Mental Illness in the Workplace: What to do Before its Too Late (Case Study)

Mariah Carey’s going public about her mental health challenges has, again, sparked discourse about mental illness. While her case does not involve a violent incident, for C-Suite leadership, nondiagnosed or untreated mental illness can represent an insidious threat to workplace safety, productivity, and maintaining organization culture. The American Psychological Association (APA) reports that nearly 20 percent of adults in the United States experience some form of mental illness. Four percent of these suffer from a serious mental illness and about 9% have a substance use disorder.

Few leaders are trained or educated in recognizing symptoms of mental illness. Dealing with the matter while staying within the bounds of civil rights, HIPPA, and employment law is difficult ground to navigate. So, we tend to ignore it. This article presents actionable advice that could keep the organization on the right side of the law, support employees affected by mental illness, and still stay on target with the strategic mission.

Questioning man.pngCASE STUDY

(The names and locations of this case have been changed to protect the privacy of the individual.)

A supervisor arrived late to work after having an automobile accident on the way to work. Upon arrival, she was denied access to the office. Security, referring to a photo they had been given, advised that they were directed not to allow her into to the building. She later learned that officials of the organization had raided her office, removed her computer, and suspended her pending a disciplinary action determination. She was facing suspension, at best. She eventually learned that she was in danger of termination.

Organization’s Position

The organization took these actions based on a series of complaints from the supervisor’s team. They had reported anger management issues, outbursts and erratic behaviors that threatened their sense of safety in the office.

The Outcome

For months this manager was placed on Administrative Leave as her case moved through various stages of appeal. In the end, the organization lost the case, a colossal amount of money in lost productivity and paid Administrative Leave, as well as restitution and legal fees. The supervisor was reinstated. Years later she voluntarily retired – on her own terms.

What Went Wrong Here?

As both labor-management leader and trained psychotherapist, I approached the C-Suite and this employee’s direct supervisor. I advised that the employee was suffering from what appeared to be an un-diagnosed mental illness. My warning was that any disciplinary action resulting from the event would constitute an illegality for the organization. They didn’t listen and moved forward in spite of this advice.

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The Back Story

About two weeks prior to the organization’s actions, I had personally observed this supervisor cycle in and out of mania and depression twice within an hour. I later learned that, during her late teens and college years, she was being treated for depression. The bipolar remained undiagnosed. The condition was neither diagnosed, nor treated, until during her appeal of the organization’s actions.

The C-Suite argued that the supervisor’s “suddenly” being diagnosis of manic depression (aka Bipolar Disorder) was convenient. They held the position that, because the employee failed to report such a medical condition, they were not obligated to accommodate it in this instance. They were glaringly wrong. It would be a few years before the head of the organization would admit that they had made a huge mistake in handling this case.

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What Leaders Need to Know About Mental Illness

  • Mental Illness is defined as, “a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.”
  • People with mental illness are productive, capable of healthy relationships, and they cope well with change. Nobody should be blacklisted or blackballed due to mental illness, which can include anything from depression to personality disorders. The APA provides a full list of mental health conditions and disorders.
  • If an employee is in denial about, or fails to disclose, a mental condition, you may not know about it. This is fine as long as there are no workplace issues. Just recognize this as a possibility whenever there is a sudden change in employee behavior. Sudden bouts of sick leave, lost productivity, or other behavioral changes should receive a case-by-case review, considering all possibilities. Do not default to disciplinary action.

What Leaders Should Do about Mental Illness

  • De-escalation Training:  Provide training to all employees on proper de-escalation methodology. The lower rung of the organizational structure are usually the ones to see warning signs or off-behaviors.


While all should be exposed to the training, work with a trained or licensed psychotherapist or social worker to provide this training. Also, stick to protocol and advise employees that their safety is the main focus, even in an active situation. Some situations are not conducive to de-escalation and the organization needs to make this very clear.

  • Clear Protocol: Establish clear protocol for addressing workplace violence situations.
    • This must include a method by which employees can anonymously report concerns. Most organizations already have Active Shooter protocols. There should also be protocol for reporting other potential work place violence situations.
    • It should also include a quick-track response protocol that clearly defines how these are routed and to whom. Cut the red-tape here. The fewer individuals through whom these are reported, the greater the degree of confidentiality.
    • Identify, clearly, who will address the matter and who has a need-to-know.
    • Drill this in by talking about it at monthly meetings, etc. Have it written down on distributed flash cards and posters displayed in breakrooms and meeting spaces.
  • Recognize the Signs: The organization is not qualified for diagnosis. However, a trained mental health professional can give an overview of warning signs that should trigger appropriate levels of employees support. In my opinion, it is a good idea to have a Social Worker or other trained and certified mental health professional on staff or retained as a consultant. Again, HR must be at the helm of this initiative.
  • Work with Human Resources: Anytime a potential problem is noticed and reported, HR should be one of your main points of contact. If your main interactions with HR are disciplinary, hiring or firing, you are missing out on a key stakeholder.

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Employees must feel safe to communicate concerns to upper management. One loose-lipped manager or leader will ensure that few will even bother to report a concern. Hold appropriate individuals accountable to the process and stress the urgency and importance of supporting employees who may have mental health challenges.

Linda Round - 2018ALinda F. Williams, MSW is a trained psychotherapist, nationally recognized behaviorist, Executive Coach, and Cultural Transformation Consultant. As founder of Whose Apple Dynamic Coaching & Consulting, she is the Award-Winning author of the Best-Seller,  Whose Apple is it, Anyway!

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