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Schizophrenia is a chronic and severe mental disorder that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be incapacitating.
The symptoms of schizophrenia, include:
- Hallucinations include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for someone else to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
- Delusions are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
- Negative symptoms diminish a person’s abilities, and include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
- Cognitive issues/disorganized thinking involve struggling to remember things, organize thoughts, or complete tasks. Commonly, the individual with schizophrenia is unaware that he has the illness, which can make treating or working with him much more challenging.
Schizophrenia and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Schizophrenia
People with schizophrenia may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with schizophrenia will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
Ben is a draftsman with schizophrenia who is generally very good at his job tasks, but has had difficulty getting along with others socially.
He has episodes where he talked to himself, though others could hear him, about things that often were not based on reality. Although this often made coworkers uncomfortable, he was not threatening or considered dangerous. At Ben’s request, the employer provided a semi-private workspace for him where he would have less contact with his coworkers, but still be part of the department.
Larue, who was recently diagnosed with schizophrenia, worked as an administrative assistant to a busy college dean.
It became apparent over time that something was happening to him. He started to isolate himself from others in his department and his work performance deteriorated over time. His employer then began noticing that his appearance had been neglected: Larue had stopped shaving, bathing, and wearing clean clothes. Once Larue began to say peculiar things during the workday, his supervisor pulled him aside for a private counseling to find out what was wrong. Larue didn’t feel that anything was wrong even after he had heard the concerns. His employer requested he go to the doctor to get information that could help them better understand what was going on and how they could assist him in the workplace.
Shirley, a clerical employee with schizophrenia who sat in the middle of a rather large office, was in constant turmoil because she believed that her coworkers were plotting behind her back.
Although the employer could find no evidence to support this claim, it was very real to Shirley. She was having difficulty functioning as the office centerpiece. The employer could get no medical information because Shirley didn’t believe she had a disability or medical condition, nor did she feel that she had any issues. The employer moved Shirley to a location on the outside perimeter of the large circular office area where she could have her back to the wall and face the other employees. This helped Shirley tremendously in getting her work completed.
Mario, who had schizophrenia, was scheduled to start work an hour later than the majority of his coworkers, and always had a suspicious feeling that they had been talking about him in the hour before he arrived.
The supervisor verified that it wasn’t the case, but Mario still felt awkward and embarrassed. The supervisor asked Mario what might be a better solution/schedule for him. He felt that working the same times as most of the employees would help him to be there at the start of the day and ensure that there was no talking behind his back. The employer modified Mario’s schedule on a trial basis for two weeks to see how it would work for both of them. After the two-week trial period, Mario was a much happier and productive worker, so the employer allowed him to work the earlier schedule on a more long-term time frame.
Kim, who was diagnosed with schizophrenia, was unable to do her job because she felt that everyone in her new department was out to get her.
She wouldn’t even come into the part of the office where she did her filing – the primary essential function of her position because of the presence of her coworkers. She had just been moved into her current position from one where the very same issues had surfaced. The employer could find no proof that there were issues with co-workers in either department, so he began addressing the issues with Kim as performance: she was refusing to work.
JAN Publications & Articles Regarding Schizophrenia
Accommodation and Compliance Series
Consultants' Corner Articles
- Cognitive Impairment and the Interactive Process
- Communication Difficulties in the Workplace
- I Understand You Are Stressed...But Aren’t We All?
- My Disability Made Me Do It! When It Does and Doesn’t Matter
- Return to Work After Hospitalization for Mental Health Treatment
- Suicidal Ideation in the Workplace