APA is urging psychiatrists to become familiar with the basic requirements of the Americans with Disabilities Act (ADA) "to help their patients avoid discrimination by invoking the act's protections such as declining to disclose personal information or requesting appropriate accommodations."

The suggestion is part of a continued battle against discrimination that was renewed again last month when the APA Board of Trustees approved a new position statement to express APA's strong opposition to discrimination against persons with psychiatric illnesses or previous psychiatric treatment.

Lawrence Kline, M.D., chair of the Council on Economic Affairs, which reviewed the statement for the Joint Reference Committee, commented at that time, "This statement dovetails nicely with APA's ongoing parity efforts."

The statement notes that APA vigorously opposes "the use of psychiatric diagnosis or treatment to deny immigration, professional or occupational licensure, employment, insurance, housing, and credit, or to deprive individuals with opportunities for full participation in the life of society."

Moreover, APA strongly supports developing measures in addition to antidiscriminatory legislation to "end stigmatization and discrimination against people with histories of psychiatric treatment."

The statement, which was prepared by APA's Council on Psychiatry and Law, focuses primarily on employment-related discrimination. "Because economic and emotional well-being are so often dependent on vocational satisfaction," this type of discrimination is particularly harmful.

The ADA prohibits the use of certain medical exams and inquiries. "Prior to employment, an employer may only raise questions about the applicant's ability to perform job-related functions and may not ask whether the person has a disability or inquire about the nature or severity of such a disability."

APA recommends that employers ask questions about past behavior in school or work settings such as absences, frequent job changes, or significant drops in grades or work performance. Such items are better indicators of performance than psychiatric history, notes the statement.

After a job offer has been made or during the course of employment, a medical evaluation can help in assessing the applicant's or employee's ability to perform a job. Likewise, it can be helpful in designing reasonable accommodations, as required by the ADA for disabled employees, according to the statement.

Psychiatrists can also assist disabled patients by providing assessments of functional capacity and recommending reasonable accommodations, urges the statement. Another option is to refer impaired patients to psychiatrists skilled in work disability when appropriate.

(Psychiatric News, April 4, 1997)