Achieving reasonable accommodation for workers with psychiatric disabilities: understanding the employer's perspective

American Rehabilitation, Spring, 1995 by Laura L. Mancuso

The employment provisions of ADA have now been in effect for almost 3 years. Among the many important aspects of the law for workers with psychiatric disabilities is the requirement that employers provide reasonable accommodation.

Although the ADA's wording on reasonable accommodation closely follows the regulations for Section 504 of the Rehabilitation Act of 1973, the new law has a much broader reach. All employers with 15 or more workers are now covered. Many employers--particularly small businesses--have never previously been subject to laws prohibiting discrimination on the basis of disability. They may be unclear about the extent of their obligations or apprehensive about the potential impact of the law on the operation of the business.

Employers are particularly concerned about how to accommodate workers with psychiatric disabilities. This is often identified as one of the more challenging aspects of ADA implementation. Statistics show that 11 percent of claims under Title I to date nationally have been filed by people identifying themselves as having emotional or psychiatric impairments, comprising the third leading category of claimants.(1) Although the situation has improved in recent years, technical assistance materials on reasonable accommodations have historically offered little guidance for employers in this area, focusing instead on workplace modifications for employees with mobility, hearing, or visual impairments.(2)

Although most workers with psychiatric disabilities will never need reasonable accommodation, rehabilitation counselors are likely to be called upon to assist those who do. Since ADA's enactment, rehabilitation counselors have been identified as a logical source of information and assistance to employers. There are several reasons: first, rehabilitation counselors are unique among human service professionals in their focus on serving people with disabilities; second, the field has always encompassed vocational issues; and finally, rehabilitation counselors are trained to perform job analyses and functional assessments, both of which are very useful in developing workplace accommodations.

Whether they consider their customers to be mental health consumers, employers, or both, rehabilitation counselors are well-positioned to assist in the development of workplace accommodations. However, those practitioners who primarily serve people with other types of disabilities may feel unprepared to assist individuals with psychiatric disabilities. Likewise, psychiatric rehabilitation specialists may be knowledgeable about the concerns of mental health consumers but less familiar with the issues of the business workplace.

This article provides information for rehabilitation counselors to use in supporting a person with a psychiatric disability who needs and wants a workplace accommodation, but has encountered obstacles to obtaining it. The article is organized around six questions that rehabilitation counselors and their clients should consider when negotiating reasonable accommodations. Consideration of the questions will elicit an understanding of potential barriers to accommodation from the employer's perspective. Each question is followed by a discussion of relevant guidance from the ADA statute or its regulations and constructive approaches to addressing the employer's concerns. The questions were derived from the author's experience in delivering training to diverse audiences on ADA implementation for workers with psychiatric disabilities.

The strategies presented here are designed to be cooperative, rather than coercive. While there are many excellent printed resources for people with disabilities on how to initiate legal action, such as filing a complaint with the U.S. Equal Employment Opportunity Commission (EEOC)(3), advice on alternative approaches to resolving ADA disputes is less readily available. This should not be construed as an attempt to deter mental health consumers from seeking legal redress when discrimination has occurred, because there are many instances in which that is the best and most appropriate course of action. But there are also many instances where reasonable accommodations are best pursued by other means. This article offers an alternative to a more contentious rights enforcement approach. Just as it would be unethical for a rehabilitation counselor to discourage a mental health consumer from pursuing legal remedies in the face of discrimination, it is equally short-sighted to prematurely rule out more cooperative methods which might bring greater benefits to the client in the near or long term.

1. Is the employee covered by ADA? One of the first questions that rehabilitation counselors and their clients should consider is whether the employer believes that the individual requesting an accommodation is covered by ADA. People with only a superficial knowledge of ADA are often not aware that the law covers individuals with substantially limiting mental impairments. This can be true of people who run businesses; depending on the size and nature of the business, there may be dozens or even hundreds of new county, state, and federal mandates each year relevant to their industry.(4) For rehabilitation counselors, on the other hand, ADA may well be the single most significant legislation in decades. Unlike most employers--especially small businesses--they are likely to have immersed themselves in studying the implications of the law through publications, professional conferences, and the day-to-day practice of their trade.