Avoiding Psychiatric Disability Overdiagnosis (Part 2): Improving Diagnosis and Assessment of Mental Health Disorders and Psychiatric Work Disability

Given the increase in psychiatric occupational disability claims over the past 20 years, better patient psychiatric assessment and management is critical. To minimize iatrogenic psychiatric disability and maximize positive outcomes, it is important to understand the issues involved and establish better procedures for diagnosing conditions and assessing any associated impact on function. This second article in a three-part series focuses on ways to improve the diagnosis and assessment of mental health work disability.

Avoiding Psychiatric Disability Overdiagnosis, Part 1: General Disability and Occupational Disability—Going Beyond Medical Impairment Assessments

Claims of occupational psychiatric disability have increased considerably over the past 20 years. To avoid psychiatric disability overdiagnosis, it is important to improve the clinical assessment of mental health work disability. This article discusses general disability issues and their impact on individual well-being, social participation, and frequently associated poverty. It defines the difference between impairment assessment and disability assessment, explores three common disability models, and raises issues about psychiatric disability and its potential overdiagnosis.

Employee disability disclosure and managerial prejudices in the return-to-work context

PurposeThis paper investigates the extent to which disability type contributes to differential evaluation of employees by managers. In particular, the authors examined managerial prejudice against 3 disability diagnoses (i.e. psychiatric, physical disability and pending diagnosis) compared to a control group in a return-to-work scenario.Design/methodology/approachWorking managers (N = 238) were randomly assigned to 1 of 3 scenarios containing medical documentation for a fictional employee that disclosed either the employee's psychiatric disability, physical disability, or a pending diagnosis. The authors also collected a separate sample (N = 42) as a control group that received a version of the medical documentation but contained no information about the disability diagnosis.FindingsCompared with employees without stated disabilities, employees with a psychiatric disability were evaluated as more aggressive toward other employees, less trustworthy and less committed to the organization. Compared to employees with either physical disabilities or pending diagnoses, employees with psychiatric disabilities were rated as less committed to the organization. The authors discuss implications for future research and the trade-offs inherent in disability labeling and disclosure.Originality/valueThe current study extends prior research by examining a broader range of outcomes (i.e. perceived aggressiveness, trustworthiness and commitment) and moving beyond performance evaluations of employees with disabilities. The authors also assess the relative status of a “pending diagnosis” category—a type of disclosure often encountered by managers in many jurisdictions as part of accommodating employees returning to work from medical-related absence.