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THE ADA'S COVERAGE OF MENTAL ILLNESS

Psychiatric disabilities receive the same protection under the ADA as physical disabilities. Under the ADA, the term disability means: "(a) A physical or mental impairment that substantially limits one or more of the major life activities of an individual, (b) a record of such an impairment; or (c) being regarded as having such an impairment."²⁷

Although the ADA clearly prohibits discrimination on the basis of a psychiatric disability, as legislation it has provided minimal guidance regarding the legal requirements. Mental illness was not discussed in legislative hearings and reports during passage of the law. The main regulatory commission never separately discussed mental illness. Therefore, the only legal rules concerning mental illness beyond the general principle of no discrimination have come from court decisions.²⁸

A complete analysis of court rulings and the regulatory commission's guidelines regarding the impact of the ADA on psychiatric disabilities and employment cannot be covered by this situation analysis. However, the following points are highlighted as relevant to understanding the nature and scope of the Americans with Disabilities Act.

What is a "mental impairment" under the ADA?

The ADA defines "mental impairment" to include "any mental or psychological disorder, such as...emotional or mental illness." Examples of emotional or mental illnesses include major depression, bipolar disorder, anxiety disorders, schizophrenia, and personality disorders. The current edition of the American Psychiatric Association's Diagnostic and statistical manual of mental disorders (DSM-IV, now in the fourth edition) is relevant to identifying these disorders. The DSM-IV has been recognized as an important reference by courts and is widely used by U.S. mental health professionals for diagnostic and insurance reimbursement purposes.²⁹ However, not all conditions listed in the DSM-IV are considered disabilities or impairments for purposes of the ADA. The DSM-IV lists several conditions that the U.S. Congress explicitly excluded from the ADA's definition of disability.³⁰ Individuals with the following mental impairments are not considered legally disabled, and receive no protection under the ADA. However, these impairments may be disabilities under some state laws:³¹

* compulsive gambling

* kleptomania

* pyromania

* psychoactive substance use disorders, resulting from current illegal use of drugs*

*Also excluded as disabilities under the ADA are transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments and other sexual behaviour disorders.

Even if a condition is an impairment, it is not automatically a disability. To rise to the level of a disability, an impairment must substantially limit one or more major life activities:³²

 

* The major life activities limited by mental impairments differ from person to person. There is no exhaustive list of major life activities. For some people, mental impairments restrict major life activities such as learning, thinking, concentrating, interacting with others, caring for oneself, speaking, performing manual tasks, or working.³³