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The ADA and People with Psychiatric Disabilities

What do you think is the fastest-growing area of legal activity relating to the Americans with Disabilities Act? People with psychiatric disabilities, or mental illnesses, are filing claims alleging that workplaces have failed to accommodate their employees' with psychological challenges.

According to the provisions of the ADA, complaints filed nearly doubled between 1998 and 2000, and they account for 15-20 percent of all ADA claims received by the Equal Employment Opportunity Commission (EEOC) to this day. This percentage may grow even larger in future years. Under the original language of the ADA, the Act applied a higher standard for legal redress to individuals whose disabilities stemmed from "any mental or psychological disorder." But legislative efforts to eliminate this higher standard have intensified in recent years.

Problems associated with employees with mental illnesses may include workplace socialization difficulties, limited stamina and irregular attendance, difficulty dealing with stress or criticism, and limited attention spans. But many experts in both the mental health and business fields insist that the people with mental illnesses can still be valuable additions if companies provide appropriate accommodations.

One valuable tool that business owners and managers can utilize in establishing and maintaining a productive work environment is the EEOC Enforcement Guidance, a comprehensive legal guidebook. As The Guidance stipulates that "traits or behaviors are not, in themselves, mental impairments. This means that stress does not automatically indicate a mental impairment, although it may be a symptom.

Similarly, such traits as irritability, chronic lateness, and poor judgment are not, in themselves, mental impairments, although they may be linked to them." Legitimate psychiatric disabilities do, however, include major depression, bipolar disorder, various anxiety disorders, schizophrenia and more, depending on how the condition affects their functioning.

There has been lengthy debate around the preferred terminology for referring to individuals with psychiatric disabilities. Some commonly used terms are "the mentally ill," "person with a psychiatric disability," "mental health consumer," and "psychiatric survivor." However, "person with a psychiatric disability" will be used here to emphasize the focus on work functions rather than medical symptoms or social identity.

There are many prevalent myths about individuals with psychiatric disabilities that reinforce negative, inaccurate stereotypes.

Myth #1: Mental illness is uncommon. The most recent estimates by the federal government indicate that 3.3 million American adults—approximately two percent—have a serious mental illness.

Myth #2: Mental illness is the same as an intellectual disability. No! The two are distinctly different and can be commonly occurring depending on the individual. A diagnosis of an intellectual disability is chiefly characterized by limitations in intellectual functioning, as well as difficulties with certain skills of daily life. By definition, intellectual disabilities -- which used to be categorized by the now derogatory mental retardation -- begin before the age of 18. In contrast, the intellectual functioning of people with psychiatric disabilities varies as it does across the general population.

The symptoms of mental illness may include emotional disturbances, disordered thinking, or perceptual difficulties. A mental illness may develop at any age, from childhood through later adult life. Bipolar disorder and schizophrenia have a high rate of onset during early adulthood. Therefore, many individuals with psychiatric disabilities enter or complete college before first experiencing symptoms.

Myth #3: People with psychiatric disabilities are likely to be violent. This is untrue. Upon learning that an applicant has a history of psychiatric treatment, some employers may expect that the individual is likely to become violent. This myth is reinforced by portrayals of people with mental illnesses in movies, television, and the news media as frequently and randomly violent. According to a recent scholarly review of research literature, no data give credence to the sensationalized caricatures of people with mental illnesses that we commonly see in movies and on TV.

Myth #4: Recovery from mental illness is not possible. On the contrary, many with a mental illness are recovering and leading healthy lives. For many decades, people with mental illnesses were separated from the rest of society through institutionalization in mental hospitals. Mental illness was thought to be permanent and untreatable, when in fact there are outpatient and medication therapies to help stabilize individuals to more functional and fulfilled ways of life.

The success of prominent figures with mental illnesses has helped to inform the public that healing and recovery are indeed possible. Two well-known mental health advocates are Patty Duke (who frequently speaks about her own experience with bipolar disorder) and William Styron (who wrote the autobiographical book “Darkness Visible” about living with major depression).

Myth #5: People with psychiatric disabilities can’t tolerate stress on the job. This myth over-simplifies the complex human response to stress. People with a variety of medical conditions - including cardiovascular disease, multiple sclerosis, and psychiatric disorders - may find their symptoms exacerbated by high levels of stress. But the sources of personal and job-related stress vary from individual to individual. Some people find an unstructured schedule stressful, while others struggle with a regimented work flow.

Some people thrive on public visibility or high levels of social contact, while others need solitude to focus and be productive. Of course, workers with psychiatric disabilities vary, too. All jobs are stressful in some regard. Productivity is maximized when there is a good match between the employee’s needs and his or her working conditions - whether or not the individual has a psychiatric disability.

How do we know when we are working alongside someone with a mental illness or psychiatric disability? Psychiatric disabilities are generally not apparent. Further, the ADA prohibits employers from asking applicants if they have psychiatric disabilities or a mental illness before making a job offer. Examples of pre-employment questions not allowed under the ADA include the following: Have you ever been hospitalized? Have you had a major illness in the last five years? Have you ever been treated by a psychiatrist or psychologist? How many days were you absent from work because of illness last year? Are you taking any prescribed drugs?

In order to determine whether applicants are qualified, the screening process should clarify the essential functions of the job, and then seek evidence that the potential employee has the needed skills, work experience, education or other qualifications. Given these guidelines, employers are unlikely to know if an applicant has a psychiatric disability unless he or she chooses to discuss it. Disclosure is a personal decision on the part of the worker that involves many factors including trust, comfort with others in the workplace, job security, and the perceived open-mindedness and support of the immediate supervisor.

Of course, the strengths and weaknesses of each applicant or employee must be assessed individually, regardless of the presence of a disability. The workers ability to perform a job will depend on his or her work experience, training, and skills, not merely the presence or absence of a psychiatric diagnosis.
Good management practices will produce many of the workplace accommodations needed by people with psychiatric disabilities. Like all employees, workers with psychiatric disabilities may benefit from supervisors who:

• approach each employee with an open mind about his/her strengths and abilities,
• clearly spell out expectations for performance,
• deliver positive feedback along with criticisms of performance in a timely and constructive fashion,
• are available regularly during the workday for consultation with employees,
• demonstrate flexibility and fairness in administering policies and work assignments.

In addition to high quality supervision, some workers with psychiatric disabilities may benefit from one or more of the following accommodation options:

• schedules which incorporate flex-time,
• part-time positions or job sharing,
• time off for scheduled medical appointments or support groups,
• the use of break time according to individual needs rather than a fixed schedule,
• physical arrangements (such as room partitions or an enclosed office space) to reduce noise or visual distractions,
• extending additional leave to allow a worker to keep his or her job after a hospitalization,
• allowing workers to phone supportive friends, family members, or professionals during the work day,
• joint meetings between the employer, supervisor, and job coach or other employment service provider.

One of the ADA’s primary goals is to promote equal employment opportunity for people with disabilities. Achieving this goal requires employers to move beyond stereotypes, think outside the box, and to assess the qualifications and performance of workers with psychiatric disabilities on an individual basis. People with psychiatric disabilities bring unique skills and sensitivities that significantly add to the value and diversity of the workplace and the world. Edgar Allen Poe, Victor Van Gogh, Patty Duke, Isaac Newton and Winston Churchill would agree.

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