Mental health and the world of work: a comparative analysis of the legal frameworks governing categories of mental health conditions
Abstract
English: Mental health conditions such as depression are common in the world of work. Despite
having been a significant concern for centuries already, these conditions are becoming
particularly prevalent in modern society and workplaces across the globe. Although
they affect the legal realm in many different areas, mental health conditions are often
misunderstood and inappropriately dealt with from a legal perspective. Inevitably, this
will give rise to concerns in the employment environment.
Depression appears to be the most prevalent of all the categories of mental health
conditions, with the most noteworthy impact on employment. Its symptoms are
debilitating and impair sufferers’ ability to fulfil the inherent requirements of their jobs.
In addition, the medication used to treat and manage mental health conditions, such
as antidepressants, also leads to various debilitating side effects, which may further
affect the person’s ability to function efficiently at work.
The United Nations (UN) Disability Convention has set the international benchmark
for all jurisdictions in addressing mental disabilities, discrimination based on mental
health as well as reasonable accommodation for these conditions. The convention
displays support for the social model of disability and a substantive approach to
equality. The International Labour Organisation (ILO) has in turn also played a
significant role in offering guidance for domestic legal frameworks to address mental
health concerns in the workplace. Against the backdrop of international instruments
such as those of the UN and the ILO, this study takes an in-depth look at the approach
to mental health conditions in employment in the jurisdictions of South Africa, the
United States (USA) and the United Kingdom (UK). More specifically, the research
analyses the various jurisdictions’ take on mental health conditions as disabilities
under the law, the disputability of workplace discrimination based on mental health,
and the procedures and measures to provide reasonable accommodation for
employees with mental health conditions.
Across the jurisdictions, depression in particular and mental health conditions in
general may amount to legally recognisable disabilities if they can satisfy the elements of the specific disability definition used. In South Africa, the USA and the UK, these
definitions and elements differ. These three jurisdictions’ legal frameworks do however
acknowledge that in order for a mental health condition to attract disability status, the
condition must be recognisable and must have a particular impact on the life or
employment potential of the employee or job applicant within a particular timeline.
Although the Constitution of the Republic of South Africa, 1996, requires a substantive
approach to equality and, thus, the consideration that mental health conditions such
as depression may amount to legally recognisable disabilities, South African disability
law has been slow to give effect to this, lagging slightly behind the USA and UK in this
regard. Consequently, the South African legal position on mental disabilities is
underdeveloped and ambiguous.
Due to the significant stigma and prejudice associated with mental health conditions,
they often form the basis for discrimination in both society and the workplace.
Discrimination based on a person’s mental health status impairs the individual’s right
to dignity, equality and non-discrimination, and may potentially even aggravate
existing mental health conditions. In the USA, UK and South Africa, discrimination
based on mental health may be challenged on the protected ground of disability,
provided that the condition in question satisfies the legal requirements to constitute a
mental disability. The UN Disability Convention along with disability-specific legislation
in the USA and UK extensively governs this consideration. South Africa, on the other
hand, does not have any legislation giving effect to the UN Disability Convention. Yet,
the Constitution and the Employment Equity Act do enable victims to challenge
discrimination based on mental health on either the protected ground of disability, or
as an unlisted analogous or arbitrary ground of unfair discrimination. The latter does
appear more viable in light of the disadvantage suffered by these persons because of
their conditions.
Under the South African legal framework, reasonable accommodation for mental
health conditions is based on two primary foundations: Firstly, reasonable
accommodation is available to people with mental disabilities as an affirmative action
measure; secondly, reasonable accommodation may possibly also be available to
persons with mental health conditions in general, since it essentially constitutes a nondiscrimination
principle. Reasonable accommodation in the comparative jurisdictions
of the USA and the UK, on the other hand, flows primarily from their respective disability-specific legislation. To provide effective reasonable accommodation on the
basis of mental health, several factors need to be considered in an interactive process
between employer and employee. These include occupational health and safety, the
intersection between reasonable accommodation and incapacity, the
disproportionate-burden threshold, and the various forms of reasonable
accommodation that may best suit the mental health condition in question, given its
specific symptoms and diagnostic features.
This study emphasises the importance of adequate and effective consideration of
mental health conditions under the legal frameworks of jurisdictions worldwide due to
the global prevalence of these conditions, their devastating effects, and the
disadvantage experienced by those who suffer from these conditions. Based on the
comparison with the USA and the UK, it is concluded that the South African legal
framework in relation to mental health conditions needs to be urgently developed in
order to promote clarity and certainty regarding the official legal position on these
conditions, as well as to safeguard the rights and interests of employees with mental
health conditions in the workplace. As an added, more practical contribution, the study
concludes with a proposed draft code of good practice on the handling of mental health
conditions in the workplace, a draft set of interpretative guidelines for the South African
judiciary, Department of Labour, employers and employees in dealing with these
conditions in the world of work, as well as a draft workplace policy on mental health
conditions for potential adoption by employers. Afrikaans: Geestesgesondheidstoestande soos depressie is algemeen in die arbeidswêreld. Al
is dit reeds eeue lank ’n beduidende kwessie, kom hierdie toestande wêreldwyd al hoe
meer in die moderne samelewing en werkplek voor. Hoewel dit die regsdomein op
verskillende maniere raak, word geestesgesondheidstoestande dikwels uit ’n
regsoogpunt verkeerd verstaan en onvanpas hanteer. Dit is daarom onafwendbaar
dat dit tot uitdagings in die werksomgewing sal lei.
Depressie kom oënskynlik die meeste van alle kategorieë
geestesgesondheidstoestande voor en het ook die merkbaarste impak op werk. Die
simptome is uitmergelend en beïnvloed depressielyers se vermoë om aan die
inherente vereistes van hulle poste te voldoen. Daarbenewens het die middels
waarmee geestesgesondheidstoestande behandel en bestuur word, soos
antidepressante, ook verskeie aftakelende newe-effekte, wat die persoon se vermoë
om doeltreffend te werk verder kan verswak.
Die Verenigde Nasies (VN) se Gestremdheidskonvensie het die internasionale rigpunt
geword vir hoe alle jurisdiksies geestesgestremdhede, diskriminasie op grond van
geestesgesondheid, sowel as redelike voorsiening vir hierdie toestande behoort te
hanteer. Die konvensie toon sydigheid vir die sosiale model van gestremdheid en ’n
substantiewe benadering tot gelykheid. Op sy beurt het die Internasionale
Arbeidsorganisasie (IAO) ook ’n beduidende bydrae gelewer om leiding te bied oor
binnelandse regsraamwerke om geestesgesondheidsprobleme in die werkplek te
benader. Teen die agtergrond van internasionale instrumente soos dié van die VN en
die IAO, onderneem hierdie studie ’n diepte-ondersoek van die benadering tot
geestesgesondheidstoestande in die werkplek in die jurisdiksies van Suid-Afrika, die
Verenigde State (VSA) en die Verenigde Koninkryk (VK). Die navorsing ontleed in die
besonder die verskillende jurisdiksies se benadering tot
geestesgesondheidstoestande as gestremdhede volgens die reg, die aanvegbaarheid
van werkplekdiskriminasie op grond van geestesgesondheid, en die prosedures en
maatreëls om redelike voorsiening te maak vir werknemers met
geestesgesondheidstoestande. In ál die jurisdiksies kan depressie in die besonder en geestesgesondheidstoestande
in die algemeen op wettige gestremdhede neerkom indien dit aan die elemente van
die heersende gestremdheidsomskrywing voldoen. Suid-Afrika, die VSA en die VK
maak van verskillende omskrywings en elemente gebruik. Tog erken die
regsraamwerke van ál drie jurisdiksies dat ’n geestesgesondheidstoestand
gestremdheidstatus kan geniet indien die toestand herkenbaar is en binne ’n sekere
tydperk ’n bepaalde impak op die lewe of indiensnemingspotensiaal van die
werknemer of werksaansoeker het. Hoewel die Grondwet van die Republiek van Suid-
Afrika, 1996, ’n substantiewe benadering tot gelykheid vereis, en dus ook die
oorweging dat geestesgesondheidstoestande soos depressie op wettige
gestremdhede kan neerkom, was Suid-Afrikaanse gestremdheidsreg tot dusver stadig
om hieraan uitvoering te gee, en is die VSA en VK meer gevorderd in hierdie verband.
Die Suid-Afrikaanse regstandpunt oor geestesgestremdhede is gevolglik
onderontwikkel en dubbelsinnig.
Weens die beduidende stigma en vooroordeel wat met geestesgesondheidstoestande
verband hou, maak dit dikwels die grondslag vir diskriminasie in die samelewing sowel
as die werkplek uit. Diskriminasie op grond van ’n persoon se
geestesgesondheidstatus tas die individu se reg op menswaardigheid, gelykheid en
nie-diskriminasie aan, en kan moontlik selfs bestaande geestesgesondheidstoestande
vererger. Diskriminasie op grond van geestesgesondheid kan in die VSA, VK én Suid-
Afrika op die beskermde grond van gestremdheid aangeveg word, mits die betrokke
toestand aan die regsvereistes van ’n geestesgestremdheid voldoen. Die
Gestremdheidskonvensie van die VN sowel as gestremdheidspesifieke wetgewing in
die VSA en VK bied omvattende bepalings hieroor. Daarteenoor het Suid-Afrika geen
wetgewing wat uitvoering gee aan die VN se Gestremdheidskonvensie nie. Tog stel
die Grondwet en die Wet op Diensbillikheid slagoffers in staat om diskriminasie op
grond van geestesgesondheid aan te veg op hetsy die beskermde grond van
gestremdheid, of ’n ongelyste analoë of arbitrêre grond van onbillike diskriminasie.
Laasgenoemde is waarskynlik meer haalbaar in die lig van die benadeling wat hierdie
persone weens hulle toestande ervaar.
Ingevolge die Suid-Afrikaanse regsraamwerk berus redelike voorsiening vir
geestesgesondheidstoestande op twee hoofgronde: Eerstens het persone met
geestesgestremdhede toegang tot redelike voorsiening as ’n maatreël van regstellende aksie; tweedens kan diegene met geestesgesondheidstoestande in die
algemeen ook op redelike voorsiening aanspraak maak aangesien dit in wese ’n niediskriminasiebeginsel
is. Daarteenoor spruit redelike voorsiening in die vergelykende
jurisdiksies van die VSA en die VK hoofsaaklik uit hulle onderskeie
gestremdheidspesifieke wetgewing. Om doeltreffende redelike voorsiening vir
geestesgesondheidstoestande te maak, moet verskeie faktore in ’n interaktiewe
proses tussen werkgewer en werknemer oorweeg word. Dit sluit in
beroepsgesondheid en -veiligheid, die oorvleueling tussen redelike voorsiening en
ongeskiktheid, die drempel van ’n oneweredige las op die werkgewer, en die mees
geskikte vorme van redelike voorsiening vir die betrokke
geestesgesondheidstoestand, met inagneming van die spesifieke simptome en
diagnostiese kenmerke.
Hierdie studie beklemtoon die belang van voldoende en doeltreffende oorweging van
geestesgesondheidstoestande ingevolge die regsraamwerke van jurisdiksies
wêreldwyd weens die hoë internasionale voorkoms van hierdie toestande, die
verwoestende uitwerking daarvan, en die benadeling wat diegene met hierdie
toestande ervaar. Op grond van die vergelyking met die VSA en die VK, is die
gevolgtrekking dat die Suid-Afrikaanse regsraamwerk in verband met
geestesgesondheidstoestande dringend ontwikkel moet word om sekerheid en
duidelikheid oor die amptelike regstandpunt oor hierdie toestande te bevorder, en om
die regte en belange van werknemers met geestesgesondheidstoestande in die
werkplek te beskerm. As ’n bykomende, meer praktiese bydrae, sluit die studie af met
’n voorgestelde konsepkode van goeie praktyk vir die hantering van
geestesgesondheidstoestande in die werkplek, ’n konsepstel vertolkende riglyne vir
die Suid-Afrikaanse regbank, Departement van Arbeid, werkgewers en werknemers
oor die hantering van hierdie toestande in die arbeidswêreld, sowel as ’n
konsepwerkplekbeleid oor geestesgesondheidstoestande vir moontlike
ingebruikneming deur werkgewers.
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