What Science Tells Us About the Mental Health Crisis at Work

Despite the Federal implementation of The Americans with Disability Act (ADA) in 1990, you are still less likely to get hired and more likely to get fired if you disclose a mental illness or show direct or indirect symptoms of such (Østerud et al., 2023; Rüsch et al., 2018; Hipes et al., 2016). You are also more likely to be discriminated against by your colleagues and supervisors, leading to loss of opportunities in social and professional realms (Shahwan et al., 2022; Brouwers, 2020). The ADA helped give legal access to resources, in particular for physical disabilities (although companies continue to violate this policy), and while it did increase awareness about disability  it did not break stigma or discrimination. A recent report from Deloitte estimated that, on average, mental health issues account for 30-40% of short-term disability and 30% of long-term disability claims. For the employees with mental illness that do not go on leave, working in un-accommodating and stigmatizing environments worsen their mental health issues and reduce their productivity.  Work is the third leading cause of stress in employees. This means that work itself can cause mental illness, which consequently leads to stigma and discriminatory behaviors that are likely to negatively impact your professional growth and even get you fired. Sadly, and perhaps unsurprisingly, being fired worsens mental health.  It is a vicious cycle and it is not exclusive to a specific profession. All professions are affected, spanning from doctors to media-professionals, and all countries are too (Brouwers, 2020; Brouwers et al., 2016; Greenberg et al., 2009). It is noteworthy that high-income countries have the highest level of stigma and discrimination against mental illness. 

You might be wondering what the big deal is. These days, companies are giving out mental health resources left and right, including free access to meditation apps, yoga sessions during work, mental health insurance coverage, and unlimited time off. Isn’t that enough? No, it is not. In fact, while these efforts give nice opportunities for self-reflection, relaxation and more free-time, they do not break the stigma and discrimination that still flourishes among colleagues and employers (Read this article from Digital Wire on the need for evidence-based support offered by companies). Moreover, employees hesitate or completely resist using employer-provided insurances for mental health treatments because of the possibility of privacy abuse by employers (A practice documented to happen in several companies. Read this NYT article on how Google accessed employees’ therapist notes) (Brouwers, 2020). Employees without mental illness still do not trust colleagues that disclose their mental illness, and in particular they question their ability to effectively do their job (Shahwan et al., 2022; Brouwers et al., 2020). Many of these non-mentally ill employees hold an ingrained, often subconscious, stigma against their colleagues with mental health challenges. The same is true for employers and HR that hold important roles in hiring and firing employees (Østerud et al., 2023). Yoga sessions, meditation apps and unlimited time off cannot fix these issues. And if all that was not enough, mental illness is expensive. Globally, one trillion USD are lost due to mental health issues (WHO, 2022). 

So what can fix this enormous problem of stigma and mental illness at the workplace? While research is limited, some studies have pointed to two game-changing strategies (Thornicroft et al., 2016): 1. Personal exposure to mental illness, directly or indirectly. 2. Education on mental illness. Interestingly, the companies that make a conscious effort to defy discriminatory practices end up hiring more people with mental illness, which consequently exposes more people in the company to mental illness indirectly.

In other words, education changes not just knowledge but also exposure, both of which are known to reduce stigma and discrimination.

• Brouwers, E.P.M. Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions. BMC Psychol 8, 36 (2020). https://doi.org/10.1186/s40359-020-00399-0
• Brouwers EP, Mathijssen J, Van Bortel T, Knifton L, Wahlbeck K, Van Audenhove C, Kadri N, Chang Ch, Goud BR, Ballester D, Tófoli LF, Bello R, Jorge-Monteiro MF, Zäske H, Milaćić I, Uçok A, Bonetto C, Lasalvia A, Thornicroft G, Van Weeghel J; ASPEN/INDIGO Study Group*. Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries. BMJ Open. 2016 Feb 23;6(2):e009961. doi: 10.1136/bmjopen-2015-009961. PMID: 26908523; PMCID: PMC4769412.
• Deloitte insights, 2022: The ROI in workplace mental health programs: Good for people, good for business. Link to report.
• Greenberg, N., Gould, M., Langston, V., Brayne, M. (2009) Journalists’ and media professionals’ attitudes to PTSD and help-seeking: A descriptive study, Journal of Mental Health, 18:6, 543-548, DOI: 10.3109/09638230903191231
• Kaiser Health News Article, 2023, on the rise of mental illness among medical doctors in the US (Link to Article).
• Hipes C, Lucas J, Phelan JC, White RC. The stigma of mental illness in the labor market. Soc Sci Res. 2016 Mar;56:16-25. doi: 10.1016/j.ssresearch.2015.12.001. Epub 2015 Dec 17. PMID: 26857169.