How does mental illness interfere with functioning on the job?

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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.

 

bullet Functional limitations due to psychiatric disability
bulletWhy I need to know about functional limitations
bulletHow I might recognize signs of mental illness in the workplace
bulletSome research findings on types of functional limitations

 

Functional limitations due to psychiatric disability

The following is a list* of some of the activities that people with psychiatric disabilities may have trouble doing:
 

bulletScreening 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.

 

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

Ex. An employee may have trouble focusing on one task for extended periods.
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.

 

bulletMaintaining 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 sharing.

 

bulletHandling 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 complete project.

 

bulletInteracting 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”.

 

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

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 then discuss.

 

bulletResponding 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, 14(2), 3-19.

 

 

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.

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Why I need to know about functional limitations

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.

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How I might recognize signs of mental illness in the workplace*

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:
 

bulletmarked personality change over time,
bulletconfused thinking; strange or grandiose ideas,
bulletprolonged severe feelings of depression or apathy,
bulletfeelings of extreme highs or lows,
bulletheightened anxieties, fears, anger or suspicion; blaming others,
bulletsocial withdrawal, diminished friendliness, increased self-centeredness,
bulletdenial of obvious problems and a strong resistance to offers of help,
bulletdramatic, persistent changes in eating or sleeping habits,
bulletsubstance abuse,
bulletthinking 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:
 

bulletconsistent late arrivals or frequent absences,
bulletlow morale,
bulletlack of cooperation or a general inability to work with colleagues,
bulletdecreased productivity,
bulletincreased accidents or safety problems,
bulletfrequent complaints of fatigue or unexplained pains,
bulletproblems concentrating, making decisions, or remembering things,
bulletmaking excuses for missed deadlines or poor work,
bulletdecreased 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

 

 

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Some research findings on types of functional limitations

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:
 

bulletInteracting with others - interviewing for the job, describing strengths and weaknesses, clarifying instructions, asking for help, starting conversations with coworkers
bulletLearning the job - remembering the routine, following instructions, learning new tasks
bulletMaintaining work stamina/pace - working 3 hours without breaks, standing for long periods, taking scheduled breaks, completing tasks in allotted times, managing time
bulletManaging 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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