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mental illness at work

On May 23, 2003, John Ponsi, a teacher at Cliffside Park High School, was unexpectedly called into the principal’s office for a meeting with two students, who accused him of making racial and lewd remarks earlier that week. Another teacher at the same meeting accused Ponsi of pushing her. Four days later, the Board of Education notified Ponsi that he was suspended with pay, pending the outcome of an investigation and psychological examination.

However, no investigation was conducted. Ponsi was referred to a psychiatrist by his physician due to the depression and anxiety resulting from the accusations and suspension. In September 2003, Ponsi was also evaluated by Dr. Meyerhoff, a psychiatrist appointed by the school board, who concluded that Ponsi was unable to teach for the foreseeable future. As a result of that examination, the Board notified Ponsi that he was ineligible to teach until he provided proof of recovery and that, if his absence exceeded two years, his employment would be terminated.

On January 31, 2005, Ponsi’s psychiatrist notified the school in writing that he was ready and able to return to teaching. Not convinced, the Board sent Ponsi back to Dr. Meyerhoff, their psychiatrist, who concluded that, while his mood disorder had abated, he was unfit to return to work because he showed no repentance or remorse over the alleged lewd and racial remarks, or the pushing incident. In essence, the Board’s psychiatrist accepted all the allegations against Mr. Ponsi as true (even though no investigation had been conducted) and, in fact, interpreted Mr. Ponsi’s assertion to the contrary as evidence of paranoid delusions. Concerned, the Board decided not to reinstate Mr. Ponsi.

Why Should I Believe You if You’re “Crazy?”

The true story cited above illustrates one of the challenges (and potential pitfalls) employers face when investigating psychiatric disability discrimination claims. All too often, the stigma of a mental illness clouds how that person is perceived, not only by managers who don’t understand psychiatric disorders but professionals who should know better. In other words, the complaint process itself becomes tainted by the underlying assumption that the complainant, because of his or her mental state, isn’t able to see reality clearly and is thus distorting what happened or misinterpreting the evidence.

Just Go See the Shrink and Get Yourself Straightened Out

Employers can also fall prey to the assumption that a trip to the psychiatrist’s office is all that is needed to get the complainant to see the light. Certainly, there’s nothing wrong with offering up an employer’s EAP to a complainant who is dealing with the inevitable stress that filing a complaint generates. The devil, however, is in the details. Employers need to be clear that their recommendations or suggestions about psychiatric treatment aren’t interpreted as a thinly disguised version of blame-the-potential-victim.

They also need to be sure that the questions they ask in their investigation don’t cross the line into sensitive medical information or stray into unwarranted territory. Asking coworkers if they’ve ever felt that Bipolar Employee X was dangerous is understandable if you’re investigating alleged threats made by this employees; it’s completely inappropriate if you’re investigating complaints of cruel comments or teasing made to this employee.

The Bottom Line

Investigating psychiatric disability harassment or discrimination claims can be especially challenging, although not necessarily for the reason many of us assume they would be. Yes, some employees with psychiatric disabilities can be difficult complainants, but so can employees without a mental illness. In fact, in my experience, it’s the stigma and fear surrounding mental illness that gets in the way of a fair and objective investigation much more often than an irrational or “crazy” complainant.

However, employers must make sure that we are basing our employment decisions on the facts rather than beliefs and opinions, even when those beliefs and/or opinions come from mental health professionals. Employers who substitute professional opinions for investigations do so at their own peril. When you do need professional input, make sure you provide them with accurate and objective information is being provided.

We’ve all worked with someone who seems hell-bent on destroying his career or someone else’s. Perhaps it’s the boss who is so narcissistic that she is unable to tolerate any hint of constructive criticism or negative feedback (and will hold a grudge if you’re brave enough to give it). It could be the employee who cannot see that his pervasive suspiciousness and distrust of others actually causes the hostile reactions he already expects from others. Or, it might be the subordinate who is unable to make even the simplest decision without the constant reassurance and input from others.

A personality disorder lies at the extreme end of the behavior continuum. No matter how maladaptive the thought, feelings and behaviors, the sufferer clings to them. This is true no how much external pressure there is to change, no matter how many problems the behavior creates. It’s as if the person is stuck in a rigid, ineffective way of relating to others and, instead of realizing the costs associated with it, blames others for the outcome.

Personality Problems and How They Grow

We don’t really know what causes personality disorders. We know they start to develop early (and are usually in place by late adolescence or early adulthood) and are probably a combination of some in-born behavioral dispositions in combination with stressful environmental circumstances. What we do know is that they develop independent of a person’s intellectual level (a highly intelligent person can have a severe personality problem) and are accompanied by a lack of insight.

Recognizing a Personality Disorder

I’m not a particular fan of psychiatric diagnoses unless there are very specific reasons (treatment recommendations, insurance reimbursement) for giving one. Certainly there’s never a need for us to diagnose a work colleague.

However, because of the interpersonal problems that can arise with these disorders, it can be useful to be aware of why a seemingly intelligent coworker or boss continues to act in a seemingly maladaptive fashion over and over again. And, of course, we must know how we can minimize the impact of our own career, especially if the problematic work colleague is our boss.

We’ll be taking a look at specific personality disorders and how to deal with them, but for now, here’s the take away:

  • A person with a personality disorder cannot, or will not, modify his or her behavior based on your feedback. As such, let go of any thoughts you may have of changing this particular person. You must focus on what you need to do to take care of yourself.
  • A person with a personality disorder is not a happy person. This is also not a person who is trying to torture you deliberately; s/he is trying to survive in the best way s/he has learned to do so.
  • Do not expect this person to operate by the same rules you do. This means that you must be prepared to set boundaries, back up communication with documentation, and, if necessary, find ways to remove yourself from the situation.
  • Employees with personality disorders always have positive personality traits and characteristics — otherwise, they would not have been hired in the first place — but the maladaptive and inflexible patterns can emerge under stress. As such, this is a time to especially be on guard.

The Bottom Line

We all know that doing the same thing over and over will get the same result. For some people, though, that “same thing” is all they know how to do. And, if you’re not careful, they’ll blame you for the result.

 

Your most gregarious employee suddenly becomes withdrawn and aloof. Your previously decisive teamleader can’t seem to make the simplest decision. Your easygoing coworker starts arguing with coworkers and takes offense at the drop of a hat. Your most dependable employee shows up late, calls in sick, and doesn’t finish projects. These are some of the symptoms of depression in the workplace.

So what’s a manager to do? On one hand, production must continue, yet the compassionate manager should also be concerned for the well-being of the employee. Performance issues have to be dealt with and yet the employee’s previously stellar record – or obvious emotional pain – tempts the manager to just pick up the slack until the employee gets back on his or her feet.

The scenario of the depressed employee often presents a dilemma for his/her manager. So why does the manager have to deal with it? The employee is a grown-up; why doesn’t s/he come to the manager first?

Note to Manager: Don’t Wait for Me to Come to You

The odds are, s/he won’t. Most depressed employees would rather eat dirt than admit to their managers that they’re depressed. Part of this is because of the shame many depression sufferers feel about what they feel is their “weakness.” However, a large part of their silence is due to the stigma many people continue to experience around mental illness.

For example, in an online survey of 1,129 workers conducted by the American Psychiatric Association, a high percentage believed that seeking help for particular psychological problems – such as drug addiction (76%), alcoholism (73%) and depression (62%) – would not be as accepted. As I mentioned in another article I wrote, for every story I’ve heard about a supportive manager or caring HR professional, I’ve heard ten from employees who felt their disclosure led to being teased, overly scrutinized, or discriminated against.

The First Step: Recognizing how Depression Impacts Work

Most managers have some employees they’d like to clone and some they’d like to clobber. And, certainly, a slacker can become depressed just as a superstar can. What’s noticeable about depression, though, is the change in the employee. The good employee’s performance declines while the marginal employee gets worse.
Here’s what that change in performance may look like:

  • Unfinished projects
  • Forgetfulness
  • Increased errors
  • Trouble concentrating
  • Indecisiveness
  • Irritability
  • Loss of interest in work or socializing with colleagues
  • Seems tired/fatigued

What to Say to a Depressed Employee

Managers are not there to talk about medical problems, counsel, or diagnose. They are there to talk about work performance and behavior. They are also there to care about their employees’ wellbeing. When talking to a potentially depressed employee, here are some ways to do both:

  1. 1. Start with your concern for the employee. “Sandy, I’m concerned about you.”
    2. Focus your comments on observable behaviors. “You’ve been late to work four times in the past two weeks and your reports have had twice as many errors.”
    3. Acknowledge the change. “This isn’t like you. You’re normally the first in to work and the last person in the department to make mistakes.”
    4. Offer them an olive branch. “I don’t know if things in your personal life are affecting you, but if they are we have a confidential employee assistance plan that might be able to help.”
    5. Be prepared to set limits. For instance, if the employee mentions marital discord, problems with a child, financial problems, and so forth, the manager should be empathic but should limit the conversation.
    6. Refer to an E.A.P. Offer the employee the telephone number for the employee assistance program or suggest that it would serve the employee well to consider outside professional counseling through health care benefits, a community clinic, an employee assistance plan, or even through pastoral counseling.
    7. Reinforce your concern. ” I’m very invested in helping you get back on track.”
    8. Reinforce the need to improve performance. “However, whether or not you contact this service, you will still be expected to meet your performance goals.”

The Bottom Line

Clinical depression has been described as a black dog, a suffocating blanket, and an endless, dark hole. Untreated, it can sap the energy and motivation out of the most productive employee. With the right help, it can be managed, overcome, or worked around. In fact, for some people, coping with depression has given them some gifts that might now have otherwise received – such as a greater perspective and empathy for others. At least, that’s what one lifelong depression sufferer you may know said – Abraham Lincoln.

 

In part 1 on suicide in the workplace, we talked about the employee who is either threatening suicide or thinking about. Now let’s take a look at what to do when the worst case scenario actually happens.

Our Employee Tried It

Scenario 3: You come in to work Monday morning to find a telephone message on your desk from the spouse of one of your employees. When you call her, she tells you that her husband, your employee, has been hospitalized over the weekend following a suicide attempt. You are stunned; not only did you have no idea this employee was in trouble, he was the last person you would ever think would attempt to take his life.

First, let’s take a look at this from a psychological perspective. If it becomes known that an employee has attempted suicide (and word almost always gets around, although, hopefully, not from you), coworkers may feel awkward or embarrassed because they don’t know what to say or how to act. However, avoiding the person or refusing to acknowledge the incident only makes matters worse. The returning employee also doesn’t want:

  • for someone to change to subject if s/he brings it up
  • to be given a pep talk
  • to be given a lecture, sermon, or put on a guilt trip
  • to be patronized, criticized or treated with kid gloves

If other employees ask you how to respond, encourage them to cue off the returning employee. If the employee brings up what happened, coworkers can offer valuable reassurance, respect and support. If the employee doesn’t, encourage coworkers to respect his/her privacy and not succumb to natural curiosity (why did you try it? how did you feel when you woke up? didn’t you think about your family?)

From an administrative perspective, of course, you need to make sure the employee is ready to return to work and able to complete the essential functions of the job. Work closely with the doctor’s office and spouse by writing the doctor, attach a job description (with ADA requirements needed to do the job), and let them know the environment and EVERYTHING and ANYTHING else that this employee may be exposed to and ask him if he/she is capable of performing the essential functions of the position.

If this person requires additional supervision or assignment of someone else to work along side this individual just to protect himself and other employees, this might be considered a hardship on the business as far as ADA is concerned. Working closely with the physician will help you decide on options like STD or LTD, further accomodation like light duty or putting in another area or position, personal leave until the person gets better.

All in all the study indicates that twice as many suicides among men can be ascribed to the “contagious effect” of the workplace than to that of the family.

Grieving at the Office

Scenario 4: This afternoon you will be attending the funeral of one of your outstanding employees, who, after attending a morning of training last week (during which everyone said he acted normal), went home during lunch and apparently took his own life. He joked with co-workers, asked questions, and took notes, leaving his books open and ready for the afternoon session. This employee was very popular with his coworkers and manager and everyone is virtually paralyzed by his death. In addition, there has been a lot of second guessing about what warning signs people may have missed or overlooked.

People develop close relationships in the workplace and the death of colleague can be as devastating as the death of a family member. In fact, a recent study found that, just as a suicide in the family increases the risk of another in the same family, men’s suicide risk increases if they have had one or more work mates who had killed themselves in the last year. In fact, this study indicates that twice as many suicides among men can be ascribed to the “contagious effect” of the workplace than to that of the family. That reason alone justifies encouraging employees to access your EAP if they would like to.

Second, while it is always good to educate your workers about the warning signs of suicide and depression, discourage employees from trying to second guess for what they might have missed. There are no easy answers. There are no simple answers. There are no single answers. Simply, there are no answers.

Part of the healing process is following the same rituals you would after any other death. Encourage employees to do whatever they would normally do to acknowledge a death. You should do the same. For example, if you would tell Mary on Sunday that you sure do miss John who died of cancer, you should tell her the same thing on Sunday if he died in this manner. Finally, no matter how tempted, don’t ask surviving family members to hypothesize about what happened. They’ll have a lifetime to ask themselves those questions without answers and they sure don’t need to try to answer them for anyone else.

The Bottom Line

Jeannette Walls once said, “When people kill themselves, they think they’re ending the pain, but all they’re doing is passing it on to those they leave behind.” HR professionals can’t prevent surviving work colleagues from grieving, but we can help them heal.


It’s been a long week. Your mom, who’s been successfully battling breast cancer, was hospitalized with a chemo-related infection. Your fiscal quarter ends at the end of the month and you’re two deals away from making quota. And could those rumors of more layoffs be true? You’re barely keeping your head above water as it is.

Suddenly, in the middle of an important sales presentation, you can’t breathe. Sweat starts to roll down your back and your heart races. Everybody is staring. What in the hell is wrong with me? You suddenly flash on your Uncle Bob; didn’t he have a heart attack in his mid-forties? Oh, God, am I dying?

Signs and Symptoms of Panic

No. You’ve just had a panic attack, an episode of intense fear that is often accompanied by physical symptoms such as a racing heartbeat, chest pains, difficulty breathing, and dizziness/lightheadedness. It’s far more intense than feeling “stressed out” or “worried.” In fact, for many panic attack sufferers, the sensations are so severe that the sufferer worries that s/he will either die or go crazy.

If you’ve ever been in a life-threatening situation, and can recall the terror you felt, you know what a panic attack feels like. These attacks, though, occur without warning and for no apparent reason.

Fear by Association

Even though they often initially have nothing to do with the situation the person is in, they can easily becomeassociated with whatever the person is doing or where the person is at the time they have the panic attack. In a way, it’s just like getting sick to your stomach after you’ve eaten something; it doesn’t matter whether or not the food had anything to do with your nausea. Odds are, for weeks, months or even years afterward, just the thought of that food can make you feel queasy. (A friend of mine off a car and got a nausea-inducing concussion after eating Kentucky Fried Chicken; thirty years later, she still can’t stand the smell of fried chicken).

So someone who has her first panic attack while driving starts to worry that she’ll have another one the next time she gets behind the wheel. This worry, of course, creates more stress, making it more likely that she will have another panic attack. Pretty soon, if this cycle continues, she can’t drive at all.

But – wait – now she unexpectedly has a panic attack in the grocery store. The cycle repeats itself and, if left untreated, can result in increased isolation and decreased functioning.

Stress, Panic and Work

According to legal secretary Nancy Topolski’s lawsuit, by 2009 she was providing full time support to four attorneys at the law firm Davis Wright Tremaine. The fourth, which had been added after a series of layoffs in early 2009, allegedly had a pattern of waiting until the last minute to give her projects, putting her under tremendous pressure and forcing her to rush to get the tasks completed. After requesting a lighter workload several times and informing her supervisor that her job responsibilities were causing her significant stress, she suffered a panic attack at work. After a second panic attack, she was terminated.

Remember that any stressful situation – work-related or not- can trigger a panic attack at the office. Most commonly, it’s a build up of lots of stressors over time that initially gets the panic attack ball rolling. Once it starts, though, it can take on a life of its own, adversely affecting the employee’s productivity as well as his or her morale.

What You Can Do

If panic attacks are left untreated it can affect the body, emotional aspect as well as the behavior of the sufferer. This can also lead to more serious problems like depression, substance abuse (drugs and alcohol) or physical ailments like ulcers or heart conditions.

  1. Don’t play doctor. If an employee’s symptoms last more than a few minutes, call 9-1-1 (especially if s/he complains of chest pains or has asthma). Better safe than sorry.
  2. If you know the employee has a diagnosis of panic disorder, reassure him or her that it will pass. Allow the person to go somewhere where s/he feels comfortable doing deep breathing or relaxation exercises.
  3. Understand where s/he is coming from. Most panic attack sufferers work really hard to keep their disorder secret because they’re afraid of what others might think. Remember; the person experiencing the panic attacks can’t will them away.
  4. Provide the employee with referrals or encourage him or her to make doctor’s appointments as needed.

The Bottom Line

John Kenneth Galbraith once said, “All of the great leaders have had one characteristic in common . . . the willingness to confront unequivocally the major anxiety of their people in their time. “ As HR professionals, we have the opportunity to lead one person at a time – and encourage our employees to confront – and conquer – the anxiety that holds them back from their peak performance.