Systemic Barriers and Facilitators to Job Accommodations in Mental Health: Experts’ Consensus

  • Izabela Z. Schultz
  • Danielle Duplassie
  • Douglas B. Hanson
  • Alanna Winter


According to the World Health Organization (WHO 2001a), mental health ­disorders comprise 40% of the top ten leading individual causes of disability ­worldwide and account for 10.5% of the total global burden of disease.


Mental Health Mental Health Problem Mental Health Disorder Vocational Rehabilitation Corporate Culture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This chapter was based on a study completed for a project funded by Social Development Canada: “Towards Evidence-Informed Best Practice Guidelines for Job Accommodations for Persons with Mental Health Disabilities.”


  1. Akabas SH (1994) Workplace responsiveness: Key employer characteristics in support of job maintenance for people with mental illness. Psychosoc Rehabil J 17(3):91–101Google Scholar
  2. Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J (2005) Cost of disorders of the brain in Europe. Eur J Neurol 12(Suppl 1):1–27PubMedCrossRefGoogle Scholar
  3. Baldwin ML, Marcus SC (2010) Stigma, discrimination, and employment outcomes among ­persons with mental health disabilities. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  4. Baril R, Berthelette D (2000). Les composantes et les déterminants organisationnels des interventions de maintien du lien d’emploi en enterprise. Institut de recherche en santé et en sécurité du travail du Québec, Montréal; Rapport No. R-238Google Scholar
  5. Bell MD, Lysaker PH, Bryson G (2003) A behavioural intervention to improve work performance in schizophrenia: Work behaviour inventory feedback. J Vocat Rehabil 18(1):43–50Google Scholar
  6. Bozzer M, Samson D, Anson J (1999) An evaluation of a community-based vocational rehabilitation program for adults with psychiatric disabilities. Can J Community Ment Health 18(1):165–179Google Scholar
  7. Bronfenbrenner U (1979) The ecology of human development: Experiments by nature and design. Harvard University Press, Cambridge, MAGoogle Scholar
  8. Carling PJ (1993) Reasonable accommodations in the workplace for individuals with psychiatric disabilities. J Consult Psychol J 45(2):46–62CrossRefGoogle Scholar
  9. Coles A (1996) Reasonable accommodations in the workplace for persons with affective mood disorders: A case study. J Appl Rehabil Couns 27(4):40–44Google Scholar
  10. Creswell JW (1998) Qualitative inquiry and research design: Choosing among five traditions. SAGE Publications, Thousand OaksGoogle Scholar
  11. DeLisio G, Maremmani I, Perugi G, Cassano GB, Deltito J, Akiskal HS (1986) Impairment of work and leisure in depressed outpatients. A preliminary communication. J Affect Disord 10(2):79–84CrossRefGoogle Scholar
  12. Dewa CS, McDaid D (2010) Investing in the mental health of the labour force: Epidemiological and economic impact of mental health disabilities in the workplace. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  13. Dewa CS, Lin E, Kooehoorn M, Goldner E (2007) Association of chronic work stress, psychiatric disorders, and chronic physical conditions with disability among workers. Psychiatr Serv 58(5):652–658PubMedCrossRefGoogle Scholar
  14. Fabian ES, Waterworth A, Ripke B (1993) Reasonable accommodations for workers with serious mental illness: Type, frequency, and associated outcomes. Psychosoc Rehabil J 17(2):163–172Google Scholar
  15. Franche R-L, Cullen K, Clarke J, MacEachen E, Frank J, Sinclair S et al (2004) Workplace-based return-to-work interventions: A systematic review of the quantitative and qualitative literature. Institute for Work and Health, Toronto, ONGoogle Scholar
  16. Gallie KA, Schultz IZ, Winter A (2010) Company-level interventions in mental health. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  17. Gates LB (2000) Workplace accommodation as a social process. J Occup Rehabil 10(1):85–98CrossRefGoogle Scholar
  18. Gates LB, Akabas SH (2010) Inclusion of people with mental health disabilities into the ­workplace: Accommodation as a social process. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  19. Gioia D, Brekke J (2003) Knowledge and use of workplace accommodations and protections by young adults with schizophrenia: A mixed method study. Psychiatr Rehabil J 27:59–68PubMedCrossRefGoogle Scholar
  20. Goldner E, Bilsker D, Gilbert M, Myette L, Corbière M, Dewa CS (2004) Disability management, return to work and treatment. Healthc Pap 5(2):59–70Google Scholar
  21. Granger B, Baron R, Robinson S (1997) Findings from a national survey of job coaches and job developers about job accommodations arranged between employers and people with psychiatric disabilities. J Vocat Rehabil 9:235–251CrossRefGoogle Scholar
  22. Greenberg PE, Kessler R, Birnbaum HG, Leong SA, Lowe SW, Bergland PA, Corey-Lisle PK (2003) The economic burden of depression in the United States: How did it change between 1990 and 2000? J Clin Psychiatry 64(12):1465–1475PubMedCrossRefGoogle Scholar
  23. Harder HG, Scott LR (2005) Comprehensive disability management. Elsevier, LondonGoogle Scholar
  24. Harder H, Hawley J, Stewart A (2010) Disability management approach to job accommodation for mental health disability. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  25. Harnois G, Gabriel P (2000) Mental health work: Impact, issues and good practices. Joint publication of the World Health Organization [WHO] and the International Labour Organization [ILO], pp 1–66. WHO/ILO, Geneva, SwitzerlandGoogle Scholar
  26. Hesslinger B, Tebartz van Elst L, Nyberg E, Dykierek P, Richter H, Berner M et al (2002) Psychotherapy of attention deficit hyperactivity disorder in adults: A pilot study using a ­structured skills training program. Eur Arch Psychiatry Clin Neurosci 252(4):177–184PubMedGoogle Scholar
  27. Hirsh A, Duckworth K, Hendricks D, Dowler D (1996) Accommodating workers with traumatic brain injury: Issues related to TBI and ADA. J Vocat Rehabil 7:217–226CrossRefGoogle Scholar
  28. Holzberg E (2001) The best practice for gaining and maintaining employment for individuals with traumatic brain injury. Work 16:245–258PubMedGoogle Scholar
  29. Job Accommodation Network [JAN] (2007) Accommodation information by disability. Morgantown, VW. Electronic version retrieved from
  30. Kirsch B, Gewurtz R (2010) Organizational culture and work issues for individuals with mental health disabilities. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  31. Kusznir A (2001, October) Understanding return to work challenges with depression. Paper presented at the second annual national symposium of the National Institute of Disability Management and Research. Ottawa, ON, CanadaGoogle Scholar
  32. Loisel P, Durand M, Berthelette D, Vézina N, Baril R, Gagnon D et al (2001) Disability prevention: New paradigm for the management of occupational back pain. Dis Manag Health Outcomes 9(7):351–360CrossRefGoogle Scholar
  33. MacDonald-Wilson KL (1994) Reasonable workplace accommodations for people with psychiatric disabilities. Reprinted from the Community Support Network News 12(1). Retrieved from Reasonable Accommodations: An on-line resource for employers and educators, at
  34. MacDonald-Wilson KL, Rogers ES, Massaro JM, Lyass A, Crean T (2002) An investigation of reasonable workplace accommodations for people with psychiatric disabilities: Quantitative findings from a multi-site study. Community Ment Health J 38(1):35–50PubMedCrossRefGoogle Scholar
  35. MacDonald-Wilson KL, Rogers ES, Massaro J (2003) Identifying relationships between ­functional limitations, job accommodations, and demographic characteristics of persons with psychiatric disabilities. J Vocat Rehabil 18:15–24Google Scholar
  36. Mac-Donald-Wilson KL, Russinova Z, rogers ES, Lin CH, Fergusin T, Dong S, et al. (2010). Disclosure of mental health disabilities in the workplace. In IZ Schultz and ES Rogers (eds) Handbook of work accommodation and rentention in mental health. New York: SpringerGoogle Scholar
  37. Mancuso LL (1993) Achieving reasonable accommodation for workers with psychiatric disabilities: Understanding the employer’s perspective. Am Rehabil 21:2–8Google Scholar
  38. Marrone J, Gandolfo C, Gold M, Hoff D (1998) Just doing it: Helping people with mental illness get good jobs. J Appl Rehabil Couns 29(1):37–48Google Scholar
  39. McFarlin DB, Song J, Sonntag M (1991) Integrating the disabled into the work force: A survey of Fortune 500 company attitudes and practices. Employee Responsib Rights J 4(2):107–123CrossRefGoogle Scholar
  40. Means CD, Stewart SL, Dowler DL (1997) Job accommodations that work: A follow-up study of adults with attention deficit disorder. J Appl Rehabil Couns 28(4):13–16Google Scholar
  41. Mpofu E, Watson E, Chan S (1999) Learning disabilities in adults: Implications for rehabilitation interventions in work settings. J Rehabil 65(3):33–41Google Scholar
  42. Parente R, Stapleton MC, Wheatley CJ (1991) Practical strategies for vocational reentry after traumatic brain injury. J Head Trauma Rehabil 6(3):35–45CrossRefGoogle Scholar
  43. Provencher HL, Gregg R, Mead S, Mueser KT (2002) The role of work in the recovery of persons with psychiatric disabilities. Psychiatr Rehabil J 26(2):132–144PubMedCrossRefGoogle Scholar
  44. Sahi S, Kleiner BH (2001) Reasonable accommodation of psychiatric disability under the ADA. Equal Opport Int 20(5/6/7):133–137Google Scholar
  45. Schultz IZ (2005) Impairment and occupational disability in research and practice. In: Schultz IZ, Gatchel RJ (eds) Handbook of complex occupational disability claims. Early risk identification, intervention, and prevention, 1st edn. Springer, New York, pp 25–42Google Scholar
  46. Schultz IZ (2008) Disentangling disability quagmire in psychological injury and law. Part I. Disability and return to work: theories, methods and applications. Psychol Inj Law 1(2):94–102CrossRefGoogle Scholar
  47. Schultz IZ, Stewart AM (2008) Disentangling disability quagmire in psychological injury and law Part II Evolution of disability models: conceptual, methodological and forensic issues. Psychol Inj Law 1(2):103–121CrossRefGoogle Scholar
  48. Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ (2007) Models of return to work for musculoskeletal disorders. J Occup Rehabil 17:327–352PubMedCrossRefGoogle Scholar
  49. Schultz IZ, Winter A, Wald J (2010) Evidentiary support for best practices in job accommodation in mental health: Macrosystem, employer-level and employee-level interventions. In: Schultz IZ, Rogers ES (eds) Handbook of work accommodation and retention in mental health. Springer, New YorkGoogle Scholar
  50. Scott J, Dickey B (2003) Global burden of depression: The intersection of culture and medicine. Br J Psychiatry 183:92–94PubMedCrossRefGoogle Scholar
  51. Smith TE, Bellack AS, Liberman RP (1996) Social skills training for schizophrenia: Review and future directions. Clin Psychol Rev 16(7):599–617CrossRefGoogle Scholar
  52. Spirito-Dalgin R, Gilbride D (2003) Perspective of people with psychiatric disabilities on employment disclosure. Psychiatr Rehabil J 26(3):306–310CrossRefGoogle Scholar
  53. Statistics Canada (2003) Canadian Community Health Survey [CCHS] – Mental health and well-being (Rep. no. catalogue no. 82-617-XIE)Google Scholar
  54. Stephens T, Joubert N (2001) The economic burden of mental health problems. Chron Dis Can 22(1):18–23Google Scholar
  55. Storey K (2002) Strategies for increasing interactions in supported employment settings: An updated review. J Vocat Rehabil 17:231–237Google Scholar
  56. Storey K, Certo NJ (1996) Natural supports for increasing integration in the workplace for people with disabilities: A review of the literature and guidelines for implementation. Rehabil Couns Bull 40(1):62–67Google Scholar
  57. Wallace CJ, Tauber R, Wilde J (1999) Teaching fundamental workplace skills to persons with serious mental illness. Psychiatr Serv 50:1147–1153PubMedGoogle Scholar
  58. Watson Wyatt Worldwide (2000) Staying at work 2000/2001 – The Dollars and sense of effective disability management. Watson Wyatt Worldwide, VancouverGoogle Scholar
  59. Weed RO, Brown TT (1993) Reasonable accommodation, job analysis, and essential functions of the job: Issues in ADA implementation for the private sector rehabilitation professional. NARPPS J 8(3):126–130Google Scholar
  60. Weiss M, Murray C (2003) Assessment and management of attention-deficit hyperactivity disorder in adults. Can Med Assoc J 168:715–722Google Scholar
  61. World Health Organization [WHO] (2001a) International classification of functioning, disability and health. World Health Organization, GenevaGoogle Scholar
  62. World Health Organization [WHO] (2001b) The World Health Report 2001 – Mental health: new understanding, new hope. World Health Organization, GenevaGoogle Scholar
  63. Yasuda S, Wehman P, Targett P, Cifu D, West M (2001) Return to work for persons with traumatic brain injury. Am J Phys Med Rehabil 80(11):852–864PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Izabela Z. Schultz
    • 1
  • Danielle Duplassie
  • Douglas B. Hanson
  • Alanna Winter
  1. 1.Vocational Rehabilitation Counselling ProgramUniversity of British ColumbiaVancouverUSA

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