More threads by David Baxter PhD

David Baxter PhD

Late Founder
Workplaces quit quietly ignoring mental illness
USA TODAY - August 22, 2006

At first, it seemed as if little things were going wrong. Bonnie Harris forgot about sales appointments; she couldn't recall colleagues' names. But as her job in sales became more stressful, Harris developed intense mood swings and moments of terror. She saw psychiatrists, who prescribed various medications, but the drugs only made things worse, she says.

At one point, she tried to throw herself out of a window.

It wasn't until Harris, an earlier victim of violent crime, was diagnosed with post-traumatic stress disorder (PTSD) that she began to recover with the help of therapy and meditation. But through her entire 1991 episode, she kept working, trying to camouflage what was going on.

"I went to work every day. I was a top salesperson, working 60-hour weeks," says Harris, 44. "Co-workers knew I was moody, but no one knew how bad it was. You don't tell people at work that you have this mental illness. It's so shameful."

Today, Harris runs her own firm, Wax Marketing, in St. Paul and knows how to manage PTSD when symptoms creep up. Despite its stigma, a growing number of employers and employees are addressing a topic that has long been taboo: mental illness in the workplace. Employees' emotional health, a topic that once seemed incongruous with the survival-of-the-fittest corporate arena, is getting attention as a real bottom-line issue. Employers are beefing up mental health services as new research shows the staggering cost of mood disorders -- depression, anxiety and panic disorder, bipolar disorder, schizophrenia and obsessive-compulsive disorder -- can have on businesses.

For example:

  • High costs. Untreated mental illness costs the USA $105 billion in lost productivity each year, with U.S. employers footing up to $44 billion of the bill, according to the National Mental Health Association, an Alexandria, Va.-based non-profit.
  • Threat of litigation. Federal guidelines issued in 1997 explain how employers can make accommodations for employees with serious mood disorders. Those who don't make accommodations, such as changing an employee's work hours, could be sued. The guidelines are further explanations of the Americans with Disabilities Act, issued by the Equal Employment Opportunity Commission. In fiscal 2004, the EEOC took in $469,000 in financial settlements for employees who complained that they'd been discriminated against because of their depression: 889 cases were filed. By 2005, that amount ballooned to more than $3 million, and there were 1,005 cases filed in that fiscal year. "There is a greater understanding among employers about these issues," says Chris Kuczynski, assistant legal counsel with the EEOC. Cases filed under the Disabilities Act have become easier to win as the public becomes more aware of mental health issues.
  • More emphasis on employer help. A number of employers are enhancing mental health coverage or programs. The number of firms with employee-assistance programs, which often provide on-call counselors and referrals, has climbed from 68% in 2001 to 71% this year, according to the Society for Human Resource Management. Seven in 10 offer mental health insurance. Eighteen percent have grief-recovery programs, up from 12% in 2002. General Motors' program provides U.S. employees with unlimited access to telephone counseling with a trained mental health professional and up to three face-to-face counseling sessions at no charge. GM also helps managers with what to do if an employee has personal issues.
Coverage lags
But companies' mental health coverage often lags behind coverage for physical ailments. Health plans may restrict the number of times an employee can see a mental health provider, for example. Americans battling depression with limited access to mental health care could face bills of $18,000 annually to cover health-related expenses due to their condition, according to the National Alliance on Mental Illness. Those with limited access were four times as likely to quit their jobs.

In recent years, famous business and entertainment leaders have given a public face to mental health issues. 60 Minutes' Mike Wallace and newspaper humorist Art Buchwald shared that they've fought depression. Actress Brooke Shields documented her postpartum depression. Actress Ashley Judd revealed she went to a treatment facility for depression and other emotional problems.

But despite the attention, some employees with mental health issues say they still struggle with how to tell managers what's going on.

Sara Kobiela, 26, of Livonia, Mich., has a master's degree in social work but has struggled to keep jobs because of a depression so severe it left her unable to care for herself or do little more than sleep. She has held a variety of jobs, such as file clerk at a medical office and waitress.

At her waitress job, she says her supervisor was very supportive and allowed her to take some time off and return after a depressive episode. But she has just started a new job as an intake counselor at a mental health outpatient center and has so far told only one other person about her struggle. She is on anti-depressants and other medication to help with depressive episodes. She is waiting for insurance to kick in so she can seek out a mental health practitioner.

"You don't want to tell employers, but you need that support at work," says Kobiela, who lives on her own with three cats. "I get very overwhelmed and frustrated at work, but I can put on this front. But I think it's a huge stigma in the workplace."

She says she fears breaking down at work. "When I get depressed, going through the motions of my day, I hate my life, but work is the one thing I can do. You can't be friendly with co-workers (so you worry) they think, 'What's wrong with her, why is she so unfriendly?' ... You don't want to get a label."

'The working wounded'
Like Kobiela, many of those with mental illnesses are younger: Mental illness is highest among those 15 to 44, says Joseph Calabrese, a psychiatry professor at Case Western Reserve University and director of the mood disorders program at the University of Cleveland. Depression ranks at the top. Mental health problems can erode work performance and lead to absenteeism.

"These people go to work, but they're the working wounded," Calabrese says.

In many cases, those with mood disorders qualify for employment protections under the federal Americans with Disabilities Act, which means employers must make accommodations to help with work.

In order for a mood disorder to be a disability, it must limit a major life activity, such as an employee's ability to sleep or take care of himself or herself. Some types of accommodations have included allowing employees to work from home, modifying supervisory methods, reassigning them or changing a work schedule.

But employers can ask for documentation of mental illness to be sure a disorder is legitimate, and they can argue whether that disorder is truly a disability under the ADA. Traits such as irritability or chronic lateness are considered behaviors, not mental impairments requiring accommodations. Employers don't have to make accommodations if doing so would impose an undue hardship, and they cannot retain an employee if that worker poses a direct threat.

Lucinda DuToit, director of human resources at Digineer, a technology consulting firm in Minneapolis, says the shift from ignoring to acknowledging mental illness has come as employers become more aware of the link between personal and professional lives.

She also says employers stand to gain valued loyalty from these workers if they make the necessary accommodations.

"There's much more of an understanding of mental illness. In the past, it was just, "We'll see you, bye,'" DuToit says. "Now it's, 'We'll get you help.'"

But some employees also have filed lawsuits saying that it's the workplace that caused, or added to, their mental health stress.

The workplace itself
Southwest Airlines employees sometimes pull pranks on co-workers once they've passed their probationary period. But customer-service agent Marcie Fuerschbach says this joke went too far.

At the end of her probation at her job in Albuquerque, co-workers got police officers to handcuff her in a mock arrest. By the time she was in on the joke, she was crying and scared, according to the lawsuit she filed. Later that day, found crying in the bathroom, Fuerschbach was sent home. She says she had to see a psychologist and was treated for post-traumatic stress disorder. She settled her case out of court with police. She lost her case against Southwest.

Southwest spokesman Ed Stewart says, "It was so unfortunate it was taken the way it was, because that was not the intent. Everybody learned from it."

But Fuerschbach, who still has the same job, says she is taking Lexapro, which is used for treating depression and anxiety.

"I figured it was real. I thought for sure it wasn't a joke," says Fuerschbach, 48.

"It was torture. I was shaking and crying. I was just shocked, handcuffed behind my back. I couldn't work after that."


Great article Dr. B.

I know for myself that I have been on both sides of the coin sort of speak where I have been told at one job "sorry but you have to go" and then another one that was so supportive and worked my schedule around my therapy time, appts. etc.

I guess it really does go to show how the stigma is slowly decreasing amongst workplaces....slowly but that not the saying :confused:

Again, great article!


my illness comes under the UK Disability Discrimination Act, and I had my job transfered by HR to stock support, away from the general public,(in a public library) to accommodate my mental health needs, mainly high anxiety from PTSD, although my 'official' diagnosis, medically speaking, is depression. the disabilities rep is very understanding, and I've been communicating with her a lot to try and get things set up with my managers to best support me and help me feel more comfortable.
I am lucky to work for the council of a London borough that has a very good disabilities policy. and colleagues who are very supportive.
(before being treated and diagnosed, in teaching, I had very very bad experiences, re-traumatising).

I've found giving people articles printed up, and writing out how things effect me, very helpful. as everyone's illness is different, and even the same illness effects different people in different ways.
The Mind site ( has particularly good articles on work and mental distress.

there's a new UN disability rights bill coming out, I noticed on the BBC website yesterday.
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