Work Accommodation and Retention in Mental Health

Growing interest in the field of mental health in the workplace among policy makers, clinicians, and researchers alike has been fueled by equal employment rights legislation and increasing disability statistics in mental heath. The importance of addressing this topic is underscored by the fact that depression now ranks second on the hierarchy of occupational disabilities. The problem is compounded by a host of factors, including major difficulties in job retention and productivity experienced by persons with mental health disabilities; younger age and higher education of persons with mental health problems; and labor shortages and an aging workforce in many industrialized countries. In addition, particularly in the United States, the vocational needs of army veterans returning from duty with mental health disorders require system-based solutions and new rehabilitation approaches.

The pressure created by these powerful legislative, societal, and economic forces has not been matched by the state of evidence-based practices in the field of employment retention and job accommodation in mental health. Current research evidence is fragmented, limited in scope, difficult to access, and adversely affected by the traditional divide between the fields of psychiatry and psychology on one hand and interdisciplinary employment research and practices on the other. As a result, policy makers, employers, disability compensation systems, and rehabilitation and disability management professionals have been left without a critical "how to" evidence-informed toolbox for occupational practices to accommodate and retain persons with mental health disabilities in the workplace. Currently, no single source of knowledge and research evidence exists in the field that would guide best practices. Yet the need for workplace accommodations for persons with mental health disabilities has been growing and, based on epidemiological trends, is anticipated to grow even more in the future. These trends leave physicians, psychologists, occupational therapists, vocational rehabilitation professionals, disability managers, human resource professionals, and policy makers poorly prepared to face the challenge of integrating and maintaining persons with mental health disabilities in the workplace.

The aim of the Handbook is to close the gap between the needs of the professionals and networks that work with or study persons with mental heath disorders in an employment context and the actual knowledge base in the field. The Handbook will be written in language that can easily be understood by readers representing a multitude of disciplines and research paradigms spanning the mental health, rehabilitation, and employment fields of inquiry. The Handbook will contribute an integration of the best quantitative and qualitative research in the field, together with experts’ consensus, regarding effective work retention and accommodation strategies and practices in mental health.The book will consist of five major sections, divided into chapters written by recognized experts in these areas.

I. Conceptual Issues in Job Accommodation in Mental Health.- 1. Law and job accommodation in mental health disability.- 2. Mental health, neurological impairments and job accommodation: a legal perspective.- 3. Disability epidemic in mental health: epidemiological and economic impact of mental health disorders in the workplace.- 4. Effects of stigma and discrimination on the economic employment outcomes of persons with mental health disorders.- II. Mental health disorders and work functioning.- 5. Relationship between psychological impairment and occupational disability: 6. Prediction of vocational outcomes in mental health.- 7. Serious mental illness and work.- 8. Depression and work performance.- 9. Anxiety disorders and work performance.- 10. Brain injuries and work performance.- 11. Personality disorders and work performance.- 12. Learning and Attention Deficit disorders and work performance: (TBA).- III. Employment interventions for persons with mental health disorders.- 13. Integration of mental health and vocational services.- 14. Employment interventions for persons with serious mental illness.- 15. Employment interventions in depression and anxiety disorders.- 16. Employment interventions for persons with cognitive disorders.- 17. Systematic review of psychological return to work interventions for persons with mental health problems.- 18. Company-level interventions in mental health.- IV. Barriers and facilitators of job accommodations in the workplace.- 19. Employer attitudes towards accommodations in mental health disability.- 20. Mental health literacy and stigma associated with depression in the working population.- 21. Systemic barriers and facilitators to job accommodations in mental health: experts’ consensus.- V. Evidence-informed practice in job accommodation.- 22. Job accommodation as a social process: 23. Evidentiary support for best practices in job accommodation in mental health: macrosystems, employer-level and employee-level interventions.- 24. Disclosure and job accommodation for persons with mental illness.- 25. Functional capacity assessments in mental disorders and job accommodations.- 26. Disability management approach to job accommodation in the workplace

Dr. Izabela Schultz is a clinical and rehabilitation psychologist specializing in medico-legal and vocational aspects of psychological, neuropsychological and pain-related disability, both in her academic research and in her forensic practice. She is doubly Board-certified and holds the Diplomate distinctions of the American Board of Professional Psychology, in Clinical Psychology and of the American Board of Vocational Experts.

Dr. Schultz is Professor in the Counselling Psychology Program at the University of British Columbia where she also serves as Director of the newly formed graduate program in Vocational Rehabilitation Counselling. She has presented, taught and published extensively in the United States, Canada, and internationally in the area of psychosocial, vocational and psycho-legal aspects of disability. Her particular research expertise is in determination of causation of psychological disability, in multivariate prediction of occupational disability, early intervention with high risk workers and employment retention of employees with complex disabilities including mental health, brain injury and pain. She has provided expert court testimony on psychological and neuropsychological matters.

Dr. Schultz’s two previous books, Psychological Injuries at Trial (2003) and Handbook of Complex Occupational Disability Claims (2005), have contributed to an evolution of the paradigm in the occupational disability field—from medical to biopsychosocial model.

Dr. Schultz is currently co-chair of the American Psychological Association’s Task Force on Guidelines for Assessment and Treatment of Persons with Disabilities, and is on the editorial boards of several scholarly journals.

E. Sally Rogers is Director of Research at the Center for Psychiatric Rehabilitation at Boston University where she had been conducting mental health and vocational research since 1981. The Center was founded under the direction of Dr. WilliamAnthony and has focused on the rehabilitation and recovery of persons with psychiatric disability since that time. Dr. Rogers currently serves as Co-Principal Investigator of a Research and Training Center grant which is funded to carry out research studies on functioning and recovery of individuals with mental illness. She is also a Co-Principal Investigator on a grant to culturally adapt a measure on recovery for Spanish speaking mental health clients. Dr. Rogers was Principal Investigator of a post-doctoral fellowship award from NIDRR for 10 years, Principal Investigator of a multi-site grant to study consumer-operated services funded by the Center for Mental Health Services, and Principal Investigator of several smaller grants.

Dr. Rogers is a reviewer for numerous scholarly publications in the field, has developed instruments currently being used by research studies and service organizations, and is a licensed psychologist in the state of Massachusetts.

Dr. Rogers isalso Research Associate Professor at Boston University, Sargent College of Health and Rehabilitation Sciences where she has taught Masters and doctoral-level research courses and seminars. She is the recipient of the Loeb Research Award from the International Association of Psychosocial Rehabilitation Services, the 2007 ARCA award for research. Dr. Rogers has written approximately 50 peer-reviewed papers on various topics related to the vocational rehabilitation, vocational assessment, and recovery of persons with severe psychiatric disability.