Work and mental health :4.

Getting support :

Should I tell my employer if I have a mental health problem?

If you have an ongoing mental health problem you may be unsure of who to tell about it, when to tell them and how much to tell. You may be worried about how they may react and the consequences.

More often than not I just ‘put on a brave face’ and make sure at all costs that no-one notices if I'm struggling.

Many employers now have positive policies on disability and equality at work and take a more positive view of mental health problems, which ought to mean that being open about your mental health is less of a risk. There are also laws in place to protect you at work if you are considered to be disabled because of a mental health problem (see Rights at work). However, you may still want to think about the risks and benefits before making a decision.

The potential risks of disclosing something about your mental health include:
•being teased or harassed by other employees
•being assumed to be a less productive member of the team
•having fewer opportunities for career development
•being treated as more vulnerable than other employees, or as having everything (anger, excitement, time off sick, or a grievance) associated with your mental health problem
•being monitored more than other employees, and having to work harder to gain the same respect
•giving your employer a reason to manage how you act and interact with colleagues.

The potential benefits of disclosure are:
•being open about it can encourage others in the same situation
•keeping it secret may be too stressful, or against your beliefs
•it gives you a stronger basis for requesting adjustments to your job or work environment (see Disability discrimination for more information on adjustments)
•it could give you the opportunity to involve an outside adviser or support worker, who could see you at work or speak directly with your employer
•it could make it easier to go into work at times when your symptoms are more visible
•it enables you to get the support of colleagues.

If you do decide to tell your employer, think about how and when to do it, how much information you want to give, and who to share it with. For example, the human resources department may know your diagnosis, but they don't have to tell your supervisor or colleagues.

You don't have to go into personal details; focus on what you need for the job. Employers want to know if you can do the job and will get along with the customers or clients and the rest of the team. If you can show that your intention is to get the job done, this should go a long way to reassuring them. Being straightforward and unembarrassed about your history will help them get it in to perspective.

If you simply want your employer to understand your needs, disclosing your mental health problem may prompt your employer to treat you in a more constructive and supportive way. From a legal point of view, an employer only has to make adjustments for needs that they know about. Therefore, if you are disabled and want the protection of the Equality Act (see Rights at work), you will have to make sure that someone in a responsible position knows what they are.

What adjustments can I ask for at work?

Changing something about your working environment or the way you do your job may help you to stay healthy and work more effectively. You may be able to organise some of these for yourself; others may require action, or at least agreement, from your employer. 

Many of the adjustments that can help your mental health are things you might expect an employer to adopt as a matter of good practice, e.g. a quiet workspace or being able to work from home, and you can ask for these even if you don’t consider yourself to be disabled or don’t want to tell your employer that you have a mental health problem.

Reasonable adjustments

However, if you have a mental health condition that is considered to be a disability (see Rights at work'for a definition), your employer has a duty under the Equality Act to make ‘reasonable adjustments’. You can ask for such adjustments at the point when you need them, even if you did not volunteer information about your mental health problem earlier.

When thinking about what adjustments to ask your employer for, the key is to think creatively about what will enable you to do your job effectively. You are probably the best judge of what would be most successful for you, but here are some examples:
•using voicemail to take messages (without slowing down the overall response time) if phone calls make you anxious
•using email when face-to-face contact is too stressful
•a quiet workspace or being able to work from home – to avoid distractions and help you concentrate
•changing your manager, if possible, and if another would be more flexible
•restructuring your job or temporarily reallocating some of the duties (for example, 'front-line' work)
•flexible hours to accommodate therapy, medical appointments, rushhour pressures or the morning drowsiness associated with some medicines
•on-the-job support, or permission for a support worker to come in or to be contacted during work hours
•permission to take time out when distressed: this could just be a few minutes away from your workstation, going out for some air, or having a short rest
•a workstation by a window; or a lightbox, if you have seasonal affective disorder.

I will cancel meetings if a panic attack sets in and I really can't face the world – and I am open and honest about it.

You may want to think through some of the possibilities with another person before speaking to your employer, or have someone to back up your request. This could be someone involved with your care or treatment, or a disability employment adviser (DEA) from Jobcentre Plus. DEAs can give you advice and carry out an employment assessment to find out what help you may need. They may be able to help you get funding – via the Access to Work scheme – for equipment, personal support or assistance, or help with extra costs of getting to work; for example, if you can’t use public transport.

What if my mental health becomes a problem at work?

Anyone can become upset and reveal to their workmates that they are human. But if you have a mental health problem you may have a particular need for a safe space to express your feelings. If you are going through a mental health crisis, whether or not it's caused by work stress, it is likely have an impact on you at work.

If you can learn to identify what triggers your episodes of ill health, this will make it a lot easier to find the right coping strategy. Keep a diary of what happened, how you felt and how you reacted – you may find that a pattern emerges over time. This can help you think about how to deal with the same type of situation next time it arises – or to learn to avoid that type of situation if at all possible.

Ways of coping
•A brief time-out period when you are feeling unwell could restore you and allow you to continue working.
•You may need a quiet place away from colleagues to shout or cry.
•You may prefer someone to be with you to help calm you down or just listen.
•You could learn specific therapeutic techniques using breathing or meditation.

These are just examples, and they may not work for you. It may take a few tries to find out what does. But once you know what you are likely to need, you may be able set up or discuss with your employer, in advance, the things that will allow you to help yourself feel better.

Be honest about what's happening, but don't let people tell you 'you can't'. Instead, tell them what you need, so that you can.

Getting help

If you are worried about your mental health, or other people are expressing concerns, you may want to get professional help.

If you work for a large organisation, they may have an occupational health service, where you can discuss worries about your health and problems you may be facing at work. Someone in the workplace is not only easier to access, but has the advantage of understanding the organisation and being a potential ally. However, if you do not feel secure enough in your job to approach them, or there is no service available, you may want to talk to your GP or a counsellor. You may need time off work – and sickness absence for a mental health problem is just as valid as that for physical health problem.

Returning to work

If you have to take time off with a mental health problem, returning to work can be quite daunting. But it can also be an important part of your recovery, and you don’t have to be a hundred per cent well to go back. You don't have to apologise or justify being unwell, any more than you would if you were recovering from an accident or operation. 

In the midst of a mental health crisis, people sometimes say or do things they wouldn't otherwise say or do. If this has happened, then you may feel the need to rebuild relationships. But, very often, other staff will just be glad to see you back at work. People are able to empathise, and are more likely to have been busy with their own lives and work, rather than preoccupied with why you have been off sick or what led up to it.

However, there are some practical things you can do to ease things, before you return completely:
•Keep in touch with colleagues on a social basis.
•Ask to be put on the mailing list for the staff bulletin or house magazine so that you have the opportunity to get up-to-date with developments.
•Drop in to work before starting back, to say hello to colleagues and get re-familiarised.

Employer support

Make use of any support you can from your employer.
•Make a plan for returning to work that focuses on what you can do.
•Ask if you could have a gradual build-up to full hours (just as you might expect after breaking a leg or a major operation).
•Find out if your employer has any specialist support services on offer e.g. occupational health services, or an employee assistance programme (EAP) which may provide services such as free counselling.
•Ask your employer to consider short-term (or even permanent) changes to your job or hours, if you feel this is needed.

Any changes to your working arrangements that might help, whether temporary or permanent, could be considered as ‘reasonable adjustments’ under the Equality Act (see above). In the longer term, a Wellness and Recovery Plan (WRAP) is something you might agree with your employer. It doesn't have legal status, but it could help you plan how to stay well at work, for what might go wrong, and what to do if to does. 

For many people, what matters is knowing that they don't have to hide mental health problems and will be allowed to get on with their job without feeling pressurised to continue if they do need to stop or slow down sometimes. If you need feedback from another person to help you recognise when you are overdoing it, you could discuss with a trusted colleague what they need to be aware of, and what kind of support you would welcome.

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