Mental disabilities no barrier to smooth and efficient work

By Scott Sleek
Monitor staff

Mike Johnson wasn?t asking for special treatment at work, but his bosses thought they?d better provide it anyway.

Two months after being hospitalized for bipolar disorder, Johnson, an accomplished, 35-year-old sales executive, told his boss that he was feeling 'stressed out.' The boss also noticed that Johnson overbooked his schedule during manic phases and would wake up late and miss appointments during depressive periods.

Years ago, companies could easily fire someone like Johnson. But his supervisors, realizing that the federal government now regards manic depression as a disability, took a more obliging route. To minimize his stress, they granted him a flexible work schedule to accommodate his therapy sessions and medical appointments, and temporarily scaled back the number of sales calls he was required to make. He gradually returned to a normal work schedule.

Psychologist Peter David Blanck, PhD, JD, director of the University of Iowa?s Law, Health Policy & Disability Center, often cites this case* to illustrate the benefits that the Americans with Disabilities Act (ADA) holds not only for people with mental disorders, but for employers as well. By providing Johnson with 'reasonable accommodations'?as required under the ADA?the firm avoided a lawsuit, the cost of training a replacement and the potential loss of Johnson?s lucrative accounts, Blanck notes.

At a time when employers complain that the ADA allows inept or uncooperative employees to protect their jobs by excusing their behavior as a psychiatric disability, Blanck and other psychologists are vigorously promoting a broader, more optimistic view of the law.

Through consulting work, public education and research, they?re trying to show employers that accommodating people with psychiatric disabilities costs little, if anything, and may be a more prudent way of doing business. With this philosophy, many psychologists are beginning to build careers as consultants for employers trying to comply with the disabilities law.

'For psychologists, there?s a wealth of opportunity when it comes to the ADA,' says Yolanda Brooks, PhD, a Dallas psychologist who advises attorneys dealing with work-and-disability cases. 'It can range from reviewing individual cases as an objective third party, to helping employers figure out what would be a reasonable accommodation for a worker with a disability.'

Minimal costs

Congress passed the ADA in 1990 to protect people with physical and psychiatric disabilities from discrimination in a variety of settings, including the workplace.

Making accommodations for people with mental illnesses causes the most difficulty for employers because they often are unable to conceptualize such illnesses. Employers? concerns about the costs of accommodating people with psychiatric problems peaked last year, when the Equal Employment Opportunity Commission (EEOC) issued its guidelines on the ADA protections for workers with psychiatric disabilities.

The guidelines labeled a range of diagnoses, including mood disorders, attention deficit disorder, schizophrenia, mental retardation and even personality disorders, as conditions considered disabilities under the ADA. The commission suggests that employers grant workers with psychiatric disabilities such 'reasonable accommodations' as changes in work hours, leaves of absence for treatment or recovery, and appropriate adjustments of job duties.

Labor lawyers and employer groups, including the U.S. Chamber of Commerce, have assailed the guidelines as a weapon for disgruntled employees who won?t take responsibility for their poor performance or behavior. They predicted that the law would allow employees to make unreasonable and expensive demands?and to file frivolous lawsuits if those demands go unmet.

Many psychologists say those complaints were based on ignorance and stereotypes about mental illnesses. And they?ve also found that the ADA, in fact, has had little financial and legal impact for employers, especially in the area of psychiatric disabilities.

'It has not been shown to be a burden, despite the myth-mongering that comes out of some areas of the business community,' Blanck says. 'And many employers see it as just another way to help them diversify their work force for the 21st century.' Blanck bases his conclusions on his research on Sears, Roebuck and Co.?s efforts to comply with the ADA.

He found that the average cost for accommodating workers with physical disabilities was $45 per employee. But accommodating those with behavioral impairments cost virtually nothing. The company took such steps as allowing people with learning disabilities to work at a slower pace and giving careful and repeated instruction to people who had trouble with comprehension.

In the litigation area, Michael Feuerstein, PhD, an occupational health consultant and the clinical training director at the Uniformed Services University of the Health Sciences, just completed a study of 197 lawsuits filed with the EEOC over alleged ADA violations. He found that cases involving emotional/psychological disorders represented only about 6 percent of all the suits.

'Employees with psychological disorders may be less likely to resolve workplace problems through litigation,' he says. 'It may be that the problem is solved before it gets to that point. But it may also mean that these workers are just less likely to create a lot of flack.'

Making ADA work

Rather than creating ominous legal and financial burdens, the ADA can provide employers with a platform to avoid disputes and resolve problems in the workplace, psychologists say.

In his consulting work, Feuerstein recommends a basic problem-solving process approach for employers and disabled workers trying to settle on a reasonable accommodation. The parties identify and analyze the problem, talk about potential solutions, try out a solution and evaluate whether it works. For example, an employee who has become extremely stressed from working with customers might be reassigned to job duties that don?t require customer interaction, Feuerstein says.

Brooks, who consults with employment law attorneys dealing with ADA cases, says psychologists can also offer employers training seminars on ADA compliance. And they can make stronger efforts to educate employers about mental disabilities, so that they better understand the symptoms an employee with a disability might demonstrate.

Judy Berry, PhD, a University of Tulsa psychologist who studies people?s attitudes toward disabilities, adds that educating employers about disabilities can help alleviate their fears of hiring people with psychiatric impairments in the first place. That involves showing them concrete examples of people with disabilities thriving in the workplace, she says.

Berry is involved in such an effort. She?s a board member on a Tulsa organization called Community Service Council, which provides job training for people with developmental disabilities. The council often takes local employers to different work sites to show clients with mental retardation who function well in their jobs. The employers also get the chance to talk to other employers who have successfully integrated people with disabilities into the workplace, she says.

The project also involves the use of job coaches, hired by the state, to help the workers learn their tasks. The coaches eventually phase out of the picture, and co-workers often step in to help the adult with a disability when necessary, Berry says.

Such a program could work for people with mental or emotional disorders as well as those with mental retardation, she contends.

Questions remain

Despite the benefits that ADA compliance can create in the workplace, the law is still relatively new and evolving. Thus, employers face unanswered questions when it comes to workers with psychiatric or emotional illness, psychologists agree. How, for example, do they keep a worker?s psychiatric disability confidential, as required, and at the same time explain to other employees why that person has been given a special job assignment or a reduced workload? Or how can they tell when an employee with a disability is exploiting a situation, such as asking for more leave than he or she needs?

Many of those dilemmas are, and will continue to be, decided in the courts.

In the meantime, psychologists say they can provide a vital service to employers who want to avoid going to court over ADA issues. And one of the best lessons they can teach employers, says Feuerstein, is the art of listening to and collaborating with employees who have a disability.

'It involves sitting down in a nondefensive manner, using a problem-solving approach,' he says. 'Often the worker has a very good idea of what?s required to achieve a successful and reasonable accommodation.'

*Johnson is a pseudonym.