How employees think, feel, and act while they are at work (and at home) may be more important than you realize. Because how they think, feel, and act reflects their mental health, which in turn shows up in their productivity and your bottom line.

Good mental health is as essential as good physical health. It’s a sense of well-being and confidence; people with good mental health are able to handle stress, relate well to others, and make wise choices. They cope better with the events and people around them, both on and off the job.

Mental Illness is Common and Misunderstood

However, one in five employees struggles with some form of mental illness each year, especially at work. (Compare this to the two in five who will develop diabetes, a very costly physical illness.) They often try to hide their symptoms, because of the stigma attached to having a mental illness. Employees suffering from depression, anxiety, and other mental illnesses are sometimes told it is "only their imagination" or to "grow up and deal with it". If the same employee showed up with a broken arm, the supervisor would understand. Mental illness isn’t always apparent, and people often feel ashamed or weak, as if they aren’t capable of controlling themselves.

Mental Health Issues are Costly

Employee health, whether mental or physical, is always a concern for employers. Serious mental disorders cost the U.S. $193 billion in lost earnings every year. Globally, the cost is estimated to be $6 trillion by 2030, more than the costs of diabetes, respiratory conditions, and cancer combined.

The prevalence of mental disorders and their place in the most expensive illness lists may surprise you. The most expensive health problems, including direct and indirect costs, are:

1.Depression

2. Obesity

3. Arthritis

4. Back and neck pain

5. Anxiety

Mental Illness is Treatable

The good news? Just as with physical illness, mental illness is real and has effective treatments. You probably have employees who are being treated and, like their co-workers with diabetes or other chronic disorder, are among your most productive workers.

Common Mental Illnesses

Let’s look at some of the most common mental disorders found in the workplace. These disorders can be different for each person, with mild to severe symptoms. Treatment is usually a combination of psychotherapy (talking to a therapist) and medication. Medication alone never cures a disorder, but helps manage symptoms.

In alphabetical order:

ADHD (Attention Deficit Hyperactivity Disorder):

People often think that ADHD (“hyperactive”) is a childhood disorder, but an international study showed that 3.5% of adults have ADHD. Harvard Medical School found that employees with ADHD lose about four weeks a year of combined sick days and low productivity. They are also 18% more likely to be disciplined and two to four times more likely to be terminated.

What ADHD looks like in the workplace:

• Inability to stay organized
• Problems handling workloads
• Unable to follow instructions
• Arguments with co-workers
• Impulsive decisions

Anxiety Disorder:

Anxiety is an excessive fear, real or imagined, of a threat. It can be specific (called a phobia) such as a fear of public speaking. It can also be a vague sense of worry. People with anxiety disorders try to avoid the situations that trigger their fears. Their muscles are tense as they struggle with a “fight or flight” reaction. They require constant reassurance from their supervisors. Their productivity is similar to employees with depression, described below.

At work, an employee may demonstrate some of these symptoms :

• Restlessness or feeling “on edge”
• Feeling self-conscious around others
• Difficulty concentrating
• Irritability
• Having a hard time making friends

Bipolar Disorder:

Employees with bipolar disorder swing back and forth between two states of being. The manic phase can be extremely energetic and happy or angry/easily excitable. The depressed state is the low that follows these "up" swings and can look much like anxiety to someone unfamiliar with the illness. Employees with a bipolar disorder use about 28 days in sick time and absences. They also cost 35 days in lost productivity. However, bipolar disorder only affects about 1% of the workforce, so the overall cost is less than that of depression.

At work, the manic phase may look like this:

• Creative
• Upbeat and energetic
• Disruptive
• Poor judgment and impulsive

The depressive phase is similar to depression.

Depression:

Depression is the most familiar and most-studied mental disorder, because it is so common. Every year, about 6% of employees have symptoms of depression. An employee with depression costs about 27 days a year: 9 are from sick days and 18 are from lost productivity. Unfortunately, only one in four receives adequate treatment, which is readily available.

Depression is usually described as a sad or low mood. In the workplace, it looks like this:

• Restlessness
• Irritability
• Complaints of illness, aches, or pains
• Passiveness or aimlessness
• Socially withdrawn

It’s clear that promoting good mental health in the workplace is an important and worthwhile endeavour. Here are 4 ways to get started now:

• Promote mental health education. Work to remove the stigma of mental health so that employees feel more comfortable in seeking help. This includes training supervisors so that they do not punish employees for being mentally unwell.
• Encourage a work/life balance. Provide breaks during the work day. Make the environment healthy by eliminating overtime and emails when at home. Offer stress reduction classes and find ways to let employees socialize and have fun. If you use an Employee Assistance Program, ask them to do workshops and remind employees of their services.
• Offer mental health screenings. Just as you would offer confidential screenings for blood pressure, diabetes, or obesity, sponsor a Mental Health Day. Over half of people with a diagnosable mental disorder don’t seek treatment because they think their symptoms are due to stress or getting older. Consider asking local mental health professionals to speak on common disorders at “Lunch-and-Learn” sessions.
• Supply a mental health questionnaire. Whether done by a local program, or online, give employees a private way to assess their need for evaluation and possible treatment. Even when people recognize that they have a mental disorder, they can avoid follow-up because they worry about being labeled “crazy” or that they will face discrimination. Confidentiality is crucial for these employees.

Mental Illness and the ADA

Do employees with mental disorders and impairments qualify as disabled under the American with Disabilities Act (ADA)? Answer: It depends.

The ADA does not have a definitive list of conditions that constitute a disability. Rather, it provides a general definition (2011) that a person must meet to qualify as disabled. The ADA Amendments Act states, “A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having such an impairment.”

The Job Accommodation Network recommends some ways to assist employees who have mental disorders, to help them be productive and healthy:

• Reduce distractions by providing space enclosures, white noise, noise-cancelling headsets, and minimal interruptions.
• Provide written instructions, checklists, task lists, and calendar. Use notebooks, planners, and sticky notes as needed. Remind the employee of deadlines.
• Divide large tasks into smaller segments. Color-coding may be helpful. Assign a mentor to coach the employee. Schedule regular supportive meetings with supervisor and mentor.
• Encourage stress management techniques. Allow phone calls to therapist or doctor. During stressful times, adapt job functions. Allow a flexible work environment.

The best workplaces are where everyone feel valued and supported. Whether the employees have a physical or mental condition, they still want to contribute and be productive. When employees feel understood and accepted, they will do their best to make the company succeed.