Employment Supports:
Informed Decisions
about Disclosure and
Seeking Accomodations
NAMI-Minnesota
State Conference
November 2014
Employment Support
Services
Handout
There are a variety of programs and
services that can help youth and adults
with mental illness who want to seek
employment.
Some programs are available to all people
and some are targeted for people with
disabilities.
Do I have a “Disability”?
Many people who think of disabilities think of
people with blindness, deafness or those who
use a wheelchair.
Mental Illness can be a disability when it
substantially limits one or more major life
activities
It is always up to you whether to disclose your
mental illness as a disability
This presentation will provide resources and
options to help guide your decisions
Mental Health Impairments
The National Alliance on Mental Illness (NAMI)
defines a mental health impairment as:
 a medical condition that disrupts a person's thinking,
feeling, mood, ability to relate to others, and daily
functioning. Just as diabetes is a disorder of the
pancreas, mental health impairments are medical
conditions that often result in a diminished capacity
for coping with the ordinary demands of life.
www.nami.org
4
Common Mental Health Impairments
 Anxiety
 Bipolar Disorder
 Major Depression
 Obsessive Compulsive Disorder (OCD)
 Panic Disorder
 Post-Traumatic Stress Disorder (PTSD)
 Seasonal Affective Disorder (SAD)
 Schizophrenia
5
Can employers ask me
about my mental
illness?
Employers are not legally allowed to ask about a
disability (including mental illness) when hiring, and
prospective employees do not need to disclose one. If an
employer does learn about a disability, that disability
cannot legally be a reason not to hire someone. Once an
offer of employment has been made, employers are
allowed to ask more questions about an employee’s
ability to perform her job duties, as long as they ask all
employees the same questions.
Can employers
discriminate against
me?
Employers may not discriminate on the
basis of disability, but employees must be
able to perform the essential functions of
the job with our without reasonable
accommodations.
Do I have to prove my
disability?
If a reasonable accommodation is
required, any employer with fifteen or
more employees must provide it. An
employee may be required to provide
written documentation of the limitations
caused by a disability from a medical or
mental health provider.
What is an
accomodation?
Job Accommodations enable people with disabilities to
perform essential job functions, be productive and
accomplish work tasks with greater ease and independence.
Common examples include modifications such as ergonomic
desk chairs, reserved parking, flexible schedules,
telecommuting, alternate workstations and periodic rest,
food or bathroom breaks.
According to the Job Accommodation Network (JAN),
nearly 60 percent of the accommodations needed by workers
with disabilities cost absolutely nothing, and only 36 percent
of employers incurred a one-time cost of roughly $500.
Does an employer have
to accommodate me?
A reasonable accommodation in
employment is an adjustment to a
workplace or position that allows the
employee equal access to the workplace
without posing an undue hardship to the
employer. The employer is not required
to lower performance standards or
remove essential job functions
Mental Health Impairments and Common
Work Issues
 Attendance
 Concentration
 Emotions
 Fatigue
 Memory
 Organization
 Panic Attacks
 Sleep Disturbances
 Stress
 Coworker Interaction
 Working Effectively
11
Disclosure!
Why wouldn’t people with mental illness want to
disclose?
STIGMA
FEAR
DISCRIMINATION
People should make informed choices about
disclosure-it should never be assumed
Benefits of disclosing
Reduce worry about hiding experience and being open
about day to day affairs
Find others who approve and have similar experiences
Find someone who can provide assistance in the future
Sense of personal power
Act as a living testimony against stigma
Allows for a job coach at the worksite
Allows for an informed third party in discussions
about accommodations
Cost of disclosing
Disapproval, social ostracism, subject of gossip, teasing
Discrimination
Increased anxiety due to worry about others perceptions
of you-everything about you get’s put in the mental
illness box
Relapse may be observed by others-others watching you
Impact career advancement/promotions negatively
May not fit with self image
Culturally mental “illness” with limitations, may be
rejected by some people
In order to disclose. . .
People need to be educated about their
own mental illness
Decide what and when to disclose…some
people may need less information
Pick and choose when to disclose and
under what circumstance and to whom
Feel in control of how much to tell
Rehearse disclosing if that would be
helpful
Three Steps to Informed
Disclosure Decisions
Determining the Need for Disclosure
Evaluate the Pros and Cons
Gather all the Facts
Deciding How to Disclose-3 Steps
1. When: During Job Development, Resume,
Cover letter, Telephone Call, In Interview, After
Interview, After Job Offer, After Job Acceptance,
After Job Start…
2. To Whom
3. What To Say
When Disclosing:
Describe needs in
functional terms
What an employment specialist may say to an
employer on your behalf:
Example: Limited interpersonal/social skills
“Joe hasn’t worked in a long time. He may
appear guarded in the interviews and he may
not look you in the eye. He is very quiet when
he meets new people. He will warm up to
others over time and once hired he will be able
to do the job.”
Examples
Rosanne:
Associate editor at publishing company.
Found job on her own. Interviewed independently after
rehearsing with placement specialist
Does not want to disclose fears embarrassment and
being treated differently
Job supports are provided off-site. Focus on meeting
with an employment specialist to discuss MH issues
that may interfere with work, discussing co-worker and
supervisor issues, practicing interpersonal skills,
rehearsal of how to deal with difficult situations and
benefits reporting and monitoring
Mental Health Impairments
Job Accommodations
19
What is an
accomodation?
Job Accommodations enable people with disabilities to
perform essential job functions, be productive and
accomplish work tasks with greater ease and independence.
Common examples include modifications such as ergonomic
desk chairs, reserved parking, flexible schedules,
telecommuting, alternate workstations and periodic rest,
food or bathroom breaks.
According to the Job Accommodation Network (JAN),
nearly 60 percent of the accommodations needed by workers
with disabilities cost absolutely nothing, and only 36 percent
of employers incurred a one-time cost of roughly $500.
Accomodation: Mental
Health vs. physical
disabilities?
Descriptive research studies show:
Most accommodations for people with psychiatric disabilities
require little to nothing in direct costs, and most frequently involve
flexible schedules, interpersonal supports (e.g., job assistance by
vocational rehabilitation service providers, interpersonal or other
support interactions provided by supervisors and coworkers), and
changes in job tasks or the training process.
Mental Health
Functional Limitations
•
Typically: Cognitive or interpersonal in nature.
•
Disclosure is necessary in accessing job accommodations
•
A complex process for which individuals need guidance in order to
weigh both the risks and the benefits of disclosing and to make
decisions about what to say, when, and to whom.
•
This issue is less complicated when employees with psychiatric
disabilities are involved in employment (Supported Employment or
IPS) services, since employment service providers often are actively
involved in the disclosure and arranging of accommodations.
Mental Health Impairments
Work Issue: Productivity
23
Mental Health Impairments
Example
A production manager for a large manufacturer had
bipolar disorder. His duties included working 40 hours
per week with additional over time to complete and
oversee paperwork and shipping orders. He was not
meeting his production standards.
24
Mental Health Impairments
Accommodation Issues: Concentration
 Reduce distractions in the work area:




Space enclosures, sound absorption panels, or a
private office
White noise, music player, or environmental sound
machines
Uninterrupted “off” work time
Desk organizers
25
Mental Health Impairments
Accommodation Issues: Concentration
 Increase natural lighting or provide




full spectrum lighting
Divide large assignments into smaller
tasks and goals
Use auditory or written cues as
appropriate
Restructure job to include only
essential functions
Provide memory aids such as
schedulers, calendars, email add-ons,
or apps
26
Mental Health Impairments
Accommodation
Initially the employee was allowed to work 30 hours
per week for one month, increasing to 40 hours per
week for the next month. Then, the manager returned
back to his regular schedule. He was also provided a
work area that was away from noise and given
earbuds to listen to music. He also met briefly with his
supervisor once a week to discuss workload issues.
27
Mental Health Impairments
Example
A housekeeper with OCD repeatedly checked and rechecked rooms for supplies. She was not completing
the number of rooms required during a shift.
28
Mental Health Impairments
Accommodation Issues: Organization





Use daily, weekly, and monthly task lists
Use calendar with automated reminders to
highlight meetings and deadlines
Divide large assignments into smaller tasks and
goals
Use a color coding scheme to prioritize tasks
Use electronic organizers or mobile devices / apps
29
Mental Health Impairments
Accommodation
The individual was accommodated with a
computerized checklist for each supply listed for each
type of room.
30
Mental Health Impairments
Example
A customer service representative with arthritis and
major depression experienced extreme fatigue
during the afternoon, which had an effect on her
speed.
31
Mental Health Impairments
Accommodation Issues: Fatigue





Allow flexible work environment
Provide a goal-oriented workload
Reduce or eliminate physical exertion and
workplace stress
Implement ergonomic workstation design
Regulate temperature and lighting
32
Mental Health Impairments
Accommodation
The individual was accommodated with a wireless
headset, an special keyboard tray, and an ergonomic
keyboard.
33
Mental Health Impairments
Example
A grocery store bagger with SAD had difficulty
working an early schedule due to oversleeping. She
also experienced fatigue and depression during late
fall and winter months. As a result her attendance was
erratic.
34
Mental Health Impairments
Accommodation Issues: Sleep Disturbances





Allow for a flexible start time
Combine scheduled short breaks into one longer break
Provide a place for the employee to rest during break
Allow the employee to work one consistent schedule
Provide work areas with natural lighting
35
Mental Health Impairments
Accommodation
She was accommodated with an afternoon schedule
and was moved to the front of the store, which had
windows that let sunlight enter her workspace.
36
Mental Health Impairments
Example
An electronic engineering technician with bipolar
disorder had difficulty managing his emotions while
experiencing the side effects of periodic prescription
changes.
37
Mental Health Impairments
Accommodation Issues: Emotions
 Encourage the use of stress management techniques
to deal with frustration
 Allow telephone calls during work hours to doctors
and others for needed support
 Allow flexible breaks
 Refer to EAP
38
Mental Health Impairments
Accommodation
The individual was accommodated with a more
flexible schedule and allowed to take breaks to call
his counselor when experiencing heightened
emotions.
39
Mental Health Impairments
Example
A claims adjuster with a history of substance abuse
was experiencing limitations from social phobia when
interacting with the public. As a result he said several
inappropriate things to clients.
40
Mental Health Impairments
Accommodation Issues: Working Effectively
 Develop clear expectations of responsibilities and the
consequences of not meeting performance standards
 Schedule consistent meetings with employee to set
goals and review progress
 Allow for open communication
 Establish written long-term and short-term goals
41
Mental Health Impairments
Accommodation
The employee was given a temporary work schedule
change to part-time for two weeks to attend the
outpatient services he needed. He returned full-time
to a later shift (when one became available) with
flexible scheduling to attend counseling appointments.
42
Mental Health Impairments
Example
A real estate appraiser with migraine headaches and
post-traumatic stress disorder became very stressed
when her work environment was noisy. She became
angry and was insubordinate to her supervisor.
43
Mental Health Impairments
Accommodation Issues: Managing Stress
 Refer to counseling and Employee Assistance
Program (EAP)
 Allow telephone calls during work hours to doctors
and others for needed support
 Allow flexible work environment:




•
Flexible scheduling
Modified break schedule
Leave for counseling
Work from home/Flexi-place
Modify environmental triggers
44
Mental Health Impairments
Accommodation
The employee was given a headset to help reduce
noise in her environment. She was also given a light
dimmer to control her workstation lighting and help
her with light sensitivity. She was also given time off
when she gets migraines.
45
Mental Health Impairments
Issue: Job Performance
46
Mental Health Impairments
Example
An electrician with severe depression needed to
attend periodic licensure trainings. The person had
difficulty taking effective notes and remembering
information in the meetings.
47
Mental Health Impairments
Accommodation Issues: Memory








Allow use of job coach /
Provide mentor
Use auditory or written cues
Allow additional training time
Provide written checklists
Use a color coding scheme
to prioritize tasks
Use notebooks, planners, sticky notes, apps to
record information
Provide labels/bulletin board to assist in locating
items
Provide minutes of meetings and trainings
48
Mental Health Impairments
Accommodation
The individual was accommodated with notes from a
remote Communication Access Realtime Translation
(CART) service.
49
Mental Health Impairments
Example
A woodworker/carpenter with
a panic disorder experienced
recurrent panic attacks
when traveling during peak
traffic times. He was required
to pick up and order supplies
when necessary.
50
Mental Health Impairments
Accommodation Issues: Panic Attacks



Allow the employee to take a break and go to a
place where s/he feels comfortable to use
relaxation techniques or contact a support person
Identify and remove environmental triggers such as
particular smells or noises
Allow the presence of a support animal
51
Mental Health Impairments
Accommodation
He was accommodated with a schedule that gave him
the opportunity to drop off and pick up materials when
coming to work in the morning.
52
Mental Health Impairments
Example
An attorney with depression experienced memory
deficits due to medication, affecting her ability to recall
actions and activities during depositions. The attorney
became frustrated and continued to miss and reschedule
meetings.
53
Mental Health Impairments
Attendance
 Allow flexible work environment:





Flexible scheduling
Modified break schedule
Leave for counseling
Work from home/Flexi-place
Modify environmental triggers
54
Mental Health Impairments
Accommodation
The attorney was given an alternate site to take
depositions. She was moved to a smaller conference
room with natural lighting away from office noise.
55
Other disclosure
examples
Panelist experiences
JAN
JAN’s publication, the Employees’ Practical
Guide to Requesting and Negotiating
Reasonable Accommodations under the
Americans with Disabilities Act (ADA)
summarizes the provisions of the ADA,
common accommodation issues and
JAN’s practical solutions for resolving
them.
Resource: The Job Accommodation Network
Contact


(800)526-7234 (V) & (877)781-9403 (TTY)
AskJAN.org & jan@askjan.org
58