Navigating mental illness in the workplace can be tricky, but employees are entitled to accommodations

Mental health challenges can affect anyone, regardless of background or circumstance, and they are becoming more common across the United States.

In 2022, a national survey^[1] found that about 60 million American adults – approximately 23% of the U.S. adult population – were living with a mental illness, defined as a diagnosable mental, emotional or behavioral disorder^[2].

This translates to a nearly 37% increase over the past decade^[3].

These conditions can have a profound and lasting effect on patients’ lives, including their ability to engage meaningfully and sustainably in the workforce.

Globally, depression and anxiety are estimated to lead to 12 billion lost working days annually^[4], costing an estimated US$1 trillion per year in lost productivity worldwide and $47 billion in the United States^[5].

I am a medical director and practicing psychiatrist^[6]. I work with graduate students, residents, faculty and staff on a health science campus, supporting their mental health – including when it intersects with challenges in the workplace.

I often meet with patients who feel unsure about how to approach conversations with their schools, programs or employers regarding their mental health, especially when it involves taking time off for care. This uncertainty can lead to delays in treatment, even when it’s truly needed.

Mental health by the numbers

Anxiety^[7] and depression^[8] are the most common mental health conditions in the U.S.^[9]. Nineteen percent of American adults suffer from an anxiety disorder, and more than 15% have depression.

Meanwhile, about 11% of Americans experience other conditions such as post-traumatic stress disorder^[10], commonly known as PTSD, bipolar disorder^[11], borderline personality disorder^[12] or obsessive-compulsive disorder^[13].

Rates of anxiety and depression increased worldwide during the COVID-19 pandemic^[14]. But one positive consequence of the pandemic is that talking about mental health^[15] has become more normalized and less stigmatized, including in the workplace^[16].

Struggling at work

For those with mental illness, the traditional expectation of maintaining a strict separation between personal and professional life is not only unrealistic, it may even be detrimental^[17]. The effect of mental illness on a person’s work varies depending on the type, severity and duration of their symptoms.

For instance, severe depression can affect basic self-care, making it difficult to complete tasks such as bathing, eating or even getting out of bed. Severe anxiety can also be profoundly debilitating and limit a person’s ability to leave the house due to intense fear or panic. The symptoms of such severe mental illness may make it difficult even to show up to work.

On the other hand, someone struggling with mild depression or anxiety may have a hard time initiating or completing tasks that they would typically manage with ease and find it difficult to interact with colleagues. Both depression and anxiety may affect sleep, which can contribute to cognitive lapses and increased fatigue during the work day.

Someone with PTSD may find that certain environments remind them of traumatic experiences, making it difficult to fully engage in their work. And a person experiencing a manic episode related to bipolar disorder might need to take time away from work entirely to focus on their stabilization and recovery.

Knowing when to ask for help

Identifying a trusted colleague, supervisor or human resources representative can be an important first step in managing your mental health^[19] at work. While selecting the right person to confide in may be challenging, especially given the vulnerability associated with disclosing mental health concerns, doing so can open pathways to appropriate resources and tailored support services^[20].

For instance, it might encourage an employer to consider offering access to free or low-cost mental health care if it’s not already available, or to provide flexible scheduling that makes it easier for employees to get mental health treatment.

It’s also important to be aware of changes in your mental health. The earlier you can recognize signs of decline, the sooner you can get the support that you need, which might prevent symptoms from worsening^[21].

On the other hand, sharing sensitive information with someone who is not equipped to respond appropriately could lead to unintended consequences^[22], such as workplace gossip, unmet expectations and increased frustration due to perceived lack of support. However, even if your supervisor or manager is not understanding, that doesn’t change the fact that you have rights in the workplace^[23].

Consider exploring accommodations

The Americans with Disabilities Act^[24] provides critical protections for individuals with disabilities in the workplace. Under the act, it is unlawful for employers to discriminate against qualified individuals based on a disability.

The law also requires employers to provide reasonable accommodations^[25] so that people who qualify are able to participate fully in the workplace provided that they do not impose undue burden on the place of employment.

There are many reasonable accommodations for workers with mental illness^[26]. These can include protected time to attend mental health appointments and flexibility in work schedules and workplace.

For instance, if your job allows for it, working from home can be helpful. If your job requires being on site, a private work space is another reasonable accommodation. Someone with anxiety might find that working in a quiet, private space helps reduce distractions that trigger their symptoms, making it easier for them to stay focused and get things done.

Other possible accommodations include providing sick leave or flexible vacation time to use for mental health days or appointments, or allowing an employee to take breaks according to their individual needs rather than a fixed schedule. Employers can also provide support by offering equipment or technology such as white noise machines or dictation software.

The role of the workplace

An organization’s commitment to supporting employee mental health can play a large role^[27] in shaping how well employees perform at work – and, ultimately, the organization’s success.

Relying on individual employees to manage their mental health is not a sustainable long-term strategy for employers and may lead to significant workplace disruptions, such as more missed work days and lower productivity^[28].

Studies show that when employers lead targeted initiatives promoting mental health, overall workplace functioning and resilience improve^[29]. These initiatives might include educating employees on mental health, providing accessible care, helping employees have better work-life balance and designing supportive workplace policies for those who are struggling. These steps help reduce stigma and signal to employees that it’s safe to seek support.

References

1. ^{^} In 2022, a national survey (www.samhsa.gov)
2. ^{^} a diagnosable mental, emotional or behavioral disorder (www.nimh.nih.gov)
3. ^{^} nearly 37% increase over the past decade (www.samhsa.gov)
4. ^{^} 12 billion lost working days annually (www.who.int)
5. ^{^} $47 billion in the United States (www.gallup.com)
6. ^{^} medical director and practicing psychiatrist (som.cuanschutz.edu)
7. ^{^} Anxiety (www.mayoclinic.org)
8. ^{^} depression (www.mayoclinic.org)
9. ^{^} most common mental health conditions in the U.S. (www.nami.org)
10. ^{^} post-traumatic stress disorder (my.clevelandclinic.org)
11. ^{^} bipolar disorder (my.clevelandclinic.org)
12. ^{^} borderline personality disorder (www.mayoclinic.org)
13. ^{^} obsessive-compulsive disorder (www.psychiatry.org)
14. ^{^} increased worldwide during the COVID-19 pandemic (www.who.int)
15. ^{^} talking about mental health (www.psychiatry.org)
16. ^{^} including in the workplace (doi.org)
17. ^{^} it may even be detrimental (doi.org)
18. ^{^} Kmatta/Moment via Getty Images (www.gettyimages.com)
19. ^{^} important first step in managing your mental health (doi.org)
20. ^{^} appropriate resources and tailored support services (doi.org)
21. ^{^} might prevent symptoms from worsening (doi.org)
22. ^{^} could lead to unintended consequences (doi.org)
23. ^{^} you have rights in the workplace (www.dol.gov)
24. ^{^} Americans with Disabilities Act (www.ada.gov)
25. ^{^} provide reasonable accommodations (www.eeoc.gov)
26. ^{^} accommodations for workers with mental illness (www.dol.gov)
27. ^{^} supporting employee mental health can play a large role (doi.org)
28. ^{^} more missed work days and lower productivity (www3.weforum.org)
29. ^{^} overall workplace functioning and resilience improve (sheffield.ac.uk)