Employee Mental Illness: Managing the Hidden Epidemic

Abstract

While the high prevalence of mental illness in workplaces is more readily documented in the literature than it was ten or so years ago, it continues to remain largely within the medical and health sciences fields. This may account for the lack of information about mental illness in workplaces (Dewa et al. Healthcare Papers 5:12–25, 2004) by operational managers and human resource departments even though such illnesses effect on average 17 % to 20 % of employees in any 12-month period (MHCC 2012; SAMHSA 2010; ABS 2007). As symptoms of mental illness have the capacity to impact negatively on employee work performance and/or attendance, the ramifications on employee performance management systems can be significant, particularly when employees choose to deliberately conceal their illness, such that any work concerns appear to derive from issues other than illness (Dewa et al. Healthcare Papers 5:12–25, 2004; De Lorenzo 2003). When employee non-disclosure of a mental illness impacts negatively in the workplace, it presents a very challenging issue in relation to performance management for both operational managers and human resource staff. Without documented medical evidence to show that impaired work performance and/or attendance is attributable to a mental illness, the issue of performance management arises. Currently, when there is no documented medical illness, performance management policies are often brought into place to improve employee performance and/or attendance by establishing achievable employee targets. Yet, given that in any twelve-month period at least a fifth of the workforce sustains a mental illness (MHCC 2012; SAMHSA 2010; ABS 2007), and that non-disclosure is significant (Barney et al. BMC Public Health 9:1–11, 2009; Munir et al. Social Science & Medicine 60:1397–1407, 2005) such targets may be unachievable for employees with a hidden mental illness. It is for these reasons that this paper reviews the incidence of mental illness in western economies, its costs, and the reasons why it is often concealed and proposes the adoption of what are termed ‘Buffer Stage’ policies as an added tool that organisations may wish to utilise in the management of hidden medical illnesses such as mental illness.