A systematic review of work accommodations for people with mental disorders

Is There Somebody Looking out for Me? A Qualitative Analysis of Bullying Experiences of Individuals Diagnosed with Bipolar Disorder

According to the World Health Organisation, there are globally 40 million individuals with bipolar disorder (BD), and they experience stigma and discrimination, as many people with mental illness do. Work bullying (WB) is a common organisational problem, deteriorating the well-being and performance of employees and organisations. Although WB experiences have been researched for over three decades, we do not know much about the experiences of this group and what they need to extend their work-life. The current research aims to understand the workplace bullying experiences of individuals with BD and factors that may foster or hinder their participation in the labour force. The research methodology was based on in-depth interviews with 19 employees diagnosed with BD. Bullying experiences were mapped onto the Negative Acts Questionnaire. The data were analysed using the deductive qualitative content analysis on MAXQDA. Results showed that individuals with BD were exposed to bullying in work settings. Perceived reasons for the negative behaviours were mainly the undesirable individual characteristics of the bully, prejudices toward bipolar disorder, and already-existing toxic behaviours within the organisation. To reduce bullying, participants suggested that, among others, top management include equal and fair treatment of disadvantaged employees as performance criteria for supervisors and that organisations provide training against bullying, investigate complaints, apply sanctions, and establish an inclusive environment. If organisations set a stable and enduring vision, enhance a common identity for all employees, work on team building, and emphasise team efforts and goals, the organisational environment would be more inclusive, and individuals with BD would have longer work lives.

Practical pathway for the management of depression in the workplace: a Canadian perspective

Major depressive disorder (MDD) and other mental health issues pose a substantial burden on the workforce. Approximately half a million Canadians will not be at work in any week because of a mental health disorder, and more than twice that number will work at a reduced level of productivity (presenteeism). Although it is important to determine whether work plays a role in a mental health condition, at initial presentation, patients should be diagnosed and treated per appropriate clinical guidelines. However, it is also important for patient care to determine the various causes or triggers including work-related factors. Clearly identifying the stressors associated with the mental health disorder can help clinicians to assess functional limitations, develop an appropriate care plan, and interact more effectively with worker's compensation and disability programs, as well as employers. There is currently no widely accepted tool to definitively identify MDD as work-related, but the presence of certain patient and work characteristics may help. This paper seeks to review the evidence specific to depression in the workplace, and provide practical tips to help clinicians to identify and treat work-related MDD, as well as navigate disability issues.

Anticipating the outcomes: how young adults with developmental disabilities and co-occurring mental health conditions make decisions about disclosure of their mental health conditions at work

PURPOSE

Little is known about how young adults (YA) with developmental disabilities (DD) and co-occurring mental health conditions navigate workplace disclosure of their mental health condition(s). We sought to understand the guidance professionals provide regarding disclosure and the decisions YA makes about disclosure of mental health conditions.

METHODS

We conducted focus groups with professionals who support YA with DD to attain and maintain employment (n = 17) and individual interviews with YA with DD and co-occurring mental health conditions (n = 12; DD diagnoses: autism, n = 9, other DD, n = 3). We conducted content analysis to identify why, when, what, and to whom YA disclose their mental health condition and guidance provided regarding disclosure.

RESULTS

YA and professionals described disclosure decisions as largely influenced by perceived needs (i.e., need for accommodations) and anticipated positive (e.g., support) and negative (e.g., stigma, not being hired) outcomes. They largely constrained disclosure to work-relevant content. Many YA disclosed to coworkers with whom they were comfortable, though both YA and professionals agreed that initial disclosure should be limited to supervisors and/or human resources.

CONCLUSIONS

Workplaces may support disclosure-a necessity for the provision of accommodations-by cultivating an inclusive environment and openly demonstrating familiarity and comfort with employees with disabilities.IMPLICATIONS FOR REHABILITATIONProfessionals who support young adults with developmental disabilities and co-occurring mental health conditions should be well-versed in current laws and regulations on disclosure and reasonable workplace accommodations.Workplace culture is one major factor impacting how disclosure is handled, including whether the disclosure is required at all.Individuals with disabilities and professionals should recognize that timing, content, and decisions to disclose may vary by individuals' needs and workplace supports, and that change may occur over time.

Examining psychosocial factors associated with receiving workplace accommodations among people with disabilities

BACKGROUND

People with disabilities experience challenges in obtaining workplace support including job accommodations.

OBJECTIVE

This study examined the impacts of psychosocial factors affecting the likelihood of an employee with disability receiving an accommodation and subsequent effects on job satisfaction and job performance.

METHODS

This study recruited 596 participants from multiple national and state agencies serving persons with disabilities in U.S. A mediation model was conducted to examine the impacts of psychosocial factors (i.e., self-efficacy, positive affect, negative affect, workplace support, Americans with Disabilities Act (ADA) knowledge, accommodation knowledge, and work goal) on receiving accommodation, and the impacts of receiving accommodations on job satisfaction and job performance. The indirect effects of the psychosocial factors on job satisfaction and job performance via receiving accommodations were examined using the Delta method.

RESULTS

Among all the examined direct effects, only the effect from workplace support to receiving accommodations and the effect from receiving accommodations to job satisfaction were significant. Nevertheless, indirect effects were non-significant, indicating that all the psychosocial factors had no indirect effect (via receiving accommodation) on job satisfaction and job performance.

CONCLUSION

The findings reveal the significance of workplace support on employees' likelihood of receiving accommodations, and subsequent association between accommodation receipt and job satisfaction. Rehabilitation professionals need to provide adequate training to employers to facilitate inclusive and supportive workplace environments.

A "win-win" perspective on workplace accommodations: RETAIN Kentucky's self-advocacy guide to promote successful return to work and stay at work outcomes for workers with disabilities

BACKGROUND

Research has long documented the low cost and effectiveness of most workplace accommodations to enable qualified people with disabilities to seek, secure, and maintain employment.

OBJECTIVE AND METHOD

RETAIN Kentucky's return to work and stay at work intervention involves focused training for participants on requesting needed accommodations from their employers.

RESULTS

In this article, we describe the win-win approach to reasonable accommodations, which serves as the basis for helping Kentuckians with disabilities identify and request on-the-job supports to aid in their efforts to remain in the workforce.

CONCLUSIONS

Workers with disabilities are more likely to stay in the workforce and continue making valuable contributions to the national and global economies if they have effective accommodations and other employment supports available to them.

Quality of life, sense of coherence and occupational balance one year after an occupational therapy intervention for people with depression and anxiety disorders

BACKGROUND

Quality of life (QOL), sense of coherence (SOC) and occupational balance (OB) have been found to increase after rehabilitation among people living with depression and anxiety. However, these aspects have not been investigated over time in participants with different paid work situations, such as being on sick leave or not.

OBJECTIVE

To describe and compare the self-rated QOL, SOC and OB after participation in occupational therapy in three groups of people with depression and anxiety disorders based on their work situation during the study period: continuous sick leave, return to work and continuous work.

METHODS

Forty-seven women and seven men, 19-60 years old with depression and anxiety were followed over time. They completed questionnaires on QOL, SOC and OB on four occasions. Data were analyzed with non-parametric statistics.

RESULTS

No statistically significant differences between the groups were identified. All groups improved in at least one of the studied areas over time: the sick leave group in OB; the return-to-work group in QOL and OB; and the Work group in QOL and SOC.

CONCLUSION

The results indicate variations in QOL, SOC and OB between people with different work situations over time after occupational therapy. Studies with larger samples are, however, warranted.

Employer and Co-worker Perspectives on Hiring and Working with People with Mental Health Conditions

The purpose of this study was to understand perspectives towards hiring and working with people with mental health conditions (PMHC). Semi-structured interviews with 25 employers and 20 co-workers were carried out. Thematic analysis was used to analyse the data. The barriers to hiring and working with PMHC identified through the interviews were concerns about safety, incompetence, PMHC not being able to get along with others, requiring more training and supervision as well as medical costs and reputational risks to the hiring organisation. Employers and co-workers suggested that improving mental health literacy of staff, pairing the PMHC with trained work buddies, having access to mental professionals when needed, and providing incentives for hiring PMHC such as tax rebates are likely to improve attitudes towards hiring and working with PMHC. Their suggestions for the additional supports required should be considered when developing initiatives to promote inclusivity of PMHC in workplaces.

The Importance of Skills Training for Service Users in Health Care: A Comparative Analysis

Health care and other human services such as education are diverse in many substantive aspects. However, arguably, they all use the skills training of service users to accomplish at least some of their key aims. This brief article uses a selective literature review and a comparative analysis to review the commonalities of skills training of service users in health care and education in order to illustrate and argue for the importance of a skills training approach in health care and other human services (recognizing that complementary approaches such as support provision are needed too and that not all service users need skills training). Research and development is needed in this area.

The role of workplace accommodations in explaining the disability employment gap in the UK

There has been limited theoretical and empirical research into the role of workplace accommodations in enabling workers with and without impairments to remain in work. This study used the International Classification of Functioning, Disability and Health (ICF) model to examine (a) whether workplace accommodations enable workers, particularly those with different impairments, to remain economically active; and (b) the predictors of the onset of work accommodations. Data from two waves of a large-scale longitudinal survey of disability in Great Britain, the Life Opportunities Survey (2009-2012) were analysed. 2307 workers with an impairment and 4308 workers without an impairment were followed up for a year. Work accommodations appear to enable workers with impairments to remain economically active, especially those with mental impairments. There was no difference in the employment rates of workers with and without mental impairments who had two or more work accommodations, in contrast to the 10% employment gap between workers with and without mental impairments who did not have any work accommodations. While there was no gender difference in the disability employment gap, barriers to employment related to caregiving were much greater for women compared to men. Moreover, only workers with incident pain impairments were associated with an increase in their work accommodations, not workers with incident mental impairments. Despite the evidence that workers with mental impairments could benefit considerably from workplace accommodations, they are less likely to have their workplace adjusted. The ICF model is particularly useful in analysing the role of work accommodations because it considers a much wider range of factors that are relevant not just to workers with different types of impairments, but are also relevant to the wider group of workers who use workplace accommodations.

[Forms of Use of Psychosomatic Rehabilitation by Patients - A Study on the Significance of the Moment of Entrance in the Rehabilitation Setting and the Dependence on the Individual Situation at Admission to Rehabilitation]

BACKGROUND AND AIMS

As expectancies of patients and physicians in psychosomatic rehabilitation are not always congruent, we focused on the patients' subjective expectancies toward rehabilitation in relation to the perceived benefit of the treatment for return to work and on the individual forms of utilization of the therapeutic services in the setting of psychosomatic clinics. A special focus was given to the changes in the patients' evaluations and coping behaviours over a follow-up period of 18 months.

METHODS

N=105 participants (F-3/F-4 Main-Diagnosis, specific vocational problems, under 3 months jobless) of 4 psychosomatic rehabilitation settings were asked for their situation at the end of the rehabilitation by means of a questionnaire. 33 patients out of the questionnaire-sample who consented to participate were interviewed for 3 times (6, 12 and 18 months after release from the clinic) by means of episodic-narrative interviewing technique.

RESULTS

Some characteristic expectancies and modes of use of the psychosomatic rehabilitation setting by the patients could be identified. The uses of the clinics' therapeutic services by the patients are pointing to different subjective felt needs that correlate with the state of coping with the illness and other psychosocial features at the moment of entrance in the rehabilitation setting. The patients' actual situation can be identified by retrospective tracing his/her positioning on an ideal-typed trajectory of the whole illness process from the beginning of the first symptoms up to Return to work. The results give hints for more individualised and person-centred propositions in rehabilitation-settings.