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Durham, N.C. -- Sixteen years after Congress enacted the Americans with Disabilities Act (ADA), people with psychiatric disabilities are faring worse in court cases against employers for discrimination than are people with physical disabilities, researchers have found in a national study.

"People with psychiatric disabilities were less likely to receive a monetary award or job-related benefit, more likely to feel as though they were not treated fairly during the legal proceedings and more likely to believe they received less respect in court," said Jeffrey Swanson, Ph.D., a study investigator and an associate professor of psychiatry at Duke University Medical Center.

"When people with disabilities sue their employers for discriminating against them, they are hoping to achieve a tangible result, such as getting their job back or receiving some monetary compensation," Swanson said. "But that's not the only thing that matters. They want to be heard and treated fairly. Sometimes that alone can signal victory for a plaintiff, but if that doesn't happen, it can add insult to injury."

The findings appear in the current issue (Volume 66, Issue 1) of the Maryland Law Review. The research was funded by the National Institute of Mental Health.

The researchers said the study is the first to examine how individuals with psychiatric disabilities fare in the court system.

The ADA gives people who believe they have experienced employment discrimination due to a physical or mental disability the right to file a complaint with the U.S. Equal Employment Opportunities Commission (EEOC). If they do not receive what they consider a satisfactory outcome, they are entitled to file a lawsuit.

The EEOC and the court system rely on the American Psychiatric Association Diagnostic and Statistical Manual to determine which psychiatric illnesses fall under ADA protection. Recognized diseases include schizophrenia, bipolar disorder, depression and most anxiety disorders.

The study team, which included researchers from three universities, reviewed court settlements and judicial decisions from 4,114 cases filed between 1993 and 2001. Team members also conducted telephone interviews with a representative sampling of 148 plaintiffs who had a psychiatric disability and 222 plaintiffs who had a physical disability, to find out how they felt about the outcome of their case.

The researchers found that 37 percent of plaintiffs with psychiatric disabilities received a settlement from the defendant or a court ruling in their favor, compared with 49 percent of plaintiffs with physical disabilities.

"A common complaint about the ADA is that the law is a boon for people with psychiatric and other 'trivial' disabilities, and our research shows this isn't correct," said Kathryn Moss, Ph.D., principal investigator of the study and head of disability research at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. "We have consistently found that painfully few people with psychiatric disabilities receive protection from the ADA's employment discrimination enforcement system."

The study participants' perceptions reflected case outcomes, the researchers said. Nineteen percent of plaintiffs with psychiatric disabilities felt the presiding judge had treated both sides fairly, compared with 31 percent of plaintiffs with physical disabilities. Thirty-nine percent of plaintiffs with psychiatric disabilities felt they were treated respectfully during the legal process, compared with 52 percent of plaintiffs with physical disabilities. Nineteen percent of plaintiffs with psychiatric disabilities reported that they were satisfied with the overall experience of filing a lawsuit, compared with 36 percent of those with physical disabilities.

"The findings shed light on a significant problem that needs to be addressed through continuing education of judges, lawyers and others responsible for enforcing the ADA," said study team member Scott Burris, James E. Beasley professor of law at Temple University. "It's not enough to give people employment rights on paper. The legal system has the responsibility to ensure that everyone has a fair chance to vindicate their rights in practice."

Other researchers involved in the study were Leah Ranney and Michael Ullman of the University of North Carolina at Chapel Hill.