Mentally ill employees victims of discrimination
A new guidance from the Equal Employment Opportunity Commission (EEOC) guidance that gives psychological and physical disabilities equal weight under the Americans With Disabilities Act (ADA) of 1990 has done more than address a murky issue, says Ralph Wittenberg, MD; it has provided an opportunity to examine what Wittenberg says is widespread workplace discrimination against employees with mental illnesses."I think there is a tremendous amount of discrimination against people who have psychological problems in terms of medical benefits, hiring, promotion, and firing, which is why the ADA was developed in the first place," says Wittenberg, who is president of the Washington (DC) Psychiatric Foundation, a nonprofit scientific and educational foundation whose aim is to get people who need psychiatric help treatment — through education designed to combat the stigma attached to mental illness.
Discrimination against employees with mental illnesses extends far beyond job evaluation, notes Wittenberg. "While psychological problems are covered [by insurance], there is still discrimination because people with physical illnesses are treated by different standards," he explains. "Insurance benefits [for psychological illnesses] usually have different co-payments, the number of covered visits is way less, the maximum dollar amount is less, the lifetime benefit is less."
For example, he says, the average insurance policy will have a lifetime cap of $1 million for physical Illnesses. "For psychiatric illnesses it’s often as little as $25,000," he says.
Such limits, Wittenberg asserts, are woefully inadequate. "If somebody has a bipolar disorder and is hospitalized for 30 days, it’s not uncommon to see a bill of $30,000," he points out. In fact, he says, employees with a history of mental illness can be denied life insurance.
Wittenberg says insurance carriers and employers can "get away with" this kind of discrimination because such employees by definition are not assertive or self-confident. "They won’t make a stink like people with physical illnesses can," he declares.
Not only does the ADA help prevent such discrimination in the workplace, says Wittenberg, but it is in the employer’s economic self-interest to treat employees with a mental illness the same as they would those with a physical illness. "Employers act like people with psychological problems are somehow a danger to them or that they will go broke if they have to take care of them," he says. "But by ignoring them and not encouraging them to get treatment, it’s more likely the condition will worsen, leading to even more expense. In fact, says Wittenberg, he’d gladly compare the track record of mental health professionals with that of physicians who treat physical illnesses. "Of all the patients who are treated for depression, 80% show significant long-term improvement," he says. "Tell me you can do that with bypass surgery."
Employers, he says, need to create an atmosphere in which employees feel it’s safe to let people know they’re having problems and that they will neither be penalized nor exposed to other people’s ridicule. "There has to be concern expressed by the employer," he asserts. "After all, if you get someone in for treatment, everyone’s way ahead of the game."
[For more information, contact: Ralph Wittenberg, MD, Washington Psychiatric Foundation, 1822 Florida Ave. NW, Washington, DC 20009. Telephone: (202) 789-0442.]
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