In the wake of the tragic Germanwings crash, we are once again confronted with just how far away we are from understanding how to deal with mental illness in the workplace, especially in high-risk professions.
Should we allow pilots with a history of depression to fly passenger planes? Should managers on meds oversee delicate or complex operations? Should employees who seek out psychiatric care be promoted to senior levels? We stumble awkwardly in the dialogue around these questions, and yet the answers have enormous implications for how we run our businesses – and for whom and how we hire.
There are no simple answers for organizations. But as someone who has suffered, sometimes silently, from a mental illness for more than 30 years, I can speak personally about how it can be managed on the job. I have worked for world-class consulting firms and publishing companies, both in Europe and
. Life in a hard-driving corporation may not have the life-or-death responsibilities that commercial pilots must bear, but it can be just as stressful.
I am one of the fortunate few: according to the National Alliance on Mental Illness, only 20% to 40% of people with mental illnesses are gainfully employed. So what sets that 20-40% apart? What enables us to function effectively in high-pressure jobs? Here is what my experience suggests.
Medication itself is not the problem. From professional associations to the man and woman on the street, people are saying that pilots on meds should not be allowed to fly jetliners. In fact, psychotropic drugs can save people from depression and other forms of mental illness, allowing us to lead ordinary lives. The problem isn’t that people perform poorly on meds, but rather that they often don’t stay on them. This backsliding is part of the illness for many people. Even brilliant individuals such as psychologist Kay Jamison and attorney Elyn Saks – each a winner of a MacArthur “genius grant” – have written compellingly of their inability to continue with psychotropic drugs early in their disease despite psychotic episodes.
That’s one reason therapy is so important. It gives people a better appreciation of the reality of mental illness, so they’re less likely to abandon their meds when they’re feeling good. Therapy also contributes to a greater understanding of what triggers episodes. Like many people with a mental illness, I don’t handle stress well. I started my career as a foreign correspondent for The Wall Street Journal Europe and TIME, but after many hours – years – of talk therapy, I exchanged that life for one as a director of client communications in a consulting firm. Do I miss the excitement of being a foreign correspondent? At times. Do I have regrets about some of the things I had to give up? Of course. Am I happier now? Absolutely. I never suffered so much as I did when I was in the throes of gut-wrenching depression brought on by extreme stress. Therapy has helped me to adjust my self-expectations; I matured in my psychiatrist’s office. I will always insist on doing high quality work – that’s just who I am – but now I work in an environment that is more flexible and where deadlines are less frequent. Given my vulnerabilities, this is the wiser choice, but I needed therapy to embrace this choice as something more than “necessary.”
Smart workplaces provide support. Therapy costs money. A lot of money. Critics who advise the mentally ill to just “fix it” by getting psychiatric help are in denial about how broken the health care system (at least in the U.S.) really is. Even with insurance, people don’t get the assistance they need. Many psychiatrists refuse to take health insurance because it doesn’t come close to matching their hourly rates. I have gold-plated health insurance, and I still pay out of pocket. Therapy in America often remains a luxury that only the rich can afford. For this reason, community must serve as a kind of prosthesis for the mentally ill. In an age when people are relying less and less on institutions such as families and churches, they are turning more and more to the work place to find structure and meaning. Companies have to start getting this right. Here are a couple of specific suggestions.
First, start a conversation. Mental illness is a cloak and dagger affair in many organizations. Ask yourself this question: “How safe is it in your company for a direct report — or another manager — to let it be known that he or she is on meds for depression and/or visits a therapist?” Addressing the issue of mental illness in the workplace has to begin with an acknowledgement that it exists and needs to be discussed openly. Many companies actually have policies to accommodate employees with mental health issues, but employees are often unaware of them or feel inhibited from taking advantage of them.
Second, promote a culture of respect. Often the greatest help to mentally ill employees comes not from some kind of official accommodation but from peers or line bosses who are willing to listen. In my experience, none of us is immune from mental illness. If we are not affected, then it is our siblings, parents, children, close friends, or neighbors who suffer from a mental illness. Companies can do more to promote a sense that work colleagues belong on this list as well. We should not regard a colleague’s mental illness as “their” problem but as “our” problem. Creating an open dialogue will help promote this culture, but for it to take hold, the organization’s senior managers should take special care to model this kind of support when they can.
And finally, understand how risky self-disclosure is. In response to the Germanwings crash, there has been a public outcry demanding that employees be upfront with their employers about depression and other forms of mental illness. During my first interview with the CEO of my current firm, I did in fact tell him that I struggle with mental illness. He thanked me for my honesty, and we moved on. But the firm is unusually empathetic, and I also went into that interview with a grab bag of credentials. Most people just don’t have those prizes – or that luck – and it’s unrealistic to expect them to self-disclose. What’s more, when hiring and promoting, there is no point in asking about mental illness openly – this is not only illegal in some countries, but the very people who admit to having a mental illness in an interview are not likely to cause the big disasters. It’s the folks who don’t say anything that you might need to watch out for, and perversely, they are the ones who often get hired. My advice for recruiters, therefore, is to be sure that the star achiever has some humility. Let me explain what I mean by that. The decision not to fly a plane while suicidal is not just a question of sanity; it’s also a matter of modesty and self-knowledge. The best employees know how to color outside the lines, but they also know their limits.
The value of support cannot be overstated. The medications work for me, but I also collaborate closely with both a superb psycho-pharmacologist and an extraordinary psychotherapist. That’s like diving into the proverbial farmer’s haystack and finding two needles. I have had phenomenal employers, who have without exception stuck by me.
And somewhere along the line — whether it was in my family, in my friendships, from my religious background, or just from my reading — I developed the capacity to suffer. This has been my greatest luck of all. I have learned that there is meaning in suffering, and this belief has reduced the desperation and hopelessness that so often results in violence to self or, in extreme cases, to others.
My heart goes out to the passengers of the Germanwings crash, and to their families — as well as to the relatives of the co-pilot. In the days to come, much will be written on mental illness in the workplace, some of it understandably distorted by the misery, grief, and confusion of the last weeks. The losses that people are enduring now must seem insurmountable. And yet I hold open the dream that we can have a sober discussion about mental illness that proceeds compassionately and collaboratively. I’ve said it already, but it bears repeating – mental illness really is about “us” and not “them,” and recognizing this fact is where we need to begin these difficult conversations.