Does the diagnosis of a psychiatric disorder perturb careers?

July 1, 2005 5:20 PM

What are the potential (career, financial) ramfications of receiving a diagnosis for a psychiatric disorder?

I'm specifically NOT referring to the effects of the disorder itself, or effects resulting from any medical treatments. I'm also not asking about the ramifications of such an official diagnosis and the effects on one's social circle.

Rather, I'd like to know whether in the U.S., having a diagnosis of ANY psyciatric disorder is a large handicap to one's academic career, career proper, ability to work in government, ability to receive financial services (e.g. loans, mortgages), and healthcare insurance, life insurance, etc. And other types of services / institutions along those lines.

Do employers, insurance companies, graduate programs, or other organizations frequently enquire about such diagnoses on application forms? Would government security clearances be more difficult to obtain? Entry into professional schools for lucrative careers more difficult? Health insurance rates higher?

And is the nature of the disorder a major considertion? Is dysthymia (minor depression) or say, seasonal affective disorder considered less problematic than say, schizoprenia? Or is it a binary type thing, where simply ticking off the "had diagnosis" checkbox tends to penalize one severely without further examination?

posted by anonymous to health (15 comments total)

If you're trying to get health insurance on your own, you're screwed. As to the rest, the only thing I can tell you is it depends.

If you have a choice disclose as little as possible, with the caveat that if you are hired for a job, it may be in your interest to disclose as then you are covered under the Disabilities Act. There again, your mileage may vary. A lot will depend on diagnosis, I think. If you are depressed, well, half the people around you are on antidepressants-if you don't believe me start asking around. Some of us have slightly more complicated diagnoses and that is when it gets fun.
posted by konolia at 5:56 PM on July 1, 2005

heh, anonyfilter time.

I have been very up-front with my employer about my diagnosis, and they've been very helpful and supportive. It didn't stop me from getting security clearance. They didn't even ask.

From what I understand, firing someone for a psychiatric diagnosis would violate the Americans with Diabilities Act. In fact, I don't think employers or potential employers can legally ask questions about your medical history at any time. (Of course, there are people that break the law. But then there are lawyers to sue them, too.)

I'm guessing more than half of my friends and family have seen a shrink. It has no negative repercussions in the circles I travel in.
posted by lbergstr at 5:57 PM on July 1, 2005

Not just that, but your employer has about a 0% right to your medical records....I can't think of any reason most employers would even ask.
posted by taumeson at 7:00 PM on July 1, 2005

Let me point out that if you want to be covered under the Disabilities Act you HAVE to disclose. If you don't they can simply fire you if for some reason you are struggling. That is one of the catch-22s of this sort of thing. I would recommend, don't tell, get hired, and then if you think you might need accomodation, THEN disclose. A little judicious Googling will tell you what kind of accomodations you can legally ask for.

But DON'T tell coworkers unless you need to or KNOW they will be supportive.

By the way, when you get or renew your driver's license, they DO ask if you have a diagnosed mental disorder. I was caught offguard last time they asked and just told them I had depression, which technically was true. Just in my case it is the bipolar type. Frankly all they really wanted and needed to know was that it was safe for me to drive while on my meds.
posted by konolia at 7:07 PM on July 1, 2005

Despite some recent gains like the ADA, having a psychiatric disorder is still a big issue in our society. It limits your ability to get insurance and it can limit you ability to be employed, law or no law. If your issues are mild you are better off not getting a diagnosis. Are you religious, do you have a good clergy? That is one option. Another option is seeing someone and not submitting the bills to insurance, and asking not to get any formal diagnosis. This is easier with a MSW (masters in social work) than with say a psychologist, or worse a psychiatrist. If you really need help then get it and prepare to suffer the consequences. They are not that steep, especially given the benefit of treatment. Our society, in the US, still discriminates against mental illness and to the extent you can avoid this discrimination it is to your benefit. The bottom line is we discourage those with low level mental health issues from seeking treatment due to the stigma still attaching to a diagnosis, and more importantly to the real negative consequences which still attach to such diagnosis.
posted by caddis at 7:53 PM on July 1, 2005

Do employers, insurance companies, graduate programs, or other organizations frequently enquire about such diagnoses on application forms?

No, in general it's illegal to ask applicants about health issues. I've never seen such a question for any of the jobs I've ever applied for, for example. Questions about physical capabilities - for example, the ability to lift items of a certain weight for, say, a warehousing job - are okay, but that's hardly the question you're asking.

If you're hired, and start having problems performing well on the job, then it's appropriate to disclose that you're having problems. A lot of companies - more than you might think, quite possibly the vast majority of larger corporations - have employee assistance programs where you can get help (for alcohol and drug problems as well as mental health issues) without that being disclosed to the employer. If you're a good employee, most organizations want to do what they can to keep you (and keep you healthy). And most mental health problems are a lot less expensive for employers than some physical problems like cancer, heart disease, or even repetitive stress injuries, when lost time and workers compensation costs are factored in.

to disagree to some extent with caddis - yes, there are people who think that those with mental health problems are (inherently) dangerous, but fortunately they are relatively few (and, I think, getting fewer), and federal and (most) state laws are, generally, fairly protective. And there are good reasons not to hide your problems from others, including employers and schools - you make it a lot harder on yourself to get help (medical, and just general support and sympathy) when you need it. If you're going to be fired, I recommend it be because someone is discriminating against you, rather than because you wouldn't tell anyone about your health issues, and you were doing a really poor job because you didn't get help and/or your employer didn't make accommodations.
posted by WestCoaster at 8:03 PM on July 1, 2005

I can't imagine any employer caring about someone having minor depression or seasonal affective disorder. Those tend to sound like self-indulgent disorders to people who don't understand them, and seem like personal but not debilitating issues to those who do.

PTSD or a severe anxiety disorder or something like that might be a concern if someone found out and you weren't being well treated. schizophrenia or borderline personality or that kind of thing, even more so. However, if those issues were being treated, they wouldn't know... it's only if you were exhibiting symptoms of a psychiatric disorder that you'd be trouble, and then because of the symptoms, not the name for them.

But I'm writing from a viewpoint of NYC, where woody allen made therapy banal & expected 25 years ago, so things may be different elsewhere.
posted by mdn at 8:55 PM on July 1, 2005

One of the most admired people in my office is outspoken about her depression and meds. A former colleague was open about her bipolar disorder. Everyone I know is either on some kind of psychiatric meds, formerly on meds, or related to someone on meds. In the workplace, people should be judging you based on your performance, not on medical diagnoses that they have no right to know unless you share.

About five years I briefly considered joining the Army. I think my tattoos were a bigger issues to the recruiter than my past treatment for anxiety and depression, though he did ask about mental ilness.

I'm suspect that some less common mental illnesses might be bigger issues for the armed forces, though.
posted by croutonsupafreak at 10:03 PM on July 1, 2005

Trying to get mortgage insurance could be a downer.
posted by five fresh fish at 10:11 PM on July 1, 2005

A friend of mine was denied car insurance by several companies because she was on disability for a mental illness. When asked why she was on disability, she responded that she was diagnosed with "severe depression." She finally ended up lying about the reason she was on disability, and her next application sailed right through. However, were she not on disability, they never would have had a reason to ask.
posted by xyzzy at 12:56 AM on July 2, 2005

Kiss your second amendment rights goodbye, both in renting a gun at a range and in purchasing one to defend your home.
posted by Asparagirl at 1:04 AM on July 2, 2005

Your family can commit you, or take legally custody over your money and property, or both, much easier if you've been diagnosed than if you haven't.

In the event of a split from your spouse/partner, expect some very unfavorable legal outcomes in terms of property and in terms of custody and visitation with the kids.
posted by MattD at 7:48 AM on July 2, 2005

Stigma, stigma, stigma. It may depend on what kind of place you work in. When I was in a retail store, I had a supervisor that I had to tell (because I had a panic attack) and did the rumors ever fly after that.
posted by IndigoRain at 9:01 PM on July 2, 2005

I haven't had any problems getting a mortgage or mortgage insurance, but it has come up in court during my divorce and custody hearings. I did remain the primary custodial parent, so in the end it wasn't an issue.

I've never disclosed anything at any job I had and I've never had a problem, but then again it's never caused a problem for me at work.

I'm very cautious about sharing my history, diagnosis and treatment still. People that aren't affected have no real idea what it's like to have a psych disorder and if they're ever upset with you, it's the first thing they use to lash out. Also, to me, my issues are fairly private and as long as I'm on meds they don't effect my day to day life, so no reason to disclose them.

The stigma is still there, even within my own family. That could be why I"m more reticent about sharing.
posted by hollygoheavy at 5:27 AM on July 4, 2005

Past psych issues you have been treated for / diagnosed with is something you are asked on a SF86 form if you're applying for security clearance. So if you are applying for positions where they are concerned with if you are "clearable" this would be pertinent and could cause you an issue. On the other hand it's entirely possible it wouldn't be an issue - many clearance issues pivot on whether you can be blackmailed or coerced.
posted by phearlez at 3:11 PM on July 5, 2005