Rachel Pruchno Ph.D.

All in the Family

Why People With Mental Illness Haven’t Gained From the ADA

The shameful wall of exclusion remains

Posted Jul 28, 2015

Barry Thumma/AP
Source: Barry Thumma/AP

This week marks the 25th anniversary of the signing of the Americans with Disabilities Act (ADA). By signing that act, President George H.W. Bush aimed to protect people with disabilities from discrimination and enable them to participate fully in the workforce and their communities.

The definition of disability in the ADA includes people who meet one of three definitions: "(1) a physical or mental impairment that substantially limits one or more major life activities of an individual; (2) a record of such an impairment; or (3) being regarded as having such an impairment." Private employers with 15 or more employees, state and local governments, employment agencies, labor organizations, and management committees are subject to the ADA.

An estimated 55 million Americans have benefitted from the ADA. Stores, theaters, and restaurants installed ramps or electric lifts, doorways were widened to accommodate wheelchairs, Braille buttons were added to elevators, and public restrooms were modified to accommodate people who couldn’t walk.

While accessibility to buildings is now routine, the ADA has not been as successful when it comes to issues of employment. Today, the unemployment rate for people with disabilities hovers around 60%, not much different than on the day the ADA was signed into law.

One group of people left behind by the ADA is people with serious mental illness. The ADA requires employers to make reasonable accommodations only if they are aware of a person’s disability. It is the responsibility of the individual with the disability to inform the employer that an accommodation is needed. Yet many people with serious mental illnesses hide their illness from employers because they fear being discriminated against in hiring and promotion decisions.

Although the ADA specifies that accommodations can’t cause undue hardship for the employer’s bottom line, shortly after the law was passed, one of the biggest fears for employers was what it would cost to accommodate the needs of people with disability. But, a study by the Department of Labor found that modifications averaged only $500 per worker.

According to NAMI, reasonable accommodations for people with serious mental illness include providing self-paced workloads and flexible hours, modifying job responsibilities, allowing leave (paid or unpaid) during periods of hospitalization or incapacity, assigning a supportive and understanding supervisor, modifying work hours to allow people to attend appointments with their psychiatrist, providing easy access to supervision and supports in the workplace, and providing frequent guidance and feedback about job performance.

These accommodations are not expensive, but they have the potential to enrich life for people with serious mental illness. By including rather than excluding people with serious mental illness, society gains. Labor forces become more diverse, stereotypes are dispelled, and fewer people are on the dole.

As he signed the ADA, President Bush said, “Let the shameful wall of exclusion come tumbling down.” To be sure, the ADA has been a life-changer for many people. An accessible community is an important start. But an adaptive workplace is a critical next step.  

Do you know someone with serious mental illness who’s received workplace accommodations that have enabled them to work? Tell me their story and help break the cycle.

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