Abstract
Purpose Employers increasingly are asked to accommodate workers living with physical and mental health conditions that cause episodic disability, where periods of wellness are punctuated by intermittent and often unpredictable activity limitations (e.g., depression, anxiety, arthritis, colitis). Episodic disabilities may be challenging for workplaces which must comply with legislation protecting the privacy of health information while believing they would benefit from personal health details to meet a worker’s accommodation needs. This research aimed to understand organizational perspectives on disability communication-support processes. Methods Twenty-seven participants from diverse employment sectors and who had responsibilities for supporting workers living with episodic disabilities (e.g., supervisors, disability managers, union representatives, occupational health representatives, labour lawyers) were interviewed. Five participants also had lived experience of a physical or mental health episodic disability. Participants were recruited through organizational associations, community networks and advertising. Semi-structured interviews and qualitative content analysis framed data collection and analyses, and mapped communication-support processes. Results Seven themes underpinned communication-support process: (1) similarities and differences among physical and mental health episodic disabilities; (2) cultures of workplace support, including contrasting medical and biopsychosocial perspectives; (3) misgivings about others and their role in communication-support processes; (4) that subjective perceptions matter; (5) the inherent complexity of the response process; (6) challenges arising when a worker denies a disability; and (7) casting disability as a performance problem. Conclusions This study identifies a conceptual framework and areas where workplace disability support processes could be enhanced to improve inclusion and the sustainability of employment among workers living with episodic disabilities.
Highlights
The number of individuals living with a disability is increasing due to an array of influences, including an aging population, the growing prevalence of chronic conditions like musculoskeletal and mental health disorders, cancer, and cardiovascular diseases, and a wide range of social and environmental factors that contribute to disability [1]
Episodic disabilities commonly arise from chronic conditions where there are times of comparative wellness punctuated by intermittent periods of more severe symptoms that can contribute to activity limitations [3]
Chronic diseases associated with episodic disability are often highly prevalent and include mental health disorders like depression and anxiety, rheumatic diseases like arthritis and lupus, Crohn’s and colitis, multiple sclerosis, migraine and epilepsy
Summary
The number of individuals living with a disability is increasing due to an array of influences, including an aging population, the growing prevalence of chronic conditions like musculoskeletal and mental health disorders, cancer, and cardiovascular diseases, and a wide range of social and environmental factors that contribute to disability [1]. Episodic disabilities commonly arise from chronic conditions where there are times of comparative wellness punctuated by intermittent periods of more severe symptoms that can contribute to activity limitations [3]. They are frequently unpredictable even when health conditions are well managed by treatment. Improved treatments for previously lifethreatening diseases like some types of cancer and HIV/AIDS have resulted in these being cast as episodic disabilities
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