Mental illness in the workplace – psychological disability management

With de-institutionalization going full steam ahead as public policy across the western world, it is likely that we are to see more and more such volumes offered by publishers. Individuals affected by even quite severe mental health conditions are increasingly likely to participate fully in the societal canvas, and employment often represents one of the first tangible manifestations of this integration. As recent UK governmental directives have evidenced, individuals with mental health conditions are often now actively encouraged to consider re-employment as a stepping stone towards increased functionality. Personal views will vary widely on this focus on employment as key tool towards inclusion, but beyond individual opinions it is impossible not to expect, for the decades ahead, a vast increase in the number of workers confronted with mental health issues; this will undoubtedly create significant issues from a human resources perspective (Attridge 2011); sadly, as the authors point out, ‘despite more recent efforts to improve treatment, inclusion, and opportunity for those with mental illness, societies still struggle to adequately and respectfully meet the needs of persons with mental illness’ (1).

Gower Publishing offers a series of guidebooks examining specific aspects of organizational life and human resources management, and this volume has a place amongst others on corruption, health safety, risk management, and so forth. It is immediately clear from the volume’s coexistence within this series that mental health – or illness as the authors have preferred to phrase it – is seen, from an editorial perspective, as one of the great contemporary challenges faced by the employment market. This is not an unprecedented view and many, in the employment field, see this as the last remaining barrier in twenty-first-century workplace diversity and inclusion (Baumann and Muijen 2010). The other immediate realization is that the perspective of the authors is that of the employer, the person with institutional authority over the work integration process, or the manager facing the pragmatic organizational challenges of inclusion. In this sense, the volume de facto accepts a deficit model view of mental health issues (Lal 2010; Beauchamp-Pryor 2011). This should not necessarily put off social model theorists as the intention of the manual is practice based, not conceptual. It seeks to be a hands-on reference manual, offering ‘real world’ suggestions to managers and colleagues who may not necessarily have a disability background, a theoretical interest, or any specialist mental health knowledge and expertise.

Chapter 2 (‘The Scope of Mental Illness’), Chapter 3 (‘Current Thinking about Mental Illness in the Workplace’) and Chapter 10 (‘Psychological Assessment for the Workplace’) provide a concise, up-to-date and comprehensive snapshot of the current challenges faced by employers in situations involving mental health issues. All three chapters also provide an excellent summary of the contemporary diagnostic processes and benchmarking. They also provide a good assessment of the limitations of these frameworks for non-specialists practitioners faced with inclusion issues, and they highlight the frustration that is too often the outcome of this uncertainty for individuals forced out of their zone of comfort by the new situations they are called upon to manage: ‘while classification systems have proven valid, reliable, and important, for research and clinical practice, they may be overly cumbersome and intensive for use in the workplace’ (27). Later chapters, such as Chapter 8 (‘Toxic Work Environments’) and Chapter 9 (‘Worksite Reactions and Interactions with Mental Health’) are also successful in bringing out and unpacking the extremely sensitive and complex themes of voluntary disclosure, covert stigma and awareness development, for which legislation usually provides employers and employees with guidance but little comfort.

One of the criticisms that can be aimed at the textbook, despite its thoroughness on the topic, is the fact that it sees mental illness as distinct from disability. This is not entirely surprising, as the question of whether mental health issues have a place within the disability field remains a matter rife for debate even amongst academics. Yet most sufferers argue that the psychosocial experience of mental illness is certainly akin in every way to the experience of disability. The authors clearly do not wish to embark on a theoretical debate about the place of mental illness in the disability field, and would rather focus simply on producing a hands-on introductory textbook for laypersons having to handle these issues, perhaps for the first time, within workplace management. The danger, however, is to treat mental illness as distinct from disability and, as a consequence, to entirely eliminate from this discourse the lens that is the social model of disability.

This is what has happened in this instance and, although Chapter 11 (‘How to Create a Healthy Workplace’) and Chapter 13 (‘Why Positivity Matters’) come close to shifting the focus back to the environment, rather than the individual or the impairment, the textbook falls short of ever mentioning the social model, or environment-focused frameworks such as universal design. The implicit intention is almost certainly to avoid overwhelming the non-specialist reader with theoretical details. Is this perhaps not, however, a mistake? The social model, explained in simple terms, may indeed have the potential to make even a layperson reconsider their views on disability – here mental illness – and help them seek simple solutions and strategies that are environment focused rather than grounded in a deficit model perspective. A section on universal design, in a general textbook of this sort, would go a long way to promoting, amongst non-disability specialists, a vision and purpose that shift away from diagnosis, while maintaining a simple, common-sense, non-technical approach.

The other shortcoming of this textbook is the one-dimensional nature of its perspective. The authors are social workers and behavioural psychologists. Richness and depth in commentary might have been gained by including in the text other voices such as disability advocates, disability studies theorists, as well as the ethnographic voice of employees and employers. Since the emergence of ‘nothing about us without us’ movement, one has come to expect the inclusion of the voice of the subjects themselves in a textbook such as this. Yet employees with mental health issues are entirely absent from the volume, their narrative unrecorded. This omission is slightly astonishing, as the voice of individuals with mental health issues – and importantly that of ‘survivors’ – has become a central pillar in the search for contemporary solutions towards inclusion in the workplace (Fullagar and O’Brien 2012). Delicate questions such as disclosure (pre and post-employment) need to be examined through the collective narrative of individuals who have themselves lived these experiences – and either gained or suffered from them.

Mental Illness in the Workplace – Psychological Disability Management remains a very practical and informative textbook that employers and human resources managers will find both pragmatically helpful and detailed. Its relevance in our contemporary context will be limited, however, by the fact that it endeavours so systematically not to tackle the current paradigm shift towards a social model view of disability (Beresford, Nettle, and Perring 2010): might the rise in mental illness simply be a symptom of the workplace`s need to urgently adapt more proactively to neuro-diversity (Reeve 2004)? Are we not at the conjuncture where the notion of ‘normalcy’ within employment should finally being deconstructed and rejected for the myth that it is?

Frederic Fovet
McGill University, Montreal, Canada
[email protected]
© 2015, Frederic Fovet
http://dx.doi.org/10.1080/09687599.2015.1014665