Managing Mental Illness

Clinical depression, or major depressive disorder, is a pervasive and growing problem for employees, their managers and organizations. At any given time, depression affects about 6 percent of the U.S. adult population, according to the National Institute of Mental Health. The World Health Organization predicts that depression will be the second-largest disease burden in the world by 2030 behind HIV and AIDS.

Already, depressed employees are a drain on workplace productivity, accounting for an average of 2.3 lost workdays a month, more than double the average sick days taken by employees, according to "The Effects of Major Depression on Moment-in-Time Work Performance," published in the October 2004 issue of the American Journal of Psychiatry.

As a manager, you should be concerned about the impact of depression on your employees and your organization. Employees diagnosed with depression are unlikely to admit their condition because of the stigma associated with mental health and because of concerns about losing their jobs. While you should not put yourself in the role of diagnostician or therapist, you should be aware of employees who might be struggling with this insidious disease.

Work-related signs and symptoms of depression include:

• Reduction in performance–in particular, difficulty completing projects well within the employee's capabilities.
• Sudden lack of teamwork.
• Need for more coaching or guidance than usual.
• Reduced ability to focus on a task for a period of time or to keep work organized.
• Decreased ability to juggle multiple assignments.
• Increased instances of finding ways to work alone or to be away from the employee's desk for long periods.
• Loss of interest in work-related social activities.
• Noticeable increase in irritability and moodiness.
• Significant decrease in energy.
• Difficulty making decisions.
• Increased criticism of plans and general pessimism.
• Increased work hours with diminishing returns.
• Decreased interest in training or development activities.

No single one of these symptoms is evidence of depression. But, if you notice several symptoms during a period of a few weeks, you may have an employee who has become depressed.

Coping Mechanisms

For the employee experiencing these performance problems, which may be attributable to depression, you must tread carefully. Meet with the employee to discuss specific changes in work behavior. If the employee brings up personal problems or feelings of sadness, stop the conversation and refer him to the company's employee assistance program or an outside resource. Offer compassion and support during this rough time, but remind the employee that performance goals must be met.

As a compassionate manager, you may be tempted to "lower the bar" for the struggling employee. But you can't treat an employee whom you believe has depression any differently from how you treat another employee when it comes to meeting performance standards.

If an employee comes to you and reveals his depression, there are actions you might be required to take. The Americans with Disabilities Act states in part that employers are required to make a "reasonable accommodation" for employees with depression who request it and who qualify under the act's disability definition.

Accommodations can include a flexible or part-time schedule, time off for doctors' appointments, extended leave for a hospitalization, or other options that don't create an "undue hardship" on the business.

Contact your company's HR specialist. He or she can help determine if the employee qualifies for protection and, if so, can work with you on reasonable accommodations that are appropriate for your business and function.

Don't treat an employee who may have depression differently regarding performance standards.

More likely, an employee will not want to reveal depression because of the stigma surrounding mental illness. In that case, present resources in a group setting to all employees. Suggest to your HR specialist that he or she bring in a mental health expert for a seminar on how to recognize signs of depression and where to get help.

At a minimum, continue giving regular feedback and coaching for performance improvement. Document work issues and results, and look forward to a time when the employee performs better professionally and gets the help he needs personally.