Accommodations

ACCOMMODATIONS FOR PEOPLE WITH PSYCHIATRIC DISABILITIES AND
SUBSTANCE ABUSE ISSUES

Characteristics of Psychiatric Disability that Affect Functioning

• The Irregular nature of mental illness may create problems in establishing or maintaining consistent work, school or daily living patterns and also impair their performance.

• Stress associated with non-disclosure, anxiety often accompanies the effort to hide an illness and its symptoms. Many individuals do not disclose an illness for fear of discrimination. This fear may be compounded if the person feels that her job, custody of their children, access to services, etc. is in jeopardy
• Side effects of medications, despite their effectiveness for many people,
medications can also have side effects that create difficulties. Each person has
an adjustment period after starting, changing the dose of or stopping medication.
Some of the most common side effects include
• Drowsiness
• Dizziness
• Dry mouth
• Nervousness
• Headaches
• Shakiness
• Confusion
• Weight gain

• Interrupted education or training, many people develop symptoms of their mental illnesses between the ages of 15 and 25, delaying traditional educational or vocational training. This may affect their qualifications for jobs, educational programs and other aspects of their life, making it difficult to create plans for independence

• Co-morbidity, 30% of adults with a mental illness also have had a diagnosable alcohol~ and/or drug abuse disorder. Treatment and accommodation in these cases need to address the effects of substance abuse as well as the effects of the person’s mental illness. (From: http:tMwwmentailtealthinfo net’psydisab.htrri)

Functional Limitations Due To Psychiatric Disability

The following is a list of some of the activities that people with psychiatric disabilities may have trouble doing:

Screening out environmental stimuli, an inability to block out sounds, sights or odors which interfere with focusing on tasks

Attendance Issues:
• Provide flexible schedules and time off
• Provide a self-paced work load and flexible hours
• Allow person to perform tasks from alternate locations
• Provide part-time schedule
• Allow person to make up activities misses


Issues of Change:
• Recognize that a change in the environment or of staff and residents may be difficult for a person with a psychiatric disability
• Maintain open channels of communication between the person and staff (new and old) in order to ensure an effective transition
• Provide weekly or monthly meetings with the person to discuss issues

Accommodating People with Post Traumatic Stress Disorder (PTSD)

People with PTSD may experience limitations that can affect their everyday life; the degree of limitation will vary from individual to individual.

Memory: People with PTSD may have difficulty with memory

• Provide written instructions
• Post written instructions
• Use a wall calendar
• Use a daily or weekly task list
• Provide verbal prompts and reminders
• Use electronic organizers or hand held devices
• Allow the person to tape record meetings
• Provide written minutes of each meeting
• Allow additional time

Lack of Concentration: People with PTSD may have difficulty concentrating.

• Reduce distractions in the living environment
• Provide space enclosures or a private space
• Allow for the use of white noise or environmental Sound machines
• Allow the person to play soothing music using a cassette player and a headset
• Increase natural lighting or increase full spectrum lighting
• Divide large assignments into smaller goal oriented tasks or steps
• Plan for uninterrupted work time

Time Management/Performing or Completing Tasks: People with PTSD may have difficulty completing tasks in a timely manner or meet deadlines.

• Make daily TO-Do lists and check items off as they are completed
• Divide large assignments into smaller tasks and steps
• Schedule weekly meetings with staff and supervisor to determine if goals are being met
• Remind person of important deadlines via memos or e-mail

Disorganization: People with PTSD may have difficulty getting or staying organized

• Use calendars to mark meetings and deadlines
• Use electronic organizers
• Hire a professional organizer or organizational coach
• Assign a mentor to assist the person




Coping with Stress: People with PTSD may have difficulty handling stress

• Allow longer or more frequent breaks
• Provide backups for when person needs to take breaks
• Provide additional time to learn new responsibilities
• Restructure tasks to include only essential functions
• Allow for time off for counseling
• Assign a supervisor, manager or mentor to answer person’s questions

Working Effectively with Others: Staff can assist people with PTSID using alternative techniques

• Giving assignments or instructions in writing or via e-mail
• Provide detailed day-to-day guidance and feedback
• Provide positive reinforcement
• Provide clear expectations and the consequences of not meeting expectations
• Develop strategies to deal with problems

Interacting with Co-workers: People with PTSID may have difficulty working with others

• Encourage the person to walk away from frustrating situations and confrontations
• Allow person to participate from alternate locations
• Provide partitions or closed doors to allow for privacy
• Provide disability awareness training to staff and other residents

Dealing with Emotions: People with PTSD could have difficulty exhibiting appropriate emotions or controlling anger.

• Refer to person to counseling
• Use stress management techniques to deal with frustration
• Allow the use of a support animal
• Allow telephone calls to doctors and others for needed support


Transportation Issues: People with PTSD may have difficulty driving their own vehicles, traveling on the job, flying or accessing public transportation

• Eliminate non-essential travel
• Provide a driver
• Allow extra time for travel
• Allow the person to bring along a support person (From:
http/janwebicdi.wvttedu/medialptsd.html)

Accommodation Considerations for People with Alcoholism

When considering accommodations for people with alcoholism, remember that the accommodation process must be conducted on a case-by-case basis. Symptoms caused by alcoholism vary from person to person. When determining effective accommodations, the person’s individual abilities and limitations should be considered and problematic tasks must be identified. Therefore, the person with alcoholism should be involved in the accommodation process.



Attendance Issues:
• Allow flexible scheduling for medical treatment
• Allow flexible scheduling for counseling
• Allow person to self-pace themselves and/or to modify their daily schedule

Maintaining Concentration:
• Reduce distractions
• Provide space enclosures or private areas
• Plan for uninterrupted time
• Allow for frequent breaks
• Divide large assignments into smaller tasks and steps
• Restructure tasks to include only essential functions

Difficulty Staying Organized and Meeting Deadlines
• Provide clerical support
• Make a daily to-do list
• Use electronic organizers
• Maintain a current calendar
• Remind the person of important dates
• Schedule weekly meeting with caseworker to determine goals and address questions, concerns and progress
• Write clear expectations of the person’s responsibilities and the consequences of not meeting them
• Establish written long term and shod term goals

Difficulty Handling Stress:
• Provide praise and positive reinforcement
Ask what the person has found helpful for stress
• Refer person to counseling
• Allow for the ability to modify daily schedule
• Allow for frequent breaks
• Do not mandate social functions where there would be exposure to alcohol

Maintaining Stamina:
• Allow flexible scheduling
• Allow for longer or more frequent breaks 

(From.
http:J/~wjan .wvu.edu/media/alcohoi. html)

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