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t's
incredible to think, as you look around that wedding reception or board meeting
or high-school reunion, that one in five of the people there has or will have
a mental illness at some point in their lives. Mood disorders, schizophrenia,
eating disorders, substance abuse problems, anxiety, bipolar depression—any
of these and other mental illnesses can affect people of all ages, ethnic backgrounds,
and income levels.
We read frequent stories about mental illness, we see depictions of people
suffering from mental illness, 20 percent of us will experience it firsthand—and
yet there is still so much stigma attached to these diseases that, according
to the Canadian Mental Health Association
almost half of sufferers never get treatment. For some people, the stigma
is so great that they cannot even tell family and friends what they are going
through. And yet, none of us is immune.
Considering so many people have such difficulty opening up to people close
to them, it's no wonder that there are real fears about being stigmatized in
the workplace. In fact, mental illness tends to strike people in their late
teens and early twenties—often just at the earliest point of their careers,
when they are least likely to ask for help or special accommodation. And the
cost of mental illness in the workplace is enormous: 30 to 40 per cent of disability
claims are for mental illness, and the losses amount to about $33 billion a
year, not including treatment and health care—plus the unknowable costs in lost
productivity by those people who suffer in silence.
The reality of mental illness in the workplace and the impact—positive
or negative—employers have on those who are dealing with it was the focus
of this year's Global
Business and Economic Roundtable on Addiction and Mental Health, a group
of senior business leaders and former federal finance minister Michael Wilson
(whose son, Cameron, committed suicide in 1995). Speakers at an April meeting
spoke of the importance to the person and the financial benefit to the company
of hanging on to and helping employees through mental illness. "We're all at
risk," stated Dr John Frank, scientific director of the Institute of Population
and Public Health at the Canadian
Institutes of Health Research. "There's not much room for stigma." Dealing
with mental illness is no different than coping with any other form of disability,
he added. "We're just worse at it."
A far-reaching impact
The word stigma means a mark indicating that something is not normal—a mark
of disgrace. Those who are stigmatized because of mental illness, or anything
else, are victims of discrimination—and the stigmatization not only intensifies
their suffering by causing feelings of rejection and isolation but it also negatively
affects treatment outcome. In a 2001 survey
conducted by CMHA and Wyeth Pharmaceuticals, two-thirds of respondents claimed
to have suffered from depression or anxiety themselves or were close to someone
who had and one-third of them said they believed other people's perceptions
of them would change if they found out.
Another report, "Mental
Illnesses in Canada," stated that stigma and discrimination "force people
to remain quiet about their mental illnesses, often causing them to delay seeking
health care, avoid following through with recommended treatment, and avoid sharing
their concerns with family, friends, co-workers, employers, health service providers
and others in the community." It also contained the Canadian
Alliance on Mental Illness and Mental Health's assertion that preventing
discrimination against the mentally ill was a most important step toward improved
mental health for Canadians.
Communication and flexibility are key
According to the Canadian Psychiatric Association, people with a mental illness
suffer more stigmatization in the workplace than those with other disabilities,
and are more likely to come up against long-term disability and under/unemployment.
"Many employers and employees have unwarranted fears and see persons with
psychiatric disabilities as unskilled, unproductive, unreliable, violent or
unable to handle workplace pressures," says a CPA pamphlet on "Mental
Illness and Work."
But changing that environment takes time and the efforts of both employees
and employers. It helps to remember that employers are better off financially—not
to mention ethically—investing in a valued employee by supporting him or
her through treatment. That may mean making some (likely) temporary changes
to working hours or work conditions but the payoff following successful treatment
is a happier, healthier, more productive employee. Employers set the tone for
the workplace. If reasonable accommodations are made willingly to help an employee
through a difficult time, that sends a powerful and important message to the
rest of the staff. And it also goes a long way to helping the employee feel
supported—a great help in the treatment process.
How employers can help
Mental Health Works, a research project involving the voluntary sector, government
and business, outlines all the rights and responsibilities of both employees
suffering from mental health problems and their employers. It also offers tips
for employers on how to help an employee return to work from a mental-health
leave. This is when leading by example is most important. The onus is on employers
to create an environment that is harassment-free and supportive for the returning
employee. Often, if an employer takes the initiative and learns more about the
employee's illness it will help him or her convey to other employees the importance
of not stigmatizing the returning employee. (First, however, an employer should
discuss how much information the returning employee wants disclosed to colleagues.)
When, how—and whom—do you tell?
Employees should think carefully about how much and to whom they are planning
to disclose information. That depends on the work environment. First of all,
if an employee can perform the job perfectly well despite a mental illness,
they are under no obligation to disclose their condition to an employer. In
fact, the benefits and risks of disclosing should be carefully weighed before
any action is taken. If an employee is at a crisis point or needs special accommodation
for doctors' appointments, they should know that an employer doesn't need every
gritty detail; the employer needs concrete information about the mental illness
and how its treatment will affect the work performed, the working day or the
work environment.
Sharing information with co-workers is a matter of personal choice, but if co-workers
will be directly affected by changes then it helps if they understand why (and
many times co-workers become a great source of support). If you have specific
needs, voice them to your employer. If you cannot do your regular job in the
same way as always, suggest other possibilities in the company while you undergo
treatment.
Reality check
The first, best way to combat stigma—at the workplace or otherwise—is
to get educated about mental illness and then educate others.
- No one asks for a mental illness. Some are caused by chemical imbalances
in the body. Some people are genetically predisposed to certain types of the
disease. Some are a result of an overload of stress, grief, pain, sadness or
difficult circumstances.
- Most mental illness will, if treated properly, be cured or at least
controlled. Treatment will be profoundly more successful when the person who
is suffering has the support of employer, family and friends. Mental illness
is not something a sufferer can simply get the better of by force of will.
- The diseases are not signs of weakness or lack of intelligence. Mental
illness can affect anyone at any time and, according to the CMHA, many studies
have indicated that people who suffer a mental illness or typically of average
or above-average intelligence.
- Contrary to a common myth, people with mental illnesses aren't any
more violent than any other group. We just hear about it more.
- Men are less likely to believe that they can suffer from mental illness
but there is a growing body of evidence to dispute that. And in Canada, 80 per
cent of those who commit suicide are male.
- The costs of mental illness are enormous in every way. The economic
cost in 1998 in Canada was estimated at $7.9 billion in care, disability and
early death. Another $6.3 billion went to uninsured health services and time
away from work for depression that was not being treated. In 1999, 1.5 million
hospital days were due to mental illness.
Changing the mindset
What can we all do to help fight the stigmatization of those who are suffering
from mental illness?
- If you have first-hand experience with a mental illness, consider sharing
it. There is almost no more powerful way to educate family and friends than
that. Think about the positive impact someone like actress Brooke Shields, who
talked about her postpartum depression, or William Styron, who wrote about his
depression, has on others.
- Know the facts and pass them on. If you hear someone talking about
mental illness who has the wrong information and is perpetuating stereotypes,
consider telling them what you know to be true.
- Be sensitive about language—and help children understand what words
just aren't cool to use. Words such as "wacko," "retard," "loony," "psycho,"
"cuckoo" are offensive not only to those who are suffering with mental illness
but also to their family and friends. Words reinforce incorrect stereotypes
and they drive people who need help into hiding.
- Have an open mind about people who have a mental illness. The disease is
only one part—and often only a temporary part—of who they are.
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