Mental illness can present unique challenges to employment. Unlike physical disabilities that can be seen and recognized, employers may not realize that a person with a mental health condition is experiencing an issue and needs a workplace accommodation to remain employed and productive.

ADAAA’s Definition of Disability

A physical or mental impairment that substantially limits one or more major life activities; a record (or past history) of such an impairment; or being regarded as having a disability.

Not every person experiencing mental illness will have difficulty at work, but some will. “Hidden” disabilities such as depression, post-traumatic stress disorder (PTSD), schizophrenia, obsessive compulsive disorder, traumatic brain injury, and intellectual and learning disabilities (e.g., attention deficit disorder and attention deficit/hyperactivity disorder) can affect a person’s ability to perform his or her job.

      Also, unlike a physical disability that may be permanent, shifts in mental health can trigger and recede without warning. When someone experiences a cognitive challenge, it can be difficult to focus, process, think clearly, remember details, organize thoughts and tasks, and stop and start activities.

For these individuals, Title I of the Americans with Disabilities Act Amendments Act of 2008 (ADAAA) requires employers to make “reasonable accommodations” to help people with mental health conditions do their jobs. The ADAAA does not list medical conditions that are disabilities, but rather gives a general definition of disability. A doctor may be required to validate the need for accommodation.

“Employers have to understand that you can’t always know what a person is living with,” says Beth Loy, Ph.D., who is a principal consultant with the Department of Labor’s Job Accommodation Network (JAN). “There may be limitations due to medication, or a flexible schedule might be needed for a person to go to therapy appointments.”

The JAN is a comprehensive resource for employees, managers and business owners, behavioral health providers, physicians, and rehabilitation counselors. People who want to understand their rights regarding disabilities and possible accommodations can access information on JAN’s website or reach out to them directly. Experts at JAN respond to questions, provide training, and conduct outreach to raise awareness about disability rights and job accommodations.

What Accommodations Look Like

Because every person is unique and may have different needs, there are many options for mental health accommodations. “Sometimes small adjustments to how the work is organized, a workday schedule, or headphones that help block out distracting noise can make a big difference,” explains Carlton Speight, a public health advisor with SAMHSA’s Center for Mental Health Services. “Also, for a person who may be easily triggered or anxious, a service dog can help with grounding. It just depends on the individual and what will help in their particular experience.”

Melanie Whetzel, MA, CBIS, the lead consultant on the Cognitive Neurological Team at JAN, says, “Most of the mental impairment questions we receive relate to service animals, flexible schedules, flexibility to leave the workstation if someone feels panicked and needs to get grounded, comfortable and private space to take breaks, and insulation to abate noise.”

What a Difference a Dog Makes: The Story of Jeanette Barnes and Chloe

Jeanette Barnes with Chloe, her service dogJeanette Barnes lives with mental illness and doesn’t respond well to medication. Part of her exploration in finding what would work for her involved understanding how and why she responded to certain circumstances. To help manage anxiety and triggers, she got Chloe, a Papillon service dog who helps her during times of anxiety or when something startling happens.

“Things changed on many levels when Chloe started coming to work with me. I can breathe easier – with Chloe’s help, I maintain the ability to focus and am able to successfully complete tasks. With Chloe’s assistance and support, I am able to sustain my recovery as well as manage triggering situations and prevent symptomatic behaviors.”

                              She also notes that sometimes the process of exploring accommodation can lead to a job change. “When an employer learns about the accommodation needed, they may offer the opportunity to shift to a different job that will make the accommodation easier or the job task will be more manageable,” she says. “And sometimes the employee will realize that there could be a better environment in which to work, where managing mental health and triggers will be easier.”

Most accommodations in the workplace can be established with little or no cost. They just require some flexibility and creativity, and can often be put in place quickly, if the need arises. Such accommodations may include:

                              • Creating a supportive environment – It is critical for individuals with mental health conditions to work with colleagues and leadership who are positive, open, and welcoming.
                              • Removing or mitigating workplace stressors – Working in an office or workspace that is quiet, with less traffic, may be more comfortable and manageable. Open floorplans can be very stress-provoking for persons living with mental health conditions.
                              • Adjusting the approach to supervising – It could be as simple as scheduling recurring one-on-one meetings to see how things are going. Check-ins may also help people manage problems before they become stressful and overwhelming.
                              • Offering flexible schedules – Flexible arrival and departure times also allow individuals to perform duties when they can be most productive. Flexible or extended breaks may also help them manage stress or attend healthcare appointments.
                              • Providing opportunity to telework – Telework may remove the exposure to the stressors of commuting and eliminating that time on the road, making it easier to be productive when beginning the workday. Working from home may also provide a substantially more comfortable environment for the employee, which may significantly reduce stress and anxiety.

With the ADAAA regulations in place, requesting an accommodation is designed to be a simple and straightforward process for employees. Workers may be requested to substantiate a disability with medical information, but it is not required. The Equal Employment Opportunity Commission also offers some guidance on accommodation procedures.

When an accommodation is needed, it is often helpful for the employer and the employee to discuss the request together to determine what will work and how that can be achieved.

“I think it is critical for employers to understand that workplace accommodations create substantial benefits for the organization,” says Matthew Aumen, a program analyst in SAMHSA’s Center for Substance Abuse Prevention. “Accommodations remove barriers, which allows employees to maximize their potential and performance. That’s something every employer wants.”

June is National PTSD Awareness Month. Visit SAMHSA.gov to learn more about PTSD and other stressor-related disorders.

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