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Job Accommodations & Employment Outcomes for Individuals with Mental Health Disability
Individual Presentation
Job Accommodations and Employment Outcomes for Individuals with Mental Health Disability
By
Clifton Michael Chow
Individuals with mental health disabilities are vulnerable to adverse labor market outcomes. Despite the passage of the of the Americans with Disabilities Act (ADA) in 1990, researchers and policy analysts have documented persistent barriers confronted by individuals with mental health disabilities in the labor market and developed a multitude of policy interventions to address these barriers. One such policy intervention is providing job accommodations, defined as an adjustment in the work environment that enables an individual with a disability to participate fully in the employment setting. This study compared the employment outcomes of hours worked and employment tenure in competitive employment settings for individuals with mental health disabilities who reported accommodations with those who did not report any.
Using an integrated conceptual framework adopted from static labor supply, capability approach and the theoretical model behind the International Classification of Functioning, Disability and Health (ICF), this study examined the extent to which job accommodations, developed originally through the ADA legislation for all categories of disabilities, prolong the labor force participation of those with mental health disabilities. Data for this study came from a longitudinal, four-year eight state multi-site demonstration project funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. All participants had been recruited from existing clinical populations receiving outpatient psychiatric services. The effects of job accommodations on hours worked were estimated using Generalized Linear Models (N= 1538). The effects of job accommodations on duration of employment across multiple spells of employment were estimated by parametric duration model analysis (N=1040) over the study period.
Controlling for demographic, environmental and clinical covariates suggested by the conceptual model, individuals who reported job accommodations worked on average seven more hours per month, and approximately 31 percent longer, with a decreasing risk of job termination by 12.7 percent over those without reported accommodations. Additionally, job accommodation was found to be a protective factor among those reporting economic burden. The results demonstrate that job accommodations show potential to improve employment outcomes in competitive employment settings for individuals with serious and persistent mental illness receiving employment services, Social Security Disability Insurance and/or Supplemental Security Income.
Since the sample was not drawn from a national probability sample, interpretation of findings is not generalizable to the population of individuals with serious mental health disabilities. The study is vulnerable to endogeneity concerns as job accommodations was likely under-reported. Results from models with instrumental variables were checked against results from the primary analysis.
This paper advances our knowledge of the labor market experience of individuals with serious mental health disability as well as provides a framework in guiding policy options to enhance their employment outcomes. It is also the first study to compare employment outcomes among those with and without job accommodations among that disability category.