When is Mental Health Illness a Disability?

When you think of a disability what usually comes to mind are physical diseases and injuries or incapacitations. However, increasingly mental illnesses account for people being unable to hold down a job or cope with everyday requirements.

What is Mental Health and Why is Mental Health Important?

Mental Health is an essential and integral part of your health. It is a state of well-being within which you can realise your abilities, cope with everyday stresses, contribute productively within your community and work environment. Our mental health determines how we think, feel, interact and relate to others, as well as the choices we make.

“Mental health determines how we are able to interact within our everyday environment.”

What Determines Mental Health?

Mental health is impacted by social, biological, and psychological factors. Stresses and changes within any of these three areas can result in poor mental health. Things to be aware of that can impact our mental health are:

• Changing social circumstances or contexts
• Stressful work and home environments
• Discrimination or social exclusion
• Unhealthy lifestyles

What is a Mental Illness?

A mental illness is a disorder which results in a partial or complete disturbance of someone’s thinking, behaviour or feeling. It can be recurring or persistent, such that it renders a person unable to successfully carry out daily activities like self-care, work or socialise.

“Mental illnesses impede someone’s ability to successfully carry out everyday activities.”

Disclosing about a Mental Illness

There is no right or wrong answer to the question of should you tell someone that you have a mental health issue. Sadly, discrimination and misunderstanding are common-place in the realm of mental illness. People’s response to someone disclosing that they have a mental health issue can range from “Pull up your socks and get over yourself” to treating that person as a “ticking time-bomb”. Resulting in deciding that the person is incompetent or too risky to trust going forward.

“Disclosure needs to be weighed up against the purpose it serves.”

While having a mental illness is nothing to be embarrassed about and no one should make you feel shameful over it, it is wise to exercise discretion when sharing your diagnosis.  This is because firstly, what you’re disclosing is personal. Unlike a broken arm in a cast, it’s not necessarily obvious to everyone, so doesn’t necessitate your taking the time and energy to explain. Secondly because disclosure often comes with consequences such as needing to manage someone else’s reaction or answer probing personal questions. All of which can draw from your already limited mental, emotional and physical reserves that you need to help get yourself better.

2 Reasons to Disclose a Mental Illness

1. When it serves a purpose: In order for your employer to understand and assist you in receiving accommodations at work. Or for a someone who cares about you to better understand what is happening so that they can assist you or not be unnecessarily worried.
2. When you are ready: Ideally you should only share anything personal like this when you are ready, have thought through how you are going to tell someone and why you are comfortable with them knowing.

Remember, you don’t need to share everything and can say that you would rather not answer questions at this point. Decide how much you want to disclose and what is relevant to the context, then set boundaries on what advice you will listen to and if you will keep them updated on how things are going. When you disclose, be gentle and patient with the other person. What you saying may be a surprise to them, may be something that they have no prior experience with or previously has caused challenges for them. It could be helpful to provide them with further resources and information after you’ve chatted, as well as think ahead of ways of supporting you should they offer to.

When is Mental Illness a Disability?

Generally mental illnesses which are likely to, or already have, cause significant distress and impacted day-to-day activity in working and personal relationships for 12 or more months are considered to be a disability.

“There is no reason for shame in having a mental illness.”

Some of the more common mental illnesses include the following:

• Dementia
• Depression
• Bipolar disorders
• Obsessive Compulsive Disorders (OCD)
• Schizophrenia
• Post-Traumatic Stress Disorder (PTSD)
• Severe Anxiety

This is not to say that if you are diagnosed with one of these mental illnesses that you are disabled or will be in the future. Many people, who commit to working with health care practitioners and psychiatrists, can manage their mental illness and live happy and fulfilling lives.

Click here to read more about accessing mental health care and why it is important to do so sooner rather than later.

Determining Disability on Psychiatric Grounds

There are four recommended areas for assessing the relationship between stress and mental health. These form the basis of understanding if someone’s mental illness could be severe enough to considered a disability.

1. Daily living activities
2. Social functioning
3. Concentration
4. Ability to adapt

Essentially what is being assessed is can someone independently look after themselves? Are they able to communicate and interact effectively within a social and work environment? Can they sustain focus for long enough to successfully complete a task? And are they able to adapt when faced with stressful circumstances or changes within a work environment?

The combination and interaction of the above four areas is important as battling with one or even two areas don’t necessarily allow for a disability diagnosis.

Additionally, there are three categories of consideration when it comes to a mental illness being considered a disability:

1. Prominent residual symptoms
2. Frequent relapses or cycles
3. Risk factors or implications of future relapses

“Many people have mental illnesses and a successful career.”

This means that if your mental illness cannot improve through medication, counselling or both, or your illness reoccurs too often to allow you to hold down a job successfully, your mental illness may be severe enough to qualify for a disability. Alternatively, if getting sick again creates a risk factor within your work, then it is quite likely that you will be considered as having a disability. For example, you’re a pilot and experience a mental health disorder that might predispose a pilot to crash a plane. A mental health professional would need to be consulted to assist in evaluating whether mental health symptoms are severe enough to qualify for a disability.

Is Mental Illness a Permanent Disability?

Many patients receive a combination of medication and psychotherapeutic interventions throughout their lifetime. Ideally a mental illness can be successfully managed in the longer term, so that someone can happily function within their day-to-day lives. Some people will be able to return to work immediately once their treatment starts working. Alternatively, you may need to return to your duties in a gradual way.  For others it could mean working part-time or with assistance. Having assistance at work could be in the form of a supervised and mentored work rehabilitation programme. These are usually set up by an employer and health care practitioner such as a psychiatrist, psychologist, or occupational therapist.

Being able to go back to work may mean making adjustments to the work you do or the environment you work within. This can be difficult, especially if it means changing careers or adjusting your longer-term goals. However, depending on how you look at it, it could also be an opportunity. It could give you the chance to change your lifestyle and work to ensure you’re happier, more flexible and doing something that you enjoy, as opposed to a career path you felt obligated to embark upon.

3 Key Factors to optimal living with a mental health challenge are:

1. Finding and committing to a long-term treatment plan (medical oversight, taking medicine…)
2. Having social support network
3. Maintaining a healthy lifestyle

Click here to read more about 5 ways to Boost Your Mental Health.

The services of mental health care professionals are essential to assisting people in maintaining a balanced and fulfilling life.

If you believe that this is something you would like to be part of SACAP offers courses that can help prepare you for a career in counselling, such as the Diploma in Counselling and Communication Skills. To find out more, click here.