Navigating the Intersection of Work and Mental Health

Working Better and Stressing Less

Ideas on work and mental health

Posts tagged depression
Mental health at work: The employer side

In the last month, approximately one in five of your coworkers suffered symptoms of a mental illness.  In the last year, one in four met criteria for a mental disorder. Over a lifetime, about 50% of US adults will meet criteria for a mental illness.  It's almost 100% certain that you, or someone close to you, is suffering from symptoms of anxiety, depression, or other mental health concerns.

Yet when we walk into the doors of work each day, most of us don't talk about it. Even the most supportive employers offer little more than "Please talk with someone at EAP about that," or "We have great health insurance benefits for that." The conversation is almost never, "We're really great at accommodating colleagues with anxiety, depressive or other disorders so please let us know how we can make work better for you if you happen to be coping with those issues." 

British Telecom (BT) in the UK has started to change that with a proactive three-tiered approach to mental health at work.  It seems that elsewhere in the world, although nonprofits do exist to help raise awareness and advocate for change in the workplace around mental health, it's difficult to find companies who stand up and express proactive support for workers with mental illness. Most workers with mental illnesses WANT to be employed and are capable of being employed with minimal if any modifications to duties. 

With at least 50% of their workforce affected personally and 100% through relationships, companies need to stand up and provide more ACTIVE support for workers with mental illness. The articles linked above detail the incredible costs of lost productivity beyond absenteeism, due to symptoms of mental illness in workers. I see the personal toll on highly qualified, capable professionals who make their way into my office. They are ashamed of their symptoms and often horrified at hearing they have a diagnosis, in large part because of how their employer might judge them if they found out. Companies can and should do something to be more supportive. 

Let your team know it's safe to come out of hiding with their needs. 

Let your team know it's safe to come out of hiding with their needs. 

Here are a few ideas:

- Ensure that when you buy health insurance coverage for your employees, that the insurance carrier provides an adequate panel of mental health clinicians OR sufficiently open benefits so that employees can get services out of network. 

- Emphasize that EAPs are often for situational stress or exacerbations of known mental illnesses and are not a replacement for proper evidence-based mental health counseling or medication-management services which should be covered under health insurance. 

- Invite the conversation. No HR cannot inquire of employees whether they have a mental illness but they can INVITE employees to request appropriate modifications by making sure employees know that if they do have a mental illness, they may be eligible for accommodations under the Americans with Disabilities Act. It's also fair to say, "even if you don't qualify under ADA, we always do our best to accommodate health needs of our workers, including mental health needs." 

What does your employer to do support mental health of its employees? Perhaps I've missed something in trying to find more proactive programs in the US. 


What is your stance on psychiatric medication?

My goal as a therapist is to help people live full, meaningful, fulfilling lives that have room for the entire human experience; good and bad. Medication can be an important part of achieving that full engagement in life, for some patients. 

I am a counselor and I am not qualified to prescribe or recommend medications. That said, there are times where I have suggested or insisted that someone seek the opinion of a qualified prescriber, such as a psychiatrist, psychiatric mental health nurse practitioner, or primary care physician, as to whether medication may be of benefit to them. 

There are some conditions where medication is necessary, others where it is helpful, and yet others where it is potentially harmful. If you are in therapy, it is great to set up a consultation between the person providing your counseling and the person prescribing your medication so they can coordinate care to make sure that the therapy and medication are supporting and not undermining each other.  

So I suppose I am pro-medication or at least, I am not anti-medication. If a biological intervention can assist a person in achieving greater engagement in life and their qualified health practitioner agrees that it is a safe and potentially effective tool, I am fully supportive of the decision to use it. 

How do therapists listen for so long?

Therapy is the only interaction I can think of (in American society, anyway) during which two people sit together for an extended period of time and the entire conversation is focused on one person. I often get the question, "don't you get bored having to listen for so long? Doesn't your mind wander?" These are two separate questions with two different answers. 

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I cannot think of a single time when I have been bored in my role as a therapist. There is so much to pay attention to in a therapy session that we do not pay attention to in daily conversations. At minimum, I have to pay attention to what was said, what my plan is with the client, and a multitude of factors that help me assess a client's state of mind including things like speech, motor activity, and mood. Because so much more is going on than would occur in a regular conversation with a friend, it is hard to get bored and still be a minimally competent therapist. 

The other question, "does your mind ever wander," requires a more complicated answer. The short answer is, "yes." The reason for my mind wandering has never been boredom, however. Therapists are only human and I assume I speak for more than myself when I say, sometimes I have a headache, get an unexpected wave of fatigue, realize mid-session that I'm coming down with a cold, or simply didn't get good quality sleep the night before. I know I really strive to show up healthy and alert and I can usually do that because I have a small practice and I can be sure to be truly "on" during the days I'm committed to my clients. But the closer to full time a therapist is, the more of a representative sample of that person's "real life" their clients are going to get. So yes my mind does occasionally wander but it is never out of lack of interest in the client. It's almost always because minds like to wander and sometimes mine takes off before I can catch it. 

Why can't I be normal, like other people?
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Why does everyone else seem to have it together while I am falling apart? I want to feel happy like everybody else but I feel sad. I wish I could relax like a normal person but I cannot stop worrying and planning for things to go wrong. Why do I keep sabotaging my relationships while other seem to have no problem? What is wrong with me?

According to the National Institute of Mental Health, 26.2 percent of all American adults will suffer from a diagnosable mental disorder, in any given year. About 9.5 percent of the population will suffer from a mood disorder while 18.1 percent of the population will qualify for the diagnosis of an anxiety disorder. 

This means that for every four people you run into, at least one was, is, or will be suffering from enough pain this year to warrant a mental health diagnosis. Remember too that these figures account for the percent that will qualify for a diagnosis THIS YEAR. Over a lifetime, the numbers are even higher. 

Given these facts, what is "normal?" It can be frightening to acknowledge suffering and even mental illness as "normal," because we confuse acceptance and acknowledgement with approval and resignation.  

Perhaps we can learn to acknowledge our suffering without approving of it. We can relieve pain without fighting it. We can live vibrantly with mental illness without curing it. We can be completely normal and completely in pain at the same time and the bright spot of hope in that is YOU ARE NOT ALONE. 

For more information on mental health statistics in the US, please visit,