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Employees with psychiatric disorders

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Mental illness is a term that describes a broad range of mental and emotional conditions that can vary in type and duration from person to person. The most common forms of mental illness are anxiety disorders, depressive disorders, and schizophrenia. The National Institute of Mental Health estimates that one in five people will experience mental illness in their lifetimes, and one in four of us knows someone personally who has a mental illness (NIMH, 2000). Anxiety disorders are the most common, affecting nearly 15% of the population at some time in their lives. The indirect economic cost of mental illnesses due to lost productivity and other factors is estimated to exceed $72 billion annually.

Many of the symptoms of mental illness can be controlled through treatment and use of medications. On the job, however, persons with mental illness may require an additional variety of strategies and accommodations, including consideration of assistive technology resources and services. Since psychiatric disabilities are often not readily apparent, and since employers are prohibited from asking applicants if they have psychiatric disabilities before making a job offer, many of these issues may not be detected or be fully understood by employers. Misconceptions and biases present serious obstacles for many persons of working age who could be in the work force. Although individuals with severe forms of mental illness may be questionable candidates for successful employment in traditional work settings, employment prospects for the vast majority of persons with psychiatric and emotional disorders are very good. Often, only general, easy to implement accommodations are needed to hire or retain employees in the workforce with psychiatric and emotional disorders.

Common Accommodation Needs and Solutions

Since most of the issues or problems faced when accommodating a person with a psychiatric disability are behavioral in nature, the tendency is to assume that assistive technology (AT) is not a probable part of the accommodation strategy. In fact, direct involvement of AT specialists working with the counselor and employer may uncover other accommodation strategies. AT specialists can perform a general AT assessment or a thorough analysis of the work environment, including the overall setting, working conditions, and the individual workstation. Some issues to consider include:

Need for Supervision - Individuals need different amounts of supervision, and there are a variety of technological and non-technological solutions.

  • A job coach can provide support to an individual
  • Extra time can be given to learn job tasks
  • Flexible scheduling, including frequent breaks
  • Modifications can be made to the way feedback and instructions are given
  • E-mail, video or audio messaging, and teleconferencing can be used to supplement normal supervision.

Stress-producing Tasks/Activities - Completion of simple work tasks can often create anxiety. If left unchecked, stress can eventually result in reduced productivity and manifest itself in inappropriate interpersonal behaviors that can be irritating to others.

  • Minor job duties can be exchanged or deleted
  • Simple changes can be made to reduce or eliminate stress where the source can be identified
  • Arrangements can be made with employers to accommodate preferences in how work is structured or how work tasks are completed
  • Mirrors or video monitors can alert a worker when others are approaching to avoid startling him or her.

Following Instructions and Making Decisions - Difficulties in following instructions or making simple decisions are common problems.

  • Digital scales can minimize decision-making with tasks that involve measuring or counting items
  • Templates and transparency overlays can be created that clearly show format and locations for information in documents
  • Color-coding component parts make assembly and organization of tasks easier to follow
  • Written instructions, including E-mail, can be used to assign new tasks
  • A list of commonly used commands that fits over the keyboard can help with remembering how to use a piece of software.

Problems with Distractibility - Concentrating in noisy, open work areas and disruptive off-task behaviors can reduce an individual's productivity and may have a negative impact on others in the immediate work area. An environmental assessment may be able to suggest ways that the work environment can be modified to reduce distraction and off-task behaviors.

  • Moveable office partitions can be used to create a sight barrier
  • Stereo headphones that play soft music can be worn to help reduce distraction without disturbing other workers
  • Environmental conditions such as room color, furnishings and lighting can have a measurable impact on performance and behavior
  • Seating can be arranged to face away from distractions
  • Lighting levels can be altered and the type of lighting changed. For example, florescent lighting, which is harsh and can be disturbing to some individuals, can be replaced with incandescent lighting.

Although technology specialists may not be very familiar with psycho-social aspects of disabilities, their skills in assessment, observation, analysis and problem-solving can be used to complement the insights of counselors and mental health specialists. Multidisciplinary teams can help identify effective solutions to existing or potential problem areas for many individuals with psychiatric or emotional disorders.


Reasonable Accommodations for People with Psychiatric Disabilities: An On-line Resource for Employers and Educators

National Mental Health Association: Supportive Employment Initiatives

Psychiatric Disabilities, Employment, and the Americans with Disabilities Act Background Paper

Employing and Accommodating Workers with Psychiatric Disabilities

Author: Tony Langton
Affiliation: Originally published in the March 2003 TC Direct Newsletter for the NIDRR-funded Tech Connections project.