Dealing with erratic behavior at the workplace article

Bending Over Backwards: Understanding What’s Reasonable in Accommodating Psychiatric Disabilities
Dr. Joni Johnston (written for HR.com)

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“Something’s wrong with Kathleen.” I remember the day at the mental health clinic when our receptionist came to tell our group of social workers and psychologists that our colleague was acting strangely. We were in total denial. In fact, it took several hours before our psychologist/supervisor admitted to herself that our social worker colleague was having an acute psychotic episode and drove her to a trusted psychiatrist. Before that, we all wasted valuable time and energy trying to talk rationally to someone whom, it was abundantly clear, was incapable of doing so.

If mental health professionals have trouble dealing effectively with a disturbed colleague, I can only imagine what it’s like for human resource professionals. Yet the reality is that 5 of the 10 leading causes of disability worldwide are mental illnesses. More working days are lost each year as the result of mental conditions than from physical conditions. Ready or not, human resource professionals have to cope with mentally ill employees and, with the 1990 signing of the Americans With Disabilities Act, have to find their way through the legal as well as the emotional complexities of dealing with psychiatric disturbances on the job. In this article, we’ll take a look at the impact of serious mental illness on work and how employers can help their employees manage them without bending over backwards (and breaking their banks) in the process.

If you’ve ever grieved over the loss of a loved one, you have a glimpse of what clinical depression feels like. When my mother died suddenly three years ago, I was in shock. For three months, I had trouble sleeping, I found myself reading the same paragraph over and over at work, and I forgot to do things. I cried over with the least provocation. With time, these symptoms passed and today I’m back to “normal.” For people who suffer from major depression, these symptoms can occur spontaneously and without warning.

Serious mental illnesses, such as recurrent major depression, a severe obsessive-compulsive or anxiety disorder, or bipolar disorder, may interfere with a person’s work functioning in different ways. Some of the illnesses affect a person’s ability to do certain things, such as thinking or communicating with others. For example:

Screening out environmental stimuli – trouble blocking out sounds, sights, or odors which can interfere with focusing on tasks

Sustaining concentration - restlessness, shortened attention span, easily distracted, trouble remembering verbal directions.

Maintaining stamina – not having energy to work a full day, combating drowsiness due to medications.

Handling time pressures and multiple tasks – having difficulty managing assignments & meeting deadlines, prioritizing tasks.

Interacting with others - getting along, fitting in, talking with coworkers, reading social cues.

Responding to negative feedback - understanding and interpreting criticism, knowing what to do to improve, initiating changes because of low self-esteem.

Responding to change - coping with unexpected changes in work, such as changes in the rules, job duties, supervisors or coworkers.

Some of these symptoms may not be readily apparent. Employers and supervisors may be able to notice significant changes in their employees’ work habits, behaviors, performance, and attendance, such as:

Managers and supervisors need to know how to respond to changes in, or erratic behavior from, an employee. Most importantly, they must understand their role in helping their employees deal with psychiatric illness – to accommodate them when necessary, to make use of available resources so they can get the help they need, and to work with human resources. Managers and supervisors also need to know their limits, i.e., not to diagnose, treat, ignore, or get overly involved with an employee’s problems. And abide by the law.

Understanding Your Legal Obligations

Title I of the ADA provides protection against disability for qualified individuals with disabilities. From a psychiatric perspective, a mental impairment is one that is severe enough to limit a major life activity such as sleeping, concentrating, thinking, working, learning, or interacting with others. Diagnoses such as major depression, post-traumatic stress disorder, schizophrenia, obsessive-compulsive disorder, and panic disorder are covered under the ADA; illegal drug use, compulsive gambling, kleptomania (compulsive stealing) are not.

If an individual discloses a mental disability, employers should make an effort to accommodate him or her. Reasonable accommodations may include physical changes in the workplace (ex. The use of room dividers for someone who has concentration difficulties), a modified work schedule (ex. time off or a change in regular hours), or an adjustment of supervisory methods (ex. more feedback, the provision of a job coach or mentor).

Advice for Five Sticky Situations

What do you do when an employee asks you what’s wrong with an impaired work colleague? ADA confidentiality prohibits any disclosure of medical information about an employee with a disability, no matter how concerned the inquiry. Furthermore, an employer is not permitted to tell other employees when it is providing a reasonable accommodation for that particular individual, since such disclose implies that the individual probably has a disability (since only individuals with a disability are covered under the ADA). You can, however, state that the company is acting for legitimate business reasons or in compliance with federal law.

What do you do when an employee stops taking medication? Focus on the employee’s misconduct and explain to the employee the consequences of the misconduct in terms of uniform disciplinary procedure. You cannot, however, require that the person take medication as a condition of employment. It is the employee’s responsibility to take medication and to consider the consequences if s/he chooses not to.

The person keeps getting disability letters from the doctor and he seems like a quack. Consider requiring the employee to get a professional opinion from a doctor you trust. It is within your rights to do so to obtain documentation of a disability and verify the need for accommodation. You must pay all costs associated with it.

An employee with a history of threatening coworkers says his behavior is part of a personality disorder. Employers are not required to provide accommodation for a person who poses a direct threat to the health or safety of the workplace. This determination cannot be made based on (the inaccurate) stereotype or belief that people with mental illness are dangerous. Rather, this determination must be based on objective evidence obtained from a healthcare professional or some other credible source (such as coworkers who have observed an employee making threats). If such evidence exists, treat the behavior like any other conduct problem.

An employee claims that her work stress is a disability. Traits or behaviors are not, in and of themselves, mental impairments. Stress, by itself, is not a mental impairment but could relate to a mental or physical impairment. If an employer complains of severe work stress, work with him or her to try to alleviate the work situation and make a referral to your EAP or consulting psychologist.

The Silver Lining in the Black Cloud

The best thing about psychiatric illnesses is that they’re highly treatable. Most individuals with significant mental illnesses can return to work and lead normal, productive lives – with minimal costs to the employee. In fact, most accommodations cost less than $500.00 – far less than it would take to replace the person. In fact, most of them are free. A highly distractible employee, for example, might benefit from wearing headphones with soft music. An employee whose having trouble concentrating might need to take more frequent breaks or might need extra help prioritizing his work tasks. Employers don’t have to invent light-duty jobs or lower their job expectations to accommodate a psychiatric disability; most of the time, they just need to be a little flexible.

Seems like more trouble than it’s worth? I guess you could try to screen out candidates with mental health problems. Of course, this strategy would have eliminated Abraham Lincoln, Winston Churchill, Michelangelo, Beethoven, or Sir Isaac Newton, just a few of the famous people who’ve successfully coped with a mental illness. Which makes a little effort to accommodate a productive employee with a mental illness good business -- and a reluctance to do so seem kind of crazy.

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