To tell, or not to tell…reasons why employees hide mental illness

As I was typing the above title, it struck me that “hide” could sound quite negative. “Hide” seems to have nefarious, dishonest connotations. As children, we hide when we’re in trouble. As adults, we hide if the I.R.S. notices us. If an employee needs accommodations at work for a condition/disability such as deafness or diabetes , I feel like “hide” would not be used in relation to those conditions. We might say “disclose” or “share” when describing the manner in which an employee chooses to inform his employer of a health condition which may warrant accommodations necessary for optimal work performance. OR, I could be reading too much into the use of that one word? OR, I am being “too sensitive” and should just get over it….? Regardless of your stance on the word hide related to mental health, it is likely that you have definite opinions on how much, when, and why an employee should, would, could, want or need to share his/her mental health challenges.

Stigma. Loss of status. Cost. Fear. All are reasons many employees do not inform their employers of their mental health issues. We are painfully aware of the consequences of undisclosed and undertreated mental health problems in the workplace. From poor job performance, absenteism to serious outcomes such as erratic behavior and violent acts of which we have become all too familiar in our news cycles. Mass shootings by armed teenagers to even more extremes such as the Germanwings Airbus tragedy in which a co-pilot hid his mental illness from his employer. As a result, Andreas Lubitz, hid his mental illness from his employer and deliberately caused the crash which killed all 144 passengers on board the flight as well as 6 crew members. It was learned after the crash that Andreas had not disclosed his mental health treatment for recurring episodes of depression accompaned by psychotic features. However, the genesis of Lubitz’ final episode was likely a combination of mitigating factors and could not readily be explained by a single cause. Would it have been possible for employers to have created an environment in which employees would feel safe enough to have disclosed their mental health challenges?

What factors could have made Lubitz keep his mental health difficulties so well protected? Stigma and discrimination may continue for the employee’s lifetime even when acute symptoms have resolved and the condition is in remission. Who among us has not heard the not-so-subtle threat that one’s abberant behavior or transgression would be made a part of one’s “permanent record.” What a shame it is when those of us struggling to overcome/manage mental health conditions are seen as burdens or liabilities in the workplace while this harsh standard would hardly be applied to a cancer survivor. Fear and anxiety frequently accompany a mental health diagnosis. Five major mental illnesses – mood disorders, anxiety disorders, dementia, eating disorders, and schizophrenia/psychotic disorder – may become chronic resulting in more pain on top of the lifechanging diagnosis. Loss of status after working hard and long can disappear in a flash. Isolation, shame and even harassment are often the result of an employee’s mental health disclosure. Despite the Americans with Disabilities Act (ADA) accommodations, mentally disabled workers are often put in lower profile projects/positions and lose their jobs when employers fire them for erratic behavior which becomes pervasive. It’s my theory that employers may let go their own employees for mental health concerns but document or promote an unrelated reason for the dismissal. Of course, in right to hire/right to fire states, the employer’s “bottom line” must be taken into account. Denial of insurance coverage, higher insurance premiums to the monetary cost of treatment accompany the actual cost of mental illness in the workplace. Despite the elimination of pre-existing conditions as a reason for insurance denial, the reality for employees in small businesses remain riddled with cost. Before the elimination of pre-existing conidtions as grounds for insurance denial or higher premiums, I witnessed the charged stress as my father attempted to negotiate with the insurer in finding the best rates for his family. The ever present threat of insurance denial resulted in anxiety, poor sleep and mood swings for him. He carried the weight of our family’s world on his shoulders. My father’s mental health challenges compounded the very real task of securing appropriate coverage as well as treatment for such struggles. I did not learn until after his death that he had aughtored a book (The Far Side of Despair, Russell K. Hampton, 1975) documenting his clinical depression from the time when I was too young to remotely comprehend the stress of carrying our familiy’s financial situation.

In the era of an “opioid crisis”, political correctness and the efforts to blame medications for society’s ills, it seems quite logical to conceal our reliance on anything except for our “wllpower”. It is unfortunate that medications are blamed for negative outcomes when several factor are often at play when mental health problems effect an employee’s work performance. The invisible stuggles associated with mental health diagnoses may make it seem as if attention is not warranted in comparison with visible health problems, for example diabetes or an arthritic knee. I do not have the solution for mental health accommodation in the workplace. It seems we must cautiously approach our employer when a mental health diagnosis lands on our doorstep. Go into business for ourselves or try to elininate stigma and educate a broader audience on the struggles as well as accomplishments of mental health survivors.

(The real reasons employees hide mental illness,, Pub.: 3-31-19)



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