Analysis: employers play a huge role in facilitating a return to work or first-time employment for those with mental health illnesses

By Margaret Tighe and Caroline Murphy, University of Limerick

Mental health is increasingly prevalent on employers' agendas, particularly as it is a major contributor to long-term absence from work. Research reveals that less than 50% of people suffering from depression or anxiety lasting more than 12 months are in employment. Much of the research and debate around workplace mental health focuses on preventative actions employers can take to promote positive working environments. But far less attention centres on the employers' role in facilitating reintegration into the workplace after mental health illness, or indeed first-time employment for someone with a history of mental health problems.

Research suggests that the marginalisation of individuals with mental health issues is most evident in the workforce and that their unemployment rate is disproportionately high. Suitable employment can enhance a person’s psychological well-being, providing people with structure, purpose, social connectedness and a sense of identity. Many individuals with a mental health difficulty consistently state their desire to return to some form of employment and view it as an important part of their recovery.

Going back to work

Given this is the case, how can we ensure that individuals are provided with the best possible chance of returning to work? Clearly, legislation, and state services play a role. Fundamental too, are employer behaviours in determining the transition to working life.

From RTÉ Radio 1's Today With Sean O'Rourke, Professor Jim Lucey with advice for people returning to work after a mental health illness

In Ireland, a report compiled by Mental Health Reform highlights that people of working age who have a mental health difficulty are nine times more likely to be out of the workforce. Interestingly, studies show that the barriers impeding individuals return to employment are in fact non-clinical in nature. Rather, these barriers centre on stigma and discrimination.  So how can such barriers be addressed?

Improved understanding of mental health 

Firstly, a greater understanding of mental health illness is needed in order to ensure that negative biases do not impact upon individuals’ abilities to join the workforce. Research suggests how mental health illness is reported in the media has a significant negative impact on employers’ attitudes to employing a person with a mental health difficulty with violence and other undesirable behaviours of concern associated

Employer concerns include levels of trust, lack of practical capabilities, the costs involved in extra supervision which may be required and frequent absenteeism. This can be improved by creating better awareness through education, supporting inclusion in the workplace. In Ireland, programmes such as the See Change programme have been introduced to address the stigma of mental health in the workplace.

From RTÉ Radio 1's The Business, Liam Geraghty reports on how studies show that singing in the workplace improves our mood, and decreases, stress, depression and anxiety

Legislation and enforcement

Secondly, legislation pertaining to mental health and employment needs to widely communicated and enforced. The Irish Human Rights and Equality Commission clearly sets out that mental health is a protected ground within the disability category. Employers are bound to meet the requirements of the Employment Equality and Equal Status acts.

A key point here is disclosure. Disclosure is defined as the "the deliberate informing of someone in the workplace about one's disability". There is no obligation on individuals to disclose a mental health problem to existing or prospective employers, except under health and safety legislation where it could create a risk to the employee, employer or other individuals.

Recent research by See Change in Ireland revealed that 46% of people under the age of 35 would conceal a mental health difficulty. This is hardly surprising as evidence in Ireland indicates that those who state their disability to be mental health are more likely to be unemployed in comparison to those who do not.

From RTÉ Radio 1's Morning Ireland, a report on a See Change survey from 2017 which found that almost 40% of people would hide mental health problems

Legislation also includes the responsibility of the employer to provide reasonable accommodations where appropriate. However, reasonable accommodations in relation to mental health can seem ambiguous for employers, with little empirical data available pertaining to suitable adaptions (Villotti, et al., 2017).

What can employers do?

Employers need to consider actions which they can take internally in their organisations which would better support employees returning to, or engaging in, work for the first time. Drawing on practices recommended by the NHS in the UK in the case of mental health, this could could mean giving someone with social anxiety their own desk rather than expecting them to hot desk.

Other changes could include a phased return to work. Patterns of working time could have a significant impact on the ability of a mental health sufferer to sustain employment so earlier or later starting times or alternative rest breaks may prove useful in reducing anxiety. Changes in workload or location are also items that employers could consider in the transition to work. Encouraging the employee to engage with an employee assistance programme where one is in place may also be a source of support.  

READ: A guide to going back to work after a mental health illness

Finally, government can support both employers and workers by funding the expansion of evidence programmes such as the Individual Placement and Support model of supported employment.

Margaret Tighe is an Individual Placement and Support Employment Specialist working within the Mayo Mental Health Services. Dr Caroline Murphy is a Lecturer in Employment Relations at the University of Limerick and a former Irish Research Council awardee.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ