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So Much for the Problem. What’s the Fix?
Like so much else in the world of preventing employment liabilities, the fix begins with training the managers who deal with the employees. It is unwise, unfair and fiscally irresponsible to leave managers on their own, without the tools they need to minimize the liabilities that bring so many businesses to their knees. They need to be equipped with the knowledge and decision-making skills that are required to make the right choices in difficult circumstances. Here’s how to do it.
The First Step: Understand the Scope of the Problem
Getting managers to be on the alert for bipolar disorder begins with convincing them that it is a real disease (as opposed to a lack of will power or personal discipline), and that it is a significant enough problem to merit their attention. That’s human nature. Presenting the documented facts usually does the trick.
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But that is not the full story. The cost of dealing with bipolar disorders far outstrips its statistical prominence. The American Journal of Psychiatry examined insurance claims for bipolar patients in 1996, and reported that one out of 5 bipolar patients had at least one psychiatric admission in 1996, and bipolar patients accounted for over 12% of all behavioral health care expenditures. The medical literature also indicates that approximately 20% of persons with untreated bipolar disorder commit suicide.
A 1991 report from the National Institutes of Mental Health tried to quantify the financial havoc the disorder had caused. The conclusion: starting with the proviso that estimates, even at that time, were much too low, the NIMH concluded that 1991 total costs for bipolar illness were a staggering $45 billion. Of that figure, $17 billion was attributed to lost productivity in the workplace.
The Second Step: Understand the Indications
Managers need to know bipolar disorder when they see it – that is, they need to be equipped with the knowledge that will cause them to think “potential disability,” not “irresponsible employee,” when observing bipolar symptoms. There is no other way to avoid the ADA consequences that will flow from non-recognition.
Here are the basics.Symptoms of the mania cycle may include periods of:
- Increased energy or restlessness
- Rapid speech and racing thoughts
- Euphoria
- Extreme irritability and distractibility
- Unrealistic belief in super-powers
- Increased sexual drive and provocative behavior
- Aggressive behavior
- Substance abuse, particularly cocaine, alcohol and sleeping pills
- Decreased need for sleep
- Unusually poor judgment
Symptoms of the depression cycle may include periods of:
- Persistent sadness or anxiety
- Hopelessness or pessimism
- Guilt, helplessness
- Loss of interest in ordinary activities and pleasures
- Loss of energy; fatigue
- Chronic pain
- Unexplained weight gain or loss; loss of appetite
- Restlessness or irritability
- Difficulty concentrating or indecisiveness
- Difficulty sleeping
- Thoughts of death or suicide; suicide attempts
The Third Step: Understand the Potential Accommodations
There is no present cure, although there are treatments for bipolar disorder. However, not all persons respond to the treatments in the same way, and there are many jobs that persons with serious bipolar disorders will not be able to perform, no matter how many accommodations you offer. The ADA protects employees who can perform the essential functions of their job if given a reasonable accommodation, and depending on the person and the job, the effort does not always work.
But as important as it is to understand that not every effort will succeed, it is equally important to understand that a great many persons with bipolar disorder will benefit, often dramatically, by one or more accommodations, and in those cases, managers need to be aware of the options. To assist that process, the Office of Disability Employment Policy of the U.S. Department of Labor’s Job Accommodation Network offers guidance on some possible accommodations specifically applicable to employees with bipolar disorders. It’s not easy, and it will take some trial and error:
Maintaining Stamina during the Workday:
- Flexible scheduling
- Allow longer or more frequent breaks
- Provide additional time to learn new responsibilities
- Provide self-paced work load
- Provide backup coverage for when the employee needs to take breaks
- Allow for time off for counseling
- Allow for use of supportive employment and job coaches
- Allow employee to work from home during part of the day or week
- Part time work schedules
Maintaining Concentration:
- Reduce distractions in the work area
- Provide space enclosures or private office
- Allow for use of white noise or environmental sound machines
- Increase natural lighting or provide full spectrum lighting
- Allow the employee to work form home and provide necessary equipment
- Plan for uninterrupted work time
- Allow for frequent breaks
- Divide large assignments into smaller tasks and goals
- Restructure job to include only essential functions
Difficulty Staying Organized and Meeting Deadlines:
- Make daily TO-DO lists and check items off as they are completed
- Use several calendars to mark meetings and deadlines
- Remind employee of important deadlines
- Use electronic organizers
- Divide large assignments into smaller tasks and goals
Working Effectively with Supervisors:
- Provide positive praise and reinforcement
- Provide written job instructions
- Develop written work agreements including the agreed upon accommodations, clear expectations of responsibilities and the consequences of not meeting performance standards
- Allow for open communication to managers and supervisors
- Establish written long term and short term goals
- Develop strategies to deal with problems before they arise
- Develop a procedure to evaluate the effectiveness of the accommodation
Difficulty Handling Stress and Emotions:
- Provide praise and positive reinforcement
- Refer to counseling and employee assistance programs
- Allow telephone calls during work hours to doctors and others for needed support
- Provide sensitivity training to coworkers and supervisors
- Allow the presence of a support animal
- Reinforce peer supports
Attendance Issues:
- Provide flexible leave for health problems
- Provide a self-paced work load and flexible hours
- Allow employee to work from home
- Provide part-time work schedule
- Allow the employee to make up time missed
Issues of Change:
- Recognize that a change in the office environment or of supervisors may be difficult for a person with bipolar disorder.
- Maintain open channels of communications between the employee and the new and old supervisor in order to ensure an effective transition.
- Provide weekly or monthly meetings with the employee to discuss workplace issues and production level
What Now?
The formula for preventing liabilities is almost always the same: figure out the most likely sources of problems; train those in the best position to prevent those problems in the most effective preventive techniques; and institutionalize procedures that make prevention a seamless part of the workplace.
As difficult as that it may be, prevention remains a much easier option than cure.
We do this for a living. Let us know if we can help.
Counsel Consulting Group LLC helps companies throughout the United States avoid employment and HR-related claims and liabilities. CCG assesses existing policies, procedures and problem areas; it provides customized liability-avoidance training to managers and executives; and it designs and implements business techniques that reduce employment liability risks on a long term basis. CCG also offers specialized workshops for managers and HR executives, customized consulting in focused employment-related areas, and CD-ROM and web-based training alternatives. For more information, contact us at info@powelltrachtman.com and visit our website at www.counselconsulting.com.
Powell, Trachtman, Logan, Carrle & Lombardo, P.C. is a full service law firm with offices in suburban Philadelphia, PA, Harrisburg, PA and Cherry Hill, NJ. Powell Trachtman represents a variety of commercial enterprises, entrepreneurs and business executives in respect to their litigation, litigation avoidance planning, business formation, business transactions, estate and tax planning, and other needs. We are also approved defense counsel for numerous insurance carriers in matters pertaining to professional malpractice, products liability, employment practices, directors and officers liability, and many other fields. For more information, contact us at info@powelltrachtman.com and visit our website at www.powelltrachtman.com.
