How does mental illness interfere with functioning on the job?
Mental illnesses may interfere with functioning in different ways. Many of the
illnesses affect a person’s ability to do certain things, such as thinking or
communicating with others. Often, the person themselves or the professionals
working with them can describe the functional limitations that are specific to
your employee. Please remember that since there are a lot of different types of
mental illnesses, that this is not a complete list, nor do these limitations
apply to everyone who has a mental illness.
The following is a list* of some of the activities that people with
psychiatric disabilities may have trouble doing:
|Screening out environmental stimuli - an inability to block out
sounds, sights, or odors which interfere with focusing on tasks
Ex. An employee may not be able to work next to a noisy printer or
in a high traffic area.
Possible solutions: Move printer away from work area, allow employee to
wear headphones playing soft music, install high partitions around desk.
|Sustaining concentration - restlessness, shortened attention span,
easily distracted, trouble remembering verbal directions
Ex. An employee may have trouble focusing on one task for extended
Possible solutions: Break large projects into smaller tasks, allow
brief but more frequent breaks to stretch, walk around, get fresh air, assign
tasks one at a time.
|Maintaining stamina - having energy to work a full day, combating
drowsiness due to medications
Ex. An employee may not be able to work a full 8 hour day.
Possible solutions: Part time hours, rest breaks in middle of day, job
|Handling time pressures and multiple tasks - managing assignments &
meeting deadlines, prioritizing tasks
Ex. An employee may not know how to decide which tasks should be
done first, or be able to complete tasks by the due date.
Possible solutions: Break larger projects down into manageable tasks,
meet regularly to help the employee to prioritize tasks or to estimate time to
|Interacting with others - getting along, fitting in, talking with
coworkers, reading social cues
Ex. An employee may not talk with coworkers at breaks, or may have
trouble knowing “ things go around here”.
Possible solutions: Establish a mentor or coworker buddy relationship
to introduce the employee to others or to show the employee “ ropes”.
|Responding to negative feedback - understanding and interpreting
criticism, knowing what to do to improve, initiating changes because of low
Ex. An employee may not seem to understand the feedback given, or
becomes upset when criticism is delivered.
Possible solutions: Arrange a meeting with the job coach and employee
to facilitate feedback, use a feedback loop (ask employee’s perspective of
performance, describe both strengths and weaknesses, suggest specific ways to
improve), give employee the chance to read written feedback privately, and
|Responding to change - coping with unexpected changes in work, such
as changes in the rules, job duties, supervisors or coworkers.
Ex. An employee may take longer to learn new routines, or feel
stressed when new supervisors or coworkers start work.
Possible solutions: Prepare employee for changes that will be
happening, explain new rules or duties, make a special effort to introduce new
staff to employee and orient new supervisors to employee’s needs.
*Adapted from Mancuso, L.L. (1990) Reasonable accommodations for workers
with psychiatric disabilities. Psychosocial Rehabilitation Journal,
Please be aware that any strategies that are considered should be discussed
with the employee in advance, identifying the particular areas of difficulty for
that person and possible solutions that may work for him or her.
The ADA states that employers only need to provide accommodations to the
known mental or physical limitations of someone with a disability that can be
attributed to that disability. Employers are not required to accommodate
limitations due to other characteristics, such as poor literacy skills (that are
not due to learning disabilities), low educational levels or lack of
credentials. You can ask the employee or a professional to document the types of
functional limitations due to the disability that lead to the need for
accommodations for that person.
While a single symptom or isolated event is rarely a sign of mental illness,
a symptom that occurs frequently, lasts for several weeks, or becomes a general
pattern of an individual’s behavior may indicate the onset of a more serious
mental health problem that requires treatment. Some of the most significant
indications of a possible mental illness include:
|marked personality change over time, |
|confused thinking; strange or grandiose ideas, |
|prolonged severe feelings of depression or apathy, |
|feelings of extreme highs or lows, |
|heightened anxieties, fears, anger or suspicion; blaming others, |
|social withdrawal, diminished friendliness, increased self-centeredness,
|denial of obvious problems and a strong resistance to offers of help, |
|dramatic, persistent changes in eating or sleeping habits, |
|substance abuse, |
|thinking or talking about suicide. |
In reality, these symptoms are not always readily apparent. Employers and
supervisors may be able to notice significant changes in their employees’ work
habits, behaviors, performance, and attendance, such as:
|consistent late arrivals or frequent absences, |
|low morale, |
|lack of cooperation or a general inability to work with colleagues, |
|decreased productivity, |
|increased accidents or safety problems, |
|frequent complaints of fatigue or unexplained pains, |
|problems concentrating, making decisions, or remembering things, |
|making excuses for missed deadlines or poor work, |
|decreased interest or involvement in one’s work. |
People who experience problems such as those listed above may simply be
having a bad day or week, or may be working through a difficult time in their
lives. A pattern that continues for a long period may, however, indicate an
underlying mental health problem.
*Source: Zuckerman, D., Debenham, K. & Moore, K. (1993) The ADA
and People with Mental Illness: A Resource Manual for Employers.
Available from the National Mental Health Association, 1021 Prince Street,
Alexandria, VA 22314-2971
One study recently conducted by the Center for Psychiatric Rehabilitation on
Reasonable Workplace Accommodations for People with Psychiatric Disabilities
found that the most common functional limitations for employees who were
involved with a supported employment service involved:
|Interacting with others - interviewing for the job, describing
strengths and weaknesses, clarifying instructions, asking for help, starting
conversations with coworkers |
|Learning the job - remembering the routine, following instructions,
learning new tasks |
|Maintaining work stamina/pace - working 3 hours without breaks,
standing for long periods, taking scheduled breaks, completing tasks in
allotted times, managing time |
|Managing symptoms/Tolerating stress - relaxing, recognizing
stressors, managing negative feelings, managing internal distractions |
These functional limitations were accommodated in a variety of ways.
Supported employment service providers were often very helpful to employers in
identifying the limitations and suggesting effective accommodations.
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