ADA Regulations: What is a Mental Impairment?

How can you be sure you’re meeting ADA regulations for workers with mental conditions? Medically speaking, the term “mental illness” describes a plethora of mental and emotional disorders ranging from mild anxiety to more serious conditions that significantly interfere with major life activities such as learning, working, and simply communicating with others. Legally speaking, “mental illness” isn’t quite as easy to define, yet under the ADA, employers are expected to reasonably accommodate employees who fall into this ambiguous category.

The issue of reasonable accommodation is nothing new for employers, but since the final ADAAA regulations became effective in May 2011, the definition of disability has been broadened, meaning more physical and mental impairments will fall into the protected category.

In a BLR webinar titled “Depression and Other Mental Illness Under New ADA: Accommodation Practices for HR,” Susan G. Fentin, Esq., and Ronald Schouten, M.D., J.D., outlined how mental conditions are treated under the ADA and gave some guidance on what to do if an employee comes to you seeking accommodation for such a disability.

What is a Mental Impairment?
In the regulations, a mental impairment is defined as “any mental or psychological disorder, such as an intellectual disability (formerly termed “mental retardation”), organic brain syndrome, emotional or mental illness, and specific learning disabilities.”

In the webinar, Fentin compared this with the definition of disability in the ADA regulations, which is: “a substantial impairment—a physical or mental impairment—in a major life activity that would substantially limit that major life activity.”

She went on to clarify that “the major life activities that can be impaired by this mental or physical impairment include thinking, concentrating, and interacting with others.”

When we talk about mental illnesses, these can present special problems for employers:

•Employees are often reluctant to ask for help.
•Symptoms are harder to identify.
•Accommodations can be more difficult for employers.
•Irregular nature of mental illness can result in inconsistent performance.
•Side effects can result from taking medication to mitigate the effects of the illness.
•Malingering and exaggeration are more difficult to prove.
◦Fentin clarified: “the employee can claim certain sorts of reactions or responses or thoughts or behaviors—and it’s very difficult for even the likes of psychiatrists to determine that those are actually not being experienced, that the employee does not actually suffer from those illnesses.”
With this expanded definition of mental illnesses that will qualify as a disability, it is easy to see that many illnesses will qualify. Fentin noted “most diagnosed mental illnesses will be disabilities.”

In a related article, Fentin and Schouten gives advice on how to handle requests for mental illness accommodations.

For more information on ADA regulations as they relate to mental conditions, order the webinar recording. To register for a future webinar, visit

Attorney Susan G. Fentin is a partner in the labor and employment firm of Skoler, Abbot & Presser, P.C. She has been ranked in 2010 and 2011 as one of the top labor and employment attorneys in Massachusetts by the prestigious Chambers USA rating agency.

Dr. Ronald Schouten is the director of the Law and Psychiatry Service at Massachusetts General Hospital and an associate professor of psychiatry at Harvard Medical School. His clinical and consultation practices are focused on executives and professionals confronted with career issues, work-life balance problems, and mood and anxiety disorders.