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Fundamental to the definition of community integration is the expectation that people with psychiatric disabilities can have the same opportunity to live in the community as everyone else. To live in the community requires the ability to seek employment, housing, education and to pursue leisure and civic activities of one's own choice. The passage of a landmark federal law and the Supreme Court's interpretation of that law have established community integration as a legal right for people with psychiatric disabilities.
Congress laid the foundation for a federal community integration mandate in 1990, when it passed the Americans with Disabilities Act (ADA). The ADA is part of a greater movement toward social change initiated by the Civil Rights Act and the Fair Housing Act of the 1960s. Although the earlier laws did not include people with disabilities, their approach to social justice set the groundwork for later laws that did, such as the Rehabilitation Act of 1973 and the ADA of 1990. The ADA was the result of grassroots organizing by people with many types of disabilities nationwide. (See http://www.adata.org/whatsada-history.aspx for more historical information.)
Definition of Disability: According to the U.S Equal Employment Opportunity Commission and U.S. Department of Justice Civil Right Division's Americans with Disabilities Act: Questions and Answers: An individual is considered to have a disability if s/he has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment. (See http://www.usdoj.gov/crt/ada/q%26aeng02.htm for more frequently asked questions on the ADA.)
Various 'titles,' or parts, of the ADA outlaw discrimination against people with disabilities in several major areas, including:
Employment: An employer is not allowed to discriminate in hiring, firing, promotion, or other aspects of the job, and must make 'reasonable accommodations' that allow a person with a disability to perform a job. Reasonable accommodations are modifications or adjustments to a workplace environment that will give a qualified applicant who has a disability the ability to apply and will enable an employee with a disability to perform essential job functions. It is necessary for employers to accommodate only known disabilities of a qualified applicant or employee. Accommodations should also be individualized, because disabilities and job requirements vary. Employers are not required to make accommodations that would pose "undue hardships" to their business i.e. an "action requiring significant difficulty or expense."
Smaller employers can receive a special tax credit for complying with accommodations of the ADA. The employment provision applies to private employers, State and local governments, employment agencies, and labor unions. Employers with 25 or more employees were covered as of July 26, 1992. Employers with 15 or more employees were covered two years later, beginning July 26, 1994. (Title I.) The ADA bars discrimination in all employment practices including: job application procedures, hiring and firing, advancement, compensation, training, recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities
Government services: Local and state governments must make their services accessible to people with disabilities and must not discriminate in providing services. . Every public entity program is covered by the ADA, including the activities of State legislatures and courts, town meetings, police and fire departments, motor vehicle licensing, and employment. (Titles II.) (See http://www.ada.gov/t2hlt95.htm for more information on Titles II.)
Businesses: Private businesses and non-profits that serve the public, called ?places of public accommodation? by the ADA, and ?commercial facilities? (other businesses), are required to make their facilities accessible to people with disabilities and must not discriminate based on disability. Some examples of places of public accommodation include: restaurants, hotels, theaters, doctors' offices, pharmacies, retail stores, museums, libraries, parks, private schools, and day care centers. (Title III.)
How are these provisions enforced?
Despite certain limits, the ADA requires major changes from businesses and governments, and Congress was aware that businesses and governments would need guidance in making those changes. To help provide that guidance, Congress specified in the ADA that certain federal agencies, like the Equal Employment Opportunity Commission (EEOC) and the Department of Justice (DOJ), would put together some more specific regulations on how to comply with the ADA.
The Equal Employment Opportunity Commission enforces Title I's prohibition against discrimination and has issued many regulations based on Title I. However, defining a reasonable accommodation in response to psychiatric symptoms can often be more challenging than designing accommodations of physical or sensory disabilities. ADA regulations disallow employers from asking disability-related questions during the application process, unless the applicant asks for reasonable accommodation during the process of hiring. Under most cases, employers must keep all information about their employees' medical conditions confidential (supervisors and managers can be told about needed accommodations; first aid and safety personnel can be informed if the person with a disability may require emergency treatment; and government officials assessing ADA compliance should be given information on request).
Some reasonable accommodations for people with psychiatric abilities include: time off from work, a modified work schedule (some medications cause morning grogginess and a modified work schedule can combat this problem), physical changes in the workplace, such as dividers or partitions (to help people with disability-related concentration problems, making exceptions in work policy, the adjusting of supervisory methods, providing a job coach, and others. The federally funded Job Accommodation Network (JAN) offers free consultation services to employers and employees. Their web site http://www.jan.wvu.edu provides a great deal of helpful information. For more listings of real-life accommodations provided by employers see http://www.jan.wvu.edu/media/SitandSol.html
For further information, visit our section on employment .
One set of regulations issued by the Department of Justice in response to Title II of the ADA has proven to be particularly significant for people with psychiatric disabilities and formed the basis of a landmark Supreme Court ruling. DOJ's 'integration regulation' states: A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities, [meaning] a setting that enables individuals with disabilities to interact with non-disabled persons to the fullest extent possible. (28 C.F.R., part 35, section 130 and Appendix A.) This regulation, which offers many people with psychiatric disabilities a chance to live in the community rather than in institutions, won the approval of the U.S. Supreme Court in the Olmstead v. L.C. decision.
Additional information about the ADA is available from the Disability & Business Technical Assistance Centers at ( http://www.adata.org) and the Bazelon Center for Mental Health Law (http://www.bazelon.org). Information about the Equal Employment Opportunity Commission is available from their website at (http://www.eeoc.gov/ada/index.html).
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