Exploring the Costs and Benefits of Hiring and Accommodating Workers With Mental Illness in Diverse Workplace Settings

PURPOSE: Most people with mental illness want to work and can make important contributions at work if they are adequately accommodated. Organizations can also benefit in multiple ways by creating inclusive workplaces that accommodate the needs of diverse workers. Many workplaces have learned how to accommodate workers with physical disabilities (Nevala, Pehkonen, Koskela, Ruusuvuori, & Anttila, 2015) but struggle to create receptive and supportive workplaces for people with mental illness (Smith, Black, Keegel, & Collie, 2014). Mental illness remains the leading cause of work disability (Mental Health Commission of Canada, 2016). The purpose of this study was to explore the costs and benefits of hiring and accommodating workers with mental illness in a range of paid positions in diverse organizations.

METHOD: Using a mixed method case study design, we conducted qualitative and economic analyses with various stakeholders in five diverse workplaces. We conducted qualitative and economic interviews with accommodated workers, co-workers, supervisors/managers, and other workplace stakeholders within each organization. Qualitative interviews focused on experiences accommodating workers with mental illness, while economic interviews centered on costs/resources and benefits/impacts of accommodations from the perspective of the participants. Qualitative data were analyzed using a critical incident approach to identify key themes (FitzGerald, Seale, Kerins, & McElvaney, 2008). Economic data were tabulated in order to calculate the benefit-to-cost ratios. The data were used to develop stylized case studies of accommodated workers in diverse settings in order to illustrate the costs and benefits of hiring and accommodating workers with mental illnesses.

RESULTS: Thirty diverse stakeholders across five organizations participated in this study. From the employer perspective, the benefit-to-cost ratios over a 5-year period ranged from 1.92 to 7.81, indicating a positive return on investment in all cases. From the accommodated workers’ perspective, the benefit-to-cost ratios over a 5-year period ranged from 4.23 to 12.19. In each case, several intangible benefits of value to the employer and worker were also identified, including increased job satisfaction, increased organizational reputation, increased employment opportunities, and improved quality of life. The qualitative interviews highlighted the importance of organizational culture during the recruitment and hiring process, and while negotiating accommodations. Co-workers and other workplace stakeholders identified important benefits to accommodating workers with mental illness that impacted their intent to stay with the organization, thereby reducing staff turnover.

CONCLUSIONS: The findings suggest that workplace accommodations for workers with mental illness are be a win-win proposition. Monetary and non-monetary costs and benefits provide a compelling business case for hiring and accommodating people living with mental illness. These findings suggest there is significant opportunity for occupational therapists focused on increasing employer capacity to hire and support a diverse workforce, including people with mental illnesses, by making workplace policies and practices more inclusive. Recommendations for organizations seeking to innovate around hiring and accommodating workers with mental illness include offering and strengthening supports and benefits available to all workers and building in flexibility where possible in terms of how, where and when people work.

References

FitzGerald, K., Seale, N. S., Kerins, C. A., & McElvaney, R. (2008). The critical incident technique: A useful tool for conducting qualitative research. Journal of Dental Education, 72(3), 299-304.

Mental Health Commission of Canada. (2016). Making the case for investing in mental health in Canada. Retrieved from Mental Health Commission of Canada Website: https://www.mentalhealthcommission.ca/sites/default/files/2016-06/Investing_in_Mental_Health_FINAL_Version_ENG.pdf

Nevala, N., Pehkonen, I., Koskela, I., Ruusuvuori, J., & Anttila, H. (2015). Workplace accommodation among persons with disabilities: A systematic review of its effectiveness and barriers or facilitators. Journal of Occupational Rehabilitation, 25, 432-448. doi:10.1007/s10926-014-9548-z

Smith, P. M., Black, O., Keegel, T., & Collie, A. (2014). Are the predictors of work absence following a work-related injury similar for musculoskeletal and mental health claims? Journal of Occupational Rehabilitation, 24, 79-88. doi:10.1007/s10926-013-9455-8