When it comes to work, those who are in the throes of depression, addiction, anxiety, a bipolar episode or some other type of mental issue typically suffer alone. Maybe you know this all too well from first-hand experience; if not, perhaps you’ve seen it in a colleague or a manager. If this has happened to you, it’s likely that you’ve tried to put your head down and just get on with what you had to get done, hoping to avoid drawing attention and hoping too, that, somehow, you’d feel better soon. Chances are good that you didn’t seek out a support network or help on the job, talk to your boss about your struggles or report what you were going through to HR.
Why wouldn’t someone take these steps? The answer is simple, of course: fear. The stigma associated with mental health disorders deters most of us from taking action, a fact that was recently reconfirmed by an October 2014 Canadian study in the International Journal of Occupational and Environmental Medicine. The study, which included data from over 2200 Canadian workers, found that most wouldn’t disclose their personal anguish to their employer lest that mean saying good-bye to a promotion and so long to a raise (or worse). Employees also didn’t want to be seen as irresponsible or jeopardize feelings of goodwill and trust with the people they work with. “In reality, when you suffer from a mental illness, your work suffers,” says Carolyn Dewa, PhD, lead author of the study and head of the Center for Addiction and Mental Health, in Toronto. “And you probably won’t get that promotion or that raise because you’re not working to your full potential.”
Thirty-nine percent of the respondents in Dr. Dewa’ study said they wouldn’t disclose a mental health issue to their manager for fear of stigma. But digging into the data shows a darker trend: Workers in their 40s, who make up the largest percentage of the workforce, were even less likely to tell their supervisor of a problem. And when the researchers asked people who were currently dealing with depression if they’d share their issue with their manager the number that would stay mum jumped to 55%. When it came to specific fears, the most common one was that opening up would amount to sabotaging their career, followed by the fear of being talked about and losing friends at work. These findings back up a 2012 review in BMC Psychiatry that found that people kept mental health issues private out of fear of prejudice and discrimination — in other words, losing credibility, being shunned or having their problem become a subject of gossip.
What Mental Illness Costs
Dr. Dewa was particularly unnerved by how many study participants misunderstood the effects of a mental health disorder on the quality of their work and productivity. “One of the jarring numbers was that 30% believed a mental health issue wouldn’t affect their work,” she says. That sort of blinkered view often leads people to deny a mental issue, including addiction, in the first place. “More often than not, somebody with all the signs and behaviors of pathological gambling will say they don’t have an addiction and they don’t need help,” says Donald Black, MD, a psychiatrist at the University of Iowa and an expert in gambling addiction. “They deny the addiction because they’re afraid of being stigmatized as a degenerate gambler and that stops them from getting the help they desperately need.”
Of course, there’s an economic cost as well. When a person goes on leave to deal with a physical disability, a major depressive episode or to go through rehab for addiction, for example, it’s the employer who pays for lost productivity — to the tune of about $9,000 per episode, according to a 2010 study in the Journal of Occupational and Environmental Medicine. But absences for mental health treatment are longer and costlier than physical therapy —averaging about $18,000 per episode, six times what a respiratory disability, such as work-related asthma or pulmonary hypertension, costs. Yet early intervention and treatment may eliminate long absences and increase productivity, saving companies huge amounts of money in the end.
Wanting to make a financial case for earlier recognition and treatment of these issues on the job, Dewa designed a study to find out when a company would break even if it implemented training for managers specifically around mental health. She found that a $10,000 investment in professional development — teaching supervisors to recognize when workers are struggling, how to have difficult conversations and how to intervene to help their employees find assistance — would lead to shorter work absences and fewer mental health claims and would pay for itself in just one year, according to Dewa. “Managers don’t know the best way to help people,” she says. “Stigma training is about implementing good management practices and making sure teams accept it and continue to work well together.”
Workers who suffer from mental disorders aren’t just likely to suffer in silence; they’re more likely to turn in subpar work and to have acute symptoms more often than they would if they could go on leave when they needed to. After all, it’s not like managing even a weekly trip to see a therapist is simple for many workers. “Professional mental help isn’t offered after hours,” notes Dewa. “It’s essential that employees, managers and colleagues know that it’s okay to take time off to get the necessary help. It’s better for the person and for the company.” She adds, too, that the acute, debilitating flare-ups of most mental health disorders typically don’t last long and are usually quickly controlled with professional help. “Nobody is stigmatized for taking time off for the flu,” she says. “They come back ready to work and they’re productive again. It’s no different with mental health.”
When employees have a safe, secure work environment they feel more willing to share a mental issue with their manager. That’s what a 2003 study in the journal Vocational Rehabilitation found, and Dewa’s study confirms these results. Her October 2014 trial found that 80% of participants listed a positive, trusting relationship with a supervisor as a key reason to disclose a mental health issue. Half of the participants also cited supportive co-workers and a company’s mental health policies as additional reasons they felt comfortable seeking help.
It may also be that the perceived stigma associated with mental health issues at work is something of an illusion. When asked, half of the respondents in Dewa’s survey said they would want to know if a colleague had a mental health issue. Why? So they could help.