It takes the EEOC 56 pages to define a “mental disability.” Approximately 58 million Americans, one in four adults, experience a mental health impairment in a given year (National Alliance on Mental Illness, 2007). One in 17 individuals lives with a serious mental health impairment, such as schizophrenia, major depression, or bipolar disorder (National Institute of Mental Health, 2008).
Common mental impairments include:
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- Bipolar disorder, sometimes referred to as manic depression, “is a medical illness that causes extreme shifts in mood, energy, and functioning. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children.” An estimated 10 million American adults have bipolar disorder.
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- Borderline personality disorder (BPD) is “an often misunderstood, serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self image, and behavior. It is a disorder of emotional dysregulation. This instability often disrupts family and work, long-term planning, and the individual’s sense of self-identity.” It’s estimated that 1% to 2% suffer from BPD.
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- Major depression is “persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity, and physical health. Among all medical illnesses, major depression is the leading cause of disability in the United States and many other developed countries.” There are approximately 15 million American adults with major depression.
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- Obsessive compulsive disorder (OCD) “occurs when an individual experiences obsessions and compulsions for more than an hour each day, in a way that interferes with his or her life.” Estimates indicate that 2% of American adults have OCD.
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- Panic disorder occurs when a person “experiences recurrent panic attacks, at least one of which leads to at least a month of increased anxiety or avoidant behavior. Panic disorder may also be indicated if a person experiences fewer than four panic episodes but has recurrent or constant fears of having another panic attack.” Approximately 2% to 5% of American adults suffer from panic disorder.
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- Post-traumatic stress disorder (PTSD) is “an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts, or situations associated with the event; and have symptoms of excessive emotions.
People with this disorder have these symptoms for longer than one month and cannot function as well as they did before the traumatic event. PTSD symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.” It’s estimated that 2% to 9% of adult Americans (including 15% to 30% of veterans) have PTSD.
- Post-traumatic stress disorder (PTSD) is “an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts, or situations associated with the event; and have symptoms of excessive emotions.
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- Schizophrenia “often interferes with a person’s ability to think clearly; to distinguish reality from fantasy; and to manage emotions, make decisions, and relate to others. Some 2 million American adults are schizophrenic.
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- Seasonal affective disorder (SAD) is “characterized by recurrent episodes of depression — usually in late fall and winter — alternating with periods of normal or high mood the rest of the year.” Note: SAD is not regarded as a separate disorder by the DSM-IV (APA, 1994), but is an added descriptor for the pattern of depressive episodes in patients with major depression or bipolar disorder.
Here’s a quick overview of some job accommodations that might be useful for people with mental health impairments.
Maintaining Stamina During the Workday:
- Provide flexible scheduling
- Allow longer or more frequent work breaks
- Allow employee to work from home during part of the day, or week
- Provide part-time work schedules
Maintaining Concentration:
- Reduce distractions in the work area
- Provide space enclosures or a private office
- Allow for use of white noise or environmental sound machines
- Allow the employee to play soothing music using a portable player and headset
- Increase natural lighting or provide full spectrum lighting
- Plan for uninterrupted work time
- Allow for frequent breaks
- Divide large assignments into smaller tasks and goals
- Restructure job to include only essential functions
Staying Organized and Meeting Deadlines:
- Make daily TO-DO lists and check items off as they are completed
- Use several calendars to mark meetings and deadlines
- Remind employee of important deadlines
- Use electronic organizers
- Divide large assignments into smaller tasks and goals
Dealing with Memory Deficits:
- Allow the employee to tape record meetings
- Provide type written minutes of each meeting
- Provide written instructions
- Allow additional training time
- Provide written checklists
Working Effectively with Supervisors:
- Provide positive praise and reinforcement
- Provide written job instructions
- Develop written work agreements that include the agreed upon accommodations, clear expectations of responsibilities, and the consequences of not meeting performance standards
- Allow for open communication to managers and supervisors
- Establish written long term and short-term goals
- Develop strategies to deal with problems before they arise
- Develop a procedure to evaluate the effectiveness of the accommodation
Interacting with Coworkers:
- Educate all employees on their right to accommodations
- Provide sensitivity training to coworkers and supervisors
- Do not require employees to attend work-related social functions
- Encourage employees to move non work-related conversations out of work areas
Handling Stress and Emotions:
- Provide praise and positive reinforcement
- Refer to counseling and employee assistance programs
- Allow telephone calls during work hours to doctors and others for needed support
- Allow the presence of a support animal
- Allow the employee to take breaks as needed
Maintaining Attendance:
- Provide flexible leave for health problems
- Provide a self-paced work load and flexible hours
- Allow employee to work from home
- Provide part-time work schedule
- Allow employee to make up time
Dealing with Change:
- Recognize that a change in the office environment or of supervisors may be difficult for a person with a mental health impairment
- Maintain open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition
- Provide weekly or monthly meetings with the employee to discuss workplace issues and productions levels
To learn more, visit the Job Accommodation Network’s Accommodations Ideas for Mental Health Impairments.
