While many people set personal New Year’s resolutions, have you ever thought of making one for your organization? As 2018 nears its end, now is the perfect time to reflect on your disability management practices and identify areas of improvement in the new year. A potential area to address? Supporting employees with behavioral health conditions in the workplace.
Many employers fail to realize that a significant percentage of people who experience symptoms of a mental health or substance use condition do not receive the appropriate treatment. In 2016 alone, 18.3% of Americans aged 18 and older experienced a mental illness, and 7.5% had a substance use condition.[1]
With the workplace serving as an important constant in an employee’s life, this presents you with the opportunity to better address and support those struggling with behavioral health conditions. That’s because, when left unaddressed, your workforce may experience challenges like lost productivity, on-the-job accidents, low morale, and increased overall healthcare costs.
How Behavioral Health Conditions Present Themselves
Understanding the typical progression of a mental health or substance use condition can help you better identify employees in need and connect them to the available resources. The following five stages explain the usual course of these conditions and tangible ways for you to assist your employees:
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General Well-Being with Emerging Risk
In the earliest stage of a mental health and/or substance use condition, the impact is likely to be mild. While conditions may be hard to identify at this stage, it’s important for you to create a safe climate and culture for employees to seek help. All managers should be trained on how to document performance on a regular basis, noting any observed performance changes. These changes can include decreased productivity, increased errors, tardiness, and the start of interpersonal conflicts in the workplace.
Managers should also be familiar with the company’s resources for support, such as management coaching and employee assistance programs (EAPs). Also, consider implementing wellness programs that may help employees avoid the emergence of symptoms or reduce their impact on work performance.
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Early Clinical Symptoms Appear
In the second stage, employees’ symptoms may increase to a moderate level and are more likely to noticeably impact their work performance. Employees may be absent more frequently or request an accommodation under the Americans with Disabilities Act (ADA) to help them cope with the situation.
Referrals to an EAP are more common at this point, and the employees are more likely to seek treatment on their own. Absence management and stay-at-work approaches may also help employees address issues in this stage.
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Severe Conditions Emerge
In this stage, employees experience severe symptoms that could directly impact their abilities and work performance. Performance problems and employee absences may escalate to the point where they require a disability leave. In many cases, the need for accommodations to support recovery becomes more visible for employers.
For those who are able to stay at work, it’s important to work with these employees and other organizational stakeholders to develop accommodations tailored to their specific limitations or restrictions. Accommodations could include schedule modifications, flexibility to attend doctors’ appointments, and even workstation accommodations, depending on their condition. Using accommodations early may keep an employee engaged in their work, successful in their role, and more supported by their peers. For employees who require a leave, being supportive of the employee’s FMLA application also is important.
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Chronic Impairment Ensues
The employee may continue to experience severe or chronic symptoms and apply for long-term disability benefits. The employee may also start seeing himself or herself as disabled, struggling to find a sense of purpose or meaning in life.
During this stage, goal-directed case management and return-to-work strategies are generally initiated or continued. Unfortunately, the impact at this point is generally lower than during previous stages. With earlier intervention, there’s a better chance that the employee will return to work.
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Recovery Process
The employee’s condition is improving, either because of treatment or as part of the natural course of the condition. But with the proper employer response and intervening strategies, recovery can occur at any stage in an employee’s journey.
Recovery before severe or chronic symptoms develop often depends on an employee connecting with timely and effective care and support. Effective support can empower the employee and rebuild confidence.
When behavioral health conditions arise, it’s important to be prepared and knowledgeable on how to provide support. Understanding the general course of these conditions can assist you in early identification and helpful responses to provide employees with the help they truly need.
Take the new year as an opportunity to evaluate how your organization addresses and supports behavioral health conditions. In providing your struggling employees with the proper resources and support, your entire organization will benefit.
Dan Jolivet, MD, is the Workplace Possibilities℠ practice consultant at The Standard, where he previously led the Behavioral Health Case Manager (BHCM) team and managed the psychiatrist and psychologist peer consultants. He is a clinical psychologist licensed in Georgia and Oregon and has worked in behavioral health since 1981. Jolivet is also the practice leader for Motivational Interviewing (MI) and goal-directed case management at The Standard. Before joining The Standard, he worked in managed behavioral healthcare organizations for 20 years in a variety of management roles and was in clinical practice as a child psychologist until 2003.
Terri L. Rhodes is the chief executive officer for the Disability Management Employer Coalition (DMEC). Rhodes has extensive knowledge and expertise in all aspects of absence and disability program management. Her career has spanned more than 25 years working for some of the most progressive companies designing and managing absence programs. Rhodes holds a master’s degree in business administration (business management) from Columbus University and a Certified Professional in Disability Management (CPDM) and a Certified Case Management Professional (CCMP) from the Insurance Educational Association.
[1] Results from the 2016 National Survey on Drug Use and Health: Detailed Tables, Substance Abuse and Mental Health Services Administration, September 2017,
https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf