Monday 24 July 2017

Dr Patricia Casey: Mental health in the workplace

You decide whether or not to inform employers of any issues

Take a break!
Take a break!

Patricia Casey

Mental health problems are common in Ireland and a question that we psychiatrists are often asked is whether those applying for jobs should disclose their illness to a prospective employer. There are understandable concerns that this information might impact on their chances of obtaining employment. For those fortunate enough to have a job concerns are often expressed that this might stall their promotion prospects.

Under the 2004 Equality Act those with disabilities cannot be discriminated against. If a person with a disability is appointed then the employer must make "reasonable accommodation" for that person. And the definition of Disability in the Act is very broad since it includes any mental health problem, current or past. Further information is available in Equality and Mental Health: what the law means for your workplace, published by The Equality Authority in 2011.

The law says that an employer cannot inquire specifically about health matters at interview, in the same way that questions about pregnancy are prohibited. However, after the interview, if consideration is being given to offering the person the post, a questionnaire that seeks information, inter alia, on health status is completed and sent to the Occupational Health Physician.

So, if an individual decides to make their illness known to the employer, it is not the managing director or the Human Resources Department or the line manager but the Occupational Health Physician, employed by the company, who should be approached in the first instance.

Some people choose not to disclose their health issues, others are truthful. In general, a prior episode of depression or anxiety, disclosed on the post-interview questionnaire, should not prevent an employer offering the position but an ongoing illness could impact negatively, depending on the opinion of the company doctor as to the suitability of the person for the job in his/her current state of mind. The decision on whether to inform an employer of say, depression or alcoholism, is one on which I advise my patients to make up their mind, bearing in mind that truthfulness is assumed.

The reluctance to disclose mental health problems is because of the niggling uncertainty that the spirit of the law will not be adhered to and that some seemingly legitimate ground will be found not to offer the position or recommend the promotion of a person with an invisible disability such as depression.

For some, non-disclosure may seem the "safest" avenue, but it has its pitfalls. Indeed a telephone call to a former employer for a reference will provide information concerning significant absenteeism in previous posts and the likely cause. This may discredit the person in the eyes of a prospective employer.

A further problem arises when, despite withholding health-related information, the individual suspects that their prospective employer knows of their illness. In these circumstances of not being offered the position, it will be very difficult to argue discrimination based on health before an employment tribunal or a court of law if disclosure did not occur.

On the other hand if they are offered the post "reasonable accommodations" cannot be put in place if there was no knowledge of the person's prior or current illness. For a person with depression such an accommodation might mean removing the obligation to do shift work.

There are also more personal reasons for choosing not to inform the doctor, or even other members of staff. Some express concerns that they might be scoffed at by their workmates or be the butt of jokes – all of which also fly in the face of the Equality Act. For others it is a matter of privacy. Mental illness is regarded as something very personal that, sometimes, is even not disclosed to family members. Others describe feeling supported when their workmates know about their illness.

Some choose to disclose their illness sometime into their employment. Even then, there are often misgivings that the company doctor's loyalty is to the firm and not to the patient. This is a difficult area since since the role of the occupational physician is to carry out a health check before commencing work, to support the person who is in remission from illness and to advise on treatment if there is a current active illness. Only in the latter situation should the employer be informed.

Small companies often do not employ Occupational Health Physicians but Equality Act applies equally to them as to multinationals.

Those with mental health problems face challenges when seeking employment but these are far less now than in past decades as a result of the Equality Act. When considering a return to work after a period of illness, it should be delayed until symptoms are fully remitted and day-to-day functioning has been restored. Then there will be no necessity to even contemplate misleading a prospective employer. And such a person will be in a position to request reasonable changes in the workplace to facilitate continued wellbeing.

Irish Independent

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