In today’s U.S. workplace, behavioral health conditions and neurodevelopmental disorders are both more commonplace and more manageable than ever. According to the Disability Management Employer Coalition (DMEC), millions of working Americans struggle with mental health and substance use conditions.  These conditions can lead to challenges such as presenteeism, absenteeism, and reduced productivity, which in turn affect the workplace environment and employer costs¹. Both employers and employees need to adapt; both have a role in ensuring that these conditions don’t exclude otherwise qualified people from success.

The Americans with Disabilities Act (ADA) protects employees with behavioral health conditions and neurodevelopmental disorders if their condition substantially limits one or more major life activities. This includes conditions such as anxiety disorders, depression, ADHD, bipolar disorder, and schizophrenia. The ADA mandates that employers provide reasonable accommodations to qualified employees with disabilities, ensuring they can perform essential job functions without undue hardship to the employer².

Are your managers prepared?

One of the biggest challenges facing employers trying to comply with the Americans with Disabilities Act (ADA) is ensuring that front-line managers understand their responsibilities related to ADA reasonable accommodations. Even if people leaders understand that qualified employees with a disability may be entitled to a reasonable accommodation, they don’t always recognize situations that should trigger the accommodation process (i.e., the interactive process).

The interactive process involves engaging in a dialogue with the employee to determine if there are workplace barriers preventing them from performing their essential job functions, and what possible solutions can be implemented to remove or reduce those barriers. Many managers don’t know what to listen for – or what to do if an employee uses language that should trigger next steps in the interactive process.

It can be particularly challenging when the employee’s disability is related to behavioral health and/or a neurodevelopmental disorder. Broadly, behavioral health conditions impact mental and emotional well-being. Examples include depression, anxiety, and substance use disorder. Neurodevelopmental disorders, such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intellectual disability (ID), affect how the brain functions and develops and can cause social, cognitive, and emotional challenges. Neurodevelopmental disorders sometimes overlap with behavioral health conditions.

Both behavioral health and neurodevelopmental conditions can impact an employee's ability to perform their work duties, interact with others, cope with stress, and maintain attendance and productivity. Employees with behavioral health and/or neurodevelopmental conditions may experience limitations such as reduced attention or focus, trouble remembering deadlines or tasks, anxiety with initiating conversations, reduced energy, or sleepiness.

Reasonable Accommodations

The ADA requires employers to provide reasonable accommodations to qualified employees with disabilities, unless doing so would cause undue hardship to the employer. A reasonable accommodation is any change or adjustment to the work environment or the way things are usually done that enables an employee to perform the essential functions of their job. Examples of reasonable accommodations for behavioral health and neurodevelopmental conditions may include:

• Flexible work schedules or locations
• Modified break times or leave policies
• Adjusted workloads or deadlines
• Assistive technology or devices
• Quiet or private workspaces
• Written or visual instructions or feedback
• Coaching or mentoring
• Training or education
• Support groups or resources

To comply with the ADA and provide effective accommodations, managers need to be aware of the signs and symptoms of behavioral health and neurodevelopmental conditions and be proactive in initiating and conducting interactive conversations with employees who may need accommodations.

5 things employers can do to comply with the law:

1. Educate all people leaders on the prevalence, impact, and diversity of behavioral health and neurodevelopmental conditions in the workplace. Provide information about the common characteristics, challenges, and strengths of these conditions, and how they may manifest in different individuals and situations. This includes educating managers that sometimes even small changes can make a remarkable difference in their employee’s performance.
   
   Like other important training, ADA awareness training should be offered on a regular basis to people leaders (many employers choose to do such training annually). While managers can’t share any medical information with other team members, broad policies can be made to accommodate the employees (i.e., prohibiting perfumes in the office due to an employee with a sensory disorder needing that accommodation). Other small changes, like dimming lights or offering light blockers to everyone allows employees with sensory disorders to take advantage of the accommodation without being “singled out” for different treatment due to a disabling condition.
   
   
2. Foster a culture of trust, respect, and inclusion in your organization, so employees feel comfortable and safe to disclose their needs and request accommodations. Communicate clearly and regularly about the availability and process of accommodations and protect the confidentiality and privacy of employees who seek them.
   
   
3. Train people leaders (at least annually) to observe and listen to their employees and notice changes in their behavior, performance, mood, or appearance that may indicate a potential need for an accommodation. These may include absenteeism, tardiness, errors, complaints, conflicts, withdrawal, fatigue, irritability, or distress.
   
   
4. Initiate an interactive conversation with an employee who may need an accommodation as soon as possible, and do so in a respectful, supportive, and empathetic manner. Ask open-ended questions and listen actively to understand their situation, needs, and preferences. Avoid making assumptions, judgments, or diagnoses and focus on finding solutions that work for both parties.
   
   
5. Document and follow up on the interactive process. Monitor the effectiveness and implementation of the accommodations. Solicit feedback from the employee and make adjustments as needed. Evaluate the outcomes and impacts of the accommodations on the employee's performance, satisfaction, and well-being. This evaluation should be made and documented in the accommodation file – not in their annual performance review. Make sure accommodation files are kept separate from performance reviews.

By following these tips, managers can get better at complying with the ADA and providing reasonable accommodations for employees with behavioral health and neurodevelopmental conditions. Your organization cannot only help avoid legal risks and costs, but also enhance the engagement, productivity, and retention of a diverse and talented workforce.

Sheri Pullen is a Senior Compliance Director at Alight Leave Solutions and provides compliance expertise, analysis, and direction regarding leave of absence, accommodation, and disability. She has written many articles about leave and accommodation and is a frequent speaker at DMEC conferences.  Connect with Sheri via LinkedIn.