At Work: A Survey of The Experiences of People With Mental Health Problems Within The Workplace
At Work: A Survey of The Experiences of People With Mental Health Problems Within The Workplace
Its work informs government policy, promotes new understandings and challenges
discrimination.
We aim to maximise expertise and resources by creating partnerships for change with
a broad range of stakeholders across the voluntary, corporate and public sectors.
Acknowledgements:
This report is based on responses from a large number of people who took part in the
survey and took the time to tell us their experiences.
Support and advice on the design of the questionnaire, questionnaire distribution and
the writing of the report was received from colleagues at the Mental Health
Foundation including Julie Ballard, Nigel Duerdoth, Alison Faulkner, Andy Field,
Anna Olek, Sarah Wright, and from Paul DePonte.
For further information on this report or any of the Foundation’s work please contact:
The Mental Health Foundation
83 Victoria Street
London
SW1H 0HW
The research was carried out by the Mental Health Foundation and the data analysed
by SurveyShop at Mercator, Bristol. The report was written by Lesley Warner, Head
of Public Affairs, Mental Health Foundation.
Contents
2. Introduction …………………………………………………………………...5
3. Methodology
4. Results
5. Recommendations …………………………………………………………...29
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We know that for many people with mental health problems work is an important
coping mechanism, providing a sense of purpose and value (Strategies for Living,
Mental Health Foundation, 2000) as well as often important social contacts.
Respondents to this survey agreed.
Certainly within society in general, one of the main ways in which people identify
themselves is through their role in the workplace. Although, as is reinforced by the
survey, a number of people believe their mental health problems to be caused or made
worse by the workplace, particularly long hours and high expectations.
However, as seen in this survey, the majority of people with mental health problems
are still not in paid employment, in either a full-time or part-time capacity. A number
of reasons were given, including the effects of medication,
“I can’t use medication whilst working due to drowsiness and sleep patterns…”
“Getting back into paid work is very difficult, not only do you have to overcome
reluctance from employers, but also risk loss of benefit if the job makes you ill and
you have to leave.”
and discrimination, particularly not being shortlisted or being turned down for jobs
because of mental health problems. The decision as to whether or not to “come out”
as a mental health service user is for many people fraught with difficulty.
Yet those who had succeeded in getting a job reported largely positive experiences.
When they had come out about their personal experience of mental health problems,
whether by choice or through disclosure, people’s recent experience was positive,
even if this had not been the case a few years before.
“Present employers know my history of illness and have been supportive, as was my
university when I went back to train as a teacher last year. It has taken seven years to
return to work after appalling experience in medical school, where I was employed as
medical researcher. I became ill with depression, was bullied, intimidated, harassed
until I resigned.…. a technician pinned up offensive articles about mentally ill people
in my lab and one person refused to speak to me……”
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Despite the general agreement that, when somebody had found a job, workplaces
were generally accepting and supportive, a number of people referred to themselves
as "lucky" and their situation as "unusual". The frequency with which this comment
was made, unprompted, in the returned questionnaires suggests that workplaces may
now perhaps be more accepting than previous experience showed and that these
respondents were less unusual than they believed.
Many of those who responded worked in mental health (one in five worked in
healthcare and a further one in five in social care for example) and so felt that their
experience of mental health problems was more likely to be accepted. This does raise
the danger that, without a guarantee of good policies and acceptance in other
employment areas, there is a danger of people being ghettoised in mental health
organisations - which may for many people be draining and not necessarily good for
their own mental health.
People's criticisms of their workplaces tended more to focus on areas where they
believed they had been perhaps over-protected, or that too much account was taken of
their mental health problems.
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Key findings
· Over half believe that they had definitely or possibly been turned down for a job
in the past because of their mental health problems.
· Only one third feel confident in disclosing their experience of mental health
problems on job application forms.
· People with anxiety or depression were more likely to be employed - but still less
than 60% were employed on a full-time or part-time basis.
· Less than half of the people who responded with psychosis, schizophrenia, manic
depression or phobias were in full-time or part-time employment.
· People with mental health problems make a major contribution to society with one
in five doing voluntary work. Some of those who are statistically least likely to be
paid for their work (particularly people with manic depression or schizophrenia)
are those most likely to be working in a voluntary capacity.
· Of those who had been open about their mental health problems in the workplace,
over half always or often had support when they needed it, with another one in
five sometimes getting support. Around two-thirds reported that people at work
were always or often very accepting.
· However, around one in four people reported that too much account was
sometimes taken of their mental health problems, saying that they always, often or
sometimes felt patronised or more monitored than other colleagues.
· More than 15% believed that they had been passed over for promotion because of
their mental health problem.
· One in ten always or often believed that colleagues made snide or sarcastic
remarks or that colleagues avoided them because of their mental health problem.
· One in three believed that bullying at work had caused or added to their mental
health problems.
· Nearly two out of three respondents believed that unrealistic workload/too high
expectations/long hours had caused or exacerbated their mental health problems.
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The Mental Health Foundation Out at work
2. Introduction
Over 25 million people in the UK spend a large part of their lives at work1. For many
people with mental health problems, work is an important coping mechanism,
providing a sense of purpose and value (Mental Health Foundation, 20002) as well as
important social contacts.
However the national situation of people who experience mental health difficulties is
far from positive when it comes to employment. Of the working UK population, only
17% of people with a diagnosis of serious mental illness are economically active
(Office for National Statistics, 19983). Further the OPCS Surveys of Psychiatry
Morbidity in Great Britain in 1995/6 discovered that mental health service users had
the highest unemployment rates of any disabled group (Office for National Statistics,
19954). A staggering 85% of people with long-term mental illness were unemployed.
A more recent report found that 95% of mental health service users felt that their
mental health problems had considerable negative effects on their employment
prospects (Focus on Mental Health, 20015).
Research by the Mental Health Foundation found that 47% of respondents who had
experience mental distress had also faced discrimination in the workplace (20006).
Thirty seven percent had also reported discrimination in seeking employment.
It is therefore no wonder that 55% felt that they could not always tell their work
colleagues about their mental health difficulties.
These results have been echoed in other studies. A survey of 778 users of mental
health services found that 34% had reported being dismissed or forced to resign from
their jobs (Read and Baker, 19967). A further 39% felt that their diagnosis was used as
grounds for being denied a job. Understandable again, over half (52%) did not reveal
that psychiatric history for fear of losing their job, and 69% feared discrimination to
the extent of being unwilling to apply for work.
Unfortunately this also makes it difficult for employers to develop strategies for
support and assistance. The Disability Discrimination Act places a duty on employers
to make 'reasonable adjustments' to prevent disabled applicants or employees being
disadvantaged at work. The Disability Discrimination Act also makes it unlawful for
employers of 15 or more people to discriminate on the grounds of disability. Whilst
many people with mental health difficulties may require no adjustments to be made,
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informing employers of mental health difficulties binds them to comply with this Act
and legally provide appropriate working arrangements when needed and to not
discriminate against mental health diagnoses when recruiting staff.
This current survey is important because it asks about people's experiences not only in
seeking employment but also within the workplace, particularly experiences of
seeking or receiving support.
If we are to try to ensure that more than 15% of people with serious mental illness are
able to work then we need to find out what sort of support best enables people to
remain in employment, and tackle the discrimination that some people may still be
experiencing.
1
The Mental Health Foundation. (1999) Mental Health in the Workplace The Mental Health
Foundation: London
2
Faulkner, A. and Layzell, S. (2000) Strategies for Living. A report of user-led research into people's
strategies for living with mental distress The Mental Health Foundation: London.
3
Office for National Statistics (1998) Labour Force Survey The Stationery Office: London.
4
Office for National Statistics (1996) 'Physical complaints, service use and treatment of residents with
psychiatric disorders' OPCS Surveys of Psychiatry Morbidity in Great Britain, Report 5, The Stationery
Office: London.
5
Focus on Mental Health (2001) 'An uphill struggle' Poverty and mental health. Focus on Mental
Health: London.
6
DePonte, P. (2000) Pull Yourself Together: A survey of the stigma and discrimination faced by people
who experience mental distress The Mental Health Foundation: London.
7
Read, J. & Baker, S. (1996) Not just sticks and stones: A survey of the discrimination experienced by
people with mental health problems Mind: London.
8
Link, et al. (1997) 'On stigma and its consequences: evidence from a longitudinal study of men and
dual diagnosis of mental illness and substance abuse' Journal of Health and Social Behaviour 38, 177-
90.
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Methodology
3.1 Recruitment
A self-complete questionnaire (see Appendix One) was constructed asking people
about their experiences of mental health in the workplace. This was distributed to a
number of people who had identified themselves as experiencing mental health
problems, particularly:
· People on the Mental Health Foundation's Strategies for Living mailing list (1,500
people) - an area of the Mental Health Foundation focusing specifically on mental
health service user and survivor-led research.
· Mental Health Media's mailing list (946 addresses) - individuals and groups,
particularly mental health service users and survivors who have received training
or guidance in how to work with the media at a local level.
· Manic Depression Fellowship self-help groups (150 addresses).
· MCCH Society Ltd (150 copies). The Clubhouse organisation which provides
drop-in support, and return-to-employment support for members.
· Other organisations, including the Kensington & Chelsea Forum (mental health
service users group) also publicised the questionnaire in their newsletter.
· The questionnaire was also on the Mental Health Foundation's website and
emailed to a people who had registered on the Foundation's Connects portal and
self-identified as having personal experience of mental health problems.
It is estimated that around 3,000 copies of the questionnaire were distributed from the
end of October through to November, with over 500 completed questionnaires
returned by Friday 21 December. Of these, 411 respondents met the inclusion criteria
of having experience of mental health problems.
3.2 Participants
Of the 411 analysed questionnaires, 30% were from males and 66% from females (3%
did not specify). Of those who provided details of their age, the majority were aged
35-44 or 45-54. Only one person was aged under 18 years.
Age of respondents
18-24 (3%)
under 18 (0%)
25-34 (21%)
65+ (2%)
55-64 (11%)
35-44 (36%)
45-54 (27%)
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The Mental Health Foundation Out at work
Of those who chose to reply, over four-fifths were White UK with only small
numbers of Black/African-Caribbean/Black British and Black
Asian/Indian/Bangladeshi/Asian British/Asian Other. 6% described themselves as
“other” identifying Punjabi/Irish, White UK/Jewish, Mixed race, European, Gypsy,
Spanish and American or Australian for example.
Black/African
Caribbean
White UK (3%)
(86%)
Black Asian
(2%)
Other
European -
Irish (4%)
Other (6%)
Respondents were asked to describe their own mental health problem in their own
words. A number of people identified more than one particular issue. The most
common experiences were depression (53%) - including clinical, reactive, postnatal,
and uni-polar affective disorder - and anxiety or panic attacks (38%).
100
90
80
70
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The Mental Health Foundation Out at work
4. Results
Percentages are presented to the nearest whole number. There therefore may be
occasions when percentages add up to over 100%.
Full-time paid
(32%)
Retired (1%)
Student (3%)
Not working or
volunteering Part-time
(17%) paid (22%)
In paid employment
Of all the respondents, 32% worked full time, 22% part time, and 9% were self-
employed or part-employed/part-self-employed. More female respondents were in
paid employment (67%) than male respondents (51%).
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The Mental Health Foundation Out at work
100%
% of respondents experiencing these symptoms
90%
80%
70% 65%
59%
60% 56%
50% 50% Paid employment
50% / self-employed
41% Unpaid w ork or
38%
40% unemployed
27%
30%
20%
10%
0%
Depression Manic- Psychosis Anxiety/stress
depression
Nearly six out of ten (58%) of people with depression (clinical, postnatal or other)
who responded were employed either full time or part time, and 56% of those with
anxiety or stress related problems were in full time or part time employment. (The
remainder of those working is made up of people describing themselves as working -
self-employed, see over).
Breakdown of working situation for the four most reported mental health
difficulties in this survey
50
% respondents experiencing these symptoms
45
40
35
Full-time
30
Part-time
25 Self-employed
Voluntary work
20
Unemployed
15
10
0
Depression Manic-depression Psychosis Anxiety/stress
Less than half of those with schizophrenia or manic depression were in paid
employment, with only 48% of those with psychosis or schizophrenia type disorders
in full time or part time employment, as were 48% of people with bipolar
disorders/manic depression.
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The Mental Health Foundation Out at work
Self-employed
“I went freelance 18 months ago after deciding to leave my job (until then I’d always
had permanent, full time work). Partly for more flexibility and new challenges but
also because I was put under pressure to resign because of my depression. Best thing
I ever did! I now have lots more leeway and independence, can take time out if I need
to, and earn more. I’ve also been able to come out about depression and work around
mental health.”
Voluntary work
Significantly nearly one in five (19%) did voluntary work, with men (26%) more
likely to describe themselves as doing voluntary work than women (17%). Those with
manic-depression/bipolar disorder were most likely to be doing voluntary work –
more than one third of respondents (35%) ticked this box - and just over a quarter of
those with psychosis or schizophrenia (26%).
Although as a group more likely to be in full time employment, people with clinical
depression were also the most likely to be not working. Nearly four out of ten (38.9%)
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The Mental Health Foundation Out at work
of those with clinical depression were not currently employed as against 15% of those
with depression overall.
21% of those with anxiety or stress-related problems and 17% of people with manic
depression replied that they were unemployed and not involved in voluntary work.
Only 15% of people with psychosis/schizophrenia were neither employed nor
working in a voluntary capacity.
Interestingly less than one per cent of people described themselves as subject to
medical or ill-health retirement, although a further 3% referred to long term sickness,
therapeutic earnings, incapacity benefit/DLA or supported/sheltered employment.
About 1% were retired/semi-retired.
Conclusion
Our results do not indicate as large an unemployment rate as reported by the other
sources: 83% of people with a diagnosis of serious mental illness were economically
inactive according to the Office for National Statistics, 1998. There are possible
explanations for the contradiction in figures.
The largest factor in this disparity is the sample used for out survey. Particularly, the
Strategies for Living mailing list consists of service users and professionals interested
in the mental health field, with many people identifying with both of these
descriptions. We would therefore expect that our sample of service users would have
a larger proportion of working people than if we were to use a general population
sample.
It also must be considered that our definition of mental health difficulties was not
restricted to medical diagnoses, so our sample is a lot more varied than in the other
studies, which identified 'serious mental illness diagnosis' as their target population.
What is important is that even in our sample, 50% of people with manic-depression,
and 41% of people with schizophrenia/psychosis did not have paid employment. Our
survey does therefore support the previous evidence that unemployment amongst
people with mental health difficulties is considerably higher than in the general
population.
Another very significant result is that 19% of our respondents were involved in
voluntary work, the figure rising to 35% and 26% for people with manic-depression
and psychosis/schizophrenia respectively. Although we do not have information on
the type of voluntary work carried out, this result does ask the question, 'How many of
these volunteers are able to carry out full-time or part-time paid employment?' And
therefore, 'Why are those that are able work, not in paid employment?' This question
will be answered in the following section.
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The Mental Health Foundation Out at work
“At interview, as soon as I declared I had a mental health problem I always lost the
job.”
Did respondents feel that they had not been offered
work due to their mental health difficulties?
Yes (31%)
No (44%)
Possibly
(25%)
There was a marked difference here depending on people’s specific diagnosis. People
with bipolar disorder/manic-depression or psychosis/schizophrenia were more likely
to report being turned down for a job because of their mental health problem.
Did respondents with the more commonly reported mental health difficulties
believe themselves to be discriminated against when job seeking?
% of respondents with these mental health
100
80
difficulties
60
Yes
49% 48%
46% Possibly
No
40
29% 29%
25% 26% 25% 23%
20
0
Depression Manic-depression Psychosis/Schizophrenia
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The Mental Health Foundation Out at work
Almost half of them agreed with this: 46% of people with manic depression/bipolar
disorder (from a total of 85 who responded to this question) and 48% of people with
schizophrenia (from 56). Only around a quarter (25%) of those with manic depression
and nearly three in ten (29%) of people with psychosis/schizophrenia said this had
never happened.
Conversely, people with various forms of depression were more likely to say that they
had never been turned down for a job for this reason. Nearly half (49%) reported that
they had never been turned down for a job, while around a quarter (26%) said
possibly and slightly more (27%) said yes.
“Was verbally offered a job, then received a phone call to say no longer available.”
“Lost a job when had to explain gap in employment record was because of being
mentally ill.”
“Not short-listed for more senior position when others with less experience and less
qualifications were.”
“Turned down because of medical after gaining place on teacher training course.”
Conclusion
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The Mental Health Foundation Out at work
35
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The fact that so many of the respondents worked in health or social care should not be
surprising as these are two of the main national employment areas. It may also be
expected that health and social care organisations have better equal opportunities
policies and mental health policies. However, this may not necessarily be the case, as
will be discussed later.
In addition, many service users and survivors work within the social care or
healthcare field, particularly mental health, where their personal experience of mental
health can be seen as valuable or, in some cases, essential.
However, research by the journal, Community Care, found that of the social workers
who regularly read the publication, only 6% felt that their stress levels were at an
acceptable level (1999). More recent research (Community Care, 2002) reported that
of nearly 500 social workers who had experienced depression, 80% of respondents
identified work as a cause of their depression.
With such rates of stress and depression experienced in health and social care fields it
does raise the question of whether there is a danger of creating a form of mental
health ghetto - with people with mental health problems believing that they are more
likely to be accepted within health or social care than anywhere else, and so working
in this area rather than bringing a variety of experiences to bear in other areas of
work.
“I feel the biggest barrier is often the fear that people will discriminate. Manic
depression is seen as a big, dangerous illness, you are likely to become a maniac at
any time!. Perhaps the only jobs open to us are in the “mental health industry” – I
resent this as I don’t want to make a career out of it."
“I work in mental health because I believed it was my only choice of work as no other
employer would employ me.”
While this obviously does bring benefits to the health and social care sector in
acceptance and understanding of mental health issues and the personal experience that
staff bring to their roles it can also mean that staff experience considerable pressures
in continually supporting not only clients but also, potentially, other staff members
experiencing mental health problems.
“As I work in mental health field my immediate line manager is very supportive.
However I feel that the structure further up is not. Also, service users still expect you
to be well no matter what pressures I am under.”
“being surrounded by mental health issues can be draining if not properly managed.”
Conclusion
Not surprisingly, there were a large variety of employment roles represented within
the sample although general management and administration, health and social care
predominated. While many people may be attracted to health and social care through
their own interest in and experience of mental health problems, working in this sector
can provide additional stress as demonstrated.
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The Mental Health Foundation Out at work
Most people had chosen to inform people at work about their mental
health problems, although disclosure could be selective, but some people
had been "outed" by former employers or doctors. They reported
generally positive responses within the workplace with acceptance and
being valued predominating.
80
70 67%
61%
60
% of respondents
50
40
31%
30
18%
20
11% 11%
6%
10
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Around two thirds (67%) declared that colleagues knew, while six out of ten (61%)
stated that their manager/deputy manager/vice principal knew.
More than one sixth (18%) informed staff or volunteers and 6% informed their clients,
students or members of the user group. Least likely to be informed were “other
organisations I work with” (1%).
2% declared that they had told a few selective people or friends, while 2% were not
sure as it had not been explicitly discussed, and a further less than half a per cent
(0.3%) responded that work was aware of the situation but not the details.
Those least likely to tell their manager were people with experience of postnatal
depression (33%), and those most likely to tell their manager were those with
obsessive behaviours or obsessive-compulsive disorders (90%) and personality
disorders (92%).
People with manic depression were slightly more likely to tell their manager (70%)
than their colleagues (67%) whereas this was reversed in people with clinical
depression, other sorts of depression and psychosis/schizophrenia. 50% of people with
clinical depression told their manager, and 70% their colleagues; 61% of people with
other types of depression told their manager and 67% their colleagues; and over two-
thirds (67%) of people with experience of psychosis/schizophrenia told their manager,
while more than four out of five (83%) told their colleagues.
Again, some people made the decision whether or not to disclose their mental health
problems according to the particular employer.
And guidelines or policies on disclosure or medicals did influence which jobs people
applied for.
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For those whose workplace did know about their experience of mental health
problems, the majority appeared to be in control of who they told about their mental
health problem within the workplace and when. Nearly six out of ten (59%) said
that they chose to let people know, even if this referred to selective people, after a
period of time or as they felt confident. Just over one third (35%) declared their
mental health problem on their application form, perhaps due to fears that they would
be discriminated against if they did. This is, however, a slight increase from the
30.2% of people who reported disclosing this information in the Mental Health
Foundation's Pull Yourself Together report in 2000.
The other major way in which people at work discovered that the person had a mental
health problem was because they were unwell for a period (24%).
But for just under one in seven respondents, experience of mental health problems
was an essential requirement of the job - because they worked for a mental health
service user charity, for example.
Of the remainder, 5% of workplaces found out because somebody else, not the
respondent told them, 1% were informed by a doctor’s sick note, a reference or an
occupational health report, 1% had applied for jobs with organisations which already
knew their mental health history. Only one person (0.4%) did not know how their
workplace found out.
Respondents were asked, in relation to their current employment, “if your mental
health experience is known about, what impact or effect has this had on your
employment?” The results are presented in the table over the page.
From these responses it appears that people currently in employment generally felt
accepted (nearly two thirds said this was the case always or often, with a further 18%
stating sometimes) particularly by colleagues. Around seven out of ten of those who
responded stated that colleagues seldom or never made snide/sarcastic remarks and
seldom or never avoid them. This is a more positive picture than the earlier findings
of the Mental Health Foundation’s report, Pull Yourself Together (2000) in which
nearly three out of ten people with personal experience of mental distress reported
discrimination in the workplace.
But some people clearly felt that colleagues were still unsure of how to react or
whether to acknowledge somebody’s mental health problems.
“There is a marked difference between the way someone with a physical illness is
treated and the way someone with a mental problem is, e.g. I came back to work after
a bout of depression, people didn’t even ask how I was. No one visited or sent a get
well card – things that always happen if people have a physical illness.” 19
The Mental Health Foundation Out at work
Some people felt that their experiences were valued by their workplace (and a number
of respondents worked in the mental health field where personal experience of the
issues was seen as a definite plus),
The following person, however, thought that mental health organisations may not be
as good employers as others might think.
“Mental health personnel sometimes seem more prejudiced than those outside the
mental health world.”
I have had support when and where I need it 52% 21% 13%
There did appear to be a slightly more reticent view towards management generally.
Only just over half of respondents said that they received support when and where
they needed it, either always or often – more than one in five had sometimes had
support but just over one in eight (13%) had seldom or never had support when they
needed it.
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The Mental Health Foundation Out at work
“When I was working in an office as a grants administrator for the voluntary sector,
management were very unsympathetic to my mental health distress. I was actually
given a warning by my line manager that if I didn’t start to look happier, I’d be given
the sack. Of course this made my situation worse.”
The latest ruling from the courts states that employers cannot be held responsible for
stress or mental ill-health unless the employee brings the situation to the employer’s
attention (The Guardian, Wednesday February 6th, 2002), so there is now an even
greater need for employees to actively seek support when they need it and not assume
that their employer is aware of their difficulties. As around six out of ten respondents
had informed their manager of their mental health problem this may still leave a
considerable number who, if they did experience problems, would be likely to fall
foul of this ruling and be unable to claim compensation if this became necessary.
Around one in ten of those who responded always or often felt that management was
patronising, they were more monitored than other colleagues or that mistakes were
attributed to their mental distress.
However, a number of people did make specific comments about their current
employment including:
Nobody knows
Of those in work, only one in ten declared that nobody at work knew of their mental
health problem, and these appear to have made a positive decision not to inform
people, stating “it’s not a current problem so not relevant” (40%), “I haven’t been
asked and don’t want to offer the information” (30%), or “it’s not relevant to the job”
(23%).
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Worryingly, a third of those who stated that nobody at work knew also believed that if
they declared their mental health problem they would not get the job, and just over a
quarter (27%) stated that they knew it would be a bad idea from previous experience.
Other people gave individual responses including:
This indicates that there are still a number of people who believe themselves to be in a
“Catch 22” situation. They believe that they wouldn’t get a job if they do declare their
experience of mental health problems, and are therefore unable to ask for support
within the workplace and liable to disciplinary procedures or sacking if they are
discovered to have omitted relevant information or lied on their application form.
While the total number of respondents here is fairly small, it should be remembered
that these responses are crucial as they are from people currently in employment.
Conclusion
There are many reasons why people would choose to inform their employer about
their mental health problem, including accessing appropriate support, and the majority
of the respondents in this survey were doing this. Unfortunately there was still fear of
discrimination reported by a third of the respondents.
A general criticism appears to be that some people with mental health problems
sometimes feel over-protected, over-monitored or over-cosseted, particularly shielded
from taking on more responsibility or passed over for promotion. While this might in
some cases be done with supportive intentions, it does indicate that people with
mental health problems are in some cases perhaps still not being accepted as able to
make their own decisions over what is right for them.
“When I challenged management re being overlooked for promotion after being ill,
and made my case for employment, they felt they’d 'acted in my best interests', and
hadn’t approached me because they didn’t want to 'put too much on me'. All without
talking to me about it. Subsequently they did employ me because I could do the job.”
In addition, there is great nervousness amongst those who have not revealed their
experience of mental health problems at work, often based on previous experience.
However this may also indicate that people are unaware of the increasingly positive
experiences of people with mental health problems within the workplace, and this
survey has demonstrated some of these positive experiences.
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Over half of those at work had flexi-time and peer support available to
them and people valued the support they received from colleagues and
managers.
Participants were asked what support was available, or what support they would find
helpful from their employer. The table below shows the experiences and opinions of
those who responded to each part of the question.
Gradual return to work after time off 44% 21% 24% 35%
The most common form of support taken up was flexi-time and peer support with
more than a quarter of people using this support, and one in five people said they had
taken advantage of the ability to return to work gradually after time off.
“I have recently had a manic episode. I was in hospital and had six weeks off work.
My workplace has been especially supportive in my gradual return to full-time work,
for which I am particularly grateful.”
Interestingly, where a support option was available, around half or less of those able
to had taken advantage of it, whereas a greater proportion of people stated that they
would be likely to use a particular support option that was currently not available in
their workplace. This may indicate the value that people place on support being
available, which may affect how they perceive their job and their role within it.
Alternatively it may suggest that although support in the workplace seems like a good
idea in theory, employees are still anxious about being seen as 'higher maintenance'
employees and so unlikely to take up available support.
“Acceptance that I may sometimes get upset but I don’t need to go home!”
“Understanding.”
“Better supervision”
“External supervision.”
“I was bullied by my female line manager and was encouraged to go part time by her
– due to this I lost half my pension rights.”
“Teaching is notoriously hard without support. I think we are the tip of the iceberg.
Many high stress jobs could benefit from the kind of debrief that exists for example, in
the counselling sector.”
When asked whether they thought they got the support needed from work, the
response was generally positive. Of those who replied, only 13% stated that they
seldom or never got the support they needed from work. Just over a quarter of
respondents (26%) always got the support they needed while more than one in three
(35%) often got this support and more than one in four (27%) sometimes received this
support.
Many people, elsewhere in the questionnaire, stated that they felt fortunate or unusual
in receiving support.
“I realise I am very lucky to have such support in my present job. I would be very
apprehensive about applying for work with another organisation.”
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“In the workplace, I have found that my fellow professionals have been very
understanding, my illness has been controlled by medication. Surprisingly, I have
found that stigma and ignorance have come from the most extraordinary sources. I
retired eventually through my own free choice. The firm I left were very
understanding, gave me an immense amount of support and asked me not to resign.
They were not concerned about my periods of hospitalisation due to hypomania, so a
lot of my work experience as a solicitor was not negative. However I am still
concerned about returning to the workplace and feel I should re-evaluate my life and
start something new.”
“My current job is exceptional, I think. My previous experiences at work have been
far from similar. I realise that I’m well supported and lucky compared to others, but
that should be the norm, not the exception.”
Conclusion
For those who have chosen, or been forced, to be open about their experiences of
mental health within the workplace, the overwhelming impression is of workplaces
which are supportive, most of the time, with particular forms of support being valued
even if they are not used.
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Stress 2%
Relationship problems 2%
(respondents were asked to tick all that applied and given the chance of stating an alternative answer or adding their own
comments; only the top five answers were prompted; answers with less than 1% of respondents agreeing have not been included
in the summary table)
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Conclusion
When asked whether they had lost or left a job because of their
experience of mental health, only three out of ten said that this had never
been the case, while a further 5% were unsure – leaving nearly two thirds
who believed that this was the case in some way.
In total nearly half of those who responded (48%) may have felt that the decision had
been made for them as they had been redeployed, made redundant, encouraged to
resign, sacked, forced out, contract not renewed, or took their employer to court. In
addition, more than one in ten (12%) felt too embarrassed to return to their place of
employment.
“Whenever I go to hospital or take time off, I know to look for work elsewhere.”
“I was a student psychiatric nurse of fifteen months when I suffered a period of severe
depression. It took me eight months to recover, no reoccurrence since 1993. However,
my employer was wanting me to sign my resignation and I did. I didn’t feel well
enough at that time to fight to keep my job. Since then I have retrained as a social
worker, have declared my illness on a medical form this year for a new post. No
discrimination happened – I was so happy about this; it has been a long road to get
back to my career which I had always envisaged, but I made it.”
“I worked for the NHS as a trained nurse. When our ward relocated, I was strongly
encouraged to take redundancy. I offered to go down one or two grades just to keep
my job but it was not considered. If I hadn’t had a mental health problem I don’t think
I would have been made redundant.”
On a more positive note nearly four in ten (39%) either chose to leave or changed
career.
Nearly five per cent (5%) took early retirement or ill health pension.
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Unsure 5%
Yes – redeployed 4%
Conclusion
With nearly half of those who responded believing that they had had to leave or lost a
job because of their mental health problem, there appear to be a number of people
who may have had cases for wrongful or constructive dismissal under disability rights
legislation. That this has not generally happened may be because people feel too
vulnerable and not determined enough to take forward claims and because only
recently has the Disability Rights Commission succeeded in such claims.
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5. Recommendations
The Disability Rights Commission should give priority to addressing discrimination
in relation to people with mental health problems.
The Government needs to recognise the importance of employment for people with
mental health problems and implement initiatives that promote, support and, where
necessary, provide opportunities for returning to employment.
The Government and all agencies working in mental health should consider whether
the time is right for a campaign encouraging people to “come out” about their mental
health problems, in order that this is identified as not a minority issue.
The benefits system should be re-examined in order that it does not penalise those
who return to work but then find they are not well enough and have to leave.
Employers should consider policies such as a gradual return to work after a period of
mental illness in order to support and retain valued employees.
Medical professionals should seriously consider service users’ views and experiences
when prescribing medications and seek a collaborative agreement to prescribe the
most effective medication with fewer or more acceptable side effects.
There should be mental health awareness training in schools to try and ensure that
future employers and colleagues, for example, have a better understanding both of
mental health problems and of how to look after their own mental wellbeing.
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6. Further reading
Baker, S. and MacPherson, J. (2000) Counting the Cost. Mental health in the media
Mind: London.
Bird, L. (1999) Suicide and Homicide by People with Mental Illness The Mental
Health Foundation Updates vol. 1, issue 5.
De Ponte, P. (2000) Pull Yourself Together! A survey of the stigma and discrimination
faced by people who experience mental distress. The Mental Health Foundation:
London
Mind, (1999) Creating Accepting Communities: Report of the Mind Inquiry into
social exclusion and mental health problems Mind: London.
Read, J. and Baker, S. (1996) Not just sticks and stones: A survey of the
discrimination experienced by people with mental health problems Mind: London.
Ward, G. (1997) Making Headlines. Mental health and the national press. Health
Education Authority: London.
Wright, S. (2001) Is Anybody There? A survey of friendship and mental health The
Mental Health Foundation: London
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4. If you answered yes to question 3, who at work knows that you have experience of mental
health problems? (tick all that apply)
My manager c My staff c
My work colleagues c No-one (go to Q 7) c
Personnel department c
Other (please specify):…………………………………………………………………………..
5. If your mental health experience is known about, what impact or effect has this had
on your employment (tick any that apply)
Always Often Sometimes Seldom Never
People are very accepting c c c c c
It makes no difference c c c c c
My workplace values my personal experiences c c c c c
I have had support when and where I need it c c c c c
Management is patronising c c c c c
I feel more monitored than other colleagues do c c c c c
Mistakes are attributed to my mental distress c c c c c
Colleagues make snide/sarcastic remarks c c c c c
I am discouraged from taking on exciting projectsc c c c c
Colleagues avoid me c c c c c
Life is very difficult and I'm thinking of leaving c c c c c
I believe I have been passed over for promotion c c c c c
Other (please specify):…………………………………………………………………………..
…………………………………………………………………………………………………..
6. How did your workplace find out about your experience of mental health problems?
I declared it on the application form c Someone else told them c
I chose to let people know c I don't know c
I was unwell for a period c
Other (please specify):………………………………………………………………………...
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7. If nobody at work knows of your mental health experience is this because: (tick all that
apply)
It's not relevant to the job c
It's not a current problem so not relevant c
I haven't been asked and don't want to offer the information c
I thought if I declared it I wouldn't get the job c
From previous experience I knew it would be a bad idea c
Other (please specify)…………………………………………………………………………..
8. What support is available or would you find useful from your employer? (tick all that
apply)
Available Taken up Not available Would use
Flexi-time c c c c
Peer support (ie staff member to talk to) c c c c
Cover for my work if I need time off c c c c
Gradual return to work after time off c c c c
Counsellor/Occupational health services c c c c
Support from Union/Staff association c c c c
Other (please specify)…………………………………………………………………………
10. Do you think that your mental health problems have been caused/made worse by: (tick all
that apply)
Unhealthy working conditions c Bullying at work c
Unrealistic workload c Threat of redeployment/redundancy c
Bad management c
Other (please specify):……………….…….…………………………………………………...
11. Have you ever left or lost a job through your experience of mental health?
No c Yes - I was made redundant c
Unsure c Yes - I was encouraged to resign c
Yes - I chose to leave c Yes - I was sacked c
Yes - I changed career c Yes - I took my employer to court c
Yes - I was redeployed c Yes - I felt too embarrassed to return c
Other (please
specify):……………….…….…………………………………………………………...
12. Do you think you have ever been turned down for a job because of your mental health
experience? Yes c Possibly c No c
Please give details (optional)
……………………………………………………...……………………………………………
……………………………………………………………………...……………………………
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13. Please use the space below for anything else you wish to add (or attach an extra sheet).
…………………………………………………………………………………………………
……...…………………………………………………………………………………………
………………...………………………………………………………………………………
…………………………...……………………………………………………………………
ABOUT YOU
14. What is or was your main job / profession? (tick one only)
Ethnic origin:
Black: African-Caribbean c African c
Black British c Other c
If you would prefer to describe your racial or ethnic identity differently to above, please do so
here:………………………………………………………………………………….…………
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