Puget Sound Energy A Leader on Mental Health

Many employers are facing increases in sickness and disability-related absences. Puget Sound Energy put services, procedures and forms in place to address the effect of psychiatric or cognitive functioning issues on employees.

Approaches to Cognitive and Behavioral Restrictions

Employers frequently have services and procedures in place for employees who become injured on the job or who develop physical disabilities. Workplace accommodations for physical impairments are common. Employees with psychiatric, cognitive, or behavioral impairments, however, often present a challenge for employers. Jenny Haykin, integrated leaves and accommodation consultant for Puget Sound Energy in Bellevue, Washington, since 2007 gained experience in this area as a disability services team lead with King County government (an employer with 13,500 employees) where she facilitated accommodations for employees with cognitive and psychiatric disabilities. When in this role, she noticed that methods for addressing employees’ physical impairments were more advanced than for mental impairments. For example, evaluation forms were available to help obtain documentation from an employee’s physician or clinician regarding a worker’s specific physical limitations to determine whether reasonable accommodations might help address a physical impairment. However, no forms were available for mental impairments and documentation of specific restrictions was rarely received.

Forms to Facilitate Accommodation

Haykin spearheaded an effort to develop forms and procedures that would facilitate accommodations for workers with diagnosed mental, behavioral or learning impairments. She worked with the King County’s team of vocational rehabilitation counselors and area psychiatrists to develop the following forms for health care providers to assess the worker’s capacities and limitations when evaluating or treating employees with cognitive and psychiatric conditions:

• The Cognitive and Behavioral Capacities Evaluation form which lists a variety of job demands for the health care provider to review and respond to.

• The Job Analysis form to document the cognitive and behavioral requirements specific to an employee’s job.

Both forms use the same cognitive and behavioral capacities so they may be used separately or in conjunction with one another. Haykin continues utlizing these forms at PSE as a step in the accommodation process for employees with cognitive and/or behavioral limitations.

The procedure for using the forms begins when it becomes known there is a cognitive or behavioral medical issue or learning disability. The employee or a vocational rehabilitation counselor, case manager or human resources representative (all with permission from the employee) then provides information to the health care provider or learning disability specialist on the nature of the job. At the same time, information about work performance concerns and specific questions are provided. This educates the health care provider or learning disability specialist so that as they make their assessments, they will better understand what is expected of the employee at work, and what information the employer will need to be able to facilitate potential accommodations with the employee. Haykin has found that employees are quite willing to allow this exchange of information with their care provider with the understanding that the performance or behavioral issues will need to be addressed. It is preferable for this to occur through accommodation rather than through a disciplinary process.

The Cognitive and Behavioral Capacities Evaluation Form and the Cognitive and Behavioral Job Analysis seek the provider’s opinion on the employee’s capacity in comprehension, memory, learning, processing information, task completion and work behaviors. For example, is the employee able to remember written instructions, maintain emotional control under stress, direct others in complex tasks or respond effectively to emergencies? This information is then used to help the representative (typically a vocational counselor) work with the employee’s supervisor to make specific adjustments in their work tasks to accommodate the employee’s disability. See examples below.

Consultant Role

Haykin frequently serves the role of educating health care providers, vocational rehabilitation counselors, HR professionals and workplace supervisors on the use of the forms, importance of assessing and documenting abilities and limitations and the therapeutic value of work. She also trains managers and supervisors on reasonable accommodations and how to use available resources to help employees.

Cognitive and behavioral impairments may first surface in the form of a work performance deficit – the employee shows up late, misses deadlines or has difficulty completing tasks. The initial discussion is often between the employee and their supervisor. Haykin encourages supervisors to document performance problems and to share objective observations that explain in clear terms what the issues are. Supervisors should explain to an employee when his/her behaviors or other performance issues are not acceptable and to communicate performance expectations, while at the same time being supportive and asking what, if anything, would help the employee prevent these behaviors from occurring in the future without a presumption that there is any disability. Haykin reinforces that once an employee has indicated a cognitive or behavioral medical or learning issue supervisors must not ask questions about conditions or treatments. Instead, discussions should be about work restrictions documented by the employee’s provider, including whether they are temporary or permanent and what reasonable accommodations may help.

When employees are informed of behavioral or performance concerns, they may see for the first time how their condition is affecting them at work. Some then seek evaluation and treatment where they have not done so previously. Once a cognitive impairment is diagnosed and limitations documentation is received, accommodation options can be considered and reviewed for possible implementation. For example, assuming the existence of a cognitive impairment or other mental disability that affects an individual’s performance, accommodations may be similar to the following case scenarios:

• Office worker – surfing the Internet, unable to stay on task. Accommodations may include coaching on organizational and focusing skills from a local learning disabilities association.

• Office clerk – engaging in extreme germ-avoidant behaviors. Worker may be provided a developmental disabilities job coach to help learn new job tasks and ways to minimize interruptions, thus reducing the stressors that resulted in the unusual behaviors. Accommodations may include setting precise routines for performing work.

• Project manager with memory deficits – unable to report verbally on project details in unstructured staff meetings. Accommodations may include providing questions in advance and allowing referral to notes.

• Repairman with phobia about driving large trucks – avoided completion of Commercial Drivers License exam. Accommodation may include waiver of the exam and job readjustment to allow driving small trucks.

Supportive and Accountable Work Culture

Haykin notes that PSE has a unique work culture where people are accountable for respectful behavior toward one another. All employees are trained in the company’s code of ethics, which is posted on their website, and targeted refresher training is provided regularly. The utility’s anonymous ethics hotline is available 24 hours a day. When workers don’t treat other people well, it is promptly investigated and addressed.

The utility itself has Employee Assistance and Wellness programs. When there are organizational changes, workers are informed as quickly as possible with as much information as can be disclosed out of respect for employees’ concerns. These are all reinforced with employee communications vehicles. Haykin, who holds a master’s degree in organizational psychology, suggests this culture may play a role in their high success rate in keeping people employed and getting them back to work after injuries or impairments. People are often with the utility for their entire career and there are multiple generations of families working for the company.

Last Updated: August 2010