Fw: Washington Post article: employment and mental health

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> Personal Message:
> Good article on pros and cons of disclosing mental illness in the work
> place.
>
> Should You Tell?
>
> By Amy Joyce
>
> If you have depression or some other mental illness, what do you do
> about work? Hope no one notices? Disclose your illness early on and
> trust that your boss will understand?
>
> To view the entire article, go to
> http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR200702
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>
> Life at Work
> Should You Tell?
> For People With a Mental Illness, There's No Easy Answer
>
> By Amy Joyce
> Washington Post Staff Writer
> Sunday, February 18, 2007; Page F01
>
> If you have depression or some other mental illness, what do you do
> about work? Hope no one notices? Disclose your illness early on and
> trust that your boss will understand?
>
> Should You Tell is a complicated question. There is no right answer, and
> there are some risks to consider.
>
> I discovered this years ago after watching a movie at home with two
> friends. One of them looked up, scared. She hesitated. And then she let
> it out: "Do you hear them? The helicopters. They're coming for me,
> guys."
>
> This sweet, gentle friend was scrunched up in the corner of the couch,
> shaking. Her Ivy League graduate degree and over-the-top intelligence
> couldn't get her out of this situation. We had to get her to the
> hospital.
>
> The next day, after she'd spent a night in the emergency room, I called
> her boss to say she had the flu. Another friend and I took turns calling
> in the flu excuse while she huddled in her room. It wasn't convincing.
>
> This friend had a prized internship that should have turned into a good
> job. It did not. From the boss's point of view, something peculiar was
> going on. My friend appeared unreliable. Her boss never knew why her
> performance so suddenly dropped. Not only was my friend soon out of a
> job, but she also knew she couldn't even ask for a reference.
>
> One in four people has depression or mental illness, and many of those
> who are affected face the same dilemma: Tell your boss, and you may be
> ostracized, penalized or not hired. Don't tell, and your boss might lose
> confidence in you. Despite the long way we've come -- public figures
> such as former Montgomery County executive Douglas Duncan, Pittsburgh
> Steelers superstar Terry Bradshaw, and writer and political adviser
> Robert Boorstin have announced that they, too, have depression or other
> related illnesses -- a strong stigma is still attached to these
> diseases.
>
> After the experience I had with my friend, I was inclined to think that
> the best thing to do is tell. But then I spoke with Sarah.
>
> She works for a Washington area aid organization and often goes on
> month-long trips to war zones, where she works seven days a week. She
> has depression, treated with therapy and medication. Until recently, it
> didn't interfere with work, so she kept silent.
>
> But stress had been accumulating during three years in the job. When a
> trip to a war-torn nation in Africa came up recently, she worried she
> wouldn't survive it. The stress had "put me in a place where I just
> couldn't function," she told me. "I thought I might truly kill myself if
> I had to go out to the field again."
>
> The only way to stay home and get treatment was to tell her boss.
>
> But she soon felt as if she was being punished for being ill. "I was
> forced to do work I had never been asked to do before. I was not seen as
> the go-to person to be relied on anymore," said Sarah, who is soon
> moving on to a new humanitarian job.
>
> "If I had diabetes or cancer, they wouldn't expect me to suck it up and
> keep going," she said.
>
> She will never tell an employer again. "I just saw the repercussions."
>
> There is more to consider than pure emotion when considering disclosure,
> however. A drug test or security clearance -- or the law -- might raise
> the issue. It is important to know what is required and what isn't.
>
> While working in public relations for a Baltimore mayor, the Visiting
> Nurse Association and other groups, Sheryl Williams hid her bipolar
> disease and anorexia. "I just feared not being credible. I knew how
> 'mental patients' were treated," she said. The effort it took for her to
> hide her illness every day at work left her exhausted, but she managed.
>
> But when she took another job and encountered the inevitable drug test,
> she knew it would come back positive because of her medications. So she
> decided to tell. It helped that she had gained the boss's trust after
> years of doing work on contract for him, she said.
>
> "My boss said, 'Okay, so what?' " Williams said. The human resources
> director concurred. "I could have just hugged both of them. Now I don't
> feel as if I am limited at all."
>
> Another reason for disclosure: It allows legal coverage. If a person has
> a mental illness and does not disclose it to a boss or other official
> entity at work, the employee can't benefit from the Americans With
> Disabilities Act.
>
> About 14 percent of all charges filed under the ADA involve mental
> illness. But an employee who does not disclose a condition loses that
> legal protection, said Chris Kuczynski, director of the ADA policy
> division at the Equal Employment Opportunity Commission.
>
> Employers cannot ask in interviews whether someone has a mental illness.
> They are permitted, however, to ask once a conditional job offer is
> made, according to Peggy Mastroianni, associate legal counsel with the
> EEOC. If the offer is withdrawn after an admission is made and the
> illness does not directly relate to the job, the company can be held
> liable for violating the ADA. (This is the only law the EEOC enforces
> that prohibits something being asked in an interview.)
>
> Companies have rights, too. In fact, if an employee creates a problem by
> doing poor work, the company can take action against that worker if it
> has not been informed of a mental illness as a potential problem,
> Mastroianni said. But if an employee's conduct or performance is
> hindered because he was denied accommodation allowed by the ADA -- a
> flexible schedule or time off to see a doctor, for instance -- the
> company might not have the same leeway.
>
> Sometimes, the health-care system reinforces the stigma, allowing
> endless treatments for a broken leg but a limited number of visits to a
> therapist.
>
> Legislation was introduced in the Senate last week by Edward M. Kennedy
> (D-Mass.), Pete V. Domenici (R-N.M.) and Mike Enzi (R-Wyo.) that would
> allow anyone with health insurance to have equitable coverage for both
> mental and physical illness. A bill is expected to be introduced in the
> House soon. So far, 40 states have passed similar laws, including
> Maryland and Virginia. The District does not have one, according to
> Andrew Sperling, director of legislative advocacy with the National
> Alliance on Mental Illness. The organization is lobbying for the Senate
> bill, he said. "Placing arbitrary limits on treatment for mental illness
> is just wrong," he said.
>
> Putting mental-health problems on the same footing as physical illnesses
> may help more people make the disclosure because it might encourage
> treatment. It also might help blunt the stigma that surrounds the
> diseases.
>
> That stigma might have kept Kay Redfield Jamison, a professor of
> psychiatry at Johns Hopkins University, from disclosing her bipolar
> disorder years ago, but she had no choice. As a medical student seeking
> hospital privileges, she had to inform her employer.
>
> The chairman at the University of California at Los Angeles, where she
> was working when her illness became apparent, "never suggested I not
> compete or leave academic medicine," she said.
>
> "He said learn from it, teach from it, write from it," Jamison said.
> "But I do not offer these up as typical examples. They are exemplary."
>
> One study conducted by the Boston University Center for Psychiatric
> Rehabilitation showed the difficulty of deciding what to disclose. Some
> study participants said it was empowering to go to work, feel like
> everyone else, and not tell anybody they had a mental illness, said
> Zlatka Russinova, one of the study's authors. But other people who were
> initially afraid to disclose but later told a supervisor "felt really
> empowered to be open," she said. "It's a personal choice."
>
> Some like that they educate or help others when they disclose. Those are
> powerful incentives, up to a point.
>
> "The vast majority are saying to themselves, 'Why would I ever disclose?
> Everybody's afraid of people with mental illness,' " said Stephen
> Hinshaw, chairman of the psychology department at the University of
> California at Berkeley and author of "The Mark of Shame: Stigma of
> Mental Illness and an Agenda for Change." "But that only perpetuates
> shame, ignorance and an inability to proactively take steps to ease the
> situation."
>
> Employers have a different incentive to encourage disclosure. They can
> save money when they help employees get treatment because though they
> may pay more for insurance, they may get a more productive and loyal
> worker in return.
>
> The National Institute of Mental Health recently released a study
> showing that slightly increasing the care for a worker's depression
> would actually save employers money.
>
> Most of the savings come from increased productivity when employees are
> able to get treatment, said author Philip Wang, director of the division
> of services and intervention research at NIMH, who conducted the study
> while researching at Harvard University. Companies often "think of
> health benefits as dumping resources into an endless black hole, and
> they get nothing back," he said. "But here's an area that's currently
> untapped."
>
> In the study, a hypothetical group of 40-year-old workers with
> depression were referred to treatment. Savings from reduced absenteeism
> and employee turnover due to the intervention began to exceed costs of
> the program by the second year.
>
> Mastroianni, the EEOC attorney, suggests that employers put policies in
> place that explain the ADA rules and outline what the company offers
> someone who might have a mental illness. This should help create a
> comfortable atmosphere in which workers can be honest.
>
> But the consensus remains: There is no one right answer on disclosure.
>
> "It is completely personal," said Williams, the public relations
> employee. "People have to feel it's the right time and right place. I
> could never say in a thousand years that you should or shouldn't. This
> was not easy for me. I came to this decision gradually and only did it
> at work because I was made to feel extremely comfortable."