An invisible disability: Mental health conditions are more common than you realise

Picture: iStock
Picture: iStock

More than 17 million people in South Africa are living with a mental health condition.

They are dealing with either, or a combination of, depression, substance abuse, anxiety, bipolar disorder and schizophrenia.

I feel the stats do not always reflect the reality of the situation as many people do not know the definition of a mental illness or do not disclose that they live with a mental illness.

However, the stats that are available are very concerning.

Figures provided by Discovery Health, South Africa’s leading medical aid, show a 41% increase in payouts relating to mental illness from 2009 to 2014.

It is anticipated that this is on the rise as suggested by the World Health Organisation (WHO) estimates that by 2020, depression alone will be one of the leading disabilities.

Only people who satisfy all the criteria in the definition of disability, according to the Employment Equity Act, no 55 of 1998, are considered as persons with disabilities. These are:

(i) long-term (12 months or longer) or recurring;

(ii) having a physical or mental impairment;

(iii) which substantially limits their entry into and advancement in employment,

So, should a person meet the above criteria, then they would be considered a person living with a disability.

The most common diagnoses that are prevalent in the workplace are anxiety, depression and bipolar mood disorder.

Depending on the severity and length of the symptoms that persist a person may need long term medical and psychological intervention.

Mental illness is considered to be an invisible disability and as such is treated and managed in that manner.

Some of the barriers that persons with disabilities face in the workplace are as follows:

• Employers have inadequate education around mental health conditions and hence they do not know how to manage employees;

• Bias and stigma around mental illness clouds employers’ judgments;

• Belief that persons with disabilities will have financial implications for the company. They anticipate that extra sick leave will be required or additional staff may be needed to support the employee or implementing reasonable accommodations will be time-consuming and costly;

• Lack of policies and procedures in the workplace that provide guidelines with respect to managing persons with disabilities and also lack of strategies for recruiting, employing and retaining people with disabilities; and

• Employers avoid implementing reasonable accommodations as they do not want to set precedents or create the impression that some employees are receiving “special” treatment.

The most important way to overcome these barriers is to educate the employer.

Providing information on what a disability is, understanding the legal requirements of an employer and employee, how to implement reasonable accommodations and managing confidentiality and disclosure should be covered.

It is also important to explore some of the biases and stereotypes that exist around people with mental illness and to challenge them.

The development of policies around recruitment, retention, reasonable accommodations and managing confidentiality and disclosure provide some comfort to employees that their rights are being protected.

A combination of education, inclusive policies and supportive attitudes create an environment that promotes disclosure of a disability.

Keshika Naidoo is an occupational therapist at Progression, a company that facilitates disability equity solutions.

5 ways to treat people who are struggling with mental health issues

1. Should an employee disclose that they are experiencing symptoms that are affecting their performance in the workplace, the first step is to encourage them to seek assistance from a medical professional. If the company has an employee wellbeing programme, then a referral would be encouraged.

2. Have a discussion with the employee to understand where their difficulties lie and together discuss what reasonable accommodations can be implemented. It is important to understand that reasonable accommodations do not mean changing the job to suit the employee’s needs. It means putting into place techniques or adjustments that allow a person to still meet the inherent requirements of their job. If the employer requires assistance with this, then consult with external medical/ legal professionals.

3. Provide support by having regular and frequent discussions with the employee to ensure that they are coping and adjust the accommodations, if required. Ensure that confidentiality is maintained at all times.

4. Be patient and understanding of the symptoms but set boundaries that are reasonable within the work setting i.e, do not allow the employee to take as much leave as they want, or to work reduced hours indefinitely. This may create an unhappy working environment for other employees.

5. Allow some time off to attend medical appointments if needed, but again, ensure that either the hours the employee is away is worked in or that the work can be completed at home or after hours.

If an employee is not coping even with the accommodations in place, then consider a referral for a medical assessment to establish if he/she is still suitable to continue in their job.

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