Harvard Business Online

The Hidden Business Cost of Mental Illness


Posted on Better Leader, Richer Life: December 3, 2009 8:35 AM

It's hard to focus on your work when your child is hallucinating.

One of the least discussed yet quite salient issues for American business in this year of health care reform is an important yet hidden cost associated with mental illness: the drain on productive work endured by family members struggling to support loved ones who suffer from such diseases. The good news for business leaders is that it's not hard to do something to help and thus feel good while improving company culture and morale, as well as your bottom line.

Mental illness comes in a staggering array of forms, and affects a broad swath of our general population. According to the National Institute of Mental Health, an "estimated 26.2 percent of Americans ages 18 and older—about one in four adults—suffer from a diagnosable mental disorder in a given year."

Awareness and understanding of mental illness has grown in recent years; still, it's often not taken seriously or treated as a legitimate medical disease either by businesses, by the health care system, or by our society. Indeed, too many people remain reluctant to get the help they need because of the stigma associated with mental illness. The website bringchange2mind.org (with a powerful new public service video by film director Ron Howard) asserts that "for many, the stigma associated with the illness can be as great a challenge as the disease itself."

This stigma extends beyond those directly stricken to family members. Parents of children with mental illness are often viewed as guilty by association, unfairly perceived as the cause of the illness—the source of harmful child-rearing practices—when the origin is mainly biological. Parents and other family members feel shame and a sense of failure. I know because one of my adult children suffers from a toxic combination of schizophrenia (a thought disorder) and bipolar illness (a mood disorder).

There are real costs associated with employees having to carry this heavy weight of worry and responsibility, especially if they feel they must do so without the understanding and support of their organization. There is stress, unwanted social isolation in the workplace, and the feeling that they must find clandestine ways of responding to urgent demands for their attention. All of this undermines productivity by causing burn-out, unplanned absences, distractions from focused effort on tasks, and poor confidence in being able to contribute to the team.

As a leader in your organization, you can reduce these costs and inspire greater performance from valued employees. You can enable them to feel freer to ask for the help they need in supporting their families by changing how you think , how you talk, and how you act. In turn, they are bound to repay you with extraordinary effort and commitment to your goals and to your company.

Mind your attitude. Changing your attitude toward one of greater understanding and acceptance requires education (see, for example, this recent Harris survey on schizophrenia). If an employee with dependent care responsibilities born of a physical abnormality or illness needs to bring a loved one to a doctor's visit, no one judges him harshly. Indeed, this is likely to evoke sympathy. On the other hand, if he has to disrupt his work schedule to care for a family member, who—for reasons difficult to grasp and explain—cannot be left alone for fear of hearing voices or of some other dread psychological symptom, then he might well be reluctant to risk letting others know why he needs the time because they might look askance or even question his own mental stability. Your attitude can make all the difference. By taking mental illness as seriously as any physical illness, you convey emotional support and encourage employees to get the help they need to cope with the strains of caring for their sick loved one.

Watch your words. The words you use, and the way you use them, convey your attitude. Here's a tip from bringchange2mind.org: "Refrain from using terms like 'crazy,' 'nuts,' 'psycho' and 'lunatic.' While there may be times when it is too challenging or simply not possible to politely correct someone else's insensitive use of language, you can always try to watch your own." To combat harmful stereotypes and demonstrate understanding, it's better to say, for example, that someone "has schizophrenia" than to call that person a "schizophrenic"—the illness is not the person.

Model behavior. The kinds of actions that show genuine support are the same ones you'd want to show all your employees in treating them as whole people, with important aspects of life playing out beyond the bounds of work: Initiate and encourage dialogue with an open mind, address the individual needs of each employee, respect confidentiality, and be flexible and willing to engage in joint problem-solving while focusing on results that matter to you and to them.

Change the culture. As a business leader you are in a position to have a positive influence on the culture of your organization which, in turn affects all your employees as well as other stakeholders—clients and customers, suppliers, community members, and so on. Your supportive attitude about those who are forced to live with mental illness—with the words and deeds to reinforce it—can shape your company's values and the behavior in it that determine whether or not all your people get the help they need to both contribute fully to your business and lead productive lives.

What else can be done to make it easier for parents and other loved ones of those who live with mental illness to perform well at work? Please comment and share your stories, advice, and resources.

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