In this excerpt from the May/June edition of Mental Health Today Magazine, Andrea Woodside looks at ways in which employers can help their staff feel more comfortable about disclosing a mental health issue. To read the article in full click here to subscribe.

Work is good for us. It sounds simple, even a given, but it remains that many people with experience of mental distress continue to face difficulties in maintaining employment both during and after a period of being unwell.

The Health and Safety Executive agrees that work is “an important part of the recovery process [and the] inability to work brings on more health problems, physical and mental. The longer people are off, the less likely is their return: one in five people off sick for six weeks will remain off work and eventually leave paid employment.”

Nevertheless, charity Rethink Mental Illness highlights that “less than 40% of employers would consider employing someone with a mental health problem. Not surprisingly, people with mental health problems have the highest levels of unemployment among any disabled group – yet also have the highest ‘want to work’ rate”.

In my experience, and that of others I have met with direct experience of mental distress, the majority of people in work who have an enduring mental health problem have lower than average rates of absence, believed to be the result of pressure not to disclose in the workplace.

When dealing with extreme demands at work, those affected by mental distress often feel as though they must prove themselves to be as ‘good as anyone else’ and ‘normal enough to cope’. While it may appear to employers that supporting people with mental health conditions to stay in work is costly, risky and time-consuming, many simply need education and support in order to genuinely be able to declare themselves an employer of choice.

As Paul Farmer, chief executive of charity Mind, points out, there has never been a better time for employers to learn how to support employees who have experience of short-term or chronic mental health problems: “…in times of economic difficulty [there is] an increase in the prevalence of mental distress… [and] it is crucial that the right services and support are available to those who need them,” he says.

People with experience of mental distress do recover, and although they may experience relapses from time-to-time, they can make enormous contributions to their employers. As a workplace well-being consultant and long-standing mental health service user, I have met many people who have felt unsupported – and, as a result, stigmatised – when they have disclosed a mental health condition at work. It can be difficult to visualise recovery when those around us withhold their support out of fear and ignorance.

'Tony’s' story  

Tony (not his real name), is an accountant in his 40s, who found that his ongoing recovery from depression was made more difficult by the barriers he experienced at work. “I was getting nowhere with my manager when I tried to address the stress I was under,” he says. “She insisted that my colleagues were coping well enough and asked me directly if I had a mental health problem. I fell into that trap and it’s something I deeply regret. I disclosed my history of depression and the human resources manager immediately became involved. All I wanted was for help in reducing my workload… not because I have depression but because it is untenable to ask a team to work 60 hours a week just to keep up.”

Always a high performer with an impressive work record, Tony remained with his organisation but experienced myriad setbacks on his journey to recovery; not least of which was a crippling and pervasive feeling of shame. “I felt inadequate” he explains. “And it didn’t help that my manager wouldn’t accept that it was the workload, not my depression that was the problem. She said that I should feel grateful for my job and just get on with it.”

The National Mental Health Development Unit’s factfile, Stigma and Discrimination in Mental Health, offers some insight into why Tony’s distress was amplified after disclosure. Consider that “92% of the UK public believe that disclosing a history of mental health problems would damage a person’s career” and it becomes clear that on top of the normal challenges of recovering from depression Tony also had good reason to feel that his livelihood was at risk through no fault of his own.

Contemplate too Mind’s finding that “one in five people admitting to a mental health problem lose their job” and it becomes clear that Tony’s fears were not unfounded. Indeed, within four months of disclosing his history of depression, he was informed that he presented a serious risk to his organisation and his clients and was subsequently cut off from the very thing that would have helped his recovery.

“I want to work but I experienced a depression unlike any I’ve ever known after being dismissed,” he says. Nearly one year after his dismissal, Tony remains unemployed and lacks the confidence to apply for another job.

The fact that an employee’s past performance is easily forgotten after disclosure is an all too common phenomenon and it can be argued that the pathologisation of a mental health condition is a major cause of stigma.

People with mental health conditions are entitled to have good days and bad, setbacks as well as moments of elation when they have achieved something important at work. But so too is any employee regardless of whether or not they are affected by mental distress. Yet employees with whom I have spoken often feel as though they are disallowed from reacting to the everyday challenges of life in anything but a measured and subsequently inauthentic way. When Tony was dismissed, a senior colleague told him that he was shocked that the organisation had taken such a step and described him as a “steady, unflappable and hard-working member of the team”. Tony has been left bemused as to how his manager linked risk with depression.

Tony is not alone. As highlighted during Mind Week 2011, one in six employees experience some form of mental distress on a daily basis – based on a current UK workforce of 29.19 million people, a potential five million employees – leaving many cut adrift and at constant risk of disengagement and, crucially, the perpetuation of their distress. Surely, it is in the best interests of employee and employer to recognise the need for a supportive environment where disclosure is not only accepted but welcomed.
Building cultures

All employers, with the right training, can contribute to building a culture of respect and openness. We all have a responsibility to ensure that our workplaces are not among those that contribute to the stigma and discrimination felt by “87% [of people] with mental health problems”.

In an ideal world, people with experience of mental distress would not even have to consider the consequences of disclosing to their employer, but until such time it can be helpful for line managers and others who are influential in their organisations to encourage disclosure at work while minding the need for positive follow-up action and support.

Organisations have their own ideas as how to conquer stigma and encourage supportive return to work policies, and there are many excellent examples of best practice in this area. But for organisations starting on the journey, there are some simple, cost-neutral ways to begin:

Employers and employees alike can commit to developing organisational learning around mental distress whether by training or providing factsheets.

While it is difficult to challenge stigma, becoming aware of damaging language is a start. Would any of us tolerate racist or sexist terminology at work? Obviously not. Why then are some people less likely to challenge the use of terms such as ‘nuts’, ‘bonkers’ or ‘unstable’?

Unfortunately, we are exposed to a media that can be guilty of identifying people with mental health conditions as being obtuse, unpredictable or even violent. It is time that such ignorance is seen as risible in and outside of work.

Mental distress affects everyone differently and any employee affected by mental distress is the expert in their own condition. It is well worth the time and effort to create a support package in partnership with the employee.

Resist the urge to pathologise. People with experience of distress are often seen as ‘problematic’ or otherwise abnormal when experiencing the same emotions and reactions as their ‘normal’ colleagues. Having a bad day, being stressed out or just plain fed up can be confused with ‘acting out’. But people with mental health issues have bad days, just as everyone else does. n

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