Mental Health in the Workplace: How to Accommodate

Meschino, who specializes in mental health and reproductive issues, observed that many workplaces aren’t structured to handle the wide-ranging HR issues involved in work, pregnancy and mental health—yet 10% to 15% of women who are pregnant have clinically relevant mental health problems.

“Many of my patients have been forced to take disability leave when they would prefer not to,” she said. “If they could only have a small accommodation, then they could continue to work right until the end—and that’s what they want to do.”

Reintegration into the workforce after an absence can be particularly challenging for those with addictions, remarked Buckley, who specializes in this area. Since addiction is a chronic illness, employees may require accommodation on an ongoing basis—for example, the freedom to go to AA meetings during the workday. “So many people fall through the cracks and stop going to those very important meetings because they can’t do it after work,” she added.

The panelists agreed that the most important aspect of accommodation is flexibility. “What the workplace can offer my group of patients is negotiation, not just wholesale adaptation,” said Pain, whose focus is on trauma patients. “The voice of my clients and the voice of their workplace is a very important, helpful interaction and engagement.”

However, offering true flexibility may mean rethinking how we understand accommodation, said Gupta, who works with patients who have mental issues along with other chronic conditions.

“We are hindered by thinking of the concept of accommodation as a response to that person’s condition or that person’s disease, rather than thinking about accommodation as the way we should optimally structure work to meet all of our diverse needs,” she explained, adding that we all need some sort of accommodation—whether due to physical needs, child care responsibilities or other aspects of our daily lives.

We should also reconsider how we view those who suffer from mental illness, said Meschino. In her experience, patients want to make a meaningful contribution—they do not want to be seen as a burden on the workplace or on society at large. “We need an attitudinal shift in the workplace if we’re actually going to promote health as opposed to respond to illness.”

And accommodation is just one aspect of ensuring the mental well-being of a workforce. The panelists explained that women with mental health issues are often dealing with emotional issues as well—for example, fear of job loss or reassignment and mistrust of their employer—that may add to the stress they experience and aggravate their conditions.

“I think probably the single biggest stressor that patients talk to me about is the way that they’re received in their workplace when they need sick time, or when they need to take a leave or they need to apply for benefits,” said Gupta. “I think they feel there’s a perception that they’re taking advantage of the system, they’re exaggerating their illness—when really, what they want to be doing is working and functioning and feeling well.”

Which brings up another sensitive issue: disclosure. The decision on whether or not to speak up about a mental illness at work is important, noted the panelists, since it affects how the employee is subsequently treated.

Gupta said she’s noticed that people are comfortable talking about their physical conditions but not about their mental health. Buckley agreed, adding that there is already a stigma associated with addictions that, for women, can be exacerbated by the “fallen woman” stereotype.

From a trauma perspective, Pain believes that disclosure is a personal choice. “Generally speaking, once you disclose, you can recruit a lot of ‘volunteer therapists’—which may be a bit of a burden in the workplace when the patient is trying to have a normal life,” she added.

Underlying many of these issues, the panelists explained, is the erroneous perception that mental illness is a one-time, curable event.

Gupta said we need to get away from the “broken leg” model, in which we view mental illness as an acute event, to a functionality model, which recognizes that conditions are chronic but also focuses on what employees can do. ‘Because we know that the range of symptomatology of people who are still able to work productively is quite wide,” she added.

Such an approach would benefit employees and employers alike. “When a workplace is able to empower an individual to structure their working life in a way that allows them to continue meaningful participation in the job, they are able to regain some of that confidence that life can be meaningful again. Life can be normal again.”

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