Understand the Issue: Mental Health in the Workplace

Understanding the issue is an important first step in building a mentally healthy workplaces.

The Prevalence of Mental Health Conditions in America

The National Alliance on Mental Illness (NAMI) presents a variety of facts and statistics on its “Mental Health by the Numbers” webpage. Among them:

• Approximately 1 in 5 adults in the U.S. (18.5%) experiences mental illness in a given year.
• Approximately 1 in 25 adults in the U.S. (4%) experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.

In the 2020 National Survey on Drug Use and Health, the Substance Abuse and Mental Health Services Administration (SAMHSA) found that:

• Approximately 1 in 3 adults in the U.S. 18 years old or older (32.1%) with any mental illness also had a co-occurring substance use disorder(s).
• Approximately 1 in 2 adults in the U.S. 18 years old or older (44.8%) with substance use disorders also had a co-occurring mental illness.

Why Foster a Mental Health-Friendly Workplace?

The Center for Workplace Mental Health makes a strong argument for investing in a mentally healthy workplace and the cost-effectiveness of treatment:

• 80% of employees treated for mental illness report improved levels of work efficacy and satisfaction.
• When employees receive effective treatment for mental illnesses, the result is lower total medical costs, increased productivity, lower absenteeism and decreased disability costs.

The National Safety Council (NSC) offers both a mental health employer cost calculator and a substance use employer cost calculator. Developed in collaboration with the National Opinion Research Center at the University of Chicago, the tools help employers understand the impact of mental health and substance use conditions on health care, absenteeism, and lost productivity. 

Types of Mental Health Conditions and Substance Use Disorders

On its Mental Health Impairments webpage, the Job Accommodation Network (JAN) summarizes some common mental health conditions as defined by NAMI. They include the following:

• Bipolar disorder, sometimes referred to as manic depression, “is a medical illness that causes extreme shifts in mood, energy and functioning. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children.”
• Borderline personality disorder is “an often misunderstood, serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image and behavior. It is a disorder of emotional dysregulation. This instability often disrupts family and work, long-term planning and the individual’s sense of self-identity.”
• Major depression is “persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity and physical health. Among all medical illnesses, major depression is the leading cause of disability in the United States and many other developed countries.”
• Obsessive compulsive disorder (OCD) “occurs when an individual experiences obsessions and compulsions for more than an hour each day, in a way that interferes with their life.”
• Panic disorder occurs when a person “experiences recurrent panic attacks, at least one of which leads to at least a month of increased anxiety or avoidant behavior. Panic disorder may also be indicated if a person experiences fewer than four panic episodes but has recurrent or constant fears of having another panic attack.”
• Post-traumatic stress disorder (PTSD) is “an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness or horror. While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts or situations associated with the event; and have symptoms of excessive emotions. People with this disorder have these symptoms for longer than one month and cannot function as well as they did before the traumatic event. PTSD symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.”
• Schizophrenia “often interferes with a person’s ability to think clearly; to distinguish reality from fantasy; and to manage emotions, make decisions and relate to others.”
• Seasonal affective disorder (SAD) is “characterized by recurrent episodes of depression usually in late fall and winter—alternating with periods of normal or high mood the rest of the year.” SAD is not regarded as a separate disorder by the DSM-5, but it is an added descriptor for the pattern of depressive episodes in patients with major depression or bipolar disorder.
• Substance use disorder is the loss of control of use of alcohol and/or prescription or illegal drugs and may co-occur with mental health conditions (see: “Prevalence of Mental Health Conditions in America” above). Visit MentalHealth.gov to learn more about the symptoms of substance use disorder. (Source: National Institute on Drug Abuse)

Mental Health Impairments and the Americans with Disabilities Act (ADA)

JAN also explores the intersection between the ADA and mental health impairments, explaining that, “The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if they have a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment or is regarded as having an impairment." For more information about how to determine whether a person has a disability under the ADA, see “How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).”

Whether a mental health condition or substance use disorder constitutes a disability or not, it is always a wise idea for employers to consider the mental health needs of their employees and implement inclusive workplace practices.