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Why Schizophrenia Is An Employer Issue: Rights And Responsibilities | 12493
Journal of Alzheimers Disease & Parkinsonism
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A major objective of this presentation is to highlight the rights and responsibilities an employer has when it has an employee
who has schizophrenia. Concurrently, given the importance of employment, clinicians and advocates who work with the
schizophrenia population may be able to identify employer-based resources for their clients. From the employer perspective,
the following are issues: it is generally accepted that the onset of schizophrenia is somewhat unpredictable. Hence, an employer
can have a mentally and physically healthy employee one month, and have an employee with symptoms of schizophrenia the
next month. This could raise coworker and supervision issues, in that there are stereotypes about violence at worst, or at best,
challenges in supervisory and coworker relationships. The use of alcohol for self-medication by people with schizophrenia is a
widely accepted co-morbidity. Hence, employees might be using/abusing alcohol in the workplace, which could raise disciplinary
issues. Many employers offer employee access to employee assistance plans, but due to privacy considerations, the employer
might not become cognizant of the nature of the illness and its related workplace consequences.
Many employers, even small employers, may be required to provide unpaid leave of up to 12 weeks, continuation of health
care benefits, and reemployment in a comparable job. This leave may be taken in small increments, possibly leading to ongoing
absences from work, not just for the employee with schizophrenia, but for close relatives as well, including spouses and
children. This is as required by the Family and Medical Leave Act. There could be elevated healthcare costs, including costs of
hospitalization and medications. Some states have mental health parity laws, which require employers to cover mental health on
the same basis as they provide coverage for physical health. Since health insurance is experience rated, these costs are eventually
passed on to the employer. Given that people with schizophrenia have shorter life expectancies, life insurance costs would also
be elevated. In addition, employers provide short-term and long-term disability insurance, which also have premiums based
on experience. It is entirely possible that a person with schizophrenia could remain indefinitely on the employer's long-term
disability insurance plan.
An important issue in the mental health literature is whether mental illness should be disclosed at the onset of employment.
On one hand, job applicants might want to avoid disclosing, since the employer might not extend an offer if it knew of the
disability. On the other hand, individuals who have or acquire schizophrenia, or for that matter, any illness, may be required
to be accommodated under the Americans with Disabilities Act. In general, if an employee is able to perform 80% of a job, an
individual with physical or mental illness is required to be accommodated for the other 20% of the job. However, it is no small
undertaking to discern what 80% of a given job is and individuals who are not properly accommodated sue, sometimes with the
assistance of third parties or with the assistance of the Equal Employment Opportunity Commission EEOC. The following cases
are illustrative of these lawsuits against employers.
Melissa LaVan, MS, is a doctoral student in the clinical psychology program at The Chicago School of Professional Psychology. Her previous
employment has been at a behavioral health hospital and at a clinical research site for trials in schizophrenia and depression. She has co-authored
two conference papers in cognitive psychology.
Helen LaVan, Ph.D. is a Professor of Management at DePaul University in Chicago. She is the co-author of over 65 journal articles, primarily related
to employee relations in the healthcare sector and employment litigation. Of special interest is how individuals with special needs or characteristics
fare in the court system. She is a licensed professional counselor LPC in the State of Illinois.
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