The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) hit the shelves of doctors’ offices and has created additional headaches for employers already struggling with accommodating claimed mental disabilities. The DSM-5 is the standard classification of mental disorders used by mental health professionals and is the single most important guide in diagnosing mental disorders. The newest edition replaces the DSM-IV, in operation for almost two decades, and it supposedly “better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but whose symptoms are not well defined by DSM-IV.”
The DSM-5 expands the number of individuals subject to a potential mental disorder diagnosis in two ways. First, DSM-5 loosens the symptom criteria of existing disorders. Second, it creates brand new disorders. Employers must now decide whether and how to accommodate the expanded and newly recognized mental conditions. In particular, the DSM-5 categorizes conditions formerly considered a result of regular life events, such as aging, into diagnosable mental disorders. For example, “mild neurocognitive disorder” is characterized by a decline in learning or memory that “goes beyond normal issues of aging.” But discerning where memory loss as a result of aging ends and mild neurocognitive disorder begins is far from clear. Similarly, “social (pragmatic) communication disorder” is characterized by significant difficulty in communicating in social situations. So employees once simply considered to be extremely shy are now diagnosable with a mental disorder. The line between mental conditions that an employer must accommodate and conduct that is within the range of normal and, therefore, need not be accommodated, is now more blurred than it ever has been.
According to the U.S. Equal Employment Opportunity Commission, the number of ADA charges has increased from 18,108 in 1997 to 26,379 in 2012. Given this expansion of diagnosable mental disorders, the potential for a further increase is alarming and virtually inevitable.