Mental health accommodations can be some of the most complex accommodation requests arising in the workplace, due in part to the complexity of the conditions themselves and the ever-evolving scientific understanding of mental health conditions. In this blog, we explore recent developments in accommodating mental health and cover the key changes employers should be aware of.
The number of mental health accommodation requests faced by employers in recent times has risen, partly due to the profound and diverse effects the COVID-19 pandemic has had on the mental health of employees through times of restrictions and lockdowns. Increased focus on and understanding of mental health issues generally has also resulted in a corresponding increase in employers’ obligations to provide accommodation.
Updates to the Diagnostic and Statistical Manual of Mental Disorders
One of the first guidelines to help employers determine when a mental health concern may qualify for accommodations on the basis of disability is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the “DSM-5”). Employers should note that the DSM-5 has recently been further updated with a text revision (“DSM-5-TR”) to reflect developments arising since its original publication in 2013.
The changes implemented in the DSM-5-TR are mainly of a textual nature, as indicated by the title of the new edition. Many of the changes involve minor updates to make the text more precise, culturally sensitive or to clarify the criteria of certain disorders. However, there are a few additions and changes within the text revision edition that are notably different than the DSM-5.
Prolonged Grief Disorder is a newly recognized disorder added to DSM-5-TR as a condition in the main category of the text. This disorder is defined as “intense yearning or longing for the deceased (often with intense sorrow and emotional pain), and preoccupation with thoughts or memories of the deceased (in children and adolescents, this preoccupation may focus on the circumstances of the death).”
Another change is the re-addition of Unspecified Mood Disorder to the DSM-5. DSM-5-TR clarifies that this classification will be used in situations where “the criteria are not met for a specific depressive disorder and includes presentations for which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings).” Thus, it seems as though Unspecified Mood Disorder is an interim diagnosis disorder until an individual’s mental state can be fully investigated.
Although these changes are not as significant as arose between the fourth and fifth editions of the DSM, they are important for employers to understand when dealing with mental health accommodation requests in the workplace. For example, as a result of the amendment, Prolonged Grief Disorder and Unspecified Mood Disorder can be grounds for accommodation requests by employees in the workplace and may give rise to the duty to accommodate on the basis of disability.
Employees must comply with an employer’s reasonable request for medical information
Notwithstanding the complexities in mental health in the workplace, the legal tests and principles governing an employer’s duty to accommodate have remained fairly static over time. A critical component of the law from an employer’s perspective is an employer’s entitlement and obligation to request that the employee provide the medical information the employer requires to properly assess an accommodation request. Correspondingly, employees have an obligation to cooperate in the process and comply with an employer’s reasonable request for medical information.
Recent arbitral caselaw continues to affirm the importance of the employer’s entitlement to sufficient medical information in mental health accommodation cases, and the limitation of the employer’s duty to accommodate where such information is not provided.
Note: This article is of a general nature only and is not exhaustive of all possible legal rights or remedies. In addition, laws may change over time and should be interpreted only in the context of particular circumstances such that these materials are not intended to be relied upon or taken as legal advice or opinion. Readers should consult a legal professional for specific advice in any particular situation.
 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (Arlington: American Psychiatric Association, 2022).
 “Prolonged Grief Disorder”, Notes on DSM-5-TR, (2022).