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.