Laura Baxter knew her work was suffering, but she didn't want to tell her boss the reason.
For years, Baxter (not her real name) had taken antidepressants for major depression. But now her medication was failing. As her doctor searched for a better drug, Baxter began to lose sleep and couldn't think clearly. "I could barely get out of bed to brush my teeth or shower," she says. "At work I was getting nothing done."
To make matters worse, a new supervisor took over Baxter's department in the biotechnology firm where she did research. Unaware of what good work Baxter had done before her illness, he was moving to fire her. "I knew I was about to get canned," she says, "but I also felt, from comments he'd made, that he would not be sympathetic if I told him what was the matter."
It's a dilemma faced by millions of Americans. One in five Americans suffers from a mental illness, says Jennifer Heffron, an attorney with the National Mental Health Association. "But most people have no idea which of their co-workers are coping with it. It's very personal information and most people do not like to disclose this about themselves because of the stereotypes surrounding the issue."
This stigma is the biggest barrier to treatment, and can result in "outright discrimination and abuse" on the job and elsewhere, wrote U.S. Surgeon General David Satcher in his December 1999 report "Mental Health."
But the stigma of mental illness need not pose an overwhelming barrier to getting and keeping good job. Federal law requires employers to give people with mental illness a fair chance at working, and many organizations offer support and counseling.
Under the Americans with Disabilities Act (ADA), employers must accommodate the mentally ill just as they do the physically ill. Often the accommodations for the mentally ill are the less costly of the two, says Heffron. "It can be something as simple as more flexible working hours, or moving a person's office to the end of a hallway so there is less distraction if concentration is a problem."
Armed with such advice and a letter from her psychiatrist, Baxter went to the company's human resources department and explained her situation. Without divulging Baxter's problem to her boss, a human resources manager was able to transfer her temporarily into a less taxing position.
Baxter handled her situation well, says Patricia Owens, a former associate commissioner of the Social Security disability program.
But the ADA rules are complex, and anyone who contemplates disclosing a disability should first become very familiar with its provisions. (Boston University's Center for Psychiatric Rehabilitation, at www.bu.edu/sarpsych/jobschool/, has information on how to disclose a psychiatric disability to an employer.)
Baxter had an advantage: she already knew she suffered from depression. Owens says many employees do not recognize the signs of mental illness in themselves. These people are in danger of losing their jobs because they don't understand why they're not functioning as well as they should.
Where to Find Help
If you think you may have symptoms of a mental illness, talk to your doctor. Many hospitals and clinics offer screenings for mental illness free of charge. To find a clinic nearby, call 1-800-573-4433 or visit www.depression-screening.org.
Employees should also realize that their physician can help, not only with treatment, but by contacting an employer if necessary. But Owens cautions that many doctors still fail to recognize mental illness, especially depression, and often don't understand its consequences in the workplace.
Mentally ill employees in most large companies can draw support from employment assistance programs. Counselors for these programs are usually better equipped than human resources personnel to provide confidential information and local contacts for mental illness, says Kelly Collins, executive director of Advocate Employee Assistance Program, Inc., in Gaithersburg, Md.
"People need to know that depression is very treatable; it needn't cost a lot of money or take a lot of time," she says. "Unfortunately, the workplace is not the best place to seek support in terms of your colleagues because they may not be familiar with what you're going through and they may feel uncomfortable about it. You're more likely to get support through depression support groups, or through your church or synagogue."
Educating employers as well as employees is the best plan for reducing stigma in the workplace, says Owens. And she adds that the stigma of mental illness is already decreasing, much as the stigma of cancer has faded. "Now people are treated for cancer and go back to work, and in general they're treated no differently."
As for Laura Baxter, new medication has helped stave off the symptoms of her illness. Now she is working in a third position where she does not believe her supervisor knows about her previous struggles with depression, and she has no plans to tell him. "A few friends at work know about it, and I think it is important for people to talk about it," she says. "But I'm still cautious."
Christine Cosgrove is a freelance writer who specializes in health and medical issues. She has worked as a reporter for UPI in New York and as a senior editor at Parenting Magazine.