A secretary who types while wearing gloves and occassionally sits on an office radiator to get warm - even though the radiator is disconnected; an engineer-technician who comes to work brandishing a carving knife and musing about how easy it would be to kill someone; a clerical worker who frequently claims that she has been working at her desk when in fact she has not...
The federal bureaucracy, attuned to uniformity in human activity, has searched agonizingly for the appropriate bureaucratic approach to such irregualr behavior among its employes as in these cases cited by personnel specialists.
The most extreme and most controversial tool provided by the system is authority for an employer to require that the employe take a psychiatric examination to determine "fitness for duty." An adverse diagnosis can result in dismissal, sometimes with disability retirement benefits, but often without them.
Statistics are sketchy, but use of such examinations appears to be increasing. according to congressional investigators. Also increasing are calls for changes in the system.
Critics, including federal workers, union leaders and their congressional allies, charge that federal employers sometimes use the examinations for nonmedical purposes, such as retaliation for personality of policy clashes between themselves and the employe. Critics also contend that the system does not provide sufficient protection of employes' rights to due process and that such examinations are unscientific and often hasty and superficial.
"The thing is, once you've got the word 'psychiatric' in your record, nobody wants to hire you either, no matter what your problem was," said a clerical worker who was put on disability retirement eight years ago after being sent for a psychiatric examination bt the Department of Transportation. She has spent years in unsuccessful legal appeals and informal efforts to get her job back.
Many agency managers and personnel specialists contend that the current system already goes far enough, if not too far, in protecting employe rights, and that vicil service red tape makes it difficult to deal with disruptive or threatening employes until they commit an overt act of violence.
After a federal employe was arrested for shooting a coworker at a Washington officebuilding recently, for example, officials and other employes of the agency said privately that the man previously had thrown a heavy object at a supervisor and otherwise indicated that he was troubled. When managers moved to dismiss the judividual, they said, they had been advised that under civil service rules, they lacked sufficient grounds. Since the shooting, the man has been under psychiatric observation, officials said.
Agencies generally resort to involvuntary fitness-for-duty examinations only as a last resort and for humanitarian purposes, to avoid even harsher action against the employe, many agency officials said.
"If you discredit these examinations, then a manager's only other options, may be to fire the employe, based on job performance, which means they get nothing, said Robert S. Smith, director of personnel for the Department of Transportation.
Still, given society's attitudes toward mental illness, "some people feel the stigma of undergoing a forced psychiatric examination is worse than being fired," said Civil Service Commission official Thomas A. Tinsley, an expert in the field whose bureau advises federal agencies on the subject.
Tinsley noted that record numbers of federal employes are voluntarily seeking psychiatric counseling and treatment, Federal health benefit programs pay most of the cost.
Most Washington hands know a few of those former government employes who trudge along the fringes of the federal establishment year after year, lugging briefcases loaded with documents that, they say, prove they were railroaded out of government for political reasons, because of their religion, race or sex or because they "blew the whistle."
But their records say the grounds were psychiatric." $"Some of them seem obviously deranged," said one Washington observer, whose legal expetise brings him into contact with these people. "Then you have to wonder whether they started out that way or became that way trying to fight the system.
"Some of them seem quite normal, whatever that means, and maybe they are. Some of them make you want to cry," this observer said.
"As an employer, you're close to violating people's rights all the time in this area," said Ray J. Sumser, deputy assistant secretary for personnel at the Department of Health, Education and Welfare.
"When you (order an examination), it's always under fire and under criticism. It means (the employe) won't take care of his own problem and the employer has thrown up his hands and said I don't know what to do... It's essentially a stalemate of ignorance," he said.
Before ordering a fitness-for-duty examination, an employer must collect enough documented evidence to convince a panel of three agency officials, ideally including one medical officer, officials said.
"You are hereby directed to report to Dr.- - -," the official letter begins. "The condition of your health is considered a possible cause of deficiencies in your service observed by Mr. - - -, your supervisor."
The letter spells out the employe's deficiencies and informs him that he has a right to choose a qualified doctor other than the one named and that he has the right to have a union or other representative act on his behalf in the matter.
Some agencies, such as HEW, have psychiatrists on their payroll, while others contact with private doctors to conduct the examinations, officials said.
The procedures parallel those used in firing and disciplining employes and are equally slow, they said.
Still, a diagnosis that can ruin an employe's life often is made on the basis of a single interview by a psychiatrist who carries the mystique of doctor-patient confidentiality but actually is working for management, according to a recent report by the House Subcommittee on Compensation and Employe Benefits, chaired by Reps. Gladys noon Spellman (D-Md.).
The report is based on Spellman's hearings last spring, on preview hearings by Del. Walter Fauntroy (D.D.C.) and on a 1977 report by the General Accounting Office.
None of the examinations lasted more than an hour in cases studied by the subcommittee, an in one case, "the employe was never interviewed (by a psychiatrist) at all," according to a subcommittee staff member. "And the employe doesn't even get to see the file."
Dr. John McGrath, a consulting psychiatrist with the State Department for 10 years, testified for the American Psychiatric Association and told the subcommittee that if a psychiatrist drew any conclusion about an employe's mental health based on failure to respond to questions, that psychiatrist's competence should be questioned.
McGrath and other psychiatrists also have maintained that a trained professional can make a proper diagnosis in a short time although more lengthly sessions would be needed to prescribe a course of treatment.
The report, however, emphasized expert testimony and writings about dissension among psychiatrists themselves as to the value of such tests in work-related situations and even as to definitions of mental illness.
Stressing the need for greater due process protections for workers, the report also quoted David L. Bazelon, chief judge of the U.S. Court of Appeals here, who stated in a 1975 case: "We may not ignore the possibility of bias in favor of the government by state-employed psychiatrists, whether they be Americans or Russians."
"Actually, we do find managers trying to force us to solve their problems by doing something they are unwilling or unable to do themselves," said a psychiatrist who has 25 years of experience with various government agencies. "We do every damn thing we can to avoid doing their job for them."
At the same time, some employes try to abuse the system, he said, by using questionable grounds to request that they be retired on mental disability caused by on-the-job stress.
"Basically," he added, "a psychiatrist working with the government is in a no-win situation."
Another psychiatrist said agencies with which he has dealt will pay him for only one session with any patient. Some agencies provide for more sessoins, officials said.
Several psychiatrists emphasized that their job is to determine whether a person is mentally ill but that managers should decide whether to keep the person on the job.
The effectiveness and method of the federal system in dealing with mental problem s varies widely, depending on the employer, according to various sources.
"I have one patient who has been mentally ill for many years," one psychiatrist said. "But her boss says she does a superb job for him, except that she has to miss work occasionally. Another employer might not be so tolerant.
"It also can depend on the problem. It's easier for coworkers to deal with a depressed person than a paranoid who's always accusing people of conspiring against him," the psychiatrist said.
Many experts recomment improvement of measures less drastic than examinations, such as "troubled employe" counseling programs at the agencies, similar to those required for alcohol and drug problems.
HEW's Sumser said he once spent "a good number of hours over at least a year trying to figure out a way to deal with an employe who was threatening and scaring people" with a knife. At one point Sumser said, he hired armed guards to sit in a room next door, "ready to shoot this guy" if he became violent.
This employe, who among other things tried to move the desks out of an executive's office because the edges were too sharp, resisted psychiatric treatment, Sumser said.
"As often happens, we ended up dragging the relatives in," Sumser said. The man's wife ahad him committed for treatment, he was given appropriate drugs and ultimately was able to return to work, Sumser said.
In some cases, he said, psychiatrists recommended that a troubled employe be transferred to a job with less pressure, but that often means a lowergrade job. "Then managers go through the roof," because the rules fo not allow them to demote people, he said.
If the Carter administration does not soon make major changes in fitness-for-duty examination procedures, the House subcommittee will "move legislatively," a subcommittee aide said. Such a change would require at least two psychiatric interviews instead of one, the aide said.
The administration would like to straighten out the problems somehow CSC's Tinsley said, but that will have to wait until the dust of the president's government reorganization and reform clears and the new lines of authority become clearer.