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psychiatric disability

Between 2007 and 2012, the number of complaints filed with the EEOC increased by more than 50%, with the second most common disability claim under the ADA involving a psychiatric illness. In fact, mental impairments account for 11.7% of the ADA claims and include depression, anxiety, post-traumatic stress disorder and bipolar disorder.

Anxiety disorders, in particular, are exceedingly common. Although most people who develop an anxiety disorder feel alone, frightened and – all too often – “crazy,” the reality is that anxiety disorders are the most commonly experienced mental illness. Forty million people in the United States – 18% of the adult population – experience an anxiety disorder at some point in their lives.

Symptoms can range from a chronic sense of worry and tension to unwanted and intrusive obsessions and compulsions to spontaneous bursts of severe anxiety with accompanying physical sensations such as a racing heart or shortness of breath. Some sufferers can pinpoint the source of their anxiety; for others, it remains a mystery.

Bringing Anxiety to Work

One of the most frustrating aspects of many anxiety disorders is the unpredictability of their symptoms. For sufferers, this can feel like perpetually waiting for the other shoe to drop. For the employer, whose business depends on predictable and consistent performance and attendance, it can be disruptive and frustrating as well.

However, most anxiety sufferers perform well at work. Many do not need accommodations at all, having learned ways to cope with their anxiety symptoms through trial and error, treatment, or a combination of both. Others require minimal assistance, i.e., a short-term flexible schedule to adjust to a new medication or an organized supervision style with regular meetings, clear assignments, and advance notice of unexpected changes. In fact, given the prevalence of anxiety disorders, it is highly likely that you have a coworker who successfully manages symptoms that no one s/he works with is aware of.

Just Give Me More (and More) Time

Much less frequent is the employee who uses his or her diagnosis to create more favorable (or convenient) work conditions. This is the employee, for example, whose use of intermittent leave routinely happens on a Friday or around a holiday, or who routinely requests a change of supervisor because his current one makes him nervous (While a change in supervision style can be a reasonable, and often effective accommodation, a change in supervisor may not be).

The best way to eliminate these situations is to a) have a clear absenteeism policy with call-in guidelines; b) track absenteeism patterns and, during medical certification, include any unusual pattern with the employee’s job description and ask the physician whether the employee’s diagnosis would create this pattern, and c) make sure job descriptions clearly outline interpersonal expectations (such as getting along with peers and managers) as essential job functions.

Don’t Worry; I’m (Trying to Be) Happy

Then there’s the flip side; the employee who keeps insisting she’s fine when she’s not. This is the employee who keeps coming to work even though she repeatedly falls apart, seeks out several coworkers to help her, and has to be taken by ambulance to the emergency room. Whether it’s because she’s fearful of losing her job if she takes time off, or in denial about the seriousness of her symptoms, she just doesn’t seem to grasp the limitations that she currently has.

In this situation, a first step is to encourage her to get the help she needs. Consider open questions that will encourage an employee to request support or accommodation. At the same time, remember that your job is not to probe into an employee’s personal life, to diagnose a problem, or to act as their counselor (It’s possible to have a conversation about this without ever mentioning the word “anxiety” or “mental illness,” i.e., by focusing on her behavior at work and the impact it is having on the people she works with.)

Make available whatever company resources you have to assist her. If she decides to pursue FMLA, make sure you provide the doctor with a copy of the job description and the employee’s attendance record; as many as one out of every three anxiety disorder sufferers also have a substance abuse problem and a Friday/Monday pattern of absences may be an indicator. You might also want to ask for a very specific return-to-work note.

The Bottom Line

Invisible disabilities like anxiety can’t be seen but they are surely felt – by the sufferer as well as those around him/her. Fortunately, they are also highly treatable; in fact, all of us work with individuals who have successfully dealt with anxiety or depression. With a little flexibility and adequate resources, employers can help anxious employees return to a more productive and happy state by focusing on whether and how they can accommodate them rather than whether or not a certain medical condition is a disability.

Companies also better take a second look at their job descriptions and address, where appropriate, the emotional stamina requirements of a job. This is important because, under the law, employers do not have to eliminate essential requirements, only how they are performed. If a job requires the ability to work long hours or with little supervision, make it clear. Not only will this provide some legal protection, it can help applicants who aren’t able to meet these demands to opt out before they fail.

On May 23, 2003, John Ponsi, a teacher at Cliffside Park High School, was unexpectedly called into the principal’s office for a meeting with two students, who accused him of making racial and lewd remarks earlier that week. Another teacher at the same meeting accused Ponsi of pushing her. Four days later, the Board of Education notified Ponsi that he was suspended with pay, pending the outcome of an investigation and psychological examination.

However, no investigation was conducted. Ponsi was referred to a psychiatrist by his physician due to the depression and anxiety resulting from the accusations and suspension. In September 2003, Ponsi was also evaluated by Dr. Meyerhoff, a psychiatrist appointed by the school board, who concluded that Ponsi was unable to teach for the foreseeable future. As a result of that examination, the Board notified Ponsi that he was ineligible to teach until he provided proof of recovery and that, if his absence exceeded two years, his employment would be terminated.

On January 31, 2005, Ponsi’s psychiatrist notified the school in writing that he was ready and able to return to teaching. Not convinced, the Board sent Ponsi back to Dr. Meyerhoff, their psychiatrist, who concluded that, while his mood disorder had abated, he was unfit to return to work because he showed no repentance or remorse over the alleged lewd and racial remarks, or the pushing incident. In essence, the Board’s psychiatrist accepted all the allegations against Mr. Ponsi as true (even though no investigation had been conducted) and, in fact, interpreted Mr. Ponsi’s assertion to the contrary as evidence of paranoid delusions. Concerned, the Board decided not to reinstate Mr. Ponsi.

Why Should I Believe You if You’re “Crazy?”

The true story cited above illustrates one of the challenges (and potential pitfalls) employers face when investigating psychiatric disability discrimination claims. All too often, the stigma of a mental illness clouds how that person is perceived, not only by managers who don’t understand psychiatric disorders but professionals who should know better. In other words, the complaint process itself becomes tainted by the underlying assumption that the complainant, because of his or her mental state, isn’t able to see reality clearly and is thus distorting what happened or misinterpreting the evidence.

Just Go See the Shrink and Get Yourself Straightened Out

Employers can also fall prey to the assumption that a trip to the psychiatrist’s office is all that is needed to get the complainant to see the light. Certainly, there’s nothing wrong with offering up an employer’s EAP to a complainant who is dealing with the inevitable stress that filing a complaint generates. The devil, however, is in the details. Employers need to be clear that their recommendations or suggestions about psychiatric treatment aren’t interpreted as a thinly disguised version of blame-the-potential-victim.

They also need to be sure that the questions they ask in their investigation don’t cross the line into sensitive medical information or stray into unwarranted territory. Asking coworkers if they’ve ever felt that Bipolar Employee X was dangerous is understandable if you’re investigating alleged threats made by this employees; it’s completely inappropriate if you’re investigating complaints of cruel comments or teasing made to this employee.

The Bottom Line

Investigating psychiatric disability harassment or discrimination claims can be especially challenging, although not necessarily for the reason many of us assume they would be. Yes, some employees with psychiatric disabilities can be difficult complainants, but so can employees without a mental illness. In fact, in my experience, it’s the stigma and fear surrounding mental illness that gets in the way of a fair and objective investigation much more often than an irrational or “crazy” complainant.

However, employers must make sure that we are basing our employment decisions on the facts rather than beliefs and opinions, even when those beliefs and/or opinions come from mental health professionals. Employers who substitute professional opinions for investigations do so at their own peril. When you do need professional input, make sure you provide them with accurate and objective information is being provided.

Your most gregarious employee suddenly becomes withdrawn and aloof. Your previously decisive teamleader can’t seem to make the simplest decision. Your easygoing coworker starts arguing with coworkers and takes offense at the drop of a hat. Your most dependable employee shows up late, calls in sick, and doesn’t finish projects. These are some of the symptoms of depression in the workplace.

So what’s a manager to do? On one hand, production must continue, yet the compassionate manager should also be concerned for the well-being of the employee. Performance issues have to be dealt with and yet the employee’s previously stellar record – or obvious emotional pain – tempts the manager to just pick up the slack until the employee gets back on his or her feet.

The scenario of the depressed employee often presents a dilemma for his/her manager. So why does the manager have to deal with it? The employee is a grown-up; why doesn’t s/he come to the manager first?

Note to Manager: Don’t Wait for Me to Come to You

The odds are, s/he won’t. Most depressed employees would rather eat dirt than admit to their managers that they’re depressed. Part of this is because of the shame many depression sufferers feel about what they feel is their “weakness.” However, a large part of their silence is due to the stigma many people continue to experience around mental illness.

For example, in an online survey of 1,129 workers conducted by the American Psychiatric Association, a high percentage believed that seeking help for particular psychological problems – such as drug addiction (76%), alcoholism (73%) and depression (62%) – would not be as accepted. As I mentioned in another article I wrote, for every story I’ve heard about a supportive manager or caring HR professional, I’ve heard ten from employees who felt their disclosure led to being teased, overly scrutinized, or discriminated against.

The First Step: Recognizing how Depression Impacts Work

Most managers have some employees they’d like to clone and some they’d like to clobber. And, certainly, a slacker can become depressed just as a superstar can. What’s noticeable about depression, though, is the change in the employee. The good employee’s performance declines while the marginal employee gets worse.
Here’s what that change in performance may look like:

  • Unfinished projects
  • Forgetfulness
  • Increased errors
  • Trouble concentrating
  • Indecisiveness
  • Irritability
  • Loss of interest in work or socializing with colleagues
  • Seems tired/fatigued

What to Say to a Depressed Employee

Managers are not there to talk about medical problems, counsel, or diagnose. They are there to talk about work performance and behavior. They are also there to care about their employees’ wellbeing. When talking to a potentially depressed employee, here are some ways to do both:

  1. 1. Start with your concern for the employee. “Sandy, I’m concerned about you.”
    2. Focus your comments on observable behaviors. “You’ve been late to work four times in the past two weeks and your reports have had twice as many errors.”
    3. Acknowledge the change. “This isn’t like you. You’re normally the first in to work and the last person in the department to make mistakes.”
    4. Offer them an olive branch. “I don’t know if things in your personal life are affecting you, but if they are we have a confidential employee assistance plan that might be able to help.”
    5. Be prepared to set limits. For instance, if the employee mentions marital discord, problems with a child, financial problems, and so forth, the manager should be empathic but should limit the conversation.
    6. Refer to an E.A.P. Offer the employee the telephone number for the employee assistance program or suggest that it would serve the employee well to consider outside professional counseling through health care benefits, a community clinic, an employee assistance plan, or even through pastoral counseling.
    7. Reinforce your concern. ” I’m very invested in helping you get back on track.”
    8. Reinforce the need to improve performance. “However, whether or not you contact this service, you will still be expected to meet your performance goals.”

The Bottom Line

Clinical depression has been described as a black dog, a suffocating blanket, and an endless, dark hole. Untreated, it can sap the energy and motivation out of the most productive employee. With the right help, it can be managed, overcome, or worked around. In fact, for some people, coping with depression has given them some gifts that might now have otherwise received – such as a greater perspective and empathy for others. At least, that’s what one lifelong depression sufferer you may know said – Abraham Lincoln.