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.”
“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.”
“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.