Encompassing a broad range from McJobs to real jobs, U.S. employers today must provide reasonable accommodation not only to the physically disabled but to workers with mental disabilities as well.

As scientific knowledge accrues, society begins to understand mental health illnesses as a profound commonality that is more normative than not. As many as 58 million Americans — or one in four adults — suffers a mental health impairment in any given year, according to the National Alliance on Mental Illness. And among them, some 9.6 million with a serious mental health impairment such as major depression, schizophrenia, or bipolar disorder.

By far, major depression is the leading cause of medical disability in the United States. Affecting one in 10 American adults at a given time, the persistent condition may significantly dampen thoughts and mood, behavior and functioning, as well as overall physical health. However, the most costly mental disabilities for employers are bipolar disorder, psychoses, anxiety, and varying psychotic and nonpsychotic disorders.

Thanks to the Americans with Disabilities Act, some of the country’s economic burden from mental illness is shouldered by employers. On average, employers pay $348 per employee every year in costs associated with major depression and other mental health illnesses, according to a study in the Journal of Occupational & Environmental Medicine.

Aside from a pragmatic acceptance of the cost of doing business, however, some employers see the classic “win-win” of the stuff best-selling business books are made. Often among the most brilliant and creative, people with bipolar disorder offer employers a characteristically mixed bag of high productivity followed by mood crashes sometimes disruptive to colleagues, according to Tom Wootton, author of The Bipolar Advantage.

“The dilemma is not that they’re hard to fire, but that they’re hard to keep,” Wootton says. “The only way to keep them is to accommodate them.”

As to how to accommodate people with bipolar disorder disorder Wootton has no help other than to advise “creative” solutions for each person. However, the federal government offers some guidance for employers on providing reasonable accommodation for documented mental disabilities, including:

  • Providing self-paced workloads and flexible hours;

  • Modifying job responsibilities;

  • Allowing leave (paid or unpaid) during periods of hospitalization or incapacity;

  • Assigning a supportive and understanding supervisor;

  • Modifying work hours to allow people to attend appointments with their psychiatrist;

  • Providing easy access to supervision and supports in the workplace;

  • Providing frequent guidance and feedback about job performance.

Yet some people are nearly unemployable in the traditional sense, including some 85 percent of people with autism spectrum disorder (ASD), according to a number of estimates. However, more U.S. employers are finding a use for such workers in jobs requiring significant attention to detail, such as software and customer-service jobs. Software maker SAP told The Wall Street Journal this week they're actively recruiting people with ASD to fill such positions. And among other shining examples, the once-scandalized Freddie Mac has joined with the Autistic Self Advocacy Network to provide paid internships to students and graduates in fields such as information technology and finance.

Jose Velasco, who leads the autism employment project at SAP's U.S. headquarters, says he has two children with the conditition, and is thus familiar with the symtomology on an intimate level. "They have a very structured nature" and like nonambiguous, precise outcomes, Mr. Velasco said. "We're looking at those strengths and looking at where those traits would be of value to the organization."

But there's more to it, says Valasco. Workers with mental disabilties bring mental diversity, a much needed difference in perspective that often fosters creativity.