Psychiatric disabilities have a unique dynamic in the workplace because they are both very common and very misunderstood. The purpose of this brief is to inform employers, job applicants and employees about:
- Legal issues around mental health conditions in the workplace.
- Practical strategies that can be used to ensure ADA rights for people with psychiatric disabilities are realized.
“Psychiatric disability” or “mental illness”?
The words “psychiatric disability” and “mental illness” are often used interchangeably. The term mental illness is typically used in a medical context to refer to a wide range of conditions related to emotional and mental health. The term psychiatric disability is typically used in a legal or policy context to refer to impairments covered under the ADA
Myths and misperceptions
Myth: Individuals with mental health conditions do not recover.
Fact: The vast majority of people with psychiatric disability do get better, thanks to improved treatments and services.
Myth: Individuals with mental health conditions cannot work in stressful or demanding jobs.
Fact: Many individuals with psychiatric disability can and do work effectively. How the condition impacts work life varies considerably and there is no “one size fits all.”
Myth: Individuals with mental health conditions have weak personalities or had bad childhoods.
Fact: Mental health conditions are brain disorders. They are not caused by a flawed personality or poor parenting.
Myth: Individuals with mental health conditions pose a danger to others in the workplace.
Fact: Despite the flashy headlines, there is no credible evidence that individuals with mental health conditions pose a danger to others in the workplace. In fact, people with psychiatric disability are far more likely to be victims than perpetrators of violence.
Myth: Individuals with mental health conditions cannot work until they are completely recovered.
Fact: Workplace accommodations enable many with psychiatric disabilities to work effectively with their disability.
About the numbers: Mental illness in the workplace
- Examples of psychiatric diagnoses include anxiety disorder, depression, attention deficit/hyperactivity disorder (ADHD), bipolar disorder and schizophrenia.
- Overall, about 44 million adults (over age 18) in the U.S. report having had any mental health condition during the past year, representing about 18.5% of the U.S. population.
- Among these U.S. adults, the National Institute of Mental Health estimates that:
- 18% have an anxiety disorder (including post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder and generalized anxiety disorder)
- 9.5% have depression
- 4% have attention deficit/hyperactivity disorder
- 2.6% have bipolar disorder
- 1% have schizophrenia
- About 18% of workers in the U.S. report having a mental health condition in any given month. This means that psychiatric disability is one of the most common types of disability covered under the ADA.
The ADA and psychiatric disability in the workplace
- Definitions. The ADA defines disability as a physical or mental impairment that substantially limits one or more major life activities. When job applicants or employees have a mental health condition that meets this criteria, they have workplace rights under the ADA. The ADA Amendments Act of 2008 (ADAAA) recently broadened the definition of disability to provide legal protections against employment discrimination for more individuals with disabilities, including people with psychiatric disabilities.
- Record of psychiatric disability. The ADA also prohibits discrimination against individuals who have a record (history) of a psychiatric disability or are regarded as having a psychiatric disability. This means, for example, that qualified individuals who have a history of psychiatric disability cannot be discriminated against just because of that history. Also, employers can’t take actions (such as failing to hire, demoting or denying training opportunities) because they believe a qualified applicant or employee might have a psychiatric disability.
- Rights under the ADA. Applicants and employees with psychiatric disabilities have two main rights under the ADA. First, they have a right to privacy. Except when asking for an accommodation, they can choose whether to tell the employer about their disability. Second, they have a right to a job accommodation unless this causes undue hardship for the employer.
Disclosing a psychiatric disability: Legal protections
- Disclosure is a choice. According to the ADA, employers can’t require applicants or employees to disclose a disability (with a few exceptions described below). So, in most cases, disclosing a psychiatric disability is a choice, not a requirement. Individuals who choose not to tell about their mental health condition are not “lying” or “hiding.” They are using a legally protected choice.
- After the job offer. Once a job has been offered, applicants may be asked to take a medical exam before starting work. If this exam reveals a psychiatric disability, the job offer can only be withdrawn if there is evidence that the person won’t be able to do the essential functions of the job without an accommodation and can’t be reasonably accommodated or the disability poses a real safety issue.
- On the job. Employees generally can’t be required to disclose a psychiatric disability unless requesting a job accommodation. Then, the employer can ask for some medical documentation about the disability. This medical information can’t be shared with others in the workplace.
- Federal contractors. Employers who are federal contractors must invite applicants and employees to voluntarily self-disclose a disability. This information is only used to track the progress in meeting disability employment goals of the employer. It must be kept confidential and can’t be shared with the manager or co-workers.
Practical Points: Employees
- Begin by asking yourself some questions. Are you able to do the main (essential) tasks of your job effectively with your disability? Are you able to keep up with your treatment and medication plans when working? Do you have what you need to perform at your best in this job as a person with a psychiatric disability? If you said “yes” to these questions, you may want to consider not telling anyone in your workplace about your disability. But if you said “no” to any of these questions, you might want to think about asking for an accommodation. Ideally, ask for an accommodation before your mental health conditions impacts your job performance.
- Start with a little homework. Before asking for an accommodation, think through a couple of things. What specifically do you struggle with on the job because of your disability? Which task(s)? How do you struggle? What’s the one thing you would most need to be able to perform better?
- When asking for an accommodation. This is one of the few times your employer can ask some questions about your psychiatric disability and can ask for medical documentation of your disability. This information must be kept confidential. When you request an accommodation, be specific, concrete and clear. Focus on how your disability impacts your job tasks, not on the details of your diagnosis or your symptoms.
Practical Points: Employers
- Connect to the business. Whether you know it or not, about one-in-five of your current employees is working with a psychiatric disability. As an organization, developing your capacity to respond effectively when a mental illness arises is not just a “nice to do” and not just about legal compliance. It is a key talent management practice that clearly connects to your ability to fully leverage talent.
- Accommodations—will they come forward? The decision to come forward with an accommodation request is particularly challenging for workers with psychiatric disabilities because of the many misperceptions around mental health conditions. Yet, it is important for these workers to request an accommodation before a disability impacts their job performance.
- Clear thinking about safety issues. Employers can always act when there is a clear safety concern. But these actions must be grounded in evidence. Vague or general fears that workers with psychiatric disabilities are going to be violent in the workplace is not supported by the evidence and would not, in itself, constitute a credible safety concern.
- Managers as first responders. As face-to-face leaders, managers and supervisors are very likely to be “first responders” to accommodation requests and set the tone for disability inclusiveness in the workplace. Get the message out to all managers and supervisors in your workplace.
- Sources of sharing and support. Having an effective Employee Assistance Program and/or Disability Employee Resource Group can go a long way toward creating a positive climate to help workers stay effective when working with psychiatric disabilities.
- Harassment and bullying. Because mental health conditions are so highly stigmatized and misunderstood, workers with psychiatric disabilities are more likely than others to experience workplace harassment. Send the message across the workplace that workers with psychiatric disabilities have the same right to a respectful and effective workplace as any other worker with a disability.
- Building trust. The most important aspects of your workplace climate might be the least tangible. Ask yourself hard questions about the climate of your workplace. What actually happens to employees with psychiatric disabilities in your workplace? What happens to them when they come forward with an accommodation request? Are they able to stay on the job? Or do they leave the job either voluntarily or involuntarily?
- Job Accommodation Network (JAN). Accommodation and Compliance Series: Employees with Mental Health Impairments. https://askjan.org/media/Psychiatric.html
- National Alliance on Mental Illness (NAMI). Succeeding at Work. https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Succeeding-at-Work
Content was developed by the Northeast Center, and is based on professional consensus of ADA experts and the ADA National Network.
Yang-Tan Institute at Cornell University
The contents of this factsheet were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DP0088 and 90DP0086). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
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