The term psychiatric/mental health (PMH) disability describes a wide range of mental and emotional conditions. Psychiatric/mental health disorders are common in the US. However, not all these disorders result in or qualify as a mental disability, as defined by the Americans with Disabilities Act (ADA) of 1990 and the ADA Amendments Act (ADAAA) of 2008 (P.L. 110-325). This definition is as follows:
Mental disability refers to a mental impairment that substantially limits one or more major life activities of an individual; having a record of such an impairment; or being regarded as having such as impairment.
The term psychiatric/mental disability describes only part of the ADA’s broader term of mental impairment (National Rehabilitation Information Center, 2014). Mental disability or mental impairment as addressed by the ADA also includes:
These are discussed in Chapter 4 and Chapter 5.
Psychiatric/mental disability—discussed in this chapter—refers to a PMH illness that significantly interferes with a person’s ability to engage in major life activities such as learning, working, and communicating.
There is less written about psychiatric disability than about other disabilities or PMH disorders (Rudnick, 2014). However, policy guidance from the Equal Employment Opportunity Commission (EEOC, 2002) addresses many questions about psychiatric disability in the context of the ADA. Although the EEOC’s main focus is on employment issues as they relate to disability (including psychiatric disability), its guidance is helpful for understanding psychiatric/mental disability.
According to the EEOC, the ADA’s definition of mental impairment includes any mental or psychological disorders such as emotional or mental illness. These include the following examples:
The EEOC (2002) guidance also lists major life activities relevant to psychiatric disability. These are as follows:
Interacting with others
Caring for oneself
Performing manual tasks
The American Psychiatric Association’s (APA) 2015 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the key reference on PMH disorders for mental health professionals for the purposes of diagnosis and insurance reimbursement. However, not all disorders included in DSM-5 are considered disabilities or impairments. According to the ADA, for an impairment to be considered a disability, its effect on a person’s major life activities must be significant. When a PMH disorder is severe enough to prevent a person from performing such activities—or significantly restricts the condition, manner, or duration under which the person can perform compared to the average person in the general population (EEOC, 2002)—it is considered a disability. Determining whether a limitation is a “substantial limitation” depends on its severity and on the length of time it restricts major life activities.