Elsevier

International Journal of Law and Psychiatry

Volume 28, Issue 6, November–December 2005, Pages 670-690
International Journal of Law and Psychiatry

Stigma as a barrier to employment: Mental disability and the Americans with Disabilities Act

https://doi.org/10.1016/j.ijlp.2005.04.003Get rights and content

Abstract

In a controversial expansion of workplace civil rights, the 1990 Americans with Disability Act (ADA) extended anti-discrimination protection to individuals with “mental impairments.” One of the most critical barriers to the employment of individuals with mental disabilities is the degree of social stigma such disabilities incur, and there is compelling evidence that employers have stigmatizing attitudes and have discriminated against those with mental disabilities. This study examines the role played by stigma in employers' response to the 1990 Americans with Disability Act (ADA). A stratified sample of one hundred ninety employers were surveyed in 1996–1997 in a major Southern metropolitan area. Telephone interviews were completed with one hundred seventeen employers (response rate of 61.6%). The article describes employers' experiences with employees with mental disabilities and accommodations, specific employment practices, and attitudes towards those with mental disabilities. Stigma played an important role in conformity to the ADA (operationalized as either hiring or having specific recruiting policies for hiring individuals with mental disabilities). Furthermore, employers expressing coercive (fear of a lawsuit) as opposed to normative (belief that it is the right thing to do) rationales for compliance were more likely to hold stigmatized attitudes. Employers' beliefs about mental disability form a crucial foundation for truly supportive work environments (those that value difference and diversity), and further research is needed to determine if over time the ADA is successful in changing attitudes as well as behavior.

Introduction

This study examines business compliance with the Americans with Disabilities Act (ADA), focusing specifically on the employment of individuals with mental disabilities. In research on another legal “mandate” regarding organizational behavior toward individuals with mental disabilities, Scheid-Cook (1992) demonstrated that mental health organizations manipulated, and in large part created (or enacted), the very legal constraints to which they then adapted. Edelman (1992) found similarly complicated implementation dynamics with regard to other, pre-ADA anti-discrimination laws. If employers do not view those with mental disabilities as employable, or if employers believe that accommodations will be costly or inefficient, they are unlikely to make any meaningful attempt to hire individuals from this traditionally stigmatized group, despite the ADA's provisions to the contrary. Conversely, if employers view the ADA as an important statement of changing social values, or if employers believe that ADA violations will result in heightened litigation risks, they may significantly change their hiring practices, even without concerted enforcement activity.

I begin with a discussion of the ADA and its potential impact on the employment of those with mental disabilities. Unlike many physical disabilities, mental disability is not easily discernable, and one of the more revolutionary aspects of the ADA is that it creates workplace rights for persons with a mental impairments. In addition, mental illness is widely associated with social stigma which is itself a significant barrier to employment for individuals with mental disabilities (Mechanic, 1998). I then report results from a telephone survey of businesses in a large southeastern metropolitan area. The survey utilized both fixed choice and open-ended questions, and addressed employers' understandings of the ADA, their responses to the ADA, their perceptions of the likelihood that ADA violations would incur sanctions, and their practices and attitudes (including stigmatization) toward employees with mental disabilities. Consequently, the data presented contributes to our understanding of the attitudes, agendas and political conditions (i.e. the institutional environment) surrounding the employment of individuals with mental disabilities, as well as the role played by stigma as a barrier to employment.

Section snippets

Employment of individuals with mental disabilities

One of the more novel and revolutionary aspects of the 1990 ADA is its coverage of persons with a mental impairment (any mental or psychological disorder, including mental retardation, developmental disability, organic brain syndrome, emotional or mental illness or specific learning disabilities). However, many do not believe that individuals with mental illnesses, or disabilities, are employable. The Executive Director of the Bazelon Center for Mental Health Law, Leonard S. Rubinstein (1996:

The ADA and mental disability

The ADA represents a federal mandate to end discrimination against those with disabilities (Blanck, 2000); Paul Miller (Commissioner of the Equality Opportunity Commission) views the ADA as a means “to the true vision of an equal society” (Miller, 2000: 11). Title I of the ADA requires that employers make reasonable accommodations for employees with disabilities (Crist & Stoffel, 1992, Essex-Sorlie, 1994, Reed, 1992, West, 1996). Excluded are those whose disability would pose a threat to the

Objectives

This is an descriptive study, designed to evaluate the impact of the ADA on the employment of those with mental disabilities as well as to examine the degree of stigma held by employers and the effect of stigma on conformity to the ADA. The following questions will be examined:

  • 1)

    What kinds of businesses have hired those with mental disabilities? What factors are associated with employers' decisions to hire such individuals? What specific accommodations have employers made for employees with

Compliance with the ADA and workplace accommodations

Only 15.4 percent of the companies had a specific policy for hiring those with mental disabilities; 67.5 percent stated they had no such policy. Of the ten businesses with a specific polity, 60 percent had developed this policy since the ADA went into effect (40 percent had developed their policy before the ADA went into effect). Only 14.3 percent of the businesses had a specific person or department which oversaw the hiring of those with mental handicaps, and this department was almost always

Conclusions

It is evident that the belief sets employers held about mental illnesses are important to understanding organizational compliance. Many employers articulated common stereotypes of mental illness as a limitation on one's ability to perform many types of work (especially that requiring cognitive skills), or work that was stressful or involved interactions with others. Employers also worried about the dangerousness of employees with mental illness; either a danger to themselves (not to be trusted

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