[Content note: mental illness, including eating disorders]
This post was requested by Kate [not FtB!Kate], who donated to my conference fundraiser. She wanted to hear my opinion on mental health in the workplace and how employees and employers can foster a culture that values and promotes mental health. She had some of her own suggestions, which I’ve incorporated into this piece with her permission.
Work is often a concern for people who suffer from mental illnesses. They might worry, for instance, that their struggles will impact their work performance, that coworkers or employers will find out that they have a diagnosis and stigmatize (or even fire) them, or that offhand comments at work could trigger eating disorder symptoms.
I wrote about this topic much more generally in this piece, which was about how to prioritize and promote mental health in one’s community. Workplaces are particular types of communities, so a lot of this still applies. At the same time, workplaces present particular challenges to promoting mental health, as well as particular capabilities that might help.
Note that I’m writing this as a person with a mental illness, as a person who works, and as a person who observes human behavior. I’m not writing this as someone who’s ever been a manager or a supervisor, so while I can speak to what I would like to see from managers and supervisors, I don’t have firsthand knowledge of what it’s like to be one. If you have that experience and you’d like to weigh in in the comments, feel free to do so.
1. Ensure that the assignments you give your employees and the culture you foster in the office encourage and allow employees to take good care of themselves.
Every workplace that expects people to skip lunch or sleep less than 7 hours a night is a workplace that is detrimental not only to physical health, but mental health as well. Sleep deprivation can dangerously exacerbate many mental illnesses, and having to skip meals can cause people with eating disorders to relapse. Obviously this is unavoidable with certain jobs or when a big important project is nearing completion, but it’s avoidable with most jobs most of the time.
(At the same time, recognize that this is a problem with American culture at large, and companies feel pressure to pressure their employees in this way because if they don’t, a competitor will, and it’ll reap the profits.)
2. Make sure that new employees understand the health coverage they’re receiving under the company’s benefits plan, especially as it pertains to mental health.
Explain in as little legalese as possible what the coverage includes and doesn’t include, and where they can go to find more detailed information or look up specialists in their area. In my experience, many people are worried that if they see a mental health professional using their employer-provided insurance plan, their employer will somehow have access to their medical records. Emphasize that it’s none of your business as an employer what your employees do with their health insurance and that providers cannot disclose such information to you without a patient’s consent. For extra points, give a short overview of HIPAA.
Going over this information not only improves the odds that employees are able to get the mental healthcare they need, but it shows that you’re comfortable discussing mental health with employees and that your company thinks it’s important.
3. If you choose to have health-related contests at the office, focus them on fitness goals or healthy eating, not weight loss.
Personally, though, I’d avoid these altogether because many people consider health a personal matter and feel pretty uncomfortable about having to discuss it publicly and competitively. Even if the contest is optional, keep in mind that people will feel a strong social pressure to join in. Who wants to be the only person in the office who doesn’t seem to care about staying in shape?
In any case, framing weight loss as an intrinsically healthy and positive goal is harmful and counterproductive. You can weigh little and be very unhealthy, and if you lose weight in an unhealthy way, you’ll probably gain it back anyway. A better way to structure a health contest is by encouraging participants to achieve goals that are proven to be healthy and doable.
4. Make sure employees understand the policies and processes about taking time off for medical reasons (and remember that mental health is a medical issue).
It’s especially important to find a way to emphasize that mental health is just as important as physical health, and little gestures make a big difference. For example, you could say something like, “If you know in advance you’re going to need time off, like for a physical or a therapy appointment, you can submit the form to me at at least a week’s notice.” That provides important information while also implicitly conveying the fact that you consider therapy to be a legitimate reason to leave work an hour early.
1. Consider your own mental health when choosing responsibilities to take on at work.
It’s understandable, especially in this economy, to try to impress your boss by offering to do as much as possible and overworking yourself. However, good mental health should be seen as an investment. If you take good care of it, you’ll ultimately be more productive than if you neglect it and burn out.
This applies to all those little volunteer opportunities that aren’t directly job-related, either. If you have social anxiety, it might be a bad idea to offer to organize a social outing for the office. If you have an eating disorder that makes it really stressful to choose food to buy, it might be a bad idea to offer to bring snacks for a meeting. You know yourself best.
2. If you feel safe and comfortable, let your boss know about mental health issues that may affect your performance and how you plan to deal with them.
The “if you feel safe and comfortable” is the key part. I’m absolutely not suggesting that everyone can and should come out about their mental illness to their boss, since I know that in many cases that’s a really bad idea. (It shouldn’t be, but it is.) But personally, I know people who did this and found it really helpful because they were able to work collaboratively with their boss to make sure that they can get the time off they need and that they can fulfill their responsibilities rather than having to keep it a secret and try to solve potential problems on their own. Disclosing also makes it possible to receive any accommodations you may need, which brings me to:
3. Educate yourself about laws related to mental illness and the workplace.
The Americans with Disabilities Act (ADA) is obviously a major one, but so is HIPAA, which I mentioned earlier. The definition of “disability” in the ADA is intentionally quite general, but mental illnesses are included: depression, anxiety, PTSD, ADHD, and so on. Title I of the ADA concerns employment. There’s a lot of useful information in there; for instance, an employer cannot ask you in a job interview whether or not you’ve been treated for mental health problems, or which medications you’re taking. Keep in mind that the ADA only applies to businesses with 15 or more employees, however. Here’s another useful article about it.
1. When someone asks you how you’re doing, be honest (within reason).
In the piece I linked to earlier, I wrote:
This is something I’ve been really making an effort to do. This doesn’t mean that every time someone asks me “What’s up?” I give them The Unabridged Chronicles of Miri’s Current Woes and Suffering. But I try not to just say “Good!” unless I mean it. Instead I’ll say, “I’ve been going through a rough patch lately, but things are looking up. How about you?” or “Pretty worried about my grad school loans, but hopefully I’ll figure it out.” The point isn’t so much that I desperately need to share these things with people; rather, I’m signaling that 1) I trust them with this information, and 2) they are welcome to open up to me, too. Ending on a positive note and/or by asking them how they are makes it clear that I’m not trying to dump all my problems on them, but I leave it up to them to decide whether or not to ask more questions and try to comfort me, or to just go ahead and tell me how they’re doing.
At work, there are obviously different standards than in other communities, or with friends and family. But even at work, there’s room for honesty and mutual support.
2. Be mindful of using language that relates to mental illness.
Casual usage of diagnostic terms (“That’s so OCD,” “You’re being delusional,” etc.) hurts people with mental illnesses by trivializing their conditions and turning them into the butt of a joke. It also makes it more difficult for people to disclose mental illnesses because it keeps people from taking them seriously. If “ADHD” is what you call it when you can’t focus on a boring project and someone tells you they have “ADHD,” you’re not going to think, “Oh, this person has a serious condition that makes it neurologically impossible for them to focus on a task unless they get treatment.” You’re going to think, “Oh, come on, they just need to close Facebook and get focused.”
3. Remember that talking about dieting and weight loss can be very triggering for people with past or current eating disorders.
Fat talk (as it’s called) is so ingrained in our culture and communication patterns that it’s hard to imagine that it could be such a serious issue for someone. But anecdotally, it seems that eating disorders in particular are very easily triggered by offhand remarks like “Ugh I need to work off this cupcake” or “My thighs are huge.” Even when not actually triggering, these comments encourage unhealthy behavior and create a social norm of dieting and preoccupation with weight loss.
I sometimes dread being around groups of women who are not my friends because more likely than not, I’m going to hear these comments. And it’s not like you can avoid your coworkers. So if you must do it, try not to do it to a captive audience.
4. Respect others’ privacy when it comes to mental health issues.
Just as you should never out an LGBT person without their permission, you shouldn’t discuss someone’s mental health with others at the office. Although I generally encourage people to be open about mental illness if they feel they can be, that has to be on their terms, not someone else’s. If you’re concerned that someone’s mental health problems are causing them to be unable to do their work, do the same thing you’d (probably) do anytime a coworker isn’t pulling their weight: talk to them about it in a kind and considerate way rather than going straight to the boss.
(An exception to this is if you’re worried that someone may harm themselves or someone else. In that case, please call 911. )
When it comes to structural issues like ableism and stigma, no community can be an island, unfortunately. There will not be stigma-free workplaces until there is a stigma-free society. But the more power you have in a workplace, the more influence yo have over its culture.
Thank you to Kate for her donation and for this prompt.
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