When we got to the discussion of "Perceived Disability" in my state a "Mental Disability" had a broad definition. An Employer cannot discriminate on the basis of "mental disability". So of course, these small business employers asked, "what if they do not disclose and it is affecting their work?" Then a person presented how one of their employees claimed they had bipolar, mismanaging their medications, and was acting out at work unable to fulfill basic job duties. This is important because as a small business, there are huge time and cost constraints that must be handles in order to run the business and when an employee is not fulfilling basic job functions, the bottomline is impacted.
At the same time, I was saddened because here is the real deal as someone who is bipolar managing my disorder attempting to function is a novel social environment that is the workplace:
Firstly, I am VERY leery is disclosing my mental health condition, because when I do, more often than not, the employer is an asshole. I have had too many assholes to count to trust impacting that relationship and I really have to trust someone A LOT to tell them. The stigma of mental illness is TOO LARGE and the educational component is TOO HUGE that why would I want to do it. All I want to do is my job and help the employer to achieve their dreams. I don't really want to confide in them a VERY personal kind of issue... Then, would you tell an employer that you have stage 4 breast cancer and that you only have 6 months to live while your under Hospice Care? NO! So why must I disclose I suffer from bipolar?
Secondly, medication management...That is called ADHERENCE in the medical circles. If the patient fails to adhere to the treatment regimen and does not inform the prescribing provider, then is there truly medical treatment? I have seen reams of studies arguing that point. Fact is medication management in my professional opinion is a "Social Determinant of Health" and the patient MUST be educated as such for maximum benefit of the prescribed drug - especially psychotropics. I must admit when I was young I thought I knew it all that I could pop on and off my pills, skip dosages, etc. etc. etc. But when I realized that skipping around was hurting other people by my behavior and really what these kinds of medications do physiologically - and YES I do know that - I adhered to my physician's directive.
I also do a lot of other things, but the meds are the FIRST LINE OF DEFENSE in managing my bipolar! What employers MUST understand is MEDICATIONS ALONE DO NOT TREAT MENTAL HEALTH DISORDERS IT MUST BE INTEGRATIVE CARE!!! THAT MEANS DIET, EXERCISE, STRESS REDUCTION, ETC. The BUSINESS has to decide is it worth DOING all that and really, it can be of LITTLE TO NO COST!!! You can mandate your employees to take a course--like smoking cessation, CE credits, etc., etc., etc. For mental health issues, I mean MY GOD all the support programs will be happy to do a 30 minute to 1 hour program overview of mental health FOR FREE!!! It is a matter of setting it up!
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Why would a Business want to do this. We live in a much more complex and diverse society wrought with the human condition. We just do not go and hunt to catch our food anymore or gather berries or nuts often. We humans have evolved to space travel, complex surgical procedures, large engineering feats and artistic wonders that we could never imagine 100 years ago. To expect that EVERY SINGLE PERSON ON THE PLANET FULLY ADAPTS to this is to be unreasonable. Even our wars are not fought the same. Invariably, human emotion as a biological component in some people has not caught up with our technological advances. One example is our children already understand how to use everything about the computer because they were born and raised under personal computers. Whereas, we over the age of 40 remember when we had typewriters, Kaypros and Trash-80's (if you are a geek like me you know what those are). So, of course when we are mounded up on with iPhone, there is going to be some anxiety there.
The flip side is our kids have NEVER experienced the horrors of devout poverty or war, where many of our older generation has actively witnessed it. So their adaptation to war is very, very difficult and when our young veterans come back how to mentally handle the rigors of labor and employment is going to be tough. As an employer would you be proud of yourself if you rejected a "crazy person" who happened to be a young veteran? HAYLE NO! So this mental illness stigma has to stop. FIND RESOURCES!
Thirdly, "Acting out at work" personally, while I have DONE it, I do not condone it, even for myself. What I can tell you is if I feel attacked, my typical response is crying. In "Mindfulness" for every 1 minute of major stress, it takes on average 20 minutes to quell that stress. For someone with a mental health condition, it takes a lot longer... Now, of course an Employer must have a fulfillment of job duties and I get that, that is pretty standard, but confined boxes RARELY fit most folks who suffer from mental health conditions with even half a brain. How can we make this work? Well, let's go back to the research! I have read numerous papers that strict adherence to a schedule is less optimal for someone who has depression or bipolar. For things like anxiety, scheduling works at some level but what hurts them is when things do not go according to plan. I have not read anything about other major mental health conditions.
So what does that mean for an employer? Well, if and when you get disclosure, and the employee is already hired, you may want to consider asking them if they could do some flex time for a change in pay - of course you would want to speak to an employment lawyer for appropriate wording. I have found for myself that when I was told as long as I can finish the project, then I am fine. That worked well for me because when I was in a lot of physical mental pain and I knew my experiments were fine that day, I could finish them up on the weekends. Some jobs work like that, most do not. It is something that can be made understood what the work requirements are 9 to 5, 5 days per week, occasional weekends. The employee has to decide if he/she can fulfill those obligations and it is fair that the employer gives them ample time to fulfill those obligations depending on the job.
What also worked for me is really understanding the nature of the business. Fact is small businesses who employ people are COMPETING for business. There are millions of businesses out there that sell the same thing. What sets your brand apart from the fray? Well, big businesses spend millions of dollars examining that process. But small businesses do not have the budgets to do so and most of their branding, advertising, etc. are done by word of mouth and participation. If we small businesses want to call ourselves competitors in our respective fields and we want employ a diverse workforce to the maximum of their ability, would it not be prudent to express the importance of the product and service as a collaboration with the employee rather than this "us versus them" mentality? It is called "socially conscious management" or some would say "touchy feely". But there is also proof in other countries, like Japan that calls it the Kaizen method that bringing in a holistic business attitude to the workplace assists all those involved to ensure better competition and assistance to the consumer. For example, "our product/service is good because we _________ and we are proud of our work". It is a kind of workmanship...A sense of unity and pride. When I was exposed to that kind of environment, I cannot begin to describe how I thrived, pride in my work, quest for more knowledge, wanting to contribute and participate in work type discussions with my colleagues, peers and benefactors... I was the model employee for that employer...I make huge contributions to my field even with my bipolar disorder, because I felt I was a part of something that had meaning to me.
Fact is, should an employer AUTOMATICALLY ASSUME that all employees share in this goal when hired? You would be deluding yourself as an employer if you thought employees thought that way and not just for the money... As an employer, if you encounter someone who has a mental health condition and they choose to share their issues with you, besides knowing if they know about resources they may have available to them, you may want to consider in a more formalized setting a resource type course to set them on the path to a fruitful employee than seeing them as a liability... Because you never know when you might just get that "diamond in the rough".
Lastly, sometimes you do have to separate from an employee to has a condition. Their behavior is inappropriate for the workplace. Crying is not a good enough reason. Anger, hostility, workplace violence is. Most people who cry, like myself, wish the water works would go away. I would do everything possible including painful distraction techniques, such as pinching myself till I bruised, to stop myself from crying. I rarely made it to the restroom. And the torture never ended. I would never hurt anyone and I never displayed any behavior that I would do so, but I got accused of that. The minute I was, I knew that those suppositions of an ignoramus boss would never go away even with any kind of education on mental health. I had some decisions to make, I made one that hit me quite hard. Fortunately, I am sharing my experience as one who has suffered from an active bipolar disorder that is managed by medications, therapy, exercise and diet so that NO ONE SUFFERS WHAT I SUFFERED!!!
As a future employer, I will make every effort to assist those in need as my strong community service component in my business, following a good work-life balance, holistic and socially conscious business. My main business goal is where science meets mental health and wellness.
Asante sana, ashe, akeerah...