Bipolar 2 From Inside and Out

Posts tagged ‘ADA’

Stigma, Prejudice, and Discrimination

Those of us with brain illnesses such as bipolar disorder, OCD, PTSD, and schizophrenia often speak of the stigma associated with our problems. It’s no wonder—stigma affects our lives in both predictable and unpredictable ways.

For instance, say you’ve become comfortable talking about your disorder. Then one day when you’re at a reunion or some other gathering, you happen to mention it and get the glazed-eyes-fixed-smile-back-away-slowly response. Sure, a lot of people don’t know what to say to you, but that reaction just makes it clear that you are different and, to that person, potentially a source of danger. Someone to be avoided. Someone not to engage with.

That’s stigma.

Prejudice is related to stigma. It’s just a short step away. Prejudice happens when people have a preconceived idea of what brain illness looks like. (That’s what prejudice means.) This could be a person who assumes that a serial killer or mass shooter is obviously “insane.” Their assumptions are reinforced when it’s revealed that the perpetrator had a history of psychological problems or had taken medication. They’re ignorant of the facts—that most killings are prompted by motivations such as rage, gender or racial hatred, jealousy, or fear. They don’t know that the mentally ill are much more likely to be the victims of violence than to be perpetrators.

People with prejudice against people with mental illness can also assume that psychiatric diagnoses are not “real.” They think people with these conditions can—and should—just “snap out of it,” “pull themselves up by their bootstraps,” or “get over” their problems. They look down on people who seek help. They make jokes about “crazies” and “lunatics.” They believe that anyone with a “real” mental illness is in a locked ward in an “insane asylum,” or should be. They don’t know that straightjackets aren’t used anymore and feel they’re funny Halloween costumes.

In other words, people who are prejudiced lack understanding and empathy.

Discrimination takes it one step further.

When people with brain illnesses suffer from discrimination, they lose opportunities because of their condition. If they are open about their diagnosis on applications, they may never receive a callback or an interview for a job. They may start receiving bad evaluations at work if they have to leave for doctor’s appointments or be let go for not getting along with other workers, many of whom may have prejudice against them. They don’t receive the accommodations required by the Americans with Disabilities Act (ADA).

Discrimination can also be involved with decisions from Social Security Disability. It’s not supposed to be that way, but people with mental illnesses are likely to have more difficulty “proving” that they have a disability severe enough to warrant supplemental income.

So what’s to be done? Education is the solution we always advocate. But it’s a hard ask. It’s difficult to get anyone to learn about the realities of brain illnesses. They don’t learn about it in school, and the messages they get from the media do little except reinforce the stigma surrounding the various conditions. In fact, they perpetuate much of the stigma.

Pushback is another strategy. We simply cannot let it pass when someone makes a prejudiced remark or demonstrates a lack of understanding. We can speak up about inappropriate Halloween costumes or assumptions about violence and the mentally ill. We can inform others that not all homeless persons are mentally ill. In fact, most homelessness is caused by a lack of affordable housing and low wages.

When it comes to discrimination, legislation and activism are often the solutions or at least the beginnings of them. Lobbying efforts regarding policy and treatment will help. Lots more needs to be done to inform legislators about the very basics, much less the possible ways to address the problems. Reporting violations of the ADA may not lead to resolutions, but it still needs to be done.

Of course, it’s difficult for many people with brain illnesses to do these things. We are frequently isolated and doubt our own abilities. Confronting legislators, educating them, and lobbying for their attention is daunting. Neurotypical people have trouble doing it, especially without an organization that gives them leverage. But it’s work that needs to be done. I admit that I’m not at the forefront, though these blog posts and my books are intended to help educate, and the groups I belong to try to do likewise.

It’s not enough. But it’s a start.

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Mental Health

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Workplace Adjustments I Would Like to Have Had

by Chinnapong / adobestock.com

I missed out on the heyday of the ADA. People didn’t become as conscious of accommodating people with disabilities until much later. And even then, the most common accommodation was wheelchair ramps. But there are some workplace adjustments or accommodations I wish I had available to me, back when I worked in an office.

According to the Americans with Disabilities Act (ADA), persons with disabilities are entitled to accommodations to make it possible for them to work. Most of us think about certain kinds of lighting, closed captions, or specialized chairs. But what about when you have an invisible disability?

The ADA definition of a disability is one that impairs an individual’s ability to – among other “major life activities” – learn, read, concentrate, think, communicate, and work. Certainly, a number of psychological or psychiatric conditions qualify as producing trouble in these areas. In my case, my bipolar disorder made it difficult to do many of those in your standard office work environment.

But would the ADA have made accommodations available to me? The ADA does include some mental illnesses in its list of disabilities. Examples of mental disabilities commonly considered under the ADA are:

  • Major depressive disorder
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Obsessive-compulsive disorder
  • Schizophrenia

Examples of accommodations or work adjustments for those with psychological disabilities include, among others:

  • Flexible Workplace – Telecommuting and/or working from home.
  • Scheduling – Part-time work hours, job sharing, adjustments in the start or end of work hours, compensation time and/or “make up” of missed time.
  • Leave – Sick leave for reasons related to mental health, flexible use of vacation time, additional unpaid or administrative leave for treatment or recovery, leaves of absence and/or use of occasional leave (a few hours at a time) for therapy and other related appointments.
  • Breaks – Breaks according to individual needs rather than a fixed schedule, more frequent breaks and/or greater flexibility in scheduling breaks, provision of backup coverage during breaks, and telephone breaks during work hours to call professionals and others needed for support.

Of course, in order to receive accommodations or adjustments, it’s necessary to reveal to someone – at least your boss or maybe the HR department – that you have a psychological or psychiatric disorder.

My own experience of needing accommodations at work was not great. In the job I held the longest, I only mentioned my depression (as it was then diagnosed), to my immediate supervisor. He was sympathetic, but the work environment was not exactly conducive to my needs.

One of the things that I could have used in dealing with the anxiety that went along with my depression was privacy. At first, that was not even possible, since my entire department was located in a cube farm, where no one had any real privacy. Even the fact that I was an editor and needed to concentrate on my work did not win me a private space.

Later, when we moved to an office that had actual offices, I snagged one with a door. The only problem was that I was not allowed to close the door, or at least looked askance at when I did.

An ideal situation for me (aside from being allowed to close my door) would have been permission to work from home. There was one person at this office who had this privilege, but it was never considered for me. Admittedly, this was very much pre-pandemic, but most of my work was done on a computer, and I had one at home that was compatible with the office computers. It wouldn’t even have been necessary for the company to supply me with one.

Another accommodation that would have helped lots would have been a hotel room to myself at business conventions, which would have allowed me time and space to decompress after a long day of being “on,” meeting and greeting, and being sociable and respectable. Unfortunately, that was a privilege reserved for the men. (As I understood it, the salesmen were booked into double rooms as well, but winked at when they rebooked them into singles.) This may have nominally been due to my sex rather than my mental condition, but not having a solitary retreat from the clamor of a convention definitely had a deleterious effect.

After 17 years at that job, I was let go, most likely because I was considered “unreliable.” At the next office where I landed, I had a boss who understood bipolar disorder (as I was then diagnosed) and who was satisfied with my work.  Never a bad evaluation – until that boss left. “I’m going to miss you,” I said. “I know you will,” she replied.

I realized what she meant when I revealed to my new boss that  I had bipolar disorder. “What does that mean?” she asked. Taken aback, the only reply I could think of was, “Sometimes I have good days and sometimes I have bad days.”  It wasn’t a great description of my condition and set me up for problems. After one year of my mother’s health and my psychiatrist appointments requiring me to miss work, and my missing work in winter owing to living at the bottom of a snowy, icy hill, I received my first bad evaluation. Nothing about my performance had actually changed since my work with the first boss. I could have easily worked from home and occasionally was permitted to, but my work was dubbed sub-par once I did.

(Not that it’s a big thing, but I would also have appreciated being able to take a “brain break” such as doing a crossword puzzle, instead of a cigarette break, since I don’t smoke. And not being asked work questions when I was on the toilet.)

After that, I went freelance, worked at home nearly all the time, and was only required to attend a meeting at an office once or twice a year. I have worked that way since and it suits me. It’s only now that I’ve become my own boss that I’ve been able to get what I really need when it comes to work.

 

References

https://www.eeoc.gov/statutes/americans-disabilities-act-amendments-act-2008#:~:text=The%20Act%20emphasizes%20that%20the,shall%20not%20require%20extensive%20analysis.

https://www.sfglife.com/blog/top-10-causes-disabilities-us-and-why-you-need-disability-insurance/

https://adata.org/factsheet/health

https://www.dol.gov/agencies/odep/program-areas/mental-health/maximizing-productivity-accommodations-for-employees-with-psychiatric-disabilities

https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/cms_011495.aspx

https://www.ada.gov/pubs/adastatute08.htm#12102

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Mental Health

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Should You Lie About Your Disorder?

We all know that when writing a resume, you should write either “good” or “excellent” when you refer to your health. Any other response will make it certain that your resume will be headed straight for the circular file.
But what about your mental health? Most resumes and most job applications don’t include a space for that, but what if they did? What would you answer? What should you answer? And should you tell the truth if you do answer?
 
In one corner of England, job seekers were encouraged to hedge their bets or to flat-out lie. The British newspaper The Guardian reported that welfare personnel “have urged jobseekers who have depression to hide their diagnosis and only admit on work applications that they are experiencing ‘low mood.'” 
 
Fortunately, there has been a backlash from mental health organizations, who describe the advice as an “outrage” likely to increase stigma. They point out that “the law provided protection to disabled people, including those with mental health problems, if their disability has a substantial, adverse, and long-term effect on normal daily activities.”
 
The welfare department in question brushed off the controversy by saying the suggestion was only “well-intentioned local advice” and encouraging people seeking jobs to “speak freely about a health condition or disability.” But that’s not a choice that everyone is willing to make.
 
Whether or not to disclose one’s mental health condition when applying for a job is not an easy decision. American law (at the moment) protects employees and potential employees under the Americans with Disabilities Act (ADA). But many people are rightly suspicious that disclosing a mental illness at the application is a one-way ticket to unemployment. Even when applications invite you to disclose and pointedly proclaim that they abide by EEOC regulations, many people choose not to disclose.
 
Disclosing after you’ve been hired or have been working at a place for a while is another matter. Many people (including me) have lost jobs because their bosses and coworkers don’t understand mental illness. There is plenty of motivation never to mention it.
 
That may not always be possible, however. Sometimes, the symptoms of bipolar disorder or another serious mental illness are obvious and negatively affect work. (I’m included here, too.) If a person isn’t able to do the work – for whatever reason – it’s understandable that they will be let go.
 
That brings us to the subject of accommodations that permit a person to do the work. Under ADA law, persons with disabilities, including mental disorders, are to be given “reasonable accommodations” to help them perform their job duties. For blind, deaf, or mobility-impaired workers, these accommodations are obviously necessary and most employers can and will provide them. (There is also no question as to whether to disclose these disabilities or not. Visible disabilities are more widely understood than invisible ones.)
 
Accommodations for mental disorders need not be difficult, either. Solutions such as flextime, work-at-home situations, or time off for appointments are more and more being offered to all employees, regardless of ability level, and these can certainly help people with mental illness, too. Other reasonable accommodations might include flexible break times, an office with a door or full-spectrum lighting, or the understanding that phone calls and emails need not be returned instantly. Of course, to receive these accommodations, one must disclose the disorder and negotiate the possible solutions, which can certainly be daunting, if not impossible, for those with anxiety disorders, for example.
 
But what we’re talking about here is not whether to disclose a disability on an application or to an employer. What we are talking about is misrepresenting a potentially disabling condition – or to use the less polite term, lying about it. I don’t have “occasional mood swings,” I have bipolar disorder. My depression is not simply a “low mood,” it can be debilitating. And I suspect that even admitting to a “low mood” might be greeted with something less than understanding by a potential or actual employer.
 
Ayaz Manji, a senior policy officer at a mental health charity in England, said of the semi-disclosure policy, “Anyone who discloses a mental health problem at work deserves to be treated with respect, and jobcentres should not be reinforcing stigma by advising people not to disclose.”
 
He’s right, of course. Disclosing or not disclosing is a hard enough choice for the mentally ill. Lying about one’s condition should not even be a consideration. And isn’t lying on resumes and applications an automatic cause for dismissal? 
 
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Mental Health

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Discrimination: Mental Illness and Disability

A while back I wrote a post called “Another Word for Stigma” (http://wp.me/p4e9Hv-oz), which was about the new-to-me term “sanism” and how it set up a dichotomy between the sane and the insane. While sanism may have been intended to reframe the discussion about mental health issues, I said, “We already know that stigma exists surrounding mental illness. We don’t really need the word ‘sanism’ to redefine it. Or to pit us against one another.”

When applied to mental illness, “ableism” is another word that subtly reinforces stigma. It implies that, unlike the neurotypical population, those of us with mental disorders are differently abled, mentally challenged, or – dare I say it – disabled.

Many of us – including me – have applied for disability and many – including me – have been turned down. Despite that, many of us live with varying levels of ability and disability, which are nearly impossible to see and therefore to prove.

When I applied for disability, I was in the depths of what would once have been called a nervous breakdown. I had mental deficits, emotional instability, trouble performing the skills of daily life, inability to hold a job – certainly at the level that I formerly had, or possibly not at all. My thoughts were disordered. My life was disordered. I got by only with the help of a caregiver – my husband. If that’s not at least partial disability, I don’t know what is.

By the time my claim was denied and my disability lawyer was prepping me for a hearing, however, I was, if not well, at least better. I had found part-time work that I could do at home, which provided as much income as disability would have. At his suggestion, I dropped my claim. Perhaps I shouldn’t have, because the lack of medical benefits has been a constant difficulty.

So, am I disabled? I would have to say, partly. I still cannot hold a full-time job – certainly not without accommodations – and my caregiver (still my husband) has to help me with many of the tasks of daily living.

The notion of requiring accommodations leads us to the subject of discrimination. Employers are required by federal law to provide “reasonable accommodations” to persons with disabilities, according to the Americans with Disabilities Act (ADA), for conditions including “a physical or mental impairment that substantially limits one or more major life activities,” and also to “a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered.”

“Reasonable accommodations” are not defined for mental disabilities, but examples of accommodations for other conditions include modifying work schedules, as well as leave flexibility and unpaid leave. But just try telling a prospective employer (as you are entitled to do) that you will need flexible hours to accommodate appointments, panic attacks, or other phenomena; or asking someone you work for to give you unpaid leave for a hospitalization. I think you know the result as well as I do.

One problem is that these forms of discrimination – which is what they are – are damnably hard to prove, as onerous and unlikely as being classified disabled in the first place. Yet the protections against these forms of discrimination are defined by law. But how many of us have the wherewithal to challenge them, prove our cases, and get by while waiting for the results of a lawsuit?

Even the act of asking for an accommodation opens us to yet another instance of stigma, and the outcome depends on the individual knowledge and understanding of an employer, when it should follow the law. We approach employers and prospective employers hat in hand, asking for – but not expecting – to get the treatment that is legally, rightfully ours.

In these days of rampant discrimination against people of any number of races, religions, national or ethnic origins, sexual orientations, and disabling conditions, our voices may not be the first to be heard. But we, the neurodivergent, the mentally ill, the emotionally disabled, the psychiatric patients, and our caregivers and loved ones deserve to be free from the effects of ableism, discrimination, and stigma.

Let’s speak up, keep educating about our issues, and support each other in banishing stigma, ending discrimination, and putting ableists on notice that we will not shut up until our rights are acknowledged.

 

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Mental Health

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