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What can be done to accommodate high-functioning mentally ill people in a work or other situation? What does "reasonable accommodation," under the Americans with Disabilities Act, look like? 

In the 1980's, I took an electronics training course. I then worked for several television repair shops--some of these jobs were more difficult than others. When I began my first television repair job, I was deemed an "apprentice." But I gained more skill and became a "trainer" of a trainee that had been hired. This first electronic repair job lasted about a year until the company went out of business. (A couple of years later I phoned the former owner of the shop to say "hi" and in the phone conversation I finally disclosed my mental health condition. She said that she had no idea.) 

Later, I worked for a television repair shop that was owned by people who knew a lot more about the TV repair industry. While I didn't disclose my psychiatric condition, the owner of the shop could tell that I was high strung, and took some steps to accommodate me. He was willing to do this, in part because he liked my work. I was pretty skilled in troubleshooting problems in analog television sets. 

Actually, there were three different television repair shops in which the owners made an effort to make it easier for me. In only one of those three did I disclose my disability. 

In one position, the owner said that when I felt too much pressure, I could go "take a break and come back." Another shop put a fair amount of pressure on me but created a nonthreatening atmosphere. The positions that worked well for me were usually part-time, with eight hour shifts, three or four days per week. 

I have always been suited to working for small companies, of about a dozen or fewer employees, in which I am supervised by the business owner. In corporate scenarios I have rarely done well. 

In my twenties, I also had a job delivering pizza in which I was accommodated. The owner confronted me after my first two weeks of work, believing, due to my sedated appearance, that I was on illegal drugs. At that point, I had no choice but to disclose, unless I wanted to be fired on the spot. The owners of the pizza shop allowed me to deliver a smaller number of pizzas at a time. 

These employers believed my work was good, and were willing to adjust the work situation to make it less stressful. 

In another instance of accommodation, my landlord waived his "no dogs" policy so that my wife could own a service dog. The dog helps us both with anxiety and also serves as a watchdog. (It is a little, yappy, Chihuahua-Terrier mix--small dogs are popular in our neighborhood.) This is yet another example of how "reasonable accommodation" doesn't need to be systematized or given an institutional stamp. 

I have also tried my hand at self-employment. I believed that I could tailor the structure of the company to suit my strengths and weaknesses. However, I kept butting up against the fact that if I wanted to make money, I would need to deal with considerable discomfort. To make a profit in almost any company, someone needs to "push the envelope" or else they will not be competitive. 

The mental health treatment system doesn't teach people how to behave in a "normal" setting, and caregivers assume that we don't need that knowledge. Once institutionalized, and this includes outpatient institutionalization, we are expected to act as people who don't understand appropriateness. 

Work settings for me have been far less stigmatizing compared to the mental health treatment system. The exception to this has been jobs that were acquired in conjunction with the system. 

Nevertheless, in or near 2003, I worked for "Sapling Project" which was a one-of-a-kind, pilot program that provided supported, computer-related employment to selected mental health consumers. Since the program was administered by a former mental health consumer, I did not feel the same stigma that I might otherwise feel. The project, unfortunately, ended when the administrator became ill.