SoberRecovery : Alcoholism Drug Addiction Help and Information - View Single Post - The work place...info about reasonable accomadations and other stuff

shutterbug · 09-01-2005, 03:40 AM

All of the following articles are from www.bipolarsurvivor.com

Work and Mental Illness - What Do We Really Know?
...NAMI Advocate, January/February 1998

Work is at the very core of contemporary life for most people, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life. For individuals with severe mental illness, however, work has been a difficult and often unattainable goal.
The following are facts about the capabilities of this emerging workforce, facts that draw upon a broad base of reliable rehabilitation research.
Copies of the entire brochure and information on specific studies cited can be obtained from MRI, 6008 Wayne Avenue, Philadelphia, PA, 19144, 215.438.8200.

FACT: There are three million working age adults with severe mental illness in the nation's communities, of whom 70 percent (about 2.5 million people) are unemployed.
The National Institute of Mental Health estimates that there are a little more than three million adults ages 18 to 69 who have a serious mental illness. Estimates of unemployment among this group are startling: Between 70 percent and 90 percent are unemployed, a rate higher in the nation than for any other group of people with disabilities.

FACT: A diagnosis of serious mental illness is not a reliable indicator that someone cannot work, indeed, many people are able to work successfully despite their symptoms.
Several years of study report only a small relationship between a diagnosis and work capacity, or between psychiatric symptoms and work capacity. While it is true that some of the symptoms of mental illness - its often unpredictable nature and its impact on both cognitive and interpersonal functioning - make work a real challenge, these symptoms vary from person to person.

FACT: On-the-job accommodations that make it possible for people with serious mental illness to succeed at work are proving relatively straightforward and inexpensive to provide.
Recent surveys indicate that job accommodations for people with disabilities of all kinds are not difficult to make or costly to implement - 68 percent of all accommodations cost less than $500.00. The changes at work that people with serious mental illness request most often - alterations in the work schedule, modifications in job descriptions, clear communication patterns or additional training for supervisors - are generally low-cost or no-cost to employers and differ only slightly from options offered for other employees.

FACT: The great majority of people with a serious mental illness want to work. Recent surveys report that approximately 70 percent of those with significant psychiatric problems rank work as an important goal for themselves.
Many consumers receiving SSI or SSDI financial and medical benefits are often reluctant to give up their eligibility for what may be low-paying and low-benefit jobs. Nonetheless, about 71 percent of those people with serious mental illness who are asked about their future goals identify work - and the financial independence and social identity it provides - as a central and important ambition for themselves.

FACT: Innovative rehabilitation programs, which help people with the most serious mental illnesses, are placing more than 50 percent of their clients into paid employment.
A number of innovative programs that move clients into "real jobs for real pay" as quickly as possible - and then provide extensive supports for them either on-the-job or off-the job - are reporting considerable success. An in-depth analysis of supported employment outcomes, for instance, found 52 percent of people still working after a year. Intensive case management and individual placement and support models that emphasize employment regularly report significant increases in wages, hours worked, work tenure, and career advancement.

FACT: Employers who have hired persons with serious mental illness in the past are generally very positive about their experience.
Many employers throughout the country have hired people with serious mental illness. More than 70 percent of these employers report their willingness to continue working with rehabilitation programs that place and support people with serious mental illness. Employers who are involved with rehabilitation programs are less likely to share the public's concerns and fears about people with mental illness, particularly with regard to violent behavior.

FACT: Although job loss continues to be a problem, those individuals with serious mental illness who are working can be helped to stay on the job if they receive the additional support they need.
The reasons for job loss vary widely. In one study, only 12 percent of those people who left their jobs said they resigned because they didn't want to work, and only 15 percent had to leave for medical reasons unrelated to their mental health. The others who became unemployed faced a variety of problems - layoffs, problems with co-workers or supervisors as well as mental health problems - that led to diminished work capacities. Many of these problems might have been resolved without job loss if ongoing support had been available.

FACT: Because people with psychiatric disabilities are the largest part of the recent increase in persons dependent upon SSI/SSDI support, the nation can't afford to shortchange rehabilitation programs that help people with mental illness to work.
With growing numbers of persons with serious mental illness seeking SSI/SSDI support, far more emphasis needs to be placed on vocational rehabilitation programs that can help people to work and live more independently. People with mental illness can and want to work and rehabilitation programs can be successful in getting people onto the job and keeping them employed.

Accommodating Workers with Bipolar disorder
...Job Accommodation Network, www.jan.wvu.edu

Bipolar Disorder in the workplace - questions to consider
What limitation is the individual with bipolar disorder experiencing?
To what degree do these limitations affect the person and his/her job performance?
What specific job tasks are problematic as a result of these limitations?
Have you consulted with the individual regarding accommodation needs?
what accommodations are available to reduce or eliminate these problems? Are all resources such as the Job Accommodation Network being utilized to identify possible accommodations?
Has the person with bipolar disorder met with his/her supervisor to evaluate the effectiveness of existing accommodations and to determine if others are needed?
Have you provided education on psychiatric disabilities in the form of sensitivity training to supervisory personnel?

Accommodation ideas for persons with bipolar disorder
Note: persons who have bipolar disorder may develop some of these limitations, but seldom develop all of them. Also, the degrees of limitation will vary among individuals. Be aware that not all people who have bipolar disorder will need accommodations to perform their jobs and others may only need a few. The following is only a sample of accommodation possibilities. Numerous other accommodation solutions exist as well.

Maintaining stamina during the work day
- Flexible scheduling
- Allow longer or more frequent breaks
- Provide additional time to learn new responsibilities
- Provide self-paced work load
- Provide backup coverage for when the employee needs to take breaks
- Allow for time off for counseling
- Allow for use of supportive employment and job coaches
-Allow employee to work from home during part of the day or week
- part time work schedules

Maintaining concentration
- Reduce distractions in the work area
- Provide space enclosures or private office
- Allow for use of white noise or environmental sound machines
- Increase natural lighting or provide full-spectrum lighting
- Allow the employee to work from home and provide necessary equipment
- Plan for uninterrupted work time
- Allow for frequent breaks
- Divide large assignments into smaller tasks and goals
- Restructure job to include only essential functions

Difficulty staying organized and meeting deadlines
- Make daily "To Do" lists and check items off as they are completed
- Use several calendars to mark meetings and deadlines
- Remind employee of important deadlines
- Use electronic organizers
- Divide large assignments into smaller tasks and goals

Working effectively with supervisors
- Provide positive praise and reinforcement
- Provide written job instructions
- Develop written work agreements, including the agreed upon accommodations, clear expectations of responsibilities and the consequences of not meeting performance standards
- Allow for open communication to managers and supervisors
- Establish written long-term and short-term goals
- Develop strategies to deal with problems before they arise
- Develop a procedure to evaluate the effectiveness of the accommodation

Difficulty handling stress and emotions
- Provide praise and reinforcement
- Refer to counseling and employee assistance programs
- Allow telephone calls during work hours to doctors and others for needed support
- Provide sensitivity training to co-workers and supervisors
- Allow the presence of a support animal
- Reinforce peer supports

Attendance issues
- Provide flexible leave for health problems
- Provide a self-paced work load and flexible hours
- Allow employee to work from home
- Provide part-time work schedule
- Allow the employee to make up time missed

Issues of change
- Recognize that a change in the office environment or of supervisors may be difficult for a person with bipolar disorder
- Maintain open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition
- Provide weekly or monthly meetings with the employee to discuss workplace issues and production level

How Does Mental Illness Affect the Way I Function at Work?
...Center for Psychiatric Rehabilitation, Boston University
www.bu.edu

Mental illnesses may interfere with your ability to function at work - or they may have no effect at all. If your mental illness is affecting your ability to do things such as concentrating or communicating effectively, you're probably aware of it. Then again, you may not have made the connection between your disability and your problems functioning. Under the ADA, your employer only needs to provide accommodations for limitations that can be directly connected to your disability. You should document the types of functioning limitations caused by your disability to show your need for accommodations.

Here's a list of some of the limitations you may be experiencing. If you have a psychiatric disability, you may have trouble doing some of these things.* Please remember that since there are many different types of mental illnesses, this isn't a complete list - and that not everyone experiences all, or even any, of these limitations.

Here's how you might cope:
- Inability to screen out environmental stimuli, such as sounds, sights, or smells, which distract you. For example, you may have a hard time working next to a noisy printer or in a high-traffic area.
Possible solutions: Move the printer away from the work area; get permission to wear headphones playing soft music while you work; ask for high partitions to be installed around your desk.
- Inability to concentrate. You may feel restless, have a short attention span, be easily distracted, or have a hard time remembering verbal directions. For example, it may be difficult for you to focus on one task for an extended period of time.
Possible solutions: Break large projects into smaller tasks; ask for tasks to be assigned in writing; take short, frequent breaks to stretch or walk around whenever you feel your attention slipping.
- Lack of stamina. You may not have enough energy to work a full day, or you may find your medication makes you drowsy.
Possible solutions: Ask for a part-time schedule; ask for flex time or job sharing to be sure you're working only during your high energy hours; take a mid-day rest break.
- Difficulty handling time pressures and multiple tasks. You may have trouble managing assignments, setting priorities, or meeting deadlines. For example, you may not know how to decide which tasks to do first in order to complete a project by its due date.
Possible solutions: Break larger projects down into manageable tasks; meet regularly with your boss or a job coach for help prioritizing or estimating how long it will take to meet a deadline.
- Difficulty interacting with others. For example, you may be too shy to talk with co-workers at breaks, or you may have trouble figuring out, "how things go around here."
Possible solutions: Ask your employer to pair you with a co-worker who can introduce you around and show you the ropes.
- Difficulty handling negative feedback. You may have a hard time understanding and interpreting criticism. For example, you may get defensive when someone tells you your work isn't up to standards. It's hard for you to figure out what to do to improve, or you may believe trying to change is worthless.
Possible solutions: Ask that a job coach be present when you meet with your employer for feedback; offer your own perspective on your strengths and weaknesses; ask for specific ways to improve; ask to receive feedback in writing with an opportunity to discuss it later.
- Difficulty responding to change. Unexpected changes at work, such as new rules, job duties, or supervisors and co-workers, may be unusually stressful for you. For example, it may take you a long time to learn new tasks, or you may feel especially anxious around new co-workers.
Possible solutions: Ask your employer for advance warning of any changes; make a special effort to introduce yourself to new co-workers; ask your employer to notify new supervisors of your needs.
* Adapted from Mancuso, L.L. (1990) Reasonable accommodations for workers with psychiatric disabilities. Psychosocial Rehabilitation Journal, 14(2), 3-19.

What are Reasonable Accommodations?
...Center for Psychiatric Rehabilitation, Boston University
www.bu.edu

Introduction
Most employees and students need some adjustments to help them perform at their best. A parent who works full-time needs a day off to get a sick child from school, or an adult student needs an extension on a term paper because his job requires him to make an unscheduled trip out of town. Both employee and student have the necessary skills to do what's required if these adjustments are made.

For people with a disability, such changes are often critical to their success. Although some of the adjustments might be different from those that work for other people, they accomplish the same goal - allowing qualified employees or students to do the best job they can. These strategies are often just good business or educational practices. Reasonable accommodations are those adjustments within a work or school site that allow an otherwise qualified employee or student with a disability to perform the tasks required.

Employers and educators are not expected to provide opportunities to those who cannot do what is necessary. The laws do not require them to lower the standards of performance or change the qualifications needed to gain entry into a job or school program. What they are expected to do is be flexible about the way the work gets done.

Employers and educators are required to provide reasonable accommodations under 2 separate laws: The Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973. Recently, the Equal Employment Opportunity Commission (EEOC) issued Enforcement Guidance on the ADA and Psychiatric Disability.

Reasonable Accommodations for People with Psychiatric Disability
It's usually easy to tell what kind of accommodation someone with a physical disability needs. Someone who uses a wheelchair needs a higher desk. Someone with visual problems needs to receive all written material in large print. But since mental illness is often invisible, it can be hard to tell what will help a person with a psychiatric disability do his or her job better.

The first step in identifying the accommodations you need is to know the demands of your job or course work. The second step is to figure out your "functional limitations" - that is, how your disability may make it hard for you to meet those demands. For example, your symptoms or the side effects of your medication may cause problems with memory, concentration, relating to others, managing or experiencing emotions, or organizing and managing your time.

Effective accommodations include changes in schedules, instructions, job tasks or other procedures, and ways the instructor interacts with you. Not all of these accommodations will work for everyone; each situation should be taken on an individual basis. Many people with psychiatric disabilities may not need accommodations of any kind.

Mental Illness and Psychiatric Disability
"Mental illness" describes a variety of psychiatric and emotional problems that vary in intensity and duration, and may recur from time to time. Mental illnesses become disabling when they interfere significantly with a person's ability to work, learn, think, care for oneself, or interact with others. Mental illness is not mental retardation or brain injury.

Benefits of Reasonable Accommodations
In our lifetimes, one in four of us will know someone who has experienced a mental illness - a family member, friend, neighbor, employee, manager, student, or teacher. Many talented people have made significant contributions despite having had a mental illness: President Abraham Lincoln, writer Ernest Hemingway, actress Patty Duke, Senator Thomas Eagleton, artist Vincent Van Gogh, scientist Isaac Newton, athlete Lionel Aldridge, and businessman Ted Turner, to name a few, have accomplished many things in spite of having a mental illness.

Reasonable accommodations may help you return to work or school from disability or medical leave sooner. Costs for treatment of mental illness may be reduced the sooner one returns to a productive role, and many people want to become productive again. For employers, the costs for providing accommodations are fairly inexpensive - most cost less than $500, and for people with psychiatric disabilities, the cost is usually less than $100. In fact, the Job Accommodation Network says that companies report an average return of $28.69 in benefits for every dollar invested in making an accommodation.

Often, these adjustments - flexible schedules, time off for medical appointments, or changes in communication, feedback and/or supervision - are not much different from the changes available to any employee or student. They can benefit everyone, not just the employee with a disability.
Sources: Job Accommodation Network; National Alliance for the Mentally Ill; President's Committee on the Employment of People with Mental Illness; Zuckerman, Debenham & Moore, (1993) The ADA and People with Mental Illness: A Resource Manual for Employers

Disclosing Your Disability to an Employer
...Center for Psychiatric Rehabilitation, Boston University
www.bu.edu

Only you can decide whether and how much to tell your employer about your psychiatric disability. On the positive side, telling your employer about your diagnosis is the only way to protect your legal right to any accommodations you might need to get or keep a job. However, revealing your disability also leaves you open to discrimination, which may limit your opportunities for employment and advancement.

It's a complex decision, and one you shouldn't make until you've thought it through. Here's what you might want to think about:

Preparing to Disclose:
Assess your job search skills to determine whether you need help from your therapist or mental health agency to:
- Initiate contact or arranging an interview with the employer
- Interview
- Describe your disability
- Negotiate the terms of employment
- Negotiate accommodations

Identify any potential accommodations your might need during the hiring process or on your first day of work
Explore your feelings about having a mental illness and about sharing that information with others - remember, no one can force you to disclose if you don't want to.
Research potential employers' attitudes toward mental illness and screen out unsupportive employers.
- Have they hired someone with a psychiatric disability before?
- Do they personally know someone with a mental illness?
- What positive or negative experiences have they had in employing someone with a mental illness?
- Do they show signs - newsletters, posted notices, employee education programs about mental illness, etc. - of encouraging a diverse workforce?
- Do they have a corporate culture that favors flex time, mentoring programs, telecommuting, flexible benefit plans, and other programs that help employees work efficiently and well?
- Does the job have certain requirements (e.g. child care, high security, some government positions) that would put you at a disadvantage if you disclosed your diagnosis?

Weigh the benefits and risks of disclosure
- Do you need to involve an outside agency to get or keep the job?
- Do you need accommodation or other employer support?
- When will you need this accommodation?
- Do other people in the company need similar accommodation?
- How stressful will it be for you to hide your disability?
If you decide not to disclose, find other ways to get the support you need.
- Behind-the-scenes support from friends, therapists, etc.
- Research potential employers who provide these supports to all employees.
If you decide to disclose, plan in advance how you'll handle it.
- Who will say it (you, your therapist, your job coach, etc.)
- What to say
- When to say it
Under the ADA, a person with a disability can choose to disclose at any time, and is not required to disclose at all unless she or he wants to request an accommodation or wants other protection under the law. Someone with a disability can disclose at any of these times:

· Before the hiring interview
· During the interview
· After the interview but before any job offer
· After a job offer but before starting a job
· Any time after beginning a job

We recommend disclosing sometime before serious problems arise on the job. It is unlikely that you would be protected under the ADA if you disclosed right before you were about to get fired. Employers are most likely to be responsive to a disclosure if they think it is done in good faith, and not as a last-ditch effort to keep your job.

Who to tell
· Your supervisor or manager, if he or she must provide or approve an accommodation
· The EEO/Affirmative Action officer or Human Resources staff, if no immediate accommodation is needed, but you would like the protection of the ADA
· The person interviewing you or Human Resources staff, if you might need accommodation during the hiring process
· The Employee Assistance Program staff, if you are already on the job, experiencing difficulties, and need help deciding how, how much, and to whom to disclose

When You Disclose
Decide how specific you will be in describing your psychiatric disability
- General terms: a disability, a medical condition, an illness
- Vague but more specific terms: a biochemical imbalance, a neurological problem, a brain disorder, difficulty with stress
- Specifically referring to mental illness: a mental illness, psychiatric disorder, mental disability
- Your exact diagnosis: schizophrenia, bipolar disorder, major depression, anxiety disorder

Describe the skills you have that make you able to perform the main duties of your job
- qualifications
- technical skills
- general work skills
Describe any functional limitations or behaviors caused by your disability, which interfere with your performance
Identify the accommodations you need to overcome those functional limitations or behaviors
Optional: you may choose to describe the behaviors or symptoms the employer might observe and tell the employer what steps to take as a result
Point the employer to resources for further information
- Employment specialist, supported employment provider, rehabilitation counselor, job coach
- Doctor, psychiatrist
- Therapist, counselor, social worker
- Job Accommodation Network
- ADA Disability and Business Technical Assistance Centers
You may find it helpful to prepare a script to read from. For example:
"I have (preferred term for psychiatric disability) that I am recovering from. Currently, I can/have (the skills required) to do (the main duties) of the job, but sometimes (functional limitations) interfere with my ability to (duties you may have trouble performing). It helps if I have (name the specific accommodations you need). I work best when (other accommodations)."
You could also add the following information:
"Sometimes you might see (symptoms or behaviors associated with symptoms). When you see that, you can (name the action steps for the employer). Here is the number of my (employment specialist, doctor, therapist, previous employer, JAN, etc.) for any information that you might need about my ability to handle the job."

09-01-2005, 03:40 AM	#1 (permalink)
shutterbug A picture's worth a 1000 words Join Date: Aug 2004 Location: With any luck, I'm lost in a view finder Posts: 2,947 Blog Entries: 5	The work place...info about reasonable accomadations and other stuff All of the following articles are from www.bipolarsurvivor.com Work and Mental Illness - What Do We Really Know? ...NAMI Advocate, January/February 1998 Work is at the very core of contemporary life for most people, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life. For individuals with severe mental illness, however, work has been a difficult and often unattainable goal. The following are facts about the capabilities of this emerging workforce, facts that draw upon a broad base of reliable rehabilitation research. Copies of the entire brochure and information on specific studies cited can be obtained from MRI, 6008 Wayne Avenue, Philadelphia, PA, 19144, 215.438.8200. FACT: There are three million working age adults with severe mental illness in the nation's communities, of whom 70 percent (about 2.5 million people) are unemployed. The National Institute of Mental Health estimates that there are a little more than three million adults ages 18 to 69 who have a serious mental illness. Estimates of unemployment among this group are startling: Between 70 percent and 90 percent are unemployed, a rate higher in the nation than for any other group of people with disabilities. FACT: A diagnosis of serious mental illness is not a reliable indicator that someone cannot work, indeed, many people are able to work successfully despite their symptoms. Several years of study report only a small relationship between a diagnosis and work capacity, or between psychiatric symptoms and work capacity. While it is true that some of the symptoms of mental illness - its often unpredictable nature and its impact on both cognitive and interpersonal functioning - make work a real challenge, these symptoms vary from person to person. FACT: On-the-job accommodations that make it possible for people with serious mental illness to succeed at work are proving relatively straightforward and inexpensive to provide. Recent surveys indicate that job accommodations for people with disabilities of all kinds are not difficult to make or costly to implement - 68 percent of all accommodations cost less than $500.00. The changes at work that people with serious mental illness request most often - alterations in the work schedule, modifications in job descriptions, clear communication patterns or additional training for supervisors - are generally low-cost or no-cost to employers and differ only slightly from options offered for other employees. FACT: The great majority of people with a serious mental illness want to work. Recent surveys report that approximately 70 percent of those with significant psychiatric problems rank work as an important goal for themselves. Many consumers receiving SSI or SSDI financial and medical benefits are often reluctant to give up their eligibility for what may be low-paying and low-benefit jobs. Nonetheless, about 71 percent of those people with serious mental illness who are asked about their future goals identify work - and the financial independence and social identity it provides - as a central and important ambition for themselves. FACT: Innovative rehabilitation programs, which help people with the most serious mental illnesses, are placing more than 50 percent of their clients into paid employment. A number of innovative programs that move clients into "real jobs for real pay" as quickly as possible - and then provide extensive supports for them either on-the-job or off-the job - are reporting considerable success. An in-depth analysis of supported employment outcomes, for instance, found 52 percent of people still working after a year. Intensive case management and individual placement and support models that emphasize employment regularly report significant increases in wages, hours worked, work tenure, and career advancement. FACT: Employers who have hired persons with serious mental illness in the past are generally very positive about their experience. Many employers throughout the country have hired people with serious mental illness. More than 70 percent of these employers report their willingness to continue working with rehabilitation programs that place and support people with serious mental illness. Employers who are involved with rehabilitation programs are less likely to share the public's concerns and fears about people with mental illness, particularly with regard to violent behavior. FACT: Although job loss continues to be a problem, those individuals with serious mental illness who are working can be helped to stay on the job if they receive the additional support they need. The reasons for job loss vary widely. In one study, only 12 percent of those people who left their jobs said they resigned because they didn't want to work, and only 15 percent had to leave for medical reasons unrelated to their mental health. The others who became unemployed faced a variety of problems - layoffs, problems with co-workers or supervisors as well as mental health problems - that led to diminished work capacities. Many of these problems might have been resolved without job loss if ongoing support had been available. FACT: Because people with psychiatric disabilities are the largest part of the recent increase in persons dependent upon SSI/SSDI support, the nation can't afford to shortchange rehabilitation programs that help people with mental illness to work. With growing numbers of persons with serious mental illness seeking SSI/SSDI support, far more emphasis needs to be placed on vocational rehabilitation programs that can help people to work and live more independently. People with mental illness can and want to work and rehabilitation programs can be successful in getting people onto the job and keeping them employed. Accommodating Workers with Bipolar disorder ...Job Accommodation Network, www.jan.wvu.edu Bipolar Disorder in the workplace - questions to consider What limitation is the individual with bipolar disorder experiencing? To what degree do these limitations affect the person and his/her job performance? What specific job tasks are problematic as a result of these limitations? Have you consulted with the individual regarding accommodation needs? what accommodations are available to reduce or eliminate these problems? Are all resources such as the Job Accommodation Network being utilized to identify possible accommodations? Has the person with bipolar disorder met with his/her supervisor to evaluate the effectiveness of existing accommodations and to determine if others are needed? Have you provided education on psychiatric disabilities in the form of sensitivity training to supervisory personnel? Accommodation ideas for persons with bipolar disorder Note: persons who have bipolar disorder may develop some of these limitations, but seldom develop all of them. Also, the degrees of limitation will vary among individuals. Be aware that not all people who have bipolar disorder will need accommodations to perform their jobs and others may only need a few. The following is only a sample of accommodation possibilities. Numerous other accommodation solutions exist as well. Maintaining stamina during the work day - Flexible scheduling - Allow longer or more frequent breaks - Provide additional time to learn new responsibilities - Provide self-paced work load - Provide backup coverage for when the employee needs to take breaks - Allow for time off for counseling - Allow for use of supportive employment and job coaches -Allow employee to work from home during part of the day or week - part time work schedules Maintaining concentration - Reduce distractions in the work area - Provide space enclosures or private office - Allow for use of white noise or environmental sound machines - Increase natural lighting or provide full-spectrum lighting - Allow the employee to work from home and provide necessary equipment - Plan for uninterrupted work time - Allow for frequent breaks - Divide large assignments into smaller tasks and goals - Restructure job to include only essential functions Difficulty staying organized and meeting deadlines - Make daily "To Do" lists and check items off as they are completed - Use several calendars to mark meetings and deadlines - Remind employee of important deadlines - Use electronic organizers - Divide large assignments into smaller tasks and goals Working effectively with supervisors - Provide positive praise and reinforcement - Provide written job instructions - Develop written work agreements, including the agreed upon accommodations, clear expectations of responsibilities and the consequences of not meeting performance standards - Allow for open communication to managers and supervisors - Establish written long-term and short-term goals - Develop strategies to deal with problems before they arise - Develop a procedure to evaluate the effectiveness of the accommodation Difficulty handling stress and emotions - Provide praise and reinforcement - Refer to counseling and employee assistance programs - Allow telephone calls during work hours to doctors and others for needed support - Provide sensitivity training to co-workers and supervisors - Allow the presence of a support animal - Reinforce peer supports Attendance issues - Provide flexible leave for health problems - Provide a self-paced work load and flexible hours - Allow employee to work from home - Provide part-time work schedule - Allow the employee to make up time missed Issues of change - Recognize that a change in the office environment or of supervisors may be difficult for a person with bipolar disorder - Maintain open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition - Provide weekly or monthly meetings with the employee to discuss workplace issues and production level How Does Mental Illness Affect the Way I Function at Work? ...Center for Psychiatric Rehabilitation, Boston University www.bu.edu Mental illnesses may interfere with your ability to function at work - or they may have no effect at all. If your mental illness is affecting your ability to do things such as concentrating or communicating effectively, you're probably aware of it. Then again, you may not have made the connection between your disability and your problems functioning. Under the ADA, your employer only needs to provide accommodations for limitations that can be directly connected to your disability. You should document the types of functioning limitations caused by your disability to show your need for accommodations. Here's a list of some of the limitations you may be experiencing. If you have a psychiatric disability, you may have trouble doing some of these things.* Please remember that since there are many different types of mental illnesses, this isn't a complete list - and that not everyone experiences all, or even any, of these limitations. Here's how you might cope: - Inability to screen out environmental stimuli, such as sounds, sights, or smells, which distract you. For example, you may have a hard time working next to a noisy printer or in a high-traffic area. Possible solutions: Move the printer away from the work area; get permission to wear headphones playing soft music while you work; ask for high partitions to be installed around your desk. - Inability to concentrate. You may feel restless, have a short attention span, be easily distracted, or have a hard time remembering verbal directions. For example, it may be difficult for you to focus on one task for an extended period of time. Possible solutions: Break large projects into smaller tasks; ask for tasks to be assigned in writing; take short, frequent breaks to stretch or walk around whenever you feel your attention slipping. - Lack of stamina. You may not have enough energy to work a full day, or you may find your medication makes you drowsy. Possible solutions: Ask for a part-time schedule; ask for flex time or job sharing to be sure you're working only during your high energy hours; take a mid-day rest break. - Difficulty handling time pressures and multiple tasks. You may have trouble managing assignments, setting priorities, or meeting deadlines. For example, you may not know how to decide which tasks to do first in order to complete a project by its due date. Possible solutions: Break larger projects down into manageable tasks; meet regularly with your boss or a job coach for help prioritizing or estimating how long it will take to meet a deadline. - Difficulty interacting with others. For example, you may be too shy to talk with co-workers at breaks, or you may have trouble figuring out, "how things go around here." Possible solutions: Ask your employer to pair you with a co-worker who can introduce you around and show you the ropes. - Difficulty handling negative feedback. You may have a hard time understanding and interpreting criticism. For example, you may get defensive when someone tells you your work isn't up to standards. It's hard for you to figure out what to do to improve, or you may believe trying to change is worthless. Possible solutions: Ask that a job coach be present when you meet with your employer for feedback; offer your own perspective on your strengths and weaknesses; ask for specific ways to improve; ask to receive feedback in writing with an opportunity to discuss it later. - Difficulty responding to change. Unexpected changes at work, such as new rules, job duties, or supervisors and co-workers, may be unusually stressful for you. For example, it may take you a long time to learn new tasks, or you may feel especially anxious around new co-workers. Possible solutions: Ask your employer for advance warning of any changes; make a special effort to introduce yourself to new co-workers; ask your employer to notify new supervisors of your needs. * Adapted from Mancuso, L.L. (1990) Reasonable accommodations for workers with psychiatric disabilities. Psychosocial Rehabilitation Journal, 14(2), 3-19. What are Reasonable Accommodations? ...Center for Psychiatric Rehabilitation, Boston University www.bu.edu Introduction Most employees and students need some adjustments to help them perform at their best. A parent who works full-time needs a day off to get a sick child from school, or an adult student needs an extension on a term paper because his job requires him to make an unscheduled trip out of town. Both employee and student have the necessary skills to do what's required if these adjustments are made. For people with a disability, such changes are often critical to their success. Although some of the adjustments might be different from those that work for other people, they accomplish the same goal - allowing qualified employees or students to do the best job they can. These strategies are often just good business or educational practices. Reasonable accommodations are those adjustments within a work or school site that allow an otherwise qualified employee or student with a disability to perform the tasks required. Employers and educators are not expected to provide opportunities to those who cannot do what is necessary. The laws do not require them to lower the standards of performance or change the qualifications needed to gain entry into a job or school program. What they are expected to do is be flexible about the way the work gets done. Employers and educators are required to provide reasonable accommodations under 2 separate laws: The Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973. Recently, the Equal Employment Opportunity Commission (EEOC) issued Enforcement Guidance on the ADA and Psychiatric Disability. Reasonable Accommodations for People with Psychiatric Disability It's usually easy to tell what kind of accommodation someone with a physical disability needs. Someone who uses a wheelchair needs a higher desk. Someone with visual problems needs to receive all written material in large print. But since mental illness is often invisible, it can be hard to tell what will help a person with a psychiatric disability do his or her job better. The first step in identifying the accommodations you need is to know the demands of your job or course work. The second step is to figure out your "functional limitations" - that is, how your disability may make it hard for you to meet those demands. For example, your symptoms or the side effects of your medication may cause problems with memory, concentration, relating to others, managing or experiencing emotions, or organizing and managing your time. Effective accommodations include changes in schedules, instructions, job tasks or other procedures, and ways the instructor interacts with you. Not all of these accommodations will work for everyone; each situation should be taken on an individual basis. Many people with psychiatric disabilities may not need accommodations of any kind. Mental Illness and Psychiatric Disability "Mental illness" describes a variety of psychiatric and emotional problems that vary in intensity and duration, and may recur from time to time. Mental illnesses become disabling when they interfere significantly with a person's ability to work, learn, think, care for oneself, or interact with others. Mental illness is not mental retardation or brain injury. Benefits of Reasonable Accommodations In our lifetimes, one in four of us will know someone who has experienced a mental illness - a family member, friend, neighbor, employee, manager, student, or teacher. Many talented people have made significant contributions despite having had a mental illness: President Abraham Lincoln, writer Ernest Hemingway, actress Patty Duke, Senator Thomas Eagleton, artist Vincent Van Gogh, scientist Isaac Newton, athlete Lionel Aldridge, and businessman Ted Turner, to name a few, have accomplished many things in spite of having a mental illness. Reasonable accommodations may help you return to work or school from disability or medical leave sooner. Costs for treatment of mental illness may be reduced the sooner one returns to a productive role, and many people want to become productive again. For employers, the costs for providing accommodations are fairly inexpensive - most cost less than $500, and for people with psychiatric disabilities, the cost is usually less than $100. In fact, the Job Accommodation Network says that companies report an average return of $28.69 in benefits for every dollar invested in making an accommodation. Often, these adjustments - flexible schedules, time off for medical appointments, or changes in communication, feedback and/or supervision - are not much different from the changes available to any employee or student. They can benefit everyone, not just the employee with a disability. Sources: Job Accommodation Network; National Alliance for the Mentally Ill; President's Committee on the Employment of People with Mental Illness; Zuckerman, Debenham & Moore, (1993) The ADA and People with Mental Illness: A Resource Manual for Employers Disclosing Your Disability to an Employer ...Center for Psychiatric Rehabilitation, Boston University www.bu.edu Only you can decide whether and how much to tell your employer about your psychiatric disability. On the positive side, telling your employer about your diagnosis is the only way to protect your legal right to any accommodations you might need to get or keep a job. However, revealing your disability also leaves you open to discrimination, which may limit your opportunities for employment and advancement. It's a complex decision, and one you shouldn't make until you've thought it through. Here's what you might want to think about: Preparing to Disclose: Assess your job search skills to determine whether you need help from your therapist or mental health agency to: - Initiate contact or arranging an interview with the employer - Interview - Describe your disability - Negotiate the terms of employment - Negotiate accommodations Identify any potential accommodations your might need during the hiring process or on your first day of work Explore your feelings about having a mental illness and about sharing that information with others - remember, no one can force you to disclose if you don't want to. Research potential employers' attitudes toward mental illness and screen out unsupportive employers. - Have they hired someone with a psychiatric disability before? - Do they personally know someone with a mental illness? - What positive or negative experiences have they had in employing someone with a mental illness? - Do they show signs - newsletters, posted notices, employee education programs about mental illness, etc. - of encouraging a diverse workforce? - Do they have a corporate culture that favors flex time, mentoring programs, telecommuting, flexible benefit plans, and other programs that help employees work efficiently and well? - Does the job have certain requirements (e.g. child care, high security, some government positions) that would put you at a disadvantage if you disclosed your diagnosis? Weigh the benefits and risks of disclosure - Do you need to involve an outside agency to get or keep the job? - Do you need accommodation or other employer support? - When will you need this accommodation? - Do other people in the company need similar accommodation? - How stressful will it be for you to hide your disability? If you decide not to disclose, find other ways to get the support you need. - Behind-the-scenes support from friends, therapists, etc. - Research potential employers who provide these supports to all employees. If you decide to disclose, plan in advance how you'll handle it. - Who will say it (you, your therapist, your job coach, etc.) - What to say - When to say it Under the ADA, a person with a disability can choose to disclose at any time, and is not required to disclose at all unless she or he wants to request an accommodation or wants other protection under the law. Someone with a disability can disclose at any of these times: · Before the hiring interview · During the interview · After the interview but before any job offer · After a job offer but before starting a job · Any time after beginning a job We recommend disclosing sometime before serious problems arise on the job. It is unlikely that you would be protected under the ADA if you disclosed right before you were about to get fired. Employers are most likely to be responsive to a disclosure if they think it is done in good faith, and not as a last-ditch effort to keep your job. Who to tell · Your supervisor or manager, if he or she must provide or approve an accommodation · The EEO/Affirmative Action officer or Human Resources staff, if no immediate accommodation is needed, but you would like the protection of the ADA · The person interviewing you or Human Resources staff, if you might need accommodation during the hiring process · The Employee Assistance Program staff, if you are already on the job, experiencing difficulties, and need help deciding how, how much, and to whom to disclose When You Disclose Decide how specific you will be in describing your psychiatric disability - General terms: a disability, a medical condition, an illness - Vague but more specific terms: a biochemical imbalance, a neurological problem, a brain disorder, difficulty with stress - Specifically referring to mental illness: a mental illness, psychiatric disorder, mental disability - Your exact diagnosis: schizophrenia, bipolar disorder, major depression, anxiety disorder Describe the skills you have that make you able to perform the main duties of your job - qualifications - technical skills - general work skills Describe any functional limitations or behaviors caused by your disability, which interfere with your performance Identify the accommodations you need to overcome those functional limitations or behaviors Optional: you may choose to describe the behaviors or symptoms the employer might observe and tell the employer what steps to take as a result Point the employer to resources for further information - Employment specialist, supported employment provider, rehabilitation counselor, job coach - Doctor, psychiatrist - Therapist, counselor, social worker - Job Accommodation Network - ADA Disability and Business Technical Assistance Centers You may find it helpful to prepare a script to read from. For example: "I have (preferred term for psychiatric disability) that I am recovering from. Currently, I can/have (the skills required) to do (the main duties) of the job, but sometimes (functional limitations) interfere with my ability to (duties you may have trouble performing). It helps if I have (name the specific accommodations you need). I work best when (other accommodations)." You could also add the following information: "Sometimes you might see (symptoms or behaviors associated with symptoms). When you see that, you can (name the action steps for the employer). Here is the number of my (employment specialist, doctor, therapist, previous employer, JAN, etc.) for any information that you might need about my ability to handle the job." __________________ I'M FINE!! Fanatically Insecure Neuratic & Emotional Bipolar/Depression support: 1-800-950-NAMI(6264).