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Hidden obstacles


Often invisible in the workplace, mental illness can be a source of lost productivity and decreased job satisfaction. If properly diagnosed and treated, employers might discover several benefits to their bottom line.

Story by Lee Marie Reinsch

You’re a business leader, not a babysitter. Your job is to run a company, not coddle your employees. If your goal were to make people happy, you would have launched a clowning company.

As long as your workers are doing their jobs, their level of psychological contentment is none of your beeswax.

Or is it?

According to the National Alliance on Mental Illness, undiagnosed mental illnesses cost more than $100 billion per year in the United States, and by 2020, major depression will be the biggest cause of disability for women and children.

“If you aren’t paying attention to mental health in your workplace, then you are losing money,” says Fox Valley resident and National Alliance on Mental Illness activist Mike Williams.

Williams is a former manufacturing company executive who now serves as president of a group that promotes mental-illness awareness in the workplace. The group, Diagnostic Organization LLC, of De Pere, argues that money is leaking right out of your bottom line if you aren’t cued in to what’s really going on with your employees.

You think you’re doing enough, but you’re not

Even if employers provide mental health coverage in their insurance plans and offer the services of an employee assistance program – or EAP, for short – it still may not be enough to attend to all of those employees who need help to actually seek it.

“Our idea is this: the thing that keeps people from getting help for a mental illness is the stigma and the fact that it costs money,” Williams said. “No one stands around the water fountain talking about mental illness – and there’s no casserole for it. If you have a heart attack, everyone comes over and brings a casserole, but nobody brings a casserole if you come down with a (debilitating) mental illness.”

What people tend to do, Williams said, is find fault and lay blame. They say the ill person is lazy or weak; or they’ll blame the spouse, parents or friends of the ill person. Or they’ll act as if the illness (depression, etc.) were a moral failing or a choice, rather than the medical condition that it is.

Mental illness is a “no-fault disease,” according to Dr. William “Brad” Lyles, psychiatrist and founder of Diagnostic Organization. He’s also the author of a book by the same name.

He cringes when he hears the term “mental health.” To his ears, it implies that it’s a state that anyone can achieve with enough willpower or effort.

“There’s no diet or special exercises that can give you mental health,” he said.

But why is this your problem as a business owner or manager? You’re the head honcho, not the head shrinker.

“Mental illness has a major impact on productivity,” said Dan Bergman, cognitive behavioral therapist with Aurora Behavioral Health in Green Bay. “People have known it for a while but probably never admitted it in the boardroom.”

Symptoms of major depression can include procrastination, decreased energy, fatigue, difficulty making decisions, feelings of pessimism, insomnia, irritability, or loss of interest in activities. “All of these lead to difficulty in getting the job done,” Bergman said.

People with mental illnesses earn on average 40 percent less than those who don’t have mental illnesses, Bergman said. The lost earnings are due to either losing a job, being inefficient in the job, or keeping a job but not earning as much due to absences or lack of confidence and motivation.

A serious mental illness is one that impairs one’s ability to function for more than 30 days in one year, according to Bergman.

Major depression, attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (previously known as manic depression) are the three biggest productivity drains, according to Lyles. They’re also three conditions Diagnostic Organization concerns itself with for that reason.

Those with ADHD aren’t necessarily hyper. Sufferers of major depression don’t necessarily have to be depressed all of the time, and someone with bipolar disease doesn’t necessarily have to be manic, Lyles said. “By 2011 this should be something everybody knows” yet they don’t.

An arm and a leg and a bunch of baloney

Common misconceptions on the part of business is that mental illness is a cost center and that it’s poppycock, according to Lyles.

“The business person will automatically have several assumptions pop into their head: ‘It’s going to cost me money and it’s a bunch of mealy-mouthed, milquetoast, namby-pamby, fuzzy-wuzzy baloney that I don’t really want to waste time interacting with or even thinking about,” Lyles said.

Diagnostic Organization isn’t peddling happy pills or trying to sell mental health insurance policy riders.

“We want the employer to do what it takes to get the employees to self-identify and self-refer, and de-stigmatize the working environment” through means such as education, newsletter articles, discussions, basic cheerleading and encouragement, Lyles said. He envisions a workplace PR campaign something along the lines of ‘Got Depression?’ as a takeoff on the ‘Got Milk?’ campaign for milk.

“People actually do have a marked increase in self-referral,” in conjunction with such workplace awareness campaigns, Lyles said.

“They suspect themselves or look across the table at their buddy and say, ‘You seem down; are you feeling OK?’”

‘Everybody loses’

At any given time, despite the access to mental health services, parity in insurance coverage and wider visibility of mental illnesses, 10 to 20 percent of the workforce has an undiagnosed mental illness, Lyles said.

But instead of referring problem employees to counseling or treatment, employers often just fire them.

“Most organizations have an HR procedure whereby they give you a verbal warning and two written warnings…and then you are out,” Williams said.

Bergman counseled someone who lost a job due to depression and trauma suffered upon seeing the suicide of a sibling.

“That is why it is so important for the employee to get the help they need,” Bergman said. “If you are depressed and you lose your job, guess what? You are even more depressed, and people start to question their value and whether they want to live.”

Because depression is an intermittent condition, it’s not something that employers can screen for. And symptoms can range from general grumpiness to fatigue, so colleagues looking for depression as the cause might not find it.

“You hire them and everything is fine and then all of a sudden, they start irritating other coworkers, not showing up for work, having poor performance,” Williams said. “When this happens, management has to do something, and their approach has been not to get to the root cause of why the person is suddenly not showing up, but to invoke the policy of one verbal and two written warnings and out the door. You have invested all this time and money in this person and everybody loses.”

Having to fire an employee isn’t necessarily easy for the employer, either. It’s usually a multi-step process that involves paper trails and procedure; plus, retraining and re-hiring take time, money and effort, too.

Bill Kime of Menasha Packaging Corp. has had decades of experience leading large plants, most of which used the “progressive discipline” method of handling difficult employees.

Two severely depressed employees stand out in his memory. One was found with a bottle of liquor and a .45 handgun. “He did not succeed in committing suicide but he came close,” Kime said. The employee eventually never showed up for work. “We lost one of our best first-line supervisors.”

The other employee, a talented programmer, was going through marital problems and became distraught after finding his wife with another man. “He slowly spiraled into deep depression, and his work suffered,” Kime said. The company had to terminate the programmer. “This is a position that is very difficult to replace – we never recovered from the loss of his genius in programming.”

Had there been an awareness campaign in those workplaces, things might have turned out differently, said Kime, who’s become active in helping Diagnostic Organization promote its cause.

“If you know the warning signs, rather than giving verbal and written warnings and then firing, you would look at the (employee) and say ‘This isn’t normal for this person,’” Williams said. “We want employees to recognize these things in themselves and their families.”

A heart-felt effort to remove stigma

The American Heart Association successfully educated the general public about heart attack symptoms and the need for routine blood pressure screenings via its “high blood pressure as the silent killer” series of public addresses several years ago.

The same can be done for mental illness, say mental health advocates.

“The main thing is public education,” Lyles said. “What I am recommending is no more, no less than what we have done with blood pressure screening and persuading people to get evaluated.”

As with medical conditions such as diabetes and hypertension, environment and biology play roles in mental illness, Bergman said.

“Even though there are environmental bases for a lot of mental illnesses, in terms of whether there have been things like abuse and trauma and certainly high levels of stress that are at the root of them, there is a biological component, and there has been much research that shows the genetic link between depression and ADHD and a lot of other mental health disorders that show the biological component,” Bergman said. “Much like diabetes, there is a biological component and an environmental component as to are you keeping your weight down. It’s the same with mental health.

“I would like to get to the point where there is no more stigma to depression than there is with diabetes.”

Lee Reinsch writes and edits from Green Bay.