The Disabled Workforce: Psychological Disabilities, the ADA, and the Stressed-Out Worker

Tasha Patterson@Work

Psychological Disabilities, the ADA, and the Stressed-Out Worker: Part 2

Stressed Out WorkersBy Rachel Shaw, JD

CEO and Principal
Shaw HR Consulting

One in four American adults experiences mental health problems in any given year,1 with employees suffering from depression alone reporting the equivalent of 27 missed work days per year.2 Loss related to mental disorders is comparable to that from cardiovascular diseases — and higher than that of cancer, chronic respiratory diseases, and diabetes.3 Every employer can reduce the negative impact of mental illness in three areas.

1) Unmanaged Leave

Sometimes terrible things happen that predicate sick or family care leave for employees, so we must support leave use when needed. Yet employers struggle with workload and staffing due to misuse, and so do coworkers. Often the early signs of mental health issues go unnoticed until a leave is requested. Address leave use head-on; have hard conversations and discuss concerns as leave is being taken.

Pay attention to leave, track it, and talk about it early and often. Choose an amount of leave that triggers a face-to-face conversation with an employee. Ask how you can support them to be at work more, and brainstorm with them how to help reduce unnecessary leave. Many times, we simply wait too long to have conversations with employees about leave. These are not disciplinary conversations; they are strategic discussions to create a win-win relationship — you need us and we need you, so let’s come up with a solution together.

2) Employee Assistance Program (EAP)

The bulk of workplace psychological matters are related to stress from such events as divorce, parenting or childcare issues, an ill or aging parent, or financial matters. While personal, these issues inevitably leak into professional life. This gives the employer a unique opportunity to provide support and solutions, while at the same time getting employees back on track at work.

When the workplace is impacted by personal matters, refer employees to your EAP. Some employees may not be comfortable accepting help. If you raise concerns yet issues continue to impact them at work or their availability for work, mandate that they attend.4 Let them attend  during work hours so family and friends don’t have to know and childcare or after-work activities are not affected.

On average, fewer than 6% of employees use an employer-funded EAP. Let’s change this! Stress, depression, and anxiety impact employees and your bottom line. A good EAP can positively address these matters to provide immediate outcomes such as improved attendance and productivity as well as helping the employee learn lifelong coping skills.

3) Start the Disability Interactive Process

If the efforts so far have not improved performance or attendance and if the organization or employee believes the issues are related to a physiological medical condition, start the disability interactive process. I use a “hallway” method with four doors or process steps.

The hallway starts at gathering the medical documentation you need (through a Family and Medical Leave Act second opinion, medical supplemental questionnaire, or fitness-for-duty examination) to determine if a disability is impacting the employee and, if so, what are the functional limitations and work restrictions. Move into the hallway with an attitude of being diligent, honest, and fair, and it will lead you to a decision you can feel confident about.


  1. Johns Hopkins Medicine. Mental Health Disorder Statistics. Retrieved from,P00753.
  2. Harvard Mental Health Letter. Mental Health Problems in the Workplace. February 2010. Retrieved from
  3. Trautmann S, J Rehm, HU Wittchen. The Economic Costs of Mental Disorders. EMBO Reports. 17(9):1245–1249. 2016. Retrieved from
  4. 4. In such a situation, an employer can require an EAP fitness for duty exam; Yin vs. State of California.