For Employers

Supporting people with mental health conditions in the workplace: a business case

The economic consequences of poor mental health are staggering. It is estimated in a World Economic Forum and Harvard School of Public Health study that the cumulative global impact of mental disorders in terms of lost economic output will amount to $16.3 trillion between 2011 and 2030.

As stated by the World Economic Forum1, however, evidence shows that treating mental health conditions is a cost effective way to promote both wellbeing and economic prosperity. A report funded by beyondblue and the National Mental Health Commission in Australia2 calculated that every dollar an organization spends on effective workplace mental health policy may generate $2.30 in financial benefits.

Beyond economics, however, employers are also powerful agents of change. An organizational climate that promotes wellbeing and modifies the risk factors for stress can be developed by targeting workplace policies as well as individual needs. Similarly, effective treatments and resources exist for common mental health conditions, and it is simple to facilitate access to care for those who could benefit from it.

As part of the the World Economic Forum Global Agenda Council on Mental Health, a practical toolkit to promote a mentally healthy workplace has been developed, with the aim of supporting individuals – no matter where they sit in an organization – and building a case for tackling mental illness in the workplace. Seven key actions can lead to mentally healthier workplaces:

  1. Consider your unique workplace environment and how it can be adapted to promote better mental health. Every workplace is unique.
  2. Consider the combination of motivators of the organizational leaders and employees who have taken action on workplace mental health; for example, they may be interested in protecting mental health and wellbeing of staff, doing the right thing for staff, and benefits in managing costs and liabilities.
  3. Become aware of the policies and strategies put in place by other companies who have taken action (five case studies are provided in the toolkit).
  4. Each organization will require a unique set of workplace mental health policies and practices. In developing these, identify the specific needs of your organization and staff.
  5. In practice, workplace mental health strategies will require both internal and external partnerships. A successful initiative will benefit from collaboration, with, for example, local training programs, human resources, and employees.
  6. Find out where to go if you or a colleague needs help. Acknowledge that seeking help can be challenging, and that the important thing is to be there for colleagues who may need support.
  7. Get started. Mental and physical health are intimately linked.

Key Messages

Here’s what to know about bipolar disorder in the workplace:

  • People with bipolar disorder can flourish in the workplace: a supportive environment is key.
  • Stigma has been found to negatively affect the performance of employees living with mental health conditions.
  • Every dollar spent on effective workplace mental health policy may generate $2.30 in benefits to an organization.

What do we know about work and bipolar disorder?

The research is mixed. On one hand, some research has shown that unemployment rates in people with bipolar disorder are much higher than in the general population, with around 40-60% of people with the condition being unemployed, often because they didn’t do as well as expected at their jobs (this is called workplace under-performance3). Other studies have found that up to 40-50% of people with the condition experience a decline in job status and income3. On the other hand, other research has found that job status for those with bipolar disorder stabilizes over about 6 years in a position — even for those with severe forms of the illness4. Furthermore, the high rate of unemployment found in some studies may be smaller, because it may not include everyone with bipolar disorder. For example, some who are doing well at work may not have told their co-workers or employers that they live with the condition due to fear of stigma in the workplace (i.e., negative stereotypes directed at them at work). People with bipolar disorder have found that stigma can negatively affect their work performance if they do not have a supportive work environment5,6.

The good news is that research suggests that improvements in the work environment, such as support from employers and co-workers, can benefit people with bipolar disorder — and are, in fact, critical for successful work outcomes7. Although we recognize that not all approaches for employers to support their employees with mental health conditions will be suited for all work environments and job types, there are common areas of support to consider.

A business meeting between three women. Two are facing away from the camera. The woman in the center, who is white and has blonde hair, is looking across the table at the other women.

The first step is education.

Disability and anti-discrimination laws protect the work rights of people living with bipolar disorder and other mental health conditions. Some laws may even require a person living with a mental health condition to tell (‘disclose’) the condition to their employer. Disclosure8,9 of a mental health condition is a difficult decision, given the reasonable concern that employers may discriminate against the person disclosing their condition, as well as the possibility of negative attitudes from co-workers5,6. Supervisors and co-workers can be excellent sources of support. As an organizational leader, you can ensure that the workplace culture is a supportive one for your staff and that it meets the legal standards set in place within your own country, state/province, and organization (be aware that rights and laws vary by location).

In addition, learn about the condition itself. A person who lives with bipolar disorder will integrate much more successfully into work settings if there is a good fit between the person and their job, if the person has a strong support system in place both at home and in the workplace, and if the person is in recovery from mood episodes10. Aspects of the condition that may impact work functioning include difficulties with cognition (memory, focus, problem solving in fast-paced environments), depressive symptoms, and medication side effects11. There is great variation in how people experience their conditions, so, if appropriate invite your employee to share their individual experiences with mental health, if they wish. The more you understand, the better able you will be as an employer to provide appropriate work accommodations, set realistic expectations, and provide a sense of positivity and empowerment — all critical facets in the successful management of a mental health condition in the workplace.

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Resources

Web MD: Tips for Managing Bipolar Disorder at Work. This site hosted by WebMD offers a range of tips for managing bipolar disorder at work and practical suggestions on topics such as: job performance, disclosure, work schedules, leaves of absence and the law.  http://www.webmd.com/bipolar-disorder/guide/managing-bipolar-disorder-at-work-job-performance-tips 

Free monthly webinars on workplace mental health promotion. Includes an archive of past videos on mental health in the workplace. http://www.staging2.bdwellness.com/Support-Tools/Resource-By-Area/Work/ctl/Edit/mid/%22http://www.mentalhealthcommission.ca/English/initiatives/11897/workplace-webinar-series%20%22 

Guarding Minds @ Work. A workplace guide to psychological health and safety. Discusses 13 psychosocial factors that impact employees’ psychological responses to work and work conditions. http://www.guardingmindsatwork.ca/ 

Mental Health Works (MHW). Provides workplace mental health workshops for both employers and employees, teaching skills for responding to challenging situations. http://www.mentalhealthworks.ca/ 

List of articles and blogs with personal stories and practical advice on employment when living with bipolar disorder. Also features current research into bipolar disorder. http://www.bphope.com/relationships/work-jobs/ 

Mental Health Commission. The Mental Health Commission of Canada aims to improve the mental health system and attitudes towards mental health. Their website provides information and resources related to: caregiving, diversity, housing and homelessness, law, recovery, and more. http://www.mentalhealthcommission.ca/English/issues/workplace 

Mental Health in the Workplace – Video Series. This Working Through It video series portrays ten individuals who have experienced mental health related issues while in the workplace. They offer ideas for coping at work, navigating the disability system, and returning to work successfully. 

www.workplacestrategiesformentalhealth.com/wti 

Workplace Strategies for Mental Health. This is an extensive website rich with tools and resources for employers, addressing everything from implementation of psychological health and safety management systems, its business advantages, union collaboration, to job-specific workplace strategies and solutions.  https://www.workplacestrategiesformentalhealth.com/ 

Mood Disorders Canada – Workplace Health. An online book by the Mood Disorders Society of Canada that looks at: the downside of unaddressed mental illness in the workplace, presenteeism vs. absenteeism, what employers and small organizations can do to support both the individual and the work environment, and how to implement a program of psychological health and safety in the workplace. http://www.mooddisorderscanada.ca/documents/WorkplaceHealth_En.pdf 

Conceal or Reveal: A guide to telling employers about a mental health condition. http://www.kcl.ac.uk/ioppn/depts/hspr/research/ciemh/cmh/CMH-Stigma-Measures/CORAL-DA-Oct13-final.pdf 

Mood FX. Monitor your mood on your phone or PC. Mood FX is designed for people with unipolar depression, but may also be of use to people living with bipolar disorder. Includes screens for symptoms of depression and anxiety, and for problems with cognition and work functioning. http://www.moodfx.ca 

BP Hope. Find Work That Works For You! This blog post was written by an individual who built a career around the realities of bipolar disorder. Many jobs have constraints and demands which may not necessarily fit with the health challenges of bipolar disorder. According to this post, one solution is to define the main parameters of your job; for example, what type of work you do can make a difference to quality of life. http://www.bphope.com/Item.aspx/526/fast-talk-find-work-that-works-for-you 

Tse, S.S., & Walsh A.E. How Does Work Work for People with Bipolar Affective Disorder? Their higher than average level of education and qualities like lateral thinking can make people living with bipolar disorder highly valued workers. These qualities become more useful when bipolar disorder symptoms and episodes are well managed. http://www.ncbi.nlm.nih.gov/pubmed/11823884 

Hale, S. Employment Experiences of People with Bipolar Disorder. This thesis research by CREST.BD member (and occupational therapist) Sandra Hale explored the perspectives of people living with bipolar disorder regarding their employment accomplishments and obstacles, and to understand the adaptive strategies they used to manage both BD and employment. https://circle.ubc.ca/bitstream/handle/2429/38196/ubc_2011_fall_hale_sandra.pdf?sequence=1 

Michalak, E.E., Yatham, L.N., Maxwell, V., Hale, S., & Lam, R. The Impact of Bipolar Disorder Upon Work Functioning: A Qualitative Analysis. Written for an academic  audience, this paper explores the factors that can make or break a career in people with bipolar disorder. The authors found several things that are critical for a person with bipolar disorder to succeed at work: absence of stigma, ability to disclose one’s condition at work, finding meaning through one’s job, and keeping a routine in all aspects of life (at work and at home). http://onlinelibrary.wiley.com/doi/10.1111/j.1399-5618.2007.00436.x/abstract 

Brohan, E., Henderson, C., Wheat, K., Malcolm, E., Clement, S., Barley, E., Slade, M., & Thornicroft, G. Systematic Review of Beliefs, Behaviours and Influencing Factors Associated with Disclosure of a Mental Health Problem in the Workplace. Disclosing a mental illness at work usually comes with repercussions of some kind; however, concealing a mental health condition can be a source of stress, too. This paper, for a healthcare provider audience, gives insights into the complex issues around disclosing, or not disclosing, a health condition at work. http://www.biomedcentral.com/1471-244X/12/11 

Borg, M., Veseth, M., Binder, P.E., & Topor, A. The Role of Work in Recovery from Bipolar Disorders. Whether it is paid or not, an occupational activity may have positive effects for somebody living with bipolar disorder. Work in a supportive, stigma-free environment can be very empowering. Yet work can also be overwhelming. This academic paper looks at the helpful and harmful work-related concerns during recovery. http://qsw.sagepub.com/content/12/3/323.abstract 

Tse, S., & Yeats, M. What Helps People with Bipolar Affective Disorder Succeed in Employment: A Grounded Theory Approach. For a person living with  bipolar disorder, the path to employment depends on multiple factors. This study, for an academic  audience, stresses what is important during early recovery times, for example, a sense of determination and the importance of having a fit between a person’s work occupation and his or her individual needs. http://www.ncbi.nlm.nih.gov/pubmed/12454350 

For Employers

Job Accommodation Network. Accommodation and Compliance Series: Employees with Bipolar Disorder. This document is part of a series to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). This document on bipolar disorder provides information about the condition, ADA information, accommodation ideas and resources. http://askjan.org/media/Bipolar.html 

Bipolar UK. Employers’ Guide to Bipolar Disorder and Employment. A downloadable PDF form that can help managers in considering the appropriate techniques and practical strategies to support employees living with bipolar disorder. http://www.bipolaruk.org.uk/leaflet-employers-guide-to-bipolar.html 

Take Action

How to create a healthy workplace:

  • Learn about mental health conditions. The more you understand, the better able you will be as an employer to facilitate a mentally healthy workplace.
  • Make connections in your community. Find out where to go if you or one of your colleagues needs help for a mental health condition.
  • Employers are powerful agents of change in promoting mental health. Get started today with one organizational change and see what benefits follow for your organization, workplace culture, and community.