Mental Health in the Workplace: A Silent and Salient Issue
Need to Know . . .
- Just under 20% of Americans suffer from some form of mental illness
- Mental health disorders cost companies directly and indirectly
- Companies must invest in their employees’ total health but tread carefully in navigating the line between safety and privacy
Companies use a variety of metrics to measure company performance, productivity, and safety, all of which can be improved by addressing and investing in mental health. Mental health issues in the workplace expose companies to legal liability and productivity, performance, profitability, and safety problems. This makes them a "silent tsunami" that can wash companies in a giant wave of disruption, leaving rippling and lasting effects.
The Swirling Storm
According to the National Alliance on Mental Illness, approximately 44 million adults in the U.S. experience mental illness in a given year—that is 1 in every 5 adults. Anxiety disorders (18.1%) and major depression (6.9%) are the most prevalent diagnoses. In a report, NAMI cited depression as the “leading cause of disability worldwide” and “a major contributor to the global burden of disease.”
The National Institute of Mental Health estimates a loss of $193 billion every year in lost earnings due to serious mental illness, with a conservative estimate of $300 billion per year in total costs. These numbers do not account for the reduced productivity resulting from presenteeism, when an employee is physically present but still grappling with a physical or emotional issue.
Statistics show that presenteeism can represent a greater drain on company resources and dollars than the productivity loss from absenteeism. In a study examining the financial impact of health conditions of 34,622 employees at 10 companies, two mental health disorders populated the top five health problems in terms of annual medical, drug, absenteeism, and presenteeism costs. Depression was first, ahead of obesity, arthritis, back and neck pain, and anxiety, respectively. Since the effects of mental illness carry a price tag, companies can't afford to shelve the issue.
The Problem with Conceal, Don’t Feel
These statistics confirm the likelihood that employers, supervisors, and employees will experience mental illness themselves or deal with issues related to a co-worker’s mental illness. This is important because employers are responsible for the safety of all employees; for many companies, safety is the very fabric of the culture. For manufacturing, there is substantial evidence linking physical safety to safety behaviors and performance. Thus, safety professionals focus on recordables, near misses, and SIFs, and spend time and resources educating employees to follow procedures and use protective equipment. And yet, if we don’t address the elephant in the room, all these protocols could be for nothing.
Mental health disorders can affect safety, absenteeism, and productivity. Despite their prevalence, mental health disorders remain largely out of sight, often undiagnosed or downplayed. Per NIMH, only about half of Americans diagnosed with major depression get treatment. In a study tracking employee responses to a questionnaire,employees with depression reported the equivalent of 27 lost work days per year—18 from lost productivity and 9 taken off from work. Consider the possibilities of a sleep-deprived employee struggling with depression who operates heavy equipment: if an employee isn’t sleeping, how will this affect decision-making? This is something to keep in mind the next time your company evaluates a workers’ compensation claim. Could there be a root cause that is being missed because mental health isn’t taken into account in the evaluation?
No Right, No Wrong
If companies want world-class safety, they must act. Countries have developed their own laws on this issue. While some, including the UK and the U.S., afford similar protections, countries largely provide their own guidance on the proper balance between workplace safety and confidentiality. Disability law in the U.S. prevents employers from directly asking about a history of disability prior to making a job offer; even then, the employee does not have to disclose the disability. Employees fear the stigma of disclosure and losing their jobs. Further complicating matters, many disability advocates advise employees to avoid revealing a disability in their résumés or during the interview process, for fear they will not get a call back.
How does an employer successfully navigate the line between safety and privacy? The onus is on the employer to create a supportive environment where employees know they can safely disclose any disability (once the offer is in hand) without fear of repercussions. Co-workers, supervisors, and managers can benefit from training to gain information, discover resources, address questions, and learn strategies to overcome any difficulties and misunderstandings. Everyone in the organization should educate themselves on how these illnesses can manifest themselves in the workplace and learn the tools for success. This will head off misunderstandings and help everyone understand why someone may appear apathetic, nervous, restless, or irritable or repeatedly complain about aches and pains.
It’s also very important for employers to carefully follow the Americans with Disabilities Act (ADA), which provides protection from employment discrimination and requires employers to make reasonable accommodations for employees to perform the essential functions of their jobs. Accommodations could be as simple as providing a quiet workspace, job coaching, telecommuting options, flexible schedules, and/or written instructions.
Recently, employees have won verdicts against employers that refuse to make reasonable accommodations. Earlier this year, a jury determined an employer violated the ADA by firing an employee after she asked for a short leave of absence to adjust medications and recover when she found herself suffering from a manic episode. The employer’s refusal resulted in an award of $32,500 for the plaintiff, including punitive damages. This decision illustrates that “an employer can’t stick his head in the ground and claim lack of knowledge” about a disability when he is repeatedly made aware of it. In January, a U.S. District Court in Pennsylvania denied an employer’s request for summary judgment after the employee brought suit, claiming the company failed to make accommodations. The company terminated the employee after he wrote a note to his supervisor seeking help because he was having homicidal thoughts. The case is proceeding to trial. The judge’s memorandum opinion lays clear the issue at heart: “two competing but equally valid public policy interests—the need for a safe workplace, as weighed against the need to accommodate and treat mental illness.” Both cases highlight the need for dialogue between employers and employees to determine the appropriate steps and accommodations to ensure these competing and valid interests are properly handled.
Finding the Calm
How can manufacturers serve these two seemingly opposite masters? It starts by having a conversation. Consult counsel, converse with peers, and face it head on. The airline industry has redundancy after redundancy built into its safety protocols, yet these were not enough to protect the passengers and employees on the Germanwings flight in March. The unfortunate tragedy temporarily put the spotlight on mental health and employers’ obligations. The increased scrutiny led the FAA to re-examine their methods, policies, and procedures. Similarly, companies need to evaluate and implement strategies to ensure employees’ total health is addressed.
At the center of any sound and healthy workplace are its people. What’s important for all parties to remember is that a diagnosis of mental illness does not equal a problem. It can be found at any level, from the factory floor to the c-suite. It can be the war veteran, the eager intern, the helpful assistant, or the knowledgeable general counsel. By proactively investing in total employee health, companies are investing in company health, which improves productivity, employee engagement, and profits; protects against litigation; and fosters a positive and safe work environment.