National Alliance on Mental Illness
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People with mental illness have often been victimized by questions on job applications or in job interviews about past treatment or hospitalization for mental illness. Guidelines recently published by the U.S Equal Employment Opportunities Commission (EEOC) establish that private employers with 15 or more employees who ask such questions prior to a formal job offer are violating Title I of the Americans with Disabilities Act (ADA).

Although the ADA statute expressly prohibits employers from inquiring about disabilities prior to an offer of employment, the specific legal parameters of what employers can and cannot ask and what types of tests can and cannot be administered before an employment offer have been unclear. Published on May 19, 1994, the EEOC guidelines are intended to provide technical assistance to EEOC investigators for these important ADA issues.

As a general rule, the guidelines establish that pre-job-offer questions or tests that are reasonably expected to elicit or reveal information about the existence of a disability cannot be asked; therefore, direct questions about current or past treatment for mental illness would clearly violate the ADA. Additionally, questions about prescription drugs would violate the ADA because responses would tend to reveal information about specific conditions or disorders.

The guidelines allow employers to ask questions about an applicant's general ability to perform the essential functions of the specific job for which he or she is applying. For example, an employer may ask if an applicant is able to meet the attendance requirements of a specific job. The employer may also inquire about the extent of leave taken in a previous job, although questions about why leave was taken are prohibited.

The guidelines further prohibit employers from asking a series of questions likely to elicit information about the presence of a disability, even if one of the questions--by itself--would be permitted. For example, an employer may ask pre-offer questions about ability to handle stress if coping with stress is essential to successful performance of the job being applied for.

However, if this question were followed by a question concerning the impact of stress on the applicant's health, this series of two questions would probably be viewed as violating the ADA because of the likelihood that certain responses would elicit information about the existence of a psychiatric disability.

The guidelines make an exception for questions about current or past use of illegal drugs. Such questions are expressly permitted in the ADA statute, and tests for illegal drugs prior to tendering employment offers are also permitted. However, questions about the extent of current or past illegal drug use are not permitted because they are viewed as eliciting information about disability.

If an applicant voluntarily discloses information about his or her disability, the employer is nevertheless precluded from asking for further information about the disability prior to a job offer. For example, an employer may not ask an applicant to provide details about his or her mental illness even if the applicant has voluntarily disclosed that he or she suffers from mental illness.

The EEOC guidelines also prohibit all pre-job-offer medical examinations. Medical examinations (as defined in EEOC guidelines) include all "procedures or tests that seek information about the existence, nature or severity of an individual's physical or mental health impairment." Therefore, psychiatric and psychological evaluations would appear to be prohibited because these elicit information about psychiatric disabilities.

Certain types of aptitude tests may be permissible as long as they are narrowly constructed to evaluate the ability to perform essential functions of the particular job applied for.

After an applicant receives a bona fide offer of employment, the employer is permitted to inquire into the candidate's medical and psychiatric history or to require the candidate to complete a test or medical examination as long as all candidates in the same job category are subjected to the same inquiries, tests, or examinations.

However, an employer who withdraws an offer of employment based on post-offer inquires or tests must prove that the decision to do so was based on evidence that the candidate would be unable to perform the essential functions of the job in question.

Although the guidelines are extensive (approximately 50 pages) and offer numerous examples intended to clarify their meaning, specific issues or controversies that are not clearly addressed are certain to arise and will have to be determined on a case-by-case basis.

Even though people with mental illnesses certainly continue to face discrimination in employment and in all areas of community life, these guidelines are a significant step toward protecting them from being victimized by the types of pre-employment questions and inquiries that have historically helped preclude them from appropriate employment opportunities.

The EEOC guidelines were published in the May 19, 1994, issue of the Federal Register. Copies can be obtained by writing to:

Office of Communications and Legislative Affairs
Equal Employment Opportunity Commission
1801 L Street, NW
Washington, DC 20507

by Ron Honberg
director, NAMI Legal Affairs


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Information Sources for personalities listed on poster
"People With Mental Illness Enrich Our Lives"

Abraham Lincoln
The revered 16th President suffered from severe, incapacitating and occasionally suicidal depressions, as documented in six biographical volumes by Carl Sandburg, and in numerous articles including "Dark Veil of Depression" by Judy Folkenberg, National Institute of Mental Health, published in The Consumer, HHS Pub. 3140, and in Your Health magazine, 3/28/90, pp.12-13.

Virginia Woolf
The British novelist who wrote To The Lighthouse and Orlando experienced bipolar depression characterized by feverish periods of writing and weeks immersed in gloom. Her story is discussed in Dynamics of Creation by Anthony Storr and in U.S. News & World Report, 3/5/90, p.50.

Lionel Aldridge
A defensive end for Vince Lombardi's legendary Green Bay Packers of the 1960s, Aldridge played in two Super Bowls. In the 1970s, he suffered from schizophrenia and was homeless for 2 1/2 years. He now gives inspirational talks on his battle against paranoid schizophrenia. His story is the subject of numerous newspaper articles.

Eugene O'Neill
The famous playwright, author of Long Day's Journey Into Night and Ah, Wilderness, suffered from clinical depression, as documented in Eugene O'Neill by Olive Coolidge.

Ludwig von Beethoven
The brilliant composer experienced bipolar depression, as documented in Beethoven by Schauffler and Key to Genius by Hershman and Lieb.

Gaetano Donizetti
The opera singer suffered from bipolar depression, as documented in Donizetti by Herbert Weinstock.

Robert Schumann
The "inspired poet of human suffering" experienced bipolar depression, as discussed in Dynamics of Creation by Anthony Storr and Creative Malady by George Pickering.

Leo Tolstoy
Author of War and Peace, Tolstoy revealed the extent of his own mental illness in My Confession. His experience is also discussed in Dynamics of Creation by Anthony Storr and Inner World of Madness by Bert Kaplan.

Vaslov Nijinsky
The dancer's clinical depression is documented in his autobiography, The Diary of Vaslov Nijinsky, in Bert Kaplan's Inner World of Madness and in U.S. News & World Report, 11/21/88, p.16.

John Keats
The renowned poet's mental illness is documented in Dynamics of Creation by Anthony Storr and The Broken Brain by Nancy Andreasen.

Edgar Allan Poe
The author's severe bouts with paranoia and alcoholism originated from his bipolar depression as documented in The Haunted Palace: The Life of Edgar Allan Poe by Frances Winwar.

Tennessee Williams
The playwright gave a personal account of his struggle with clinical depression in his own Memoirs. His experience is also documented in Five O'Clock Angel by Marie St. Just, in Kindness of Strangers by Donald Spoto, in Tennessee: Cry of the Heart by Dotson Rader and in "Remembering Tennessee Williams," New York Times, 5/30/90, p.B3.

Vincent Van Gogh
The celebrated artist's bipolar depression is discussed in Key to Genius by Hershman and Lieb, Dear Theo: Autobiography of Van Gogh by Irving Stone and an article in Your Health magazine, 3/28/89, pp.12-13.

Isaac Newton
The scientist's mental illness is discussed in Creative Malady by George Pickering, in Dynamics of Creation by Anthony Storr and in Key to Genius by Hershman and Lieb.

Ernest Hemingway
The novelist's publicized suicidal depression is examined in The True Gen by Denis Brian.

Sylvia Plath
The poet and novelist ended her lifelong struggle with clinical depression by taking her own life, as reported in A Memory of Sylvia Plath by Nancy Hunter Steiner.

The mental illness of one of the world's greatest artists is discussed in Dynamics of Creation by Anthony Storr.

Winston Churchill
"Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished," wrote Anthony Storr in Churchill. Storr also discussed Churchill's bipolar depression in Dynamics of Creation.

Vivien Leigh
The "Gone with the Wind" star suffered from mental illness, as documented in Vivien Leigh by Anne Edwards.

Emperor Joshua Norton
Self-appointed "Norton I, Emperor of the United States and Protector of Mexico," Joshua Norton won "a permanent place in the annals of San Francisco, as the wisest and shrewdest of madmen." His life is chronicled in Emperor Norton of San Francisco by William Kramer, Emperor Norton I by William Drury, Pioneer Jews by Drachman and Guide to San Francisco, pp.40-45.

Jimmy Piersall
The baseball player for the Boston Red Sox who suffered from bipolar depression detailed his experience in The Truth Hurts.

Patty Duke
The Academy Award-winning actress told of her bipolar depression in her autobiography and made-for-TV-movie, Call Me Anna and its sequel, A Brilliant Madness, co-authored by Gloria Hochman. Her story appears in U.S. News & World Report, 3/5/90, p.51 and in Your Health magazine, 3/28/89, pp.12-13.

Charles Dickens
One of the greatest authors in English language suffered from clinical depression, as documented in Key to Genius by Hershman and Lieb and in Charles Dickens, Vols. I and II, by Edgar Johnson.