participants: purposive and snowball sampling approaches. The nature of these sampling approaches, together with the qualitative nature of the study, makes it impossible to generalize the findings, interpretations, and conclusions. However, the qualitative approach offered an in-depth understanding of student's experiences regarding the supports they received from the university. Therefore, future studies could recruit more participants with disabilities from other higher education institutions to give a broad outlook as to the supports that are provided to them to access and participate in university education. Future studies could also adopt quantitative research methods to investigate the views of a larger number of participants. Despite these limitations, we believe that the findings of the current study make valuable contributions to existing literature in terms of the supports students with disabilities receive during their university education.

Conclusion and Policy Implications
The current study adds to the literature on the psychosocial support received by university students with disabilities. The findings of the study show reliable support from the micro-system and meso-system. Indeed, this study highlights the role of family support in the education of students with disabilities in higher education. The support, encouragement, care, and respect students with disabilities obtained from their families and the larger community played a vital role in their education. This finding suggests that the support from the family unit is a fundamental motivation that ignites a sense of hard work among students with disabilities. In developing policies geared toward promoting the inclusion of students with disabilities in universities, consideration could be given to the role of the family. Families may be educated about their role and encouraged to continue supporting the education of students with disabilities.
Second, the impact of peer support in the participation of students with disabilities in higher education is identified as significant. Inaccessible physical and learning environments require students with disabilities to be supported by their peers. Although the negative attitudes toward students with disabilities are rife, the results probably underscore the need for an intensification of public education about the acceptance of students with disabilities. At university campuses, peers without disabilities may be engaged about the contribution they can make to enhance the education of students with disabilities.
The emotional stability of students is critical to their success as well. Although all students face such challenges, students with disabilities suffer the most due to the additional burdens of marginalization and discrimination. This study shows that students with disabilities encounter different challenges that make them vulnerable to experiencing multiple stressors. This result brings to light the importance of psychological support and responding to the diverse needs of students with disabilities. The psychological support could be in the form of enhancing adaptive behavior and could also focus on anxiety, finances, fears, depression, academic pressure, time management, and managing emotional stress. In this way, the academic potentials of students with disabilities could be realized. Therefore, there is a need for universities to strengthen their counseling units by employing people who understand and are willing to support the needs of students with disabilities. Qualified staff members could be resourced to run professional development in inclusive education and teaching pedagogies. This effort could enable the teaching staff to be able to respond to the learning needs of students with disabilities. education policy analysis archives Volume 30 Number 152 October 11, 2022ISSN 1068-2341 Readers are free to copy, display, distribute, and adapt this article, as long as the work is attributed to the author(s) and Education Policy Analysis Archives, the changes are identified, and the same license applies to the derivative work. More details of this Creative Commons license are available at https://creativecommons. About the Editorial Team: https://epaa.asu.edu/ojs/index.php/epaa/about/editorialTeam Please send errata notes to Audrey Amrein-Beardsley at audrey.beardsley@asu.edu Join EPAA's Facebook community at https://www.facebook.com/EPAAAAPE and Twitter feed @epaa_aape.