It seems every day we are reading of someone who appeared to be happy and successful, attempted or succeeded in taking their own life. The lack of discussion around mental health reflects a lack of knowledge and understanding about its part in one’s overall medical health. The stigma of having any kind of mental health disorder sadly lives on. While we have come a long way in recognizing mental and emotional disorders that can and do respond to treatment, we obviously have a very long way to go towards full understanding and acceptance.
First and most importantly, let’s address mental health in the workplace and the specific rules under which an employer or a future employer can request personal health information. These rules fall under laws that protect health privacy.
Under these rules, employers can make disability-related inquiries or ask for a medical examination of an employee only if it’s job-related and consistent with business necessity. There are additional rules that must be followed as to who can obtain your medical information and how that information is used. No personal medical information can be released without an individual’s written consent.
There are many medical reasons for prescribing what are referred to as “mood altering” or psychoactive medicines, such as; clinical depression, anxiety disorder, PTSD, bipolar disorder, schizoaffective disorder, eating disorders, obsessive/ compulsive disorder, attention disorder and pain management to name a few.
Many people can live very happy and productive lives, at home and at work, while taking psychoactive medication. Antidepressant medications are commonly prescribed by primary doctors on both long term and short term basis and if taken as prescribed have little or no impact on motor functionality.
Antipsychotic medicines are another matter, used to treat more serious conditions such as schizophrenia, bipolar disorder. These conditions require close medical management with medicines or combinations of medicines requiring in some instances periodic blood level testing. They can have side effects that impact mental and motor function.
In many cases it would be difficult to tell if a person’s behavior is due to the prescribed medicine or more likely, to the disorder being left untreated or improperly treated. There are no tests to determine which medicine or what dose is best to treat certain mental conditions. It is often trial and error until the right medicine is found and the dose is adjusted for maximum benefit and minimum side effect.
On job descriptions and in job interviews it should be stressed that if you have a diagnosed medical or mental condition, it could be made worse by the work demands and maybe this is not the job for you.
Many jobs require erratic schedules, long work hours, stress, lack of sleep, lack of privacy, long periods away from home and family, resulting in long periods without medical visits, monitoring, or supportive therapy and counselling. Behavior and mood can become markedly altered. Add alcohol and recreational drug use, running out of prescribed medication, inability to obtain refills or blood tests before a refill, and you have a recipe for problems.
These working conditions are not conducive to anyone’s good mental health and can certainly push someone over the edge if they are already experiencing some mental or emotional instability. If a certain job is attractive and exciting to someone seeking adventure or travel, often an individual will not disclose in an interview or on a health questionnaire that they take mood altering medication if they risk not being hired.
If you have a friend, family member or coworker that displays any unusual behavior or symptoms, such as physical or emotional withdrawal, poor hygiene, sleeping too much, not sleeping at all, anxiety, fretfulness, inappropriate laughing or crying, irritability or easy anger, increase in alcohol or recreational drug use, they should be immediately encouraged to seek medical attention and they are to be treated with dignity, understanding and privacy.
According to recent studies, one in four adults’ experiences some form of mental illness in a given year. One in seventeen lives with a serious mental illness such as schizophrenia, major depression or bipolar disorder. Approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year and three-quarters of those will develop chronic mental disorders by the age of 24. This is the time young adults are just entering the workforce.
With these numbers you can clearly see that mental illness affects many more people than is thought. It is suspected there are many who are undiagnosed, untreated and using non-medicine means to control symptoms.
We can all be more open to talking about, encouraging, and supporting diagnosis and treatment for mental disorders. We can all play a part in continuing to change the perception and treatment of these disorders. We have learned that disability is not inability.
Rebecca Castellano, RN