Staying in Employment while Suffering from Mental Health Problems: Surviving to Thriving

This blog post topic has been on my mind for weeks, months even, but I just haven't had the chance to take the time to put it into writing.  This has been mainly due to being generally busy with work and PhD applications, becoming afflicted with the standard seasonal cold and flu, as well as the usual complications and colourful existence my mental health problems tend to present me with!

Anyway, all that mess aside, I'm pleased to finally be able to bash out my thoughts on staying in employment while suffering with mental health problems - a position that I am quite proud of being able to maintain.

Quite a long time ago now, I wrote a blog post on Surviving Mental Health Related Sickness Leave
that you may be interested in reading.

That in a way brings me to my first point...

If you are really not coping and work is having a detrimental effect on your mental health, do not be afraid to take some time off.
Based upon my own personal experience, I would also say don't wait until the situation is absolutely rock bottom before taking time off!  I will never forget the dreaded phone call I was left with no choice but to make to my employer explaining that I was facing the prospect of being sectioned the following day, when they had absolutely no idea that I was suffering from mental health problems!  Never leave it that late!

It is perfectly legitimate to take sickness leave from work for mental health problems.
It is not something to be looked down upon and if it is really affecting your ability to function then it makes complete sense to take some time off to recover, in the same way that you would if you had a physical health problem - you probably wouldn't give it a second thought.

Giving yourself a couple of weeks to focus on yourself without the added stress of work, sort out therapy, appointments etc, make medication changes if needed, could in the long run avoid much lengthier absences.

How staying in employment can benefit people with mental health problems...

~ It gives you a sense of purpose

~ Provides a routine and structure

~ Can build self esteem

~ Creates a life aside from illness

~ The social aspect - provides regular contact with others (most jobs anyway!)

~ Earning your own money gives you a sense of independence

~ In my case, it makes me feel more like a functioning member of society - I can provide a service,
I can give something back...

I cannot begin to describe just how grateful I am to have been able to hold onto my job through the very worst of my mental illness and to carry it with me to what I hope will be brighter times.

I think I have mentioned what job I do on here before but for those of you who have not read my other posts...

I work as a learning support assistant in a mainstream (Catholic) secondary school.  I support children with special education needs, disabilities, emotional and behavioural problems in a classroom setting.

I have been in the role in said school for over four years now, minus 7 months in which I was on sickness leave due to mental health problems.  It isn't the most well paid job in the world to say the least, I don't plan for it to be my forever job but I do absolutely adore my job and I have always maintained that it was the best thing to have ever happened to me.

To disclose or not to disclose?

My advice = Be honest.

I spent years trying desperately to hide my mental health problems at work and it only exacerbated the problem.

I honestly believed that if my employers knew the full extent of my mental health problems, I would lose my job - there would be no way that I would be allowed to work with children.  For a long time, it felt as though my job was the only thing keeping me alive - if I lost that then it felt as though I would lose everything.

What lead me to think this way?  

The stigma surrounding mental health problems - partly society's stigma, partly my own.

The truth was and still is that I have never posed a risk to others.  I can see now with hindsight that I was too unwell at the time to work but in no way had I done anything to deserve to lose my job - 

I was just sick and I needed to get better so I could return to the job that I was so passionate about.

I so wish I had spoken up earlier about my mental health problems rather than it getting to the point where I had no choice but to disclose.

If I was to get one main message across through this blog post, it would be that if you have a mental health problem that significantly affects your life (be that inside or outside of work) then make your employers aware of it.

Share as much as you feel comfortable sharing.

You can keep the detail fairly minimal - simply stating that you are experiencing mental health problems, or just specifying what mental health problem you are suffering from.

You could go a little further - sharing how your illness affects you at work and what help or support you are receiving.

You may wish to share more detail over time.

Most people will be more understanding than you might think.

The reality is that mental health problems are incredibly common.  The likelihood is that the person you tell will have either suffered from mental health problems themselves and/or will know personally a number of people who have.

You also most probably won't be the first or the last employee who will declare mental health problems to them.  Although you might not hear about it so much, it is a common occurrence and employers will have (or should have) strategies to deal with and manage it.

I have been quite surprised that even some people who I have previously found quite unapproachable (and a little bit scary :o) have responded in a really helpful and supportive way when I have made them aware of my mental health problems.  

Mental health is often a lot closer to home for a lot of people than you might think.

If they don't understand or try understand then they are not worth your time or worry.

Unfortunately you do come across people who will not understand, or worse will choose not to understand and my advice would be to pity them - it is not a reflection on you but rather the result of their own issues.  I would sincerely hope that if they are to ever face similar difficulties in their lives, they are not treated with the same disregard they showed others.

I have been incredibly fortunate in that my employers have always been (for the most part) understanding about my mental health difficulties - in many ways I really couldn't ask for better.  However, sadly, I know this is probably not true of all employers.

My feeling on this is that if my employers were not able to accept and attempt to understand me for who I am then it would not be a company/service I would want to work for.  I do know it is not always as straightforwards as that but in principle, I can't see it any other way.

While I have said that my employers have always been very understanding that is not to say it has all been plain sailing - their support did really reach its limits with me at times.

There were lots of factors involved - staff shortages and me not being able to increase my hours quickly enough to fill the shortages.  About three months after returning to work after my lengthy absence, I started to develop seizures, which began to happen at work on a fairly regular basis - it resulted in a lot of disruption, exits from the school via ambulance, suddenly leaving in the middle of the working day etc.  I can appreciate now that none of those things were my fault - it was completely out of my control and if I could have changed any one of those things I would have.  At the same time though, I can also appreciate that it was a very testing time for all involved.

The words, 'I can't run a department with you in it' have stuck with me for a long time but they didn't break me.

You might think me really selfish for insisting upon holding onto my job through all of that but in the most difficult of times sometimes the only thing you can do is hold onto what you have left.

I've been told countless times that I am making life difficult for myself by sticking with a job that is emotionally draining and has so much potential to trigger me when there are so many other things I could be doing.  However, I would make the choice of what feels right over what is easy any day of the week.  

Genuinely, I am really blessed to be surrounded by so many colleagues who have always been supportive towards me and many of whom I now consider to be close friends.  

Unfortunately it is often that one negative comment from that one person that seems to leave an imprint on your mind more though.

I've been told before by someone that I am liability, I only have the job because the school legally can't get rid of me but no one wants me there, I cry when anyone tells me how it is and I am simply not up to the job - 

'You can't work with messed up kids when you're so messed up yourself.'

Those words hurt.

I felt as though I was being bullied into leaving my job but I wasn't going to give anyone the satisfaction.  I knew in myself that I could do it.  I wouldn't have come back after 7 months off, countless assessments by occupational health (some humiliating) and a number of colleagues knowing the dire circumstances surrounding my absence unless I knew that I could do it.  

I don't claim to be the best learning support assistant in the world but I strive to be a really good one and I like to think that I make a difference - I think that's all anyone can ever strive to be in their role.

What I want to get across from sharing this...

If someone criticises you, is intent on getting you down and to admit defeat - Don't let them!

Believe in yourself, trust your instincts and focus your attention on those who value you.

Stand your ground and stay true to what belief in yourself you have left -

Don't do it to prove something to them.  Do it to prove something to yourself.

As I've said, I work with young people who face a number of difficulties and challenges in their lives and I would really hate for them to grow up feeling as though they couldn't pursue something that they are truly passionate about.

Inspirational words from The Imitation Game...

Employers cannot discriminate against you because of your mental health problems.

They actually have a legal duty to make reasonable adjustments to accommodate your needs.

In my case, when I returned to work after sickness leave, I had scheduled in termly meetings with the headteacher and human resources manager to discuss and review the adjustments they had made for me.

When I faced the prospect of requesting 'reasonable adjustments', I found it very difficult to know what would be reasonable to ask for.  If you find yourself in this position, you may find this guide by Rethink Mental Health of use to you...

What's reasonable at work?

To give some examples of the kind of adjustments my employers made for me:

~ Flexibility regarding having to go to mental health related appointments

~ Being pre-warned in the case of fire drills and lock down drills (trauma related issue)

~ Arranged my timetable not to include supporting children in Food Tech lessons 

(food phobias and eating disorder issues)

~ Nominating a colleague who I could check in with on a regular basis

~ Reducing my contracted hours to part time

There is more support out there than you think.

I wasn't aware that there were so many services out there to support people with mental health problems to stay in employment until I was in a position in which I needed to access that support.

The Community Mental Health Team that I am under the care of have an employment service which I was referred to.  I was provided with an employment specialist who would attend my review meetings at work with me.  She was able to suggest suitable adjustments that could be put in place to support me, as well as liaising with the rest of my care team to consider what kind of strategies could but put in place to support me at work.  In short, she helped to clarify to both of us what would be 'reasonable'.  Plus she was a really lovely lady to talk to and it was reassuring to attend the meetings with her support.

Staying in employment is seen to have a really positive impact on a person's recovery from mental health problems - it is something that professionals tend to promote.

The chances are that the services you use will have some form of employment support or they will be able to refer you to another service who can provide that support.  

Sometimes you just won't know unless you ask - so ask!

Failing this, if you have concerns about the way you are being treated by your employments on account of your mental health problems then you can request an advocate to ensure that the way you are being treated is in line with the law and your rights as an employee.  

The charity Mind provides mental health advocates and the service is completely free.

The wonderful world of occupational health...

Aside from the support I have already listed, you can be referred by your employers to an occupational health service who can assess your fitness to work and make recommendations as to what adjustments could be made for you to ensure you are supported in the workplace.

Some companies will have an internal occupational health team within the company, others will have to refer you to an external agency.  

In my case, the school had an external occupational health team and referred me to them for the first time during my long term absence.  The occupational health team assessed my fitness to work and whether I was emotionally in a position to return to work at that time.  They contacted the CMHT to receive reports and information about the mental health problems I was suffering from.  They made assessments as to the level of risk I posed to myself and others.  When deemed fit enough to return to work, they recommended a phased return plan as well as some other adjustments for my employers to follow.  I was referred to occupational health a second time when I started to experience seizures - once again they had to reassess my fitness to work, the level of risk I posed and suggested procedures to be put in place to manage the problem in the workplace.

My experience with the occupational health team I was referred to was variable - some people were knowledgeable, practical and helpful, others were not!

An occupational health team is made up of a number of medical professionals with different specialisms who are able to make medical assessments within their specialist areas.

In the first instance, I was referred to a nurse who had no experience of working with people with mental health problems.  As a result, I was then referred onto a mental health nurse.  However, she felt unable to make an assessment in light of the complexity of my mental health problems.  

So I was then passed onto one of their physicians - that was a lot of time of being passed around the team!

In the end, I found that even the physician I saw had very little knowledge or experience of the specific mental health problems I suffered from and as a result I felt some of the information she reported about me was inaccurate and misleading.  She believed that my dissociative symptoms were a form of psychosis, for example!  All that being said, I was declared fit to return to work eventually, so the outcome at least was positive!

What I would say is that if, for whatever reason, you are not happy with the professional to whom you have been referred to be assessed, it is well within your rights to request another opinion.

The aim of occupational health teams is to keep you well at work and ensure you are properly supported - they are not there to criticise and scrutinise you, they are there to help you.

Your mental health problems could actually make you better at your job.

I think there is this misconception out there where mental health problems are seen as a weakness and sufferers are seen as being less able to cope with the 'normal' stresses of everyday life in the workplace.

In truth, I believe that mental health difficulties can actually have a positive impact on your ability to do your job.

So embrace it and see it as a positive.

At the end of the day, I think it can all be put down as life experience and that experience can be channelled to help others who face similar difficulties.

In my job, I feel that it has increased my empathy and understanding of the difficulties young people face.  I am more aware of the services and support that are available to people with mental health problems and can offer advice on how to access them.  Sometimes being able to relate on a deep, personal level can be painful but at the same time, it can lead to others being given a sense that they are not alone in what they are experiencing.

What I feel has become a bit of a mantra for me on this blog post - mental health problems are incredibly common.

If in your workplace, you are surrounded by colleagues who day to day are completely hole and corner about how they are feeling in themselves, then be the person who breaks the silence.

You can model the need to be open about mental health problems in the workplace, or indeed just any personal problem.  So many people have a tendency to lose themselves completely under the abundance of things that need to get done at work and the simple questions of 'how are you?' and 'what did you do at the weekend?' fall by the wayside.

Sometimes you have to take it upon yourself to be the change that all could benefit from.

Everyone can have a bad day...

So long as nobody is seriously hurt or killed then it's all good!

As someone who is known to suffer from mental health problems, I often worry that having a bad day at work will be perceived by others as me not coping.

In fact, it just shows I'm human.

Everyone is entitled to have a really bad day every once in a while and sometimes just feeling as though you're allowed to have one is enough to help you to move on to better days.

So be honest with yourself and others when you are not having the best of days.

Accept your limitations for now and make the most of what you can do.

This is one of the hardest things I have personally found to accept.

I went from a position of being in my job full time to having to work part time.

As I've said, I love my job - I find it so rewarding, it gives me a sense of identity and purpose, it is a way in which I feel I can give back to others.  If I could be there everyday doing what I love then I would but I know that wouldn't be the best thing for me overall right now.

I find this quite difficult to get across to others in a way that they understand.  Not least because from the outside when I'm at work I appear (or I hope I do) quite together, organised, enthusiastic and in control.  However, as ever, what is going on in the inside is quite a different story.  

As I have Dissociative Identity Disorder in order to be able to function appropriately at work, I have to keep the adult part of me present at all times and the needs and other wants of other parts are pushed into the background while I'm there.  In so many ways, work is great because of this reason - it helps me develop myself as an adult and my future.  

Yet it does take a huge amount of energy to maintain.

I need time outside of work to simply be me and attend to other parts of my system who make me who I am.

I also am engaging in some quite intensive therapy on a weekly basis as well as having other mental health related appointments.  There is a lot going on emotionally for me, which I need time and space to process through.  Sometimes I feel as though there is this whole internal struggle going on inside of me that no one else can see - it is like a hidden world.

It can be frustrating when you are so passionate about your work but there are various factors that seem to prevent you from dedicating yourself to the extent that you would like to.

At the same time though, having balance in your life is so important and with mental health problems, there is often a lot more to balance.

It can help to see yourself as a working progress - you may have limitations for now but the situation can and will change over time.  In the meantime, you should make the most of and celebrate all the things that you are still able to achieve in spite of the challenges you face.

I may only work three days a week but that in itself is an achievement considering where I've come from.  I try to give all I have on the days that I am in work, as well as making the most of my recovery days in between so that I can give the same all over again my following work day.

In the workplace, as well as life in general, you can only ever strive to give and be the very best you have - nothing more can ever be expected of you and so you should expect nothing more of yourself.

I hope you have found the guidance I have given helpful.
Staying in employment while suffering from mental health problems can positively enhance your recovery.  It is all about having the right support in place to help carry you through your journey.  There is no end to what you can achieve.
Being able to use your experience of mental health problems to positively help and support others can feel incredibly empowering and can give you a sense of achievement in that your recovery has to some extent come around full circle.

Love and Strength,
The One Day Seeker.