i do not know that the ada directly applys, but, most states have ways that
families with their doctors can have mentally disabled folk declared thus.
after that, then their family could ask that the ada be considered in play
and at that time i think it would come  into play.

-----Original Message-----
From: Yvonne Craig [mailto:[log in to unmask]]
Sent: Thursday, November 16, 2000 4:20 PM
To: [log in to unmask]
Subject: Re: Cognitive Dis. & Reason. Accomd. Requests & ADA


I live in Canada so I'm not really familiar with the ADA and this may not =
apply...

I work with people living with chronic mental illness (schizophrenia, =
manic-depression, depression, etc.). Awareness (or acceptance) of illness =
is sometimes an issue. (Irrelevant for me as a nurse as my focus is health =
and lifestyle choices - but there are areas of overlap and the system IS =
based on medical models of diagnosis, etc.) If a client doesn't see =
themselves as medically ill or as having a disability, that is their =
perspective and that should be respected as much as possible ie the right =
to refuse medical treatment / medication.=20

If that person's choices result in potentially dangerous behaviours =
(either to themselves or others) then there are legal means to step in for =
protective interventions (for the individual or for society). Examples =
would include suicidal behaviour, self-neglect (not eating, skin breakdown =
from poor hygeine, wearing clothing inappropriate for the weather, etc.), =
or violence. In these instances the family, the police or the medical =
system can act to have the patient assessed and possibly treated against =
their will in certain circumstances.

The only other instances where one could act contrary to the person's =
expressed wishes would be if that person is deemed to be incompetent. This =
is a medical/psychiatric evaluation. If declared incompetent then a =
substitute decision maker is appointed (usually a family member but =
sometimes a court-appointed guardian).

As far as I know these are pretty standard guidelines in psychiatry in =
North America, though every jurisdiction would have some variations.=20

Unfortunately that means that many people are at risk of falling between =
the cracks. If they don't see themselves as either ill or disabled they =
are unlikely to seek out assistance or accomodations offered by ADA. If =
they have cognitive impairment they may not be able to navigate the system =
to access services. If their behaviour does not fall into one of the =
categories mentioned above then no one may even become aware of their =
situation to offer assistance or education re their rights. My understandin=
g is that a large percentage of the homeless population in North America =
consists of people who have some form of chronic mental illness (including =
addiction issues) that is untreated. This makes them highly vulnerable - =
to malnutrition, exposure, crime, neglect...=20

The hardest part of my job sometimes is to have to respect a person's =
right to walk away from the help I can offer. But people have to have the =
right to make their own choices for themselves and live their lives as =
they wish.=20

Just my thoughts.

Yvonne

>>> [log in to unmask] 11/15/00 10:40PM >>>
I need to know if there's any ADA or other federal case law regarding
reasonable accommodations which addresses the needs of cognitively or
psychiatrically impaired individuals who may be impaired from requesting a
reasonable accommodation due to the nature of their disability? In other
words, if the requirement for reasonable accommodation is that the PWD =
must
initiate the request, what happens when the disability prevents the PWD =
from
being able to do so?

What happens when they don't see themselves as disabled, even when by any
objective standard, they clearly are?

Don't the above situations leave these individuals unnecessarily vulnerable=

under the law if no other provisions are in place.

I know some state statutes address these issues, but what about Federal?
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