By Dr. David Clayman
Like a complex machine, any business or organization depends on the proper functioning of all individual components working in an effective, interactive manner. Everything must be operating properly for the machine to be maintained in top working order, no matter how big or small the component may be. Just think what happens when the smallest ball bearing goes bad—the machine can be brought to a standstill.
The same is also true with the human component. It goes without saying that people are essential to all enterprises, no matter how big or small their roles may be. No one should take issue with the idea that employees are a business’ greatest asset, yet at the same time payroll and benefits account for a large share of a company’s expenses. More importantly, when an employee’s ability to function effectively is compromised, it becomes a potentially serious liability.
Employers and human resource professionals are used to dealing with physical problems within their work force that result in decrements in work performance. Pain complaints or noticeable injuries result in referrals to health care professionals who may assess the worker’s ability to perform essential job functions. Questions are asked about someone’s abilities—for example, to stand, climb stairs, sit for a specified number of hours, lift certain amounts of weight or perform repetitive tasks—with or without accommodation under the Americans with Disabilities Act. Treatment recommendations may be made, rehabilitation might proceed and hopefully the condition is resolved or the employee moves toward disability. An individual’s functional capacity—the ability to carry out essential job duties—is the primary focus.
But what about mental fitness, where the ability to think and process information, pay attention, act appropriately and responsibly, get along well with others and be in control could be reasons that someone isn’t getting the job done? Such an individual can be disruptive to co-workers and other aspects of operations, resulting in a poorly functioning work environment, damaged product or dissatisfied customers. In some cases, dysfunctional employees can create fear of emotional or physical harm which puts everyone at risk. As someone becomes more problematic, the employer faces numerous liabilities, including costly litigation. Risk management usually focuses on the physical issues, both with people and in a facility, when it is mental fitness that may be most important.
The difficulties facing an employee may not be immediately obvious. It may take time to discover that someone charged with monitoring a computer is being inattentive because of problems with maintaining attention and concentration. If a worker is distracted because of worry about a sick spouse, safety procedures may be forgotten. Deadlines may be missed. Errors may be made in assembly. Tempers may flare. Work product may be sloppy and inaccurate. Dosages of medicines may be wrong. Fellow workers may find themselves picking up the slack or covering for the poor performance of others. Any or all of these potential sources of error or harm can have a significant adverse impact on the operational and financial integrity of any business.
There are three basic strategies for dealing with these kinds of problems when a good employee seems to have gone bad: ignore or tolerate the employee; terminate or disable the employee or accommodate or rehabilitate the employee. All of these have costs associated with them. Which option is chosen depends on the value of the employee. In making this determination, it is necessary to consider what it would take to replace the individual with someone with similar experience and knowledge. Also, it is essential to assess possible legal consequences involved in either ignoring the problem or firing someone who may decide to sue.
In many cases, a distressed employee is not referred to an evaluator until an unacceptable act occurs. Preventive action may be taken when an individual’s behavior changes from the norm—the quiet employee who becomes overly garrulous; the neat and fastidious person whose hygiene changes or workspace becomes a mess; the ambitious salesperson who misses goals and doesn’t seem to care; the physician who screams at a patient—and any other change off baseline.
It is a mistaken assumption that someone who may be encountering problems grounded in emotional issues needs to undergo a mental health evaluation by a psychologist or psychiatrist. Such an undertaking will likely only address whether there is a diagnosable condition that may justify time off from work and either treatment with medication or weekly counseling. The latter is not much different than services that might be obtained through an employee assistance program. This often addresses personal issues (e.g., anxiety, depression, substance abuse, marital discord) that impact work performance but does so over an extended period of time. The demands of the job are secondary.
A fitness for duty evaluation is designed to address work-related issues and determine whether an individual has the capacity to effectively perform essential job functions. Many factors other than a mental disorder can be the source of any one of the types of problems cited earlier. When aggression or violence is identified, an assessment of potential risk for harm to self or others is added. The goal of this undertaking is to provide the employer with objective data upon which informed decisions may be made. This is accomplished by a combination of interviews, selected testing and review of material provided by the employer. Consideration must be given to a host of possible contributing factors, including ingestion of toxic or mind/behavior altering substances; change in brain function brought on by injury, growths or dementia; medical conditions and their treatments that could influence mood and actions; mental disorders and personality problems. The last of these, as well as acute stressors, are usually found to be the bases for problems, which means that short-term intervention and structure can help remediate a managerial problem.
The evaluator may work with the owner, human resources or legal counsel to process information and design a plan that can assist in helping an employee identify and deal with those things that are interfering with acceptable work performance. Very often, employees are relieved when their sources of stress or dysfunction are identified in a non-judgmental manner and a reasonable plan is implemented. Additionally, this approach allows managers to be coached to deal with difficulties that are outside of their skill set in a way that shows concern for the employee while remaining accountable to the mission of the company. This should be done with an awareness of applicable state and federal laws as well as the policies and procedures of the company or organization.
Willingness to undergo an evaluation that should include recommendations for future action takes courage and commitment on the part of the employer and employee. When all factors are addressed appropriately, everyone wins. The goal is to assure that the safest and most efficacious decisions are made considering the needs and demands of all parties.
As stated in the February 2011 issue of Golf magazine, “No heavy lifting is required, but mental fitness demands discipline. In that sense, it’s not different than honing washboard abs.” A functional capacity assessment helps determine what efforts have to be made to bring damaged employees back into psychological shape or helps find a new activity that better fits their capabilities.
