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Guide to spotting mental illness at work

30th Apr 2014
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Mental health literacy is the extent to which lay people are able to recognise mental illnesses in people that they meet in daily life, writes Mary-Clare Race, author of 'Mental Illness at Work'.

This article was originally published by our sister site HRZone - an online HR publication dedicated to bringing science, opinion, analysis and insight to bear on the rapidly-developing HR function.

While we know people are pretty good at spotting stress or even depression they are much less able to recognise schizophrenia or identify a personality disorder in a colleague.

And according to a recent YouGov poll, more than 90% of people believe that admitting to a mental health condition could damage their career prospects, and most surveyed give a different reason to their employer if they need time off from work.

The same data also suggests that four out 10 employers have seen a rise in the number of employees reporting mental health problems.

Improving mental health literacy

To improve the mental health literacy of people at work is not to turn them into amateur psychiatrists but rather to know what different behaviour means and the sort of help and intervention that can be offered.

By shedding some light on this topic we can provide some practical food for thought for managers in the workplace.

There is a dark side of behaviour at work and a surprisingly large number of people at work “fail and derail”. Estimates put this to be 50% for senior managers.

In plain terms this means half of all people appointed to senior management positions will fail in some way whether that be through plateauing below the level they were expected to reach, causing poor moral and business results, or in extreme cases getting sacked or ending up in prison.

A part explanation of this is the extent to which people with certain sub-clinical personality disorders like narcissism and anti-social personality disorder can thrive in business.

Thanks to the brilliant insights of people such as Robert Hogan we have started to understand how the personality disorders can lead to people being promoted to senior positions only to cause mayhem all around them.

The impact of personality disorders

But what impact do personality disorders have in a broader business context? And how does this fit in with the wider mental health agenda? How does one tell if a colleague is suffering from a serious mental illness or if they are just suffering from the winter blues? 

How can we distinguish between those with personality disorders and those ‘normal’ difficult individuals we all come up against at work? 

There is a lot that individuals can do - from having a greater awareness of the trigger signs of mental illness; both in themselves and in others through to challenging stigma and knowing when to reach out to a colleague in distress. 

Organisations though must also play a role and despite an improved understanding about mental illness many employers still fail to address the issue of mental health at work in a proactive way. 

Organisations for example who have implemented initiatives aimed at managing workplace stress have had considerable success but these companies are still very much in the minority and more severe health problems such as depression are largely ignored.

Reality v perception

Part of the problem is the disparity between managers’ perception of mental health problems in their workforce and the reality of how frequently it occurs.

According to a survey of 550 senior managers in the private and public sector, for the Shaw Trust, one in 10 managers reported that none of their employees were likely to ever suffer from mental illness.

This indicates that managers are not aware of the full extent of mental illness and do not characterise common workplace problems such as stress and depression in this way. Furthermore the interventions that are geared towards addressing mental illness in the workplace are often reactive in nature and focus on how to cope with mental illness when it becomes a problem. 

If this epidemic is to be properly addressed in today’s workplace a more proactive approach to creating a healthy workplace is needed.

Approaching mental illness in this way should not be seen as an obligation to those who may be at risk of illness but rather as a smart way of looking after your greatest asset; your people. A workplace environment that approaches mental health in a positive way supports the well-being of all employees, not just those at risk, and encourages a culture of openness about sensitive matters including mental health problems.

Looking after staff in this way has many benefits such as encouraging loyalty, job satisfaction, increased productivity and organisational commitment. 

Companies are in a position to do something to respond and pre-empt causal factors and these steps can be broken into three broad areas:

Promoting a positive attitude towards mental health:

  • Encouraging mental health education
  • Part of the responsibility of today’s organisation and its leaders is in educating the work force. Investing in this is good for business. The costs of poorly managed mental health problems in the workplace are astronomical and on the rise
  • Challenging stigma
  • One of the most prominent areas where mentally ill people suffer because of negative attitudes is in the workplace. Labelling can have a negative impact on their income, work status and ability to cope. Organisations have a responsibility to challenge this stigma through education and awareness raising
  • Promoting happiness and well-being
  • Often work itself can be a trigger for mental illness and promoting happier organisations is one of the most important ways an employer can reverse the trend. This can be done in lots of ways such as encouraging employees to engage in charity work and provide them with the time to do so; advocating a strength-based approach to performance management and appraisals and encouraging leaders to role model happiness in their behaviours

Understanding and addressing organisational barriers:

  • Assessing the culture of the organisation – is it one that helps or hinders a healthy state of mind? Is work perceived to be worthwhile, full of purpose and aligned to ‘the greater good’? Are toxic individuals and derailing leaders dealt with in an appropriate way?
  • Ensuring the top team in the organisation is aware of and willing to address the mental health agenda. Do senior leaders role model appropriate behaviours and make a public commitment to the issue?
  • Identifying potential work place hazards and developing systems to encourage a healthy approach to work. For instance is there a culture of presenteeism and long hours that could be addressed?

Monitoring the situation:

  • Actively targeting depression, stress and other mental illnesses with key performance indicators
  • Measuring productivity and thereby promoting mental health
  • Building a ‘mental health at work’ referral system where individuals are clear about the process to follow if they have concerns about themselves or a colleague.

With these types of interventions we can at last see improvements in the mental health of the workforce and the topic can finally move up the agenda of many public and private sector organisations. 

Mary-Clare Race is the author of Mental Illness at Work - a manager’s guide to identifying, managing and preventing psychological problems in the workplace.

Replies (14)

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By david5541
30th Apr 2014 11:50


Dear mary clare,


whilst your article may increase awareness among more senior hr people, I think you will find that the non unionised small employers sector run by owner managers remain out of touch with hr obligations and requirements and move (or will have moved) staff "off payroll" onto a contract basis. the "pshycoligical contract" originally connected with employment in this country before margeret thatcher has been totally undermined by supposed "employers" at large who tend to either outsource/offshore or contract out, and this process is now moving beyond the private sector to the public sector, so just the nature of any agreement employers/employees tend to come to nowadays undermines the mental health of staff, since there is more often than not no psychological contract, or no presumption that care of staff is a pre-requisite to the contract.


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By Gail Purvis
30th Apr 2014 12:42


MedUni Vienna  demonstrate the possibility of using a blood test to detect depression. While blood tests for mental illnesses have until recently been regarded as impossible, a recent study clearly indicates that, in principle, depression can in fact be diagnosed in this way, and this could become reality in the not too distant future!


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By Constantly Confused
30th Apr 2014 13:00

Personally I have a couple of diagnosed mental issues which I would prefer no-one else in the office to know about.  No good comes of people knowing about my 'illnesses' (I know from experience), I'm dealing with things and don't want random people trying to help by following some gudie they found after 5 minutes of Googling at lunch.

That said, my work environment is a huge trigger for parts of my issues, but such is life (to remove those triggers would not be practical for my employer and I accept that without it needing to be brought up).

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By david5541
30th Apr 2014 13:22

well done constantly confused

thank you,


that is just my point about employers/people who call themselves employers-workplace issues are a major source of mental health problems and it doesnt do anyone anygood to have others in a small working  team to be snooping around

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By Flash Gordon
30th Apr 2014 17:59

Most people's reaction

Let's face it, most (or plenty of) people, if you tell them you're suffering with depression, will feel the need to say 'oh yes, I've been feeling down / stressed too' and will then either tell you all of their problems or change the subject. Or there's the alternative - 'you don't look depressed', 'cheer up', or my personal favourite 'what have you got to be depressed about'. 

I'm all for HR departments (in organisations large enough to have them) having training to deal with mental health issues so that employees can talk to them in confidence but I'd say that it's a safe bet that the second you disclose it to anyone else (and possibly to HR) you've buggered your chances of getting far within the organisation. Depression certainly is still seen as a weakness by many. 

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By carnmores
01st May 2014 13:27

i recommend


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06th May 2014 17:17

were all 'mental'
Erm, 'mental illness' also means just being human, there are extremes of course where the label is required. Treating staff so that they feel well respected, cared for, given opportunities, helps to keep people towards an optimum state of mind.

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Replying to vstrad:
By stepurhan
12th May 2014 09:19


Erm, 'mental illness' also means just being human, there are extremes of course where the label is required.
Treating mental illness as just an extreme form of normal thought processes is just plain wrong. In fact, this is the sort of thinking that leads to those with genuine mental illness being stigmatised. If you think of it as just a more extreme version of normal thinking, then it is all too easy to think that ALL those suffering have to do is make their thinking less extreme. The reality is that overcoming or coping with mental illness is nowhere near that simple. Having others treat it otherwise makes it even harder to deal with. As for applying labels, mental illness is as varied as its sufferers, and any label applied in anything other than a diagnostic context is meaningless.
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By paula_t42
06th May 2014 16:14

Need to be careful here....

As Flash Gordon has said - being honest about an issue you are dealing with can severely hamper rather than help the work experience - Being regarded as "unstable", removal of prospects for advancement and also the removal of any chance of being taken seriously when making legitimate complaints or requests - and yes, I do speak from experience having been honest about a bout of depression following a road accident.

Whilst I am all for awareness and removal of stigma, I think that trying to encourage illness spotting in the workplace has far more negative possibilities at the present time (last bullet point in monitoring)  - much better to focus on education to try and remove the negative impact than try and spot the sufferers


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12th May 2014 09:55

It's not plain wrong to consider mental suffering as within the normal range, if your suffering mild depression say for example due to anxiety disorder, I would say you are not "mentally ill" in the same way as if you had bi-polar or schizophrenia.

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By stepurhan
15th May 2014 00:13

Accent on mild

Mild issues are possibly within the normal range, but your posts imply you think the extremes are just part of normal human thinking as well. Putting mentally ill in quotes, as if you don't believe such a thing is real, is really not helping.

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15th May 2014 08:39

I specifically mentioned extremes in my post. I used the quotes as it is not helpful in my opinion from the sufferers mindset to label themselves as mentally ill, a bit like a placebo effect it can make things worse, anxiety/depression is very common, every one in their work life can expect to encounter others with these issues or experience themselves, it needs to be recognised and dealt with, more positive acceptance as a norm rather than dread and fear by the sufferer or others.

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By Flash Gordon
15th May 2014 09:39

Saying that mental illness also means just being human is akin to saying that asthma just means shortness of breath. I don't think me being out of puff having tried to keep up with my uber-fast dog feels anything like having a full-blown asthma attack. Certainly mental illness has many forms and many levels. And anxiety (at a level or frequency greater than the average person encounters in everyday life) is indeed a whole different ballgame to schizophrenia. But implying that everyone is 'mental' to some degree runs the risk that some people won't take it seriously and will either think that the person concerned is over-reacting or just needs to pull themselves together. And that is far more damaging.

I'm currently self-diagnosed with Asperger's (waiting for assessment - nice long wait) but having steeled myself up to start the process by requesting a referral from my doctor it was pretty damn devastating to sit there and hear her be incredibly patronising and condescending and, well everything that you expect a doctor not to be. I got my referral but left there having felt myself shrink down inside myself, and spent the next fortnight doubting myself and feeling closer to depression than I've felt in a long time. I'm just praying that the pyschiatrist responsible for assessment is more clued up on mental health than the doctor (who I've since found out is very much a believer of 'we're all mental to some extent' - I'll be changing practices in due course), particularly since adult diagnosis for Asperger's is harder because of spending so many years trying to play the part of 'normal' and suppressing all your regular habits that would earn you strange looks out in public.

But I digress (easily). I don't think labels are damaging to the individual if they are genuinely attached. I'm sure someone who says they're depressed when they're nowhere near that state could manage to convince themselves they feel worse. But for someone who actually is depressed, or has an anxiety disorder, or OCD (genuinely), or whatever, actually managing to identify what is different about you (either different to how you usually are, or different to others) can be the first step in coping better with it. Certainly for me, the more I read about other Aspies and their experiences, the more I realise that I'm not completely weird; I'm just different to the majority but very like a lot of Aspies. I've found my place, my funny-shaped peg has a funny-shaped hole, in the same area (but not too close, I don't like company) as lots of other funny-shaped pegs and holes. It's a great feeling and I'm already coping better with everything.

And I could ramble happily on about Asperger's but I won't :) 

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15th May 2014 13:38

Not a good analogy because asthma is a very specific medical name for an illness where as 'mental illness' is a very broad term. Depression is much more common than asthma.

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