Leave Management, Policy, and Compliance, Leave Policy/Compliance

Mental Illness and the Workplace: How Might DSM-5 Changes Affect You?

Ever heard of DSM-5? It’s the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is the latest update to the American Psychiatric Association’s classification and diagnostic tool. This update was published on May 18, 2013 and includes some significant expansions to definitions of a few mental disorders.

“This is the diagnostic manual that is used by psychiatrists and mental health professionals and others who are not mental health specialists in making diagnoses.” Patricia Eyres explained in a recent BLR webinar. In some ways, these changes are controversial because it so broadly defines emotional and mental disorders and various types of depression.

Changes in DSM-5

The DSM-5 changes include some new or broadened definitions of mental disorders. This is important for employers because it may mean that more people will qualify as depressed and may need accommodation. Here are some of the biggest changes to be aware of:

Major Depressive Disorder and Bereavement. Under earlier editions of the DSM, major depression could not be diagnosed for ordinary bereavement symptoms lasting under 2 months. This has now changed; in DSM-5, the “bereavement exclusion” has been removed from the definition of major depressive disorder. This means a person having symptoms of depression for longer than 2 weeks may qualify for a diagnosis of major depression even if those symptoms are the result of bereavement.

Employees, therefore, might seek more lengthy bereavement leaves than are currently available following the death of a family member or close friend. This may result in more FMLA-CFRA leave requests or more restrictions from health care providers following an individual’s return from a bereavement leave.

“If the employee needs further leave [beyond standard bereavement leave] because they have a serious health condition that arises out of the bereavement, that’s going to be covered by FMLA. That’s not new, ” Eyres explained.

“What is new is that it’s going to come under a definition of ‘major depressive disorder,’ which means that we may see more requests—we undoubtedly will see, over time, more requests for reasonable accommodations from the impact of major depressive disorder where the source is a bereavement.”

Social Anxiety Disorder. Social Anxiety Disorder affects individuals who suffer from significant distress or anxiety that interferes with their ordinary routine in a variety of social situations, including the workplace. This is a new definition in DSM-5. It’s significant not only because it is new, but also because it directly highlights distress or anxiety in the workplace.

Post-Traumatic Stress Disorder (PTSD). DSM-5 broadens the diagnostic criteria for PTSD. First, it permits a PTSD diagnosis where the person merely learns about a traumatic event, versus the prior requirement that the event actually be witnessed or experienced. Second, it eliminates the prior requirement that the person experience fear, helplessness, or horror at the time of the traumatic event. (They could experience it later and still have the diagnosis). These changes may increase the number of employees who will qualify for a PTSD diagnosis and thus may have work restrictions or request a leave of absence.

“If that’s the case, to the extent that you have functional limitations and work restrictions, you’re going to need to address it as a reasonable accommodation issue.” Eyres advised.

For more information on depression in the workplace, order the webinar recording of “Depression in the Workplace: Strategies for Seamlessly Handling FMLA Requests and ADA Accommodations.” To register for a future webinar, visit http://store.blr.com/events/webinars.

Patricia S. Eyres, Esq., the managing partner of Eyres Law Group, LLP, focuses on helping employers manage disability discrimination issues for both workers’ comp and non-occupational disabilities. As president of Litigation Management & Training Services and CEO/Publisher of Proactive Law Press, LLC, Eyres trains managers and supervisors on how to recognize risks, prevent lawsuits, and maintain defensible documentation.