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When and How to Disclose a Psychiatric Illness in the Workplace

Susan Romanelli, LCSW, PhD
Former Program Director of the Menninger Hope Adult Program

Except for infectious diseases like HIV or AIDS, most physical illnesses are viewed and responded to with compassion, understanding and support. If you tell your boss that you need to take time off for chemotherapy because of breast cancer, there is usually a thoughtful and empathic response. Supervisors are more likely to have a response similar to when they send food to the employee when they have suffered a death in the family.

Disclosing a psychiatric illness has significantly different ramifications than disclosing a physical problem. The difference is evident because it is law that you can’t ask a perspective employee about their current or past emotional/psychiatric difficulties.

The stigma of mental illness in this country remains paramount, despite the advocacy of the National Alliance for Mental Health (NAMI), which is a grass-root, consumer-run advocacy group that was started by family members in the ‘70s to combat stigma and stereotyping. I think stereotyping is probably one of the greatest problems with self-disclosure in the workplace. The media continues to portray mental illness as dangerous and something to be feared, especially persons with such diagnoses as Schizophrenia or Bipolar Disorder. Major Depression is more acceptable, but again there remains the question of whether to tell a supervisor that you are on medications. Except for large metropolitan cities such as New York, many people view psychotherapy (talk therapy) as an indulgence or a sign that you may have psychological or psychiatric problems, which some bosses misinterpret as a sign of an employee’s personal weakness.

If a person’s psychiatric symptoms and behaviors do not interfere with their ability to function in their job, the person is not obligated to tell their employer upon hire. If the person feels their supervisor could fairly weigh their work performance without prejudice, it might be helpful to share the nature of the difficulties or medications. For example, a person who suffers from a Generalized Anxiety Disorder may react to situations with much more anxiety than what the supervisor thinks the situation warrants. If a supervisor knows of the problem, they may be more empathic and not assume that the employee can handle certain tasks without significant support, such as giving presentations in front of large groups. The amount of detail given to a supervisor or in your workplace should be weighed in a manner similar to any personal information that is shared with supervisors and colleagues.

I once had a staff member share with me that her father had committed suicide. This was very helpful knowledge as this staff member was a mental health therapist who had a patient’s father die by suicide that week. She became very angry with the father and much too close to the patient. As her supervisor, the knowledge made me help her understand why her reactions and feelings were stronger than if she hadn’t had this same experience in her own life.

Although this doesn’t directly apply to your subject about disclosure in the workplace, research has shown that the rate for rehospitalization for individuals with Schizophrenia is significantly lower in families who do not isolate themselves from their other family members, friends or the community. Individuals with psychiatric problems feel stigmatized as individuals; and families feel stigmatized because if one family member has a significant mental illness or drug addiction that is their fate. What this signifies is that individuals with a mental illness should find and develop a supportive network of family members and friends. Whether that network includes anyone at work is an individual decision that should be carefully determined.