How to talk to your boss about your mental health (but only if you really need to)

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More than any other place outside our homes, our workplaces can have an enormous influence on our mental well-being. We’ve seen this relationship between work and mental health play out on a grand scale in recent years, as millions of burned- out workers have quit their stressful jobs amid the pandemic in search of better work-life balance.

The opposite is also true; when we’re struggling mentally or emotionally, it can be extremely difficult to show up for work every day and be organized and productive. And if our workplaces aren’t aware of or responsive to our challenges, our jobs can make them even worse, creating a cycle of stress and overwhelm.

A Group Therapy reader asked how we can navigate these murky workplace waters: “What is best practice when communicating my mental illness to current and potential employers?�

I think this is a great question, because American work culture is at a crossroads. More employers are increasing access to mental health resources in response to the Great Resignation. The stigma around talking about your mental health at work appears to have lessened (although it’s debatable whether that improved understanding has extended to the most stigmatized conditions, like bipolar disorder and schizophrenia). All that to say: Disclosing in certain workplaces can have serious consequences, so the advice our experts gave this week comes with a lot of caveats.

I spoke with Alison Green, a career expert who’s been fielding workplace questions for a decade on her website Ask a Manager, and Tanisha Ranger, a clinical psychologist in Las Vegas, about when it might be helpful to talk to your boss about your mental health, and how that conversation can sound.

When should you talk about mental health with your employer?

Green said she gets a lot of letters from people wondering if they should talk with their employers about their mental health conditions. They’re also unsure of what they’d like to get out of the interaction.

“You should only be having this conversation when you have a specific accommodation you want to request that will better enable you to do your job,� Green told me. “Think about why you’re bringing it up and what you’re hoping your boss will do with that information. If you don’t ask for anything, your boss will assume you want her to take an action, and it might not be the help that you want or need.�

Under the Americans With Disabilities Act (ADA), organizations with 15 or more employees are required to provide “reasonable accommodations� to workers with mental and physical disabilities to help them perform the essential functions of their jobs. The ADA doesn’t list specific psychiatric conditions it covers, but stipulates that the condition must “substantially limit one or more major life activities,� including how you interact with others, communicating, eating, sleeping and caring for yourself.

In California, even more workers have protections. The state’s Fair Employment and Housing Act gives workers at companies with five or more full- or part-time employees the right to reasonable accommodations for organizations, and the state law’s definition of disability is broader than federal standards.

It’s worth noting that your situation may not meet the ADA’s bar; you might not be considered significantly impaired by your condition, although your condition could still affect your work to the extent that you need some accommodations.

Here are a few questions to ask yourself, via this helpful guidance from the ADA National Network:

• Are you able to do the main (essential) tasks of your job effectively with your disability?
• Are you able to keep up with your treatment and medication plans when working?
• Do you have what you need to perform at your best in this job as a person with a psychiatric disability?

If you said “yes� to these questions, you might not want to tell anyone at your job about your mental health condition. If you said “no� to any of these questions, you might consider asking for an accommodation. As the ADA National Network notes: “Ideally, ask for an accommodation before your mental health conditions impact your job performance.�

If you’re not sure what would help you, the Job Accommodation Network provides ideas for what type of accommodations you might ask for. For example, if you struggle with deadlines and juggling several tasks at once because of your depression, you could ask for written instructions and checklists and additional time to complete new tasks.

Is it safe to disclose your mental health needs to your employer?

Before you request a meeting with your employer, you should first try to suss out whether your boss is someone you can trust with this sensitive information.

“I wish it weren’t the case, but mental health issues still have a lot of stigma around them,� Green said. And in the wrong hands, your request for help could be used against you.

For example, if you tell your supervisor you have ADHD, they may perceive you as being more disorganized or lacking attention to detail, even if you aren’t making mistakes at a higher rate than anyone else. Or if you disclose your depression, you may get passed up for certain opportunities, like high-stress projects or promotions with extra responsibilities, even if you’re a great candidate for those roles.

It can be really hard to know whether your supervisor is safe to talk with about your mental health, Green said. “‘I hear from people all the time who say, ‘I disclosed this to my manager because she’s talked about her own mental health issues. I thought it would be fine, but it wasn’t.’�

Green recommends gathering intel from colleagues on how your manager has worked to accommodate their needs, if they’ve disclosed something similar. And find out from your HR department what kind of policies, if any, your organization has regarding mental health.

Some examples are open-door policies that strongly encourage employees to communicate their need for support and accommodations, and reasonable accommodation policies, which under the best of circumstances are broadened to include all diagnosed and undiagnosed mental health conditions.

“Sometimes these policies are lip service and sometimes they’re not,� Green said. “You may need to be there long enough to know that it’s not lip service, and have a baseline of trust that they’ll handle it well.�

Ranger encourages clients to ask about an organization’s mental health policies during interviews. Some questions to ask include whether the workplace offers employee assistance programs, and what kind of practices the company has in place to ensure that staff members are doing OK.

How to talk with your employer about your mental health

Alright, so now you’ve established that your supervisor is probably a safe person. How do you talk with them about your mental health condition?

For one, you don’t need to provide specifics about your diagnosis; in fact, Green and Ranger advise against it, for all of the potential stigma-related repercussions I described above.

One option is to file a formal ADA accommodation request (you can find guidance and a template for such a letter here). “Under the ADA, employers don’t have to give you the exact accommodation you request. Don’t assume you’ll get exactly what you’re asking for; the law requires that you enter into an interactive process through which you’ll find something that works for both of you,� Green said.

There are pros and cons to both submitting a formal and informal request. Many managers will agree to accommodations without a formal process. “Just like you needing a more ergonomic chair, you wouldn’t need to do an ADA request for many accommodations,� Green said.

The argument in favor of the formal route is that your manager could change, or the company culture could change, and the accommodations could start presenting a problem for the organization. You could be subtly penalized in ways that aren’t immediately obvious, and a formal ADA accommodation on record could provide extra protection, Green said.

“If you go the informal route and it doesn’t work, you could always try submitting an ADA request,� Green said.

The general formula for an informal request includes: 1. The accommodations you need; 2. What you’re already doing to manage your condition.

Ranger gave me a loose script for what you might say if you have ADHD: “I have a diagnosed condition that makes it hard for me to stay organized and meet deadlines. Here’s what I do to manage it (give examples), and here’s the help I could use at work to make sure I’m doing my job at my very highest capacity (explain what you’d like). Sometimes my condition means that if you send me an email, you won’t hear from me in two days. If that happens, send it again. I won’t think it’s micromanaging. I also need deadlines to be firm. And if you’re going to set up a meeting, set up multiple reminders.�

And here’s an example if you have depression: “I have a diagnosed medical condition that can affect my concentration, and I sometimes have problems with motivation and energy. And this is how it affects me as I’m doing my job. This is what I have in place to make sure I’m OK. I have a therapist I see, I take medication, and I’ve set up this structure for myself in order to make sure I get things done. It would be incredibly helpful for me to know that you can accommodate me in these ways.�

Green gave an even simpler script that omits how your condition affects you, which may make it less likely that your employer could identify what it is: “I’m struggling with some health stuff right now, and X could really help me. Is that something we could implement?�

Mental health days & therapy

We’ve all been there. You’re just so burned out, or you’re feeling really anxious or depressed (or all three!) and you desperately need what’s become colloquially known as a mental health day.

Relatively few workplaces formally offer mental health days. If you need one, Green recommends simply telling your manager that you’re under the weather. “It’s legitimate to use your sick leave for this reason, and you don’t need to provide details,� Green said. “Normalize not giving out your private health information.�

The same is true if you need time off from work for therapy. “The easiest way to approach it is the way you would with any other standing medical appointment,� Green wrote in a column. “You don’t need to explain that it’s for therapy, just like you wouldn’t need to explain that a recurring medical appointment was for allergy shots or chemotherapy. You can just say something like, ‘I am going to have a recurring weekly medical appointment for the foreseeable future. I’ll need to leave about an hour early every Thursday for it. Could I come in early on those days so my hours balance out?’�

...

I hope for a future in which we don’t need to be so careful when asking for what we need at work. Green agrees: “I think it sucks that people still have to dance around this, in a way we don’t have to do with a lot of physical health issues,� she said. “This isn’t the advice I want to be able to give — which is that openly sharing your struggles at work is to everyone’s advantage. We’re not there yet. Hopefully we’ll get there.�

Until next week,

Laura

If what you learned today from these experts spoke to you or you’d like to tell us about your own experiences, please email us and let us know if it is OK to share your thoughts with the larger Group Therapy community. The email [email protected] gets right to our team. As always, find us on Instagram at @latimesforyourmind, where we’ll continue this conversation.

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More perspectives on today’s topic and other resources

For a different take on how to approach the mental health conversation with your boss, read this Harvard Business Review piece from consultant Deborah Grayson Riegel, who teaches leadership communication at Duke University’s Fuqua School of Business. “A job is just a job,� she writes. “No project, deadline, or meeting is worth sacrificing your physical and mental health. It is possible to be an effective and productive employee while still taking care of yourself.�

Faced with high levels of worker stress, anxiety and burnout because of the COVID-19 pandemic, many companies pledged that employee mental health would become a top priority. But actions haven’t always followed promises, write my colleagues Denise Guerra and Samantha Masunaga.

Other interesting stuff

Los Angeles’ outdoor labyrinths have offered a COVID-safe way for people to gather in meditation and community, according to my colleague and friend Deborah Netburn. “You cannot get lost in a labyrinth as long as you follow the path,� she writes. “Perhaps, then, it is no surprise that in a time when so many people feel they have lost their way, interest in labyrinths has soared.�

One of my longtime favorite podcasts, “Death, Sex & Money,� is hosting three live national call-in shows about mental health and getting help. Topics so far have included how to find a therapist that fits, bias in diagnostics, and the increasing number of Americans who are taking psychiatric medications to manage their mental health conditions. You can listen to the shows that have already aired here, and listen live on May 18 (5 p.m. to 7 p.m. PST) here.

“Life B� by Bethane Patrick expertly captures the nefarious ways depression causes us to lose sight of ourselves, writes L.A. Times contributor Jessica Ferri. Patrick spent years feeling “flawed, broken, weak, fragile, lazy.� She beat herself up about not being there for her daughters, about being “a depressed mother.� She regrets the decisions she made because she believed she couldn’t do life on her own. “Life B� asks, “What does it mean to be ill and not know it?�