To tell, or not to tell

I’ve seen a lot of discussion recently about the disclosure of mental health problems at work. Should you? Shouldn’t you? If you do decide to disclose, how should you do it – and when? In your application? At interview? After you’ve already started the job? The topic has featured in Time to Change blogs and Guardian jobs articles, and is central to the winter edition of Mind’s membership newsletter.

I’ll declare my position: when applying for a new job, it never crosses my mind not to disclose. I behave at work in exactly the same way as I behave on this blog and in conversation with friends and relatives – I am completely upfront about the fact that I have a disability. I don’t enjoy being disabled, but I don’t get a choice about it, so that’s the reality that any employer has to deal with. I also, of course, have skills, experience and talents. I’ve had years where I’ve been completely knocked out of the workplace by mental distress, but I’ve had long periods when I’ve been a high-flier, academically and professionally. If employers want my expertise and skills, they will have to accommodate my disability and support me so that I can perform the role. In fact, is it their legal duty to do so under the Equality Act 2010.

Maybe I sound naïve, or possibly just pigheaded. As the Mind article points out, up to one in four people are sacked or forced to leave their job after disclosing a mental health problem at work. Sure, there is a framework for employees to take employers to an Employment Tribunal if they have been unfairly dismissed or discriminated against on grounds of disability – but I know that the road to ET is long, expensive, and extremely stressful.

I guess my confidence comes partly from generally working with big public or charitable sector employers, organisations that are likely to have policies on disability (or, if I’m really lucky, mental health) in the workplace and be signed up to the “two ticks” scheme. The scheme is intended to identify employers who are “positive about disabled people” and will guarantee a disabled person an interview if s/he meets the minimum criteria for the job vacancy (although this is not legally binding). In a large organisation, it is also more likely that the HR department will have come across a similar disability before and will accept that reasonable adjustments are broadly necessary. But mostly, I just believe in showing employers how I expect to be treated by being matter of fact about bipolar and implying that they should be the same.

My attitude as an employee has always been that my line manager is my first port of call, and that the best thing for both of us is for me to be completely honest. This gives my manager plenty of notice that even if I seem OK at the moment, at some point I might need extra support. My belief – and this has only been strengthened by a period of 18 months working as a line manager myself – is that most managers would rather hear this:

“Hi… you know that mental health condition I mentioned, back when I first starting working here? The one you did some reading about, in case I ever needed support? Well, I’m just a bit worried it might be recurring and I wondered if we could put my support plan into effect before things get too bad.”

than this:

“Hi…look, I know I’ve been working here for a year and I never said anything, but I have this mental health condition…I don’t know if you’ve ever heard of bipolar affective disorder? Thing is, I’m not feeling too well right now, and I know we’ve got a big inspection coming up and everything, but I really need some time off.”

or this:

“Hi, listen I’m really sorry about this but I’m going to have to call in sick again today. I’ve got a…um, a migraine. Yes, another one. Yes, I do know what the sickness policy says about repeated short absences.”

The support plans I have had have included both things that I might do if I feel “wobbly”, along “reasonable adjustments” that my employer undertakes to  make under the Equality Act 2010. The key word here is reasonable – an employee can make suggestions, but it is for the employer to decide if an adjustment is practical within the context of their business. Even within large organisations, some requests may be easier to accommodate than others. For example, supposing an employee of a hospital would like a delayed start time because their medication makes them in the mornings. A member of nursing staff might be allowed to work only late shifts without too much disruption; a clerical worker might be permitted to start at 10am, and work until 5.30pm with a shorter lunch break. But the hospital might take the view that for a receptionist dealing with patients at a 9am clinic, a late start is unreasonable.

The NHS Mental Health Network produced some useful guidance last year on reasonable adjustments for people with mental health conditions (see resources section). It makes suggestions for possible variations in working hours; variations in environment (e.g. finding a quieter place to sit, or giving the employee a space to take breaks); changes in workload (e.g. considering a job-share so someone can go part time, or allowing someone to focus on a single task instead of “juggling”); or offering greater support (e.g. increased supervision, a mentor or “job buddy”). The document is very clear that in agreeing reasonable adjustments, the focus should be on what the employee thinks they need rather than the employer trying to impose their ideas. It should also focus on what a disabled employee can do, rather than what they can’t.

I do understand that some people with mental health issues – perhaps especially bipolar, since many of us have at least some element of positive regard for our condition – do not always see themselves as disabled, or wish other people to view them as such. The definition of a disability under the Equality Act 2010 (which replaced the Disability Discrimination Act 1995) is anyone who has “a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative affect on your ability to do normal daily activities”. I would recommend anyone to read the EA2012 guidance (below) before deciding whether to declare themselves disabled, but here’s a summary of the key issues.

-       Substantial in this context means more than minor or trivial. For example, it might be more difficult for you, or perhaps take you longer, to undertake daily tasks in comparison with someone who was non-disabled. A daily task could be anything you have to do, from washing and dressing, to taking public transport, or interacting with others.

-       Long-term means lasting for 12 months or more.

-       How the condition was caused is considered irrelevant – it’s the effects that constitute a person’s disablement.

Depression, schizophrenia, bipolar, eating disorders, personality disorders, OCD and “some self-harming behaviours” (not specified) are explicitly mentioned on the guidance as being disabilities.

The Act “provides that where an impairment is subject to treatment or correction, the impairment is to be treated as having a substantial adverse effect if, but for the treatment or correction, the impairment is likely to have that effect.” In other words, it is recognised that you do not become non-disabled just because you are undergoing successful treatment. You would still experience substantial impairment if your treatment was withdrawn, so you are still disabled. For example, someone who is in remission from bipolar symptoms and is very stable, but has reached that point because of successful treatment with mood stabilisers, still has an underlying disability.

Bipolar, depression and schizophrenia are also specifically referred to in the guidance as being “fluctuating conditions” that may be more obvious to an employer at some times than others. It’s worth noting that the type of “substantial effect” a person experiences doesn’t have to be the same in different episodes or flare-ups of a condition. This is particularly important for bipolar people with their range of mood states. When depressed, for example, I might have difficulty coping on public transport to work during rush hour; but when hypomanic, I might find a tube ride exhilarating but then have problems with concentration in the office environment.

So what have I got out of these years of disclosure? Well, I have always felt it laid a foundation of honesty, so that whenever I have reached the point where I needed time off, shorter working hours or any other adjustment, my manager has instantly understood why. I can’t change my disability, but I want to be seen responsible, as doing my best to manage the hand I have been dealt. In my last few years of employment, I had a formal Reasonable Adjustment Action Plan which allowed for flexible start times and gave me the opportunity of working from home with work laptop. It also recognised that although the sickness absence policy usually saw a pattern of short absences as a cause for concern, in my case taking a few days off here and there to de-stress was a responsible way of managing my bipolar.

It didn’t stop me losing my job, of course. It’s now almost two years since I realised I was too sick to go in, and I’m still working on getting stable via medication and self-management. No employer could be expected to wait for me forever, no matter how highly I was valued. But because I had been open with management and HR all along, everyone treated me with the utmost kindness and offered what felt like sincere condolences over the end of career with them. There was no question at all of my lengthy sickness absence being treated as a disciplinary issue, or of me being called to any kind of stressful hearing under the sickness absence policy. Instead, I was allowed to leave by mutual agreement, and with payment in lieu of notice. Whoever next employs me will get a glowing reference from them, which focuses on what I achieved and does not mention my health. Never have I been so grateful for being honest. And if – well, I’ll be optimistic and say when – I do finally get back into the workplace, I will do exactly the same all over again.

Resources

Paul Farmer (Chief Executive of Mind) discusses disclosure at work in the Guardian jobs section

Guidance on application of the Equality Act 2010

NHS document on reasonable adjustments in the workplace for mental health

Mind resources for creating a mentally healthy workplace

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About purplepersuasion

30 something service user, activist, writer and mother living with bipolar disorder. Proud winner of the Mark Hanson Prize for Digital Media at the Mind Media Awards #VMGMindAwards 2013. Winner of the World in Mentalists Mood Disorder blog 2012. Regular guest blogger for the International Bipolar Foundation http://www.internationalbipolarfoundation.org/ Expert by Experience working with Mind training department. Working on The Incoming Tide, a bipolar memoir. Find me on Twitter @BipolarBlogger or at my Facebook page http://www.facebook.com/BipolarBlogger
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16 Responses to To tell, or not to tell

  1. I completely agree. Excellent post. Saving this to my favourites!

  2. Andrea says:

    I’ve had experience of disclosing and not disclosing- when I first started working after uni I didn’t disclose, because, to be quite honest, I felt well and not disabled in the slightest. I felt like my mental health issues were in the past and therefore a non-issue. I did then go on to have a massive relapse a few years later, though, and while everyone was great about it, I do think things could have been a bit easier if my employer had been aware of my mental health problems before I went off sick for months.

    When I went back to work part time after relapsing and not working for a bit I was determined to disclose, because I knew that I would need reasonable adjustments and managerial support in order to work at all, so I don’t feel like I had a choice, really. And honestly, if an employer was going to react badly to my mental health issues I wouldn’t want to work there so I felt disclosing at application stage was the way to go. I’ve never regretted it, although like you I have experience working in places with very clear disability policies so I always had that to back me up. I will say though that while I have been honest in disclosing the effects of my mental health issues, I haven’t given employers my psychiatric diagnoses (which includes the dreaded borderline personality disorder.) That will be the next hurdle to jump when it comes to disclosure, I think!

  3. ladylazarus says:

    What a great post. I really like your approach, and all the information you’ve given about backing it up with equalities legislation is so helpful, thank you. I’ve never disclosed at work myself, but hope that I will feel able to at some point. Your post has made me feel a little more confident about it being something I will do in the future.

  4. SolentSessions says:

    To tell, always to tell. I am lucky to have a very supportive line manager; I think it helps that the workplace I’m currently in is a mental health one. She changed my working hours to 9-5 when everyone else has to work shifts. She even moved me to another setting for a bit to try and make things less stressful. She understands my bipolar and we have a mutually agreed ‘rating scale’ from 0-5 and 5-10 where I can rate my mood if she asks. I honestly couldn’t ask for more and I hope other line managers out there are just as supportive.

    • Nick says:

      I find it interesting talking about honesty. I remember being told that I was too honest for my own good. I used to wear my heart on my sleeve. It wasn’t until many years later that I realised this was probably part of my anxiety disorder and the psychosis that emanates. However, to me it seemed the natural thing to do. I think we have to be careful and think hard about how we describe ourselves to all and sundry. I have experienced abuse by people who mistakenly confuse mental health conditions with learning disabilities. I have also been the subject of allegations in the workplace that may have some basis in reality but then embellished out of proportion and truth in the belief that due to my mental health problems being known this would add weight to the embellished allegations against me. I opposed the (anonymous) allegations and said let the accusser/s come forward but they never did. Some of the allegations I faced went back over a period of years. After this incident I got the feeling that I was watched to see if I was behaving an odd manner. As regards the original basis for the allegations, this could have been resolved with a conversation at the outset when the anonymous person making the allegations should have approached someone to have a meeting with me to discuss any concerns. I felt the whole
      basis of what I went through was little more than prejudice against me as an individual with mental health issues. But to say there are laws that now protect us didn’t stop the allegations being made. In resolving the issue my management told me that nothing would go into my record regarding this incident. I demanded that something did go into my record – the fact that I had rejected these false anonymous allegations and that this had never been contested. Was I too honest for my own good?

      • I can’t answer that, I’m afraid…. all I can say is that for myself, I have never encountered issues like that in 12 years of continuous work. If someone doesn’t understand the difference between LD and mental health conditions I either explain it to them, or stick a leaflet in their hand for Mind’s mental health awareness training!

    • Hey Kat, great to see you here :) This confirms my own experiences and is a really positive example of how honesty can work :D xxx

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  6. Really great piece! I struggle with using the word ‘disabled’ for myself, but reading your description of the criteria has made me think that I have more a problem with the word and the stigma related to it, I do meet that criteria and am probably preventing myself from receiving support by refusing to use it. I think this information will be greatly useful to a lot of people, thanks for putting it out there!

  7. pattyxx77 says:

    I wish I could say that honesty worked for me but I must be one of the 1 in 4 who finds themselves out of a job! I used to be very open about my mentsl health as I really didn’t think this would happen. How wrong I was, this was 6 years ago. It hurt so much and had a huge negative impact on me. Only now 6 years later am I once again risking “spesking out”. I widh it wasn’t the case but for some people it is risky. I even hated telling people what had happened as I felt they would think “well there’s no smoke without fire, it mudt have been for some other reason”.
    I didn’t have the strength to fight the people at the time but I was devastated and the experience still affects me to this day. I am pleased yo hesr that you could be honest snd it worked for you but honesty doesn’t always work like that, if only it did.

    • I thought I was quite honest about the fact that it was risky, and that for a quarter of people, it won’t have a good result. But that is exactly the reason we should keep on trying! If we’re ever going to get to a point where an employer doesn’t dear “let someone go” because of their mental ill health, that’s only going to come by changing the culture around speaking about mental health. I refuse not to tell the truth about who I am. If someone treats me differently for having bipolar than for having diabetes or heart disease, that’s not someone I want to work for – it would be unsustainable. We MUST keep speaking out and being honest about who we are.

  8. supersamface says:

    Thanks for sharing this, and your post about your experiences. I had to leave a job because of depression (bad, bad, bad experience, with an employer I had, at one stage loved, and it all made me much, much worse), and sometimes wonder if (or rather, WHEN) I apply for work again, should I declare my issues (now the main one is M.E, and the depression is .. there, nipping at me heels, but I can sort of manage it, but the first sign of stress and I’ll potentially implode again). I know I have no choice – the walking stick makes it patently obvious I have a disability, but when it is a mental one that you can ‘hide’ to a certain extent, some of the time.. there is that temptation. You’ve strengthened my feelings that, if an employer would discriminate against me because of my disabilities, then they can stuff it. You can guarantee if I did get a job there, I’d end up with a full breakdown in health anyway. The internet is brilliant for stuff like this. Thanks to you, and all who shared in the comments :). Sam.

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  10. I never disclose. To new people I met, people I’ve known for years (who know anyway because I found that when you’re manic and running naked around the place people tend to notice), and especially not to people I work for. I respect your position and you are most definitely more affected by this illness than I have been for a long time now. I hope one day I will take the plunge and be able to be open as you are.

  11. Thank you for taking the time to write this Charlotte! It has been so helpful to me! I’m applying for jobs now and I can say that I’ve only probably disclosed on 5% of my applications. Thankfully now I am employed part time through Remploy, but when I go to apply for full time jobs related to my career, I will certainly consider disclosing more. Thanks for the NHS mental health at work adjustment section, I’ve been looking for something like that, without knowing! I’m glad to hear of your positive experiences.

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