Disability claims on psychiatric grounds in the South African context: A review

Abstract

We review the nature of disability claims on psychiatric grounds in the South African context, including factors contributing to disability claims, specific disorders usually leading to disability claims, impairment and disability, assessing the degree of impairment, guidelines in assessing psychiatric disability, ethical considerations, consequences of medical boarding, and rehabilitation. Psychiatrists should consider the potential benefits of supervised and mentored work rehabilitation programmes, graded return to work or an appropriate alternative position in consultation with employers.

Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review

“…Severe mental illnesses such as schizophrenia, bipolar disorder and schizoaffective disorders are major causes of mental disability [8]. Also, globally, depression is one of the leading causes of disability [9], but in some African countries it is hard if not impossible to get a disability status approved for Common Mental Disorders (CMD) [10]. Taking this contextual specificity in mind, this review focuses on severe mental health disorders.…”

Challenges of inclusion: a qualitative study exploring barriers and pathways to inclusion of persons with mental disabilities in technical and vocational education and training programmes in East Africa

“…This classification is essential for persons with mental illness because it also affects their opportunities of employment and inclusion in TVET programme; especially in climes where person with intellectual disability are tagged slow learners and excluded from educational endeavours by persons without the relevant skill to teach them. Clear and precise definition of mental illness and definition of what constitutes mental disability has been a source of controversy [38]. The pertinent lesson to note is that inaccurate and poor understanding boosts stigma and poor attitude towards persons with mental illness [28,[39][40][41].…”

Perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries

“…Their provision of care and support is pivotal to recovery and the ability to work [9,11]. In the work environment, occupational health physicians and therapists also contribute to workers' health and wellbeing by providing advice on mental health care and promotion [12][13][14][15]. A study using the Delphi method by Dekkers-Sánchez and colleagues suggest that occupational physicians and rehabilitations physicians have relevant role in work retention and return to work of employees [11].…”

“…Despite the suggestion in some studies that mental illness can lead to impaired social and occupational functioning [16], controversy and challenges remain in the certification of disability as it is sometimes keenly contested by society, persons with mental illness, and mental healthcare providers [15,17]. In the United States, this has been a subject of several court cases, despite the guidance provided by the Americans with Disabilities Act [18].…”

“…In the United States, this has been a subject of several court cases, despite the guidance provided by the Americans with Disabilities Act [18]. In South Africa, persons with mental disorders still face an uphill task in obtaining the disability certificate they need to obtain social benefits [15]. In Kenya, the process is protracted and difficult [19], while in Nigeria, persons with mental illness are not regarded as living with a disability [20].…”