Mental illness as a disability pt 2

Relevant to my last post about mental illness and disability, for the first time I’ve experienced a tangible disadvantage as a consequence of having a psychiatric disability in the work place.

Earlier this week I received the  news that I was not going to get the promotion that I had been promised (and had been already announced to the team) primarily because of my particularly poor attendance of late.  Now, I understand my manager’s position, though she handled the matter poorly. She didn’t talk to me about it before, in a rather frustrating conversation, announcing her decision and the reasons for it. While she does genuinely care about my well being, she lacks a certain level of understanding and tact, as well as the interest in learning.

The fact is I have been away from work a lot lately because it’s been a particularly hard time for me; I was even more stressed than usual to finish my Honours thesis on time. Really, I’ve always struggled with regular attendance; at school and after school activities, social activities, then later work and university. I’ve always felt very guilty about not being able to regularly attend things – and then of course my guilt feeds my anxiety, creates more self hate, more fear of the outside world, leads into depression and thus more difficulty with attendance. In the workplace I’ve always worked hard when there and tried my best to be open, honest and discussed my reasons for not being there. I must say that overall I’ve received support, understanding and compromise.

This recent setback, however, has led me to even more doubt and fear. It’s made me worry that I won’t be able to succeed in my chosen career, because of the effects of my illnesses. I know that I work hard and am very capable, but maybe that simply isn’t enough. I can only hope to improve my attendance over time with more therapy etc, but realistically I will never be able to be somewhere 100% of the time.

What really struck me about this situation, is that this is a serious problem for the chronically ill (psychically or psychologically). For those of us who cannot always be at work it has serious repercussions. The options are to 1) try and work full time but then have lots of time off resulting in leave without pay and not being given development opportunities; 2)  try to find part time work and accept a lesser earning capacity; 3) not work at all and struggle financially. When these are the options you are faced with it is no wonder that statistically people with mental illness earn less and are regularly among society’s most disadvantaged.

Mental illness as a disability

In this post I’ve simply collated information from a few different websites about mental illness as a disability. The information either relates to Australia in general or NSW more specifically. Of course even if you have a mental illness, that does not mean that you will necessarily have a disability (especially if you are not effected long-term). I spent some time researching this because of the separation in my mind between mental illness and disability; I have trouble accepting that, both by theoretical definition and practical experience, I have a disability.

The legal definition of ‘disability’ under NSW anti-discrimination law

Disability is defined in section 4 of the Disability Discrimination Act 1992 (Cth) and in section 4 of the Anti-Discrimination Act 1977 (NSW). The definition in both Acts is very similar. This is the definition in the Anti-Discrimination Act 1977 (NSW):

disability means:

(a) total or partial loss of a person’s bodily or mental functions or of a part of a person’s body, or

(b) the presence in a person’s body of organisms causing or capable of causing disease or illness, or

(c) the malfunction, malformation or disfigurement of a part of a person’s body, or

(d) a disorder or malfunction that results in a person learning differently from a person without the disorder or malfunction, or

(e) a disorder, illness or disease that affects a person’s thought processes, perception of reality, emotions or judgement or that results in disturbed behaviour.

This definition includes mental illnesses under (e).

These laws also say that you don’t have to have the disability at the time of the discrimination for the way you are treated to be unlawful. So, the laws says that the disability can be one that:

  • ‘presently exists’;
  • ‘previously existed but no longer exists’: for example you may have had an episode of mental illness several years ago, but have been well ever since;
  • ‘may exist in the future’: for example, an insurance company might decide that you are likely to develop a condition based on your previous medical history or the medical history of your parents;
  • ‘is imputed to a person’: for example, an employer might believe you have a mental illness because of the way you responded to a particularly stressful situation even though you don’t have that illness.

The point of discrimination law is to stop you being treated worse or being excluded from opportunities because you have a disability or someone believes you have a disability. (Taken from Mental Health Coordinating Council)

The difference between mental illness and (pyschiatric) disability

There is often confusion regarding the use of the terms “mental illness” and “psychiatric disability”. Disabilities are the consequences of an illness, that is, a person may have difficulty in being able to carry out tasks and roles as a result of having an illness. The terms “illness” and “disability” relate to the World Health Organisation’s International classification of Impairments, Disabilities and Handicaps (Geneva 1980, reprinted 1989) which established a system of classification to identify consequences of disease and illness. (WHO is in the process of reviewing and rewriting this classification system.)

With regard to mental illness 

Impairment refers to the loss or effect of the illness on psychological, physiological or anatomical systems, for instance, experiencing hallucinations, thought disorder or depression.

With regard to disability

Disability refers to the restriction, lack or loss of the ability (as a result of the illness and impairment) to perform an activity or task, for instance, the tasks of everyday living, tasks at work, study or activities in the community. Handicap refers to social and environmental factors such as discrimination and poverty which disadvantage a person with a psychiatric disability.

Psychiatric disabilities are significantly different from many other disabilities in that they can fluctuate and are a result of an intermittent and episodic process. As well, not all people who have a mental illness will develop a psychiatric disability. (Taken from here)

Development of a mental illness into a disability

Why does it happen?

  • symptoms such as disordered thoughts, hallucinations and loss of contact with reality can make it difficult for a person to concentrate, process information, solve problems, make judgements or follow instructions
  • the intermittent or constant presence of symptoms can result in the person being emotionally fragile and vulnerable to stress
  • medication does not always control symptoms
  • the person can lose confidence in their ability to make decisions, perform tasks and engage in activities
  • loss of confidence and self-worth has a compounding impact in all areas of the person’s life and can lead to loss of motivation, neglect of self and overwhelming feelings of hopelessness
  • loss of positive emotional feelings, apathy, withdrawal, loss of self-esteem and confidence have traditionally been untreatable by medication
  • interruption to education, training and developmental phases caused by the illness can impact on the person’s ability to perform tasks and achieve independence and a valued role in society

Psychiatric disability – the social disadvantages 

The social stigma and lack of understanding about mental illness and psychiatric disability means that, for many people, overcoming these hurdles can be more daunting than coping with and overcoming the illness itself. The myth that “mad” equals “bad” still has currency in some parts of society.  People with psychiatric disability can be socially disadvantaged through:

  • limited choice due to limited income
  • lowered social status
  • lack of expectation from others
  • rejection by friends and family
  • vulnerability to being victims of crime and abuse
  • insufficient opportunities to learn new skills
  • limited options for developing a valued role in the community

(information taken from here)

Despite the obvious potential consequences of having a psychiatric disability, I am fortunate that I can mostly function fairly well.

Achievement unlocked: Honours

This week I did something I didn’t believe I could do; I finished my honours thesis. I’ve now finished my Bachelor of Arts (hons). I now have to wait an indefinite period to get my final mark and then actually graduate.

In some ways this doesn’t feel like a particularly amazing accomplishment, since I know lots of people who have done degrees and it’s pretty common. On the other hand, I cannot believe that I actually did it. I put myself through so much mental anguish and pain over the past year and a half (in fact, it was only meant to take a year but I had to extend it), I was so consumed by the voices in my head telling me I couldn’t do it and I truly believed at times I wasn’t capable, that I am a little astonished that I did it. I actually, for once, feel proud of myself. Mind you, it won’t necessarily last too long as I start applications for post-grad study.

Despite what I thought was the finality of my decision to start a PhD in Aus, I am going to apply to do a coursework masters overseas next year first. I’m terrified at the prospect, and I won’t be able to go if I don’t get a scholarship, but I am forcing myself to at least try. Because I’ve realised that if I try, I can accomplish what I want, no matter how anxious, how paralyzed I feel or how obsessed I am with perfection.