Fear, stigma, and discrimination have made mental illness a workplace taboo. But some local employers and business leaders are starting a dialogue around workplace mental health with the goal of creating a healthier, more productive workforce.
Words by Todd Matthews // Photos by Rachel Coward
Katherine Switz clearly recalls the moment her double life of working full-time and dealing with her fragile and troubled mental health reached a strange crossroads.
It was the early aughts, she recently had earned an MBA at Harvard Business School, and was working as a strategy manager at McKinsey & Company in Washington, D.C., when her boss announced that Switz had earned her division’s award for critical thinking. Switz, a cum laude Dartmouth graduate, always had been a high achiever. But what was most impressive about this latest accolade was that earlier that year, Switz was lying in a hospital bed, anti-psychotic medications slowly suffusing her bloodstream, and trying to figure out how to keep all of this — the psychotic break, the hospitalization, and her mental health disorder — a secret from her colleagues.
“You don’t think you usually do (critical thinking) when you are on anti-psychotics,” Switz, 46, said with a warm smile, amused and confounded by the dichotomy as we sat at a small wooden table inside an old house-turned-coffee-shop in Seattle’s Fremont neighborhood.
Warm light poured through a bay window next to us, illuminating Switz’s rich brown eyes and short black hair, reflecting glints of light off the delicate necklace she wore. Switz is small and fit, a result of a healthy regimen of yoga and cardiovascular exercise, no alcohol, a fastidiously nutritional diet, and copious sleep (she’s in bed every night by 8:45 and awake at 6:30 a.m. — no exceptions). She is sharp, erudite, and funny.
Switz suffers from four types of mental illness — bipolar disorder with recurrent psychosis, suicidal depression, anxiety, and obsessive compulsive disorder. She experiences severe psychotic episodes every few months or so.
“I will come into a Starbucks, and I will get confused and think that everybody is talking about me,” she said. “Or I’ll think that I have special powers or something, and I’ll have to go up on the medication and cancel all my meetings and regroup. It’s very serious.”
Switz also requires a team of professional and familial caregivers who help with day-to-day activities — particularly when her husband, Mark Suzman, the chief strategy officer at the Bill & Melinda Gates Foundation, is required to travel for business — such as caring for her 3-year-old son or assisting her during psychotic breaks.
Switz traces the first inklings of her mental health disorders back to her adolescence. But they didn’t fully present until she reached adulthood and experienced severe psychotic episodes. In 1999, during her final year at Harvard Business School, Switz recalled that she would stare out at the Charles River’s coursing expanse and believe that she could walk across it. “I was flailing wildly, disheveled, confused, and exhibiting severe signs of psychosis — including thinking I was Jesus and could walk on water,” she said. “My friend brought me back to my room, and my mom flew in to town because my family was worried.”
She was rushed to a psychiatric wing of Harvard Medical Center and received her first official diagnoses of mental health disorders.
Switz kept her fractured mental health under wraps at McKinsey and excelled at work. But in 2006, then employed as a strategy manager at GE Capital on the East Coast, she experienced another psychotic breakdown just a few weeks after she married Suzman (on their first date, Switz revealed she had a mental illness and told him to do his research before he decided whether he wanted to continue to see her; they will celebrate their 12th wedding anniversary in February).
In both instances, she was furtive about her illnesses. Her psychotic breakdown at Harvard occurred during Christmas break, when most students and faculty weren’t around. At GE Capital, she blamed her hospitalization on a thyroid condition. “They wanted to send me flowers when I was in the hospital, but I didn’t want them sent to a psychiatric hospital,” said Switz. “You can’t give the human resources department the address to the psychiatric hospital, so they sent them home a couple days later. So there was a lot of hiding.”
Some might think Switz, living with such severe mental illnesses, would be sidelined from doing the things most people take for granted, like, say, raising a family or holding down a job. But that misconception, as well as the shame associated with mental illness, is what she is trying to eliminate. In 2013, Switz created The Stability Network, a nonprofit organization that counts more than 80 business leaders and executives who have a mental health disorder, are willing to speak about it, and are committed to some form of a treatment regimen that will help keep them healthy.
The organization is headquartered in Seattle but includes workers from across the country. The Stability Network allows Switz and other network participants to educate people about mental health disorders.
“I don’t want people to think, ‘Oh, it’s just (all about our) mental health condition all the time,’” she explained. “Part of our message is that you can have a full life. There are other aspects of our lives.”
The idea that working professionals who suffer the effects of a mental illness would purposely out themselves is so anomalous that Switz and other Stability Network partners have been reported on in The Washington Post, The Wall Street Journal, The Seattle Times, and a local National Public Radio affiliate. The attention is welcomed, and sometimes overwhelming. After one participant was profiled in The Wall Street Journal, for example, he was inundated with phone calls and emails from people who wanted information about how to share their own stories about workplace mental health. Another participant had well-meaning strangers show up to her office.
“People didn’t used to say the word ‘cancer,’” Switz explained. “I think mental illness will be (as accepted as) cancer and Alzheimer’s. I just think we are years behind those (illnesses). We are at a tipping point. It’s like the last bastion, the last taboo topic. There’s just so much pent-up need. People haven’t been talking about it, and now they are starting to.”
WE KNOW THE American workplace is filled with people who experience one or more mental illnesses. The American Psychiatric Association reports that 1 in 5 American adults suffers from some form of mental illness — attention-deficit/hyperactivity disorder (ADHD), anxiety, autism, bipolar disorder, depression, eating disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and schizophrenia, among others — in a given year. These people aren’t checking their ailments in office-tower lobbies before they board elevators and get situated at their desks when the workday begins. These disorders follow them into their cubicles and board rooms. For a myriad of reasons, the American workplace is in a terrible space when it comes to mental health: fear of prejudice and discrimination; lack of education and understanding; overblown and inaccurate representations in media; a lack of clarity in the workplace about whether employers can ask their staff about the issue, and whether employees should divulge this personal information; and even just the sheer mystery and unknowable nature of the human brain’s complexity.
Experts say it shouldn’t be that way, and studies show that addressing the issue leads to more productive workers.
According to Partnership for Workplace Mental Health — a national program of the American Psychiatric Association Foundation that works with businesses to ensure that employees living with one or more mental illnesses receive effective care — mental health disorders and substance abuse cost employers between $80 billion and $100 billion annually, and more workers miss work due to stress and anxiety than due to physical injuries or illnesses. Just as astounding is the knowledge that basic steps toward improving workplace mental health have promising results. For example, Partnership for Workplace Mental Health reports nearly 86 percent of employees who take medicine to treat depression see improvements in their performance at work. Similarly, one ongoing and national workplace study administered by Beacon Health Options showed employees who completed at least one session with a mental health provider had statistically significant improvements in work performance: less absenteeism, increased productivity, and substantial improvement in overall mental health.
Attitudes about workplace mental health are evolving in positive ways, according to some experts who follow this issue closely, but it’s not a sudden sea change. Programs are being introduced at some companies — including here on the Eastside — to assist workers who experience mental health disorders the same way programs assist workers who experience physical injuries.
The Washington State Human Rights Commission, which enforces the state’s anti-discrimination law, notes workers who suffer from disabilities — including mental illnesses — are legally protected from discrimination, and employers must provide necessary accommodations unless they prove to be an undue hardship on the employer.
“It’s not one of the low-hanging fruits, so to speak,” said Nancy Spangler, an expert who has spent more than a decade as a consultant to the Partnership for Workplace Mental Health. “It is something that still has stigma attached to it because people don’t really understand the nature of a mental illness. We haven’t used the terms depression, anxiety, or stress-related disorders in a universal way. But the more we talk about them, the more people will recognize the common symptoms of these conditions. The more people will accept the simple, effective intervention options that research has suggested will be helpful.”
Spangler was encouraged by a two-day conference she recently attended in New York City. It was hosted by Mayor Bill de Blasio and his wife, writer Chirlane McCray, and touched on many of the recommendations outlined in a 28-page report released in 2006 by the Partnership for Workplace Mental Health, such as educating managers about mental illnesses; conducting an employee awareness program; adopting a proactive approach; and collaborating and consulting with mental health doctors, stakeholders, and even other employers.
Employers should let their staff know that talking openly about mental health is just another part of their workplace culture and not taboo, according to Spangler. They should regularly share information about available services, whether it is an Employee Assistance Program or services that are included in existing health benefits packages already being offered or free public services. And they should offer screenings or seminars that might identify mental health disorders early and get employees on a recovery track sooner. “We’ve documented that people are more likely to seek care and check out every single piece of information when you have an employer talking about it and communicating about it,” said Spangler.
Spangler also advised that managers should be educated, trained, and familiar with how to address mental health. Spangler has worked with managers who keep a “tip sheet” of simple phrases that are acceptable to say to struggling employees. “Something as simple as that gives managers confidence,” she said. “Some of these things are really simple to do, and there are training programs that can address that. It should be OK to say, ‘Are you OK? You’re not exactly yourself lately. I see you missing deadlines; I see you having trouble setting priorities. Is there some way, as your manager, that I can help you?’” added Spangler. “Those are very common symptoms of depression and anxiety. Helping managers recognize those kinds of behaviors and know that there could be an underlying mental health condition is really, really helpful and really simple.”
Another helpful factor is to build coalitions of employers and mental health professionals who address the issue. “No employer wants to be the first one to do something. They are more likely to adopt new communication programs around mental health and new benefits around mental health if they see others are doing that,” said Spangler. “So when a business coalition or city officials can convene employers to talk about it and brainstorm ways to communicate about it, it really makes a difference.”
PUGET SOUND ENERGY is one Eastside company that has taken steps to address workplace mental health by implementing an innovative program that has been lauded by professionals in the field. The program was introduced by Jenny Haykin, Puget Sound Energy’s integrated leaves & accommodations program manager, who is recognized as an expert on the issue and previously worked as the disability services team lead at King County and introduced new protocols for accommodating employees with cognitive and psychiatric disabilities.
In 2009, Haykin first realized the issue was permeating the workplace and overwhelming employers when a vocational rehabilitation counselor encouraged her to put together a presentation for a conference hosted by the Disability Management Coalition in Minneapolis. A year later, Haykin flew to the Midwest to speak at the conference. The attendance was standing-room only, with a line trailing out the door and down the hall. In 2016, she participated in a similar presentation hosted by the Job Accommodation Network at a conference in San Francisco, and the crowd was just as large.
“So I know that there’s a real hunger out there for employers wanting to understand and learn more about how to accommodate folks (with mental illnesses),” Haykin said. In her experience, most employers have processes in place for physical accommodations — a broken arm, carpal tunnel syndrome, mobility issues — but not for psychiatric disabilities, such as anxiety, depression, or bipolar disorder.
Haykin, who started her career as a vocational rehabilitation counselor, set out to change that — first at King County, then at Puget Sound Energy — by looking at the models that existed to aid the process of identifying reasonable accommodations for cognitive and behavioral disabilities. For example, forms exist to help physicians identify a worker’s limitations when he or she suffers a physical injury. Why not create similar forms that help workers with mental impairments?
To that end, Haykin worked with local psychiatrists and vocational rehabilitation counselors to develop a Job Analysis form that lays out the requirements for individual positions at Puget Sound Energy, and a Cognitive and Behavioral Capacities Evaluation form that a physician can use to assess an employee’s situation, look at the skill set required in their Job Analysis form, and then provide specific limitations applicable to the employee.
“We’ve had a lot of success with the folks who provide documentation of their limitations on the form when they have restrictions that can be reasonably accommodated,” Haykin said. “I think the very important thing for employers to know is that you need to understand when a person is asking for an accommodation and might need one and act on it the same as you would if they came to you with a broken limb.”
Beyond the evaluation forms, Puget Sound Energy encourages employees to feel comfortable discussing mental health without discrimination.
“Here, people know that we will do whatever we can to reasonably accommodate them,” Haykin said. “So there isn’t as much of a fear of doing that. But when you have employers who indicate that they don’t provide support and they are very quick to performance-manage instead of saying, ‘Hey, I can see there’s this going on; how can I help?’ then people aren’t going to want to come forward.”
Another local effort that aims to address workplace mental health involves a partnership between National Alliance on Mental Illness (NAMI) Eastside and Leadership Eastside, a networking organization for business leaders who are interested in community outreach and stewardship. Last year, the two Redmond-based organizations began to meet with representatives of large local employers to explore ways to offer help to workers who might suffer from mental health disorders. Solutions could involve implementing assistance programs, sharing information about resources that are available while hosting new-hire orientation meetings, or anything else that lets employees know that workplace mental health is supported companywide and employees don’t need to hide their ailments. The partnership is still in its early phases, but NAMI Eastside’s executive director is excited about its possibilities.
“The goal for us is to be able to start these conversations with these businesses about how they are talking about mental health with their staff,” said Lyndsay Campbell, NAMI Eastside’s executive director.
“Our role in this isn’t going to be to say, ‘This is going to be the policy you put in place, and this is how you should do it,’” added NAMI Eastside Development Manager Shannon Boehm. “It’s going to be us coming in to help them open the conversation within their own company, and then they build a structure and policy that suits their workplace. But we want to be there to open the conversation, do presentations, and support them. All it takes is kind of opening the conversation and shedding a light on the fact that a bunch of your employees are struggling with a mental illness.”
FOR MOST OF his 20s, TJ Singh disastrously cycled through the manic highs and enfeebling lows of a mental health disorder that had yet to be formally identified and treated.
“I was not in the right space,” Singh, 31, said during an interview at a Starbucks in Bellevue Square. He was referring to the period just after he graduated from the University of Washington and was working part-time managing his parents’ commercial real estate holdings. “I didn’t know what was going on 100 percent at that time. I knew I was depressed — those revolving thoughts of regret, suicide, lack of hope, darkness — it is just overwhelming. In a way, you want to get out. You want to participate. You want to do something and make something of yourself, but it’s just so heavy. It’s so heavy.”
Singh finally sought professional medical help and received a diagnosis of bipolar disorder in February 2015. Today, the Newcastle resident’s treatment regimen includes prescription medication and regular consultations with a therapist. He also works full-time as a commercial real estate broker at Skyline Properties in Bellevue, where he is comfortable discussing his mental illness with colleagues.
“I was initially a little bit scared of coming out, sharing my story, and just sort of putting it out there,” he said. “But as soon as I started to get more involved and tell people at my work that I volunteer for NAMI, they would say, ‘Oh, my God! My friend, my sister, my brother is suffering from that!’ It really opened my eyes to how prevalent it is out there. After seeing that, I wasn’t so hesitant about sharing my story, being so open about it, and bringing it out to the public.”
Singh is so open about his mental health disorder that he has joined NAMI Seattle’s “In Our Own Voice” speakers series, which puts him and others who suffer from mental illnesses in front of organizations and employers to share their firsthand experiences. It’s such an important part of Singh’s life now that he considers it another facet of his treatment protocol.
“It’s more about inspiration, hope, and giving a message that recovery is possible,” he said. “It’s about raising awareness and telling your own story. Through that, hopefully people who learn more about mental health see it in a different light and perspective. Going out into the public is kind of where I can make the most impact by sharing my story, raising the awareness about mental health, and making that shift happen. I want to be involved in changing those perceptions and reducing the stigma.”
That’s something, incrementally, more and more employees and employers are starting to recognize, too.
Campbell likes to share a story that her father told her about his experience growing up in a small town in South Dakota. According to Campbell, a town resident had a son who suffered from schizophrenia and often sneaked out of the house — naked and hallucinating — to wander the streets.
“The reaction from this tiny town was to help him,” Campbell said. “That was the only possibility in this town. You wouldn’t shun him. You wouldn’t point and laugh at him. You were getting a blanket, covering him up, getting him in the car, and driving him home. That’s what you did. Nobody was freaking out. Nobody was saying, ‘Oh, God, don’t look at him! Walk on the other side of the street!’ Wouldn’t it be amazing if that’s just how it was? I think it could be the same way in a business. It’s kind of like your small little town. You go there every day. Why isn’t that the reaction? How can I help? It really should be.”
This article originally appeared in the January 2017 issue of 425 Business.