Reasonable Accommodations: An On-line Resource for Employers and Educators

Mental Health Disorders with Workplace Consequences

By Sheila H. Akabas, Ph.D., Director and
Lauren B. Gates, Ph.D., Research Director, The Workplace Center,
Columbia University School of Social Work, New York City, New York

Funded by a grant from the National Institute on Disability and Rehabilitation Research, the Workplace Center, a training, research, and program development institute of Columbia University’s School of Social Work, is conducting a project to identify the conditions that support successful job maintenance or return to work for people who experience mental illness.

With support from both District Council’s 37’s Health and Security Plan and New York City’s management, project activities have focused on members of District Council 37, AFSCME, (all employees of the City of New York). The first phase of the project involved interviewing, under conditions of informed consent, over 180 City workers who had received psychotropic medication as part of their mental health treatment for approximately one year.

Our interest was in determining both the history of their mental illness and the accommodations that had been made at the workplace to achieve their successful employment. Previous research conducted by the Workplace Center in disability management for employees with physical disabilities provided the key questions to pose in relation to effective continuation of employment.

Study Findings

Findings from the first phase confirmed that there are many persons working despite severe and long term mental health problems, and that a portion of them are in constant job jeopardy, partly because the supervisor and others in the workplace are uninformed about mental illness and ineffective in supporting and accommodating workers with these presenting problems.

During Phase I of the project, workplace interventions that can reduce the risk of job loss were identified. For Phase II, employees who were on leave with a diagnosis of a serious mental illness (which includes employees with depression, bipolar disorder, anxiety disorders, and schizophrenia) were contacted.

Using data and findings from Phase I, employees were interviewed to determine, with them, the intervention most appropriate to securing their return to work. The interventions included case management with the employee’s supervisor; case management with medical and community resources particularly around the possibility of better symptom control in relation to job requirements; or case management that includes psychoeducation involving the employee, his or her supervisor and co-workers, and a management and union representative who can sanction needed accommodation.

Each of the Phase II interventions is backed up by instruments that gather the information vital to the selection and implementation of an appropriate strategy. The major innovations of this project have been the use of a workplace mapping system to determine the key work group players, application of House’s (1981) construct for social support that identifies four key sources of support including informational, instrumental, emotional and appraisal support, and an intervention that focuses on the work group as a “” unit appropriate for targeting with a psychoeducational training initiative.

Built upon the understanding of accommodation as a social process, this approach has proven effective in meeting the needs of both individuals and organizations. It demonstrates that, along with effective accommodation to job tasks, routines, and physical work space, the support of supervisors and co-workers plays a significant role in successful employment outcomes for workers with mental illness.


House, J.S. (1981). Work Stress and Social Support. Reading, Massachusetts: Addison Wesley Publishing Company.

For more information contact The Workplace Center, Columbia University School of Social Work, 622 West 113th Street, New York, NY 10025. Dr. Sheila H. Akabas, Director and Dr. Lauren B. Gates, Research Director can be reached at 212/854-5173, FAX 212/854-2975, e-mail

Reprinted from the Community Support Network News, Summer/Fall, 1994 , 12 (1)

Note: The information contained in these pages is for educational purposes only, and is not legal advice. Individuals should contact the appropriate legal resources for specific legal advice regarding their particular situations.