Mental Illness and the Workplace: How to Accommodate Employees

Organizations have made great progress to accommodate individuals with physical disabilities, but do HR professionals have the skills and knowledge to address the concerns of workers with mental impairments?

Several high-profile suicides in recent months have brought renewed attention to the issue of mental health. It’s also raised new questions about how employers can better accommodate workers with mental illness in the same way they might support someone with a physical handicap.

“We’re starting to see it changing in recent years where people are being more open about the struggle with mental health,” says Laurie Greenlees, PHR, Director of HR Hotline and Safety Services at MRA-The Management Association, which represents employers in the Midwest.

Greenlees says her organization is handling more calls from organizations looking for advice on how to comply with rules governing mental health and employment.

“Each case really is unique in and of itself,” she says. “That’s what makes it really challenging for employers.”

The Legal Landscape

The Americans With Disabilities Act (ADA) requires employers to offer accommodations to those with physical disabilities, and that same law applies to people suffering from mental impairments that limit “one or more major life activities.” Based on this definition, some people with mental health challenges are considered disabled while others are not.

Under the ADA, mental illness is referred to as “psychiatric disability” and can cover bipolar disorder, major depression, post-traumatic stress disorder, obsessive-compulsive disorder and many other conditions.

Workers with these conditions can seek “reasonable accommodations” to allow them to do their jobs. For example, someone who experiences periodic panic attacks may be permitted to have a support animal or take additional breaks when necessary. A person with post-traumatic stress disorder stemming from a car accident may be allowed to work an earlier schedule to avoid driving home in the dark. 

Employers should not assume these accommodations would create a burden to the organization, Greenlees said.

“A lot of people jump to the conclusion that the accommodation is going to create a hardship,” she says. “Often, these are easy adjustments that can help the individual.”

A worker with mental illness is also covered under the Family Medical Leave Act (FMLA), which allows workers to take unpaid leave and keep their job if they are receiving treatment. In many cases, allowing for a short leave of absence is all that is required —a worker takes time off and returns without further issues. But often, mental health impairments are long-term or even permanent, requiring the employer to take special steps.

While the ADA offers little guidance in this area, the Equal Employment Opportunity Commission (EEOC) does. The EEOC notes that a worker can receive an accommodation for a condition that, if left untreated, would impact their ability to “concentrate, interact with others, communicate, eat, sleep, care for yourself, regulate your thoughts or emotions, or do any other ‘major life activity.’”

Greenlees says it’s essential for HR professionals to be familiar with these rules and guidance, and that supervisors should also receive some education.

“Make sure you are training you managers on the basics of FMLA and the ADA,” she says. “They don’t need to be experts, but they need to know enough when to bring human resources into that discussion.”

Accommodations and an Interactive Process

Make the Employee Part of the Process [Is this better?]

Mental illness doesn’t manifest itself like a broken leg, and employers may not be aware that a person needs an accommodation to effectively carry out the responsibilities of their job. Workers, meanwhile, may be reluctant to seek help for fear of being stigmatized for their mental illness.

So what is considered a “reasonable accommodation”?

 “HR professionals are not doctors. They don’t have a medical degree,” Greenlees says. “They may not be real familiar with all of the medical conditions and what the accommodations might be.”

It’s far easier for an employer to accommodate someone with a physical handicap. Finding the right accommodation for someone with a mental health challenge is not as simple.

“It’s harder for employers to think through how to deal with a person who has difficulty concentrating, or has problems dealing with others,” Greenlees says. “It’s a little bit different than coming up with an accommodation for someone who has a lifting restriction, for example.”

The key, Greenlees says, is to try out various approaches to see what works.

“It should be treated as an interactive process,” she says. “Try more than one thing. What are some ideas the employee has? Give it a try. If it’s not working, try something else. It’s not a one-time solution where you can say case closed and we’re moving on.”

Many HR professionals turn to the Job Accommodation Network (JAN), which offers comprehensive information on disabilities and job accommodations, including those for people with mental illness.

JAN offers a series of questions employers should ask when formulating an accommodations plan. In addition, it offers suggested accommodations for workers dealing with challenges related to concentration, memory, time management, organization, attendance, co-worker interaction, stress, fatigue, panic attacks and sleep disturbances.

On its website, JAN notes that there is no one-size-fits all approach to accommodating workers with mental illness.

“The degree of limitation will vary among individuals,” JAN says. “Be aware that not all people with mental health impairments will need accommodations to perform their jobs and many others may only need a few accommodations.”

Workers are not required to reveal a mental illness to their boss, though it is advised that they seek an accommodation if they are having trouble doing their job effectively.

“Because an employer does not have to excuse poor job performance, even if it was caused by a medical condition or the side effects of medication, it is generally better to get a reasonable accommodation before any problems occur or become worse,” guidelines from the EEOC state.

Greenlees says workers with mental illness seek out an accommodation themselves about half the time. The rest of the time, the need for an accommodation becomes obvious when a supervisor approaches a worker about their performance.

“It may be an individual who is seeking treatment and they know they are going through a rough patch and decides to initiate a conversation,” Greenlees says. “Or, you have an employee who is having attendance issues or performance issues and that leads to a conversation in which the mental impairment is revealed.”

Career and Privacy Concerns

Many workers with mental impairments never ask for an accommodation because they fear for job security. But the EEOC specifically notes that a worker can’t be fired for asking for an accommodation.

That said, HR professionals should take care to keep a worker’s mental health information private. Greenlees said all medical information should be kept separate from a person’s normal personnel file. Moreover, if other workers ask why a colleague is receiving special accommodations, a supervisor should disclose as little information as possible.

That said, employers should be open about their willingness to assist those with mental illness and remove any negative misconceptions.

“We’ve come a long way as a society,” Greenlees says. “People are being more open about it. There  shouldn’t be a stigma.”

Want to ensure that all employees — especially supervisors — have foundational knowledge of HR practices and principles? Non-HR employees are eligible and urged to earn the Associate Professional in Human Resources™ (aPHR™) or the Associate Professional in Human Resources - International™ (aPHRi™) to help your organization engage employees and reduce risks.