Workforce reentry for employees with mental disorders

• TYPE OF PSYCHOLOGY: Social psychology
• Appropriately timed workforce reentry is a priority for individuals suffering from mental disorders, including drug and alcohol addiction. Approximately one in five employees may have a mental condition, and many employers say the condition with the highest indirect cost to the company is mental illness. Providing a safe and accepting work environment is essential to workforce reentry.

Introduction

The unemployment rate for individuals with severe mental illnesses is estimated to be as high as 80 to 90 percent, even when these individuals want to work or are able to work. With treatment, many people have manageable symptoms and lead productive lives. Reintegration into society, including a return to the workforce, is a priority of mental health management. Work is an important step in becoming self-reliant and provides a focus away from their mental health condition.

In 1990, President George H. W. Bush signed the Americans with Disabilities Act (ADA) into law. The ADA prohibits discrimination against people with various disabilities, including psychiatric disabilities, in employment and other services. Under the ADA, employers must provide reasonable accommodations when workforce reentry occurs. In 1999, President Bill Clinton signed legislation to eliminate work disincentives called the Ticket to Work and Work Incentives Improvement Act. The act provided people with disabilities the opportunity to pursue a job without losing healthcare coverage.

According to the ADA, an individual with a disability is defined as "a person who has a physical or mental impairment that substantially limits one or more major life activities." A mental impairment may be any mental or psychological disorder, such as depression, anxiety disorders, schizophrenia, and personality disorders. Substance use disorders are also impediments to workforce re-entry. Research has demonstrated that individuals with certain mental health conditions or psychiatric disorders have increased instances of absenteeism and lower productivity in the workplace than their peers. To ensure workforce efficiency, employers should define a program to enable potential and existing employees with mental health conditions to reenter the workforce. A healthy workplace environment can foster positive mental health in employees, but a negative environment can contribute to mental health decline and, subsequently, a decline in productivity, job satisfaction, and employee retention.

Implications for Employers

The ADA requires employers to hold all information about the employee reentering the workforce in strict confidence. Supervisors and select others may receive information necessary to manage the work and needs of the returning employee. The employer is also not allowed to disclose any medical information about the returning employee to coworkers. If employees question why the returning worker is receiving different or special treatment, the employer can only state that it complies with federal law for legitimate business reasons. Additionally, employers may not inquire about an individual's mental health treatment or any condition or diagnosis.

The cost of care for mental-health-related conditions is a major factor in high healthcare costs for businesses. Research continues to reveal the connection between mental and physical well-being. Fostering positive mental health in employees extends beyond the apparent benefits, providing a foundation for better quality work, inter-departmental collaboration, and creativity that increase the company's intellectual assets. The goals for employers are to improve and maintain the employee’s treatment outcomes, decrease future absenteeism, and minimize the cost and impact of behavioral health conditions on the workplace and the employee’s colleagues.

These goals are accomplished in different ways depending on the individual and the severity of the condition. Behavioral health problems, poor self-esteem and work habits, and fear of the work environment may cause the employee to avoid working longer than necessary, increasing the workload for coworkers. Colleagues may grow to resent the employee because of frequent absences. The same stigma attached to mental illness that prevents individuals from seeking care may also negatively affect coworkers’ support for the returning employee if they know why the coworker was absent. If the workplace and colleagues are unprepared to provide the necessary support, the stress of returning to work may prevent the affected individual from moving into an environment that will enhance recovery.

To enhance the employee's assimilation into the workforce, a program designed to support reentry while minimizing disruption is critical. The company’s leadership must communicate a clear message of a non-discriminatory workplace. Supervisors are essential to a successful employee reentry and must receive education and training to understand their role. All employees should be informed of their right to seek care for mental health concerns and the resources available to them. A greater understanding of mental health in the workplace encourages a climate of acceptance and support.

Reasonable Accommodations

The ADA requires reasonable accommodations for individuals with disabilities. Changes to workplace policies, procedures, or practices that are not excessive in cost or disruption are expected. Under the ADA’s reasonable accommodation requirements, employers may be asked to permit more frequent breaks, the use of noise-canceling headphones in the office, flexible work schedules, modified deadlines, or remote work. Changing a schedule to allow the returning employee to increase to full-time work gradually or to carpool if unable to drive; providing a quiet workspace to minimize sensory stimulation, such as for the employee with severe attention deficit hyperactivity disorder (ADHD); and providing time off for recurrent physician visits are examples of other reasonable accommodations. Employers are not expected to make changes that create undue hardship or that allow a disruptive or threatening employee to return to the workforce, but a healthcare professional must participate in the decision to refuse workforce reentry.

Bibliography

Corrigan, Patrick W., et al. Challenging the Stigma of Mental Illness: Lessons for Therapists and Advocates. Wiley, 2011.

Kessler, Ronald C., et al. “Prevalence and Effects of Mood Disorders on Work Performance in a Nationally Representative Sample of U.S. Workers.” The American Journal of Psychiatry, vol. 163, no. 9, 2006, pp. 1561–68, doi:10.1176/ajp.2006.163.9.1561. Accessed 18 Dec. 2024.

Lengnick-Hall, Mark L., editor. Hidden Talent: How Leading Companies Hire, Retain, and Benefit from People with Disabilities. Praeger, 2007.

Lloyd, Chris. Vocational Rehabilitation and Mental Health. Wiley, 2010.

"Mental Health at Work." World Health Organization, 2 Sept. 2024, www.who.int/news-room/fact-sheets/detail/mental-health-at-work. Accessed 18 Dec. 2024.

National Council on Disability. Implementation of the Americans with Disabilities Act: Challenges, Best Practices, and New Opportunities for Success. Author, 2007.

"Sick on the Job?: Myths and Realities about Mental Health and Work." OECD, 2012, www.oecd.org/en/publications/2012/01/sick-on-the-job‗g1g1525d.html. Accessed 18 Dec. 2024.

Rubin, Stanford E., et al. Foundations of the Vocational Rehabilitation Process. 7th ed., PRO-ED, 2016.

Warren, Frank, and Richard G. Luecking. Jobs for People: A Handbook—Finding Employment Opportunities for Citizens Who Have Disabilities. TransCen, 1989.