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Mental Health at Work: Managing mental illness as an employee and employer

By Lisa Twang, Oct 15, 2020

One in seven adults in Singapore have experienced a mental health condition in their life.* Yet the stigma continues, particularly in the workplace. 

Discrimination against people with mental illness (PMIs) at work starts with the assumption that they have suffered a permanent loss in their capabilities, and are less productive and stable. This bias affects both employers, who may hesitate to hire and promote PMIs, and employees, who may think they must limit themselves in their careers if they suffer from a mental illness. The truth is, there are many PMIs who enjoy successful careers. To deny them the opportunity to work would be to deny them the right to contribute to society, their families, and their personal development. 

In Singapore, attitudes towards PMIs are gradually changing for the better. Last year, the Tripartite Alliance for Fair and Progressive Employment Practices (TAFEP) made an addition to its employer guidelines, stating that asking job applicants to declare their mental health conditions without good reason is discriminatory. It respects the right of PMIs to keep their history of mental illness confidential, so they will not be unfairly judged for it.

In the second story of our series, ‘Mental Health: How are we talking about it?’, we speak to 32-year-old Sumaiyah Mohamed, who had schizophrenia as a student and now works as a programme coordinator in Club Heal, a non-profit organisation which assists and empowers PMIs.

Sumaiyah is married with a four-year-old daughter, and is also an ambassador for Beyond the Label, a mental health awareness campaign by the National Council of Social Service (NCSS). 

 

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For PMIs, being able to work is an important step in our recovery, as it gives us a mission in life, a sense of identity, and boosts our self-esteem. I see myself as a creative, resourceful, and hardworking person. I love working as part of my team, and am proud of myself for being financially independent.  

If I were to share one thing about people like me who live with mental illness, I’d say please give us a fair chance at work.

Sometimes, PMIs feel underestimated at work because our supervisors and colleagues are concerned that we can’t manage stress. Stress is a normal part of work, but with good support, and sometimes medication, we can learn to handle it well. 

I consider myself to be in recovery from schizophrenia; I’ve not had any episodes of psychosis since I was discharged from hospital about 12 years ago, and I’ve learned ways to cope with the occasional nervousness and anxiety around work.

It’s also important for employers not to overestimate PMI employees, because we need more understanding at times. We may deal with stress in different ways, and might require reassurance and support. We may also need to take medical leave to see mental health professionals, like psychiatrists and counsellors, for our own well-being. But I believe PMIs can contribute just as much as other employees. 

Because of the stigma surrounding mental illness, PMIs often worry about being judged at work, and treated differently from our colleagues. 

Many people think we are fragile and may suffer a relapse, which may lead them to be biased against us professionally (expecting us to underperform) and socially (not wanting to engage with us at work). So many people hide their conditions as they fear they may not be hired, promoted, or treated like other staff, if their employers learn of their conditions. 

I’ve known people whose mental illness became a barrier to their careers. One lost her job because she was diagnosed with anxiety and couldn’t concentrate on her work, and another struggled because his colleagues’ perception towards him changed after they found out he had mental health issues. This made it very difficult and stressful for them, but they recovered and moved on to other jobs, where they’re doing well. 

Many PMIs are unsure about whether to share their mental illness with their employers. It’s a very personal decision, but I believe it’s better to share.

TAFEP has updated their guidelines to say PMIs don’t have to declare our mental health condition when applying for a job here, so we won’t be discriminated against. If you’d rather not share your condition with your employer, I understand, as everyone has a right to privacy, and it can feel like a scary thing to tell others. Some people may not want to risk losing their jobs or being held back from promotions, because they need to work to support their families, so they keep their mental illness a secret. It’s a tricky situation, but do what you think is best for your career and health.

I personally believe when you have a mental illness, sharing this with others helps give you peace of mind, because hiding it can be very stressful. I have an open and supportive environment at work, which has helped me manage my workload well. I know I can talk to my supervisors and colleagues if I’m feeling stressed or overwhelmed, so we can solve issues in a productive way. 

Being open about your mental illness at work also means you’ll get more understanding if you need to see a counsellor or psychiatrist during working hours. I’m able to take medical leave when I see my psychiatrist every three to four months, because my supervisors and colleagues know it’s for my own well-being; in fact, they will worry for me if I don’t go for my appointments.

To start conversations about mental health in the workplace, employees can talk to their supervisors one-on-one, and share a wellness plan with their teams on how to support them in their mental health. 

When first applying for a job, I would personally choose to be upfront with my employer about my mental illness. But another option would be to wait and see if your company environment is supportive, and if you trust your supervisor enough to share your condition. After the first few months, when you feel confident that you’re managing well at work and feel comfortable sharing your condition with your employer, you can ask to meet them one-on-one, and explain more about your diagnosis and how you would like to be supported at work, such as having more flexible hours or regular chats about your work progress. 

Sharing a wellness plan with your supervisors is another good way to have an open, non-judgemental conversation around mental health. It can include details of what you’re like when you’re well and unwell, and how to treat you when you’re unwell. Last year, I wrote a wellness plan at work and shared that I tend to be more teary or be in a low mood, but I feel better if I speak to my team, and we analyse the situation together constructively. I also asked for my team to treat me normally when I return to work after being unwell, and talk to me as usual, so I won’t feel like I’ve been singled out for special treatment.

I know it can feel intimidating to tell your employer about your mental health issues. But I think if your employer doesn’t support you or penalises you unfairly, it’s best that you don’t work for them anyway. Work takes up many hours of our lives, and it’s better to find a supportive workplace where you can feel comfortable being honest with your colleagues and supervisors. Having that reassurance from my team has helped me a lot in coping with work stress, and I hope other PMIs can have that, too. 

If employers would like to talk to their employees about mental health, it starts with encouraging an open, inclusive environment at work.

Employees are more likely to open up to their employers if they feel safe to share their vulnerabilities with them. I feel that companies should treat everyone with respect and kindness, and encourage their employees to come to them if they need support. 

If an employee shares their mental health issues with you, hear them out and ask how you can help. Or if you notice an employee struggling at work, talk to them personally and ask about their mental health. 

Addressing the topic of mental health at work can feel awkward, and you may worry about asking too many uncomfortable questions. You can start by asking employees or colleagues about their mental health in one-to-one conversations or smaller groups, instead of in front of a whole team. I’ve found that these personal conversations are more comfortable for everyone. Show that you’re honest and empathetic, and be accurate and objective when giving feedback on their work. Your colleagues can sense if your feedback is given in the spirit of wanting to help them improve, instead of bringing them down.

If your colleagues don’t wish to share more private details, or let their others know about their conditions, respect their wishes and don’t take it personally. Sometimes we may not be ready to share, but we appreciate knowing that the door is open to us. b

I think things in Singapore are getting better for those with mental illness, and there are a lot more conversations going on about supporting PMIs in the workplace.

Last year, Singapore hosted the Together Against Stigma international conference to discuss the stigma around mental health conditions, with NCSS, the Institute of Mental Health (IMH) and its partners. We discussed how companies and PMIs can work hand-in-hand to support PMIs, and recognise our contributions in the workplace. I’ve also seen more organisations being open to hiring and training PMIs, and encouraging staff to discuss mental health issues at events and support groups. 

 

There’s a tendency for PMIs to think we must lower our expectations when it comes to our careers. But it’s still possible to fulfil our dreams, and pursue great job opportunities.

I always dreamed of being a teacher, and had a scholarship with the Ministry of Education (MOE). But when I was 19, I had a psychotic breakdown after putting too much pressure on myself in school, was diagnosed with schizophrenia and spent two months recovering in hospital. I began the path of recovery with the support of family and friends, and graduated from university.

As I couldn’t cope with the stress of being a contract teacher, my psychiatrist recommended me to do admin work in MOE instead of teaching. I tried appealing to MOE to become a school counsellor or Allied Educator so I could still work with students, but my appeal was rejected. I was transferred to do administrative work at MOE’s headquarters to serve my bond, and at first I was really disappointed and frustrated that I couldn’t work with kids as I had planned.

Now I’ve been working at Club Heal for three years, and it’s my dream job. I realise I’ve come full circle: having mental illness, learning to overcome it, and now helping other PMIs through my work. 

At a panel discussion (third from left) with Dr Radiah (second from left) for Club Heal in 2017.

At a panel discussion (third from left) with Dr Radiah (second from left) for Club Heal in 2017.

Though I love my job, I’m opening myself to other career options if I choose to move on to a different job in future. 

Club Heal is a safe space for me and I love it here, but I used to fear that I couldn’t work outside of the mental health sphere. I worried that other jobs would be too stressful for me, and that other workplaces would not be as understanding. But I also don’t want to limit myself, and over time, I’ve told myself that it’s okay to keep dreaming of doing more. 

I’d like to consider other careers, like being an art therapist (I have a degree in psychology, and recently picked up art as a hobby). I may not have been able to teach in a school, but maybe I can teach at an enrichment centre in future. I think it’s good to continue exploring new career possibilities, and remember that I can continue to manage my mental health well, with the support of my employer. 

I’m enjoying my career now as I didn’t self-stigmatise after having a mental illness. And that started because my family didn’t stigmatise me.

My family never felt ashamed of me or thought I couldn’t do well in life, so that gave me the confidence. My husband knew about my schizophrenia from the start and has always supported me: he’s ready to listen when I’m stressed about work, and reminds me to look at things in perspective, or recite a prayer to feel better.

It’s important to remember that PMIs can recover after we’ve been diagnosed with mental illness, and that employers can play a part in helping us stay mentally healthy. 

I’m enjoying my career despite having a history of mental illness. I hope we can all do our part to reduce the stigma around PMIs, so they reach their full potential at work, too.

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We also spoke to Dr Radiah Salim, President of Club Heal, on how to support employees with mental illness.

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When I became a resident medical officer in the Institute of Mental Health (IMH) in 2008, I noticed that many Malay Muslim patients and their caregivers don’t get enough psychosocial support.

 My sister was diagnosed with schizophrenia when I was a child, and I also lost two close relatives due to mental illness. I felt I should be a mental health advocate, because I didn’t want similar tragedies happening to other people. I formed Club Heal in 2012 to help reduce the stigma around PMIs, especially in the Malay Muslim community where there was a lack of proper information on mental illness.

I feel strongly about equal opportunity employment: when employers hire employees, they should not discriminate against PMIs. 

Some employers have concerns that staff with a history of mental illness may be less productive or unstable. When they hire employees, they can get potential employees to do a medical examination, and if the doctor is satisfied that the candidate is well and stable, there should not be any discrimination against them. I usually encourage PMIs to declare their condition to their employers, and also get a letter from their psychiatrist to certify that they are managing their illness well and are ready for employment. 

I disagree that PMIs should be barred from certain occupations, like being a pilot or police officer. I think mental illness should be viewed like any physical illness: if a person has recovered and is managing their illness well, they can work just as well as everyone else. 

For example, if someone has diabetes but is taking medication and living a healthy lifestyle, there is no reason why he or she cannot work. The same goes for mental illness: people who are in recovery, and are mentally healthy, should be given the same chances to work if they are qualified for their jobs. They are not permanently ill, and should not be treated as though they are.

A lot of people live with mental illness, but don’t tell anyone about it, so it remains a secret. They work regular jobs, but no one can tell they have mental illness. If PMIs choose not to reveal their conditions because they don’t want to be discriminated against, I feel it is up to them. But I wish more PMIs would share their conditions, so the community realises that PMIs are as capable as anyone else, and can contribute to society and the workforce.

I believe the sky’s the limit when it comes to occupations suitable for people living with mental health issues. It all depends on their strengths and interests. 

Many PMIs are very successful in their work, like Elyn Saks, a professor of law at UCLA, who lives with schizophrenia. Talented artists like Beethoven, Vincent Van Gogh, and Catherine Zeta-Jones all had bipolar disorder, and accomplished great things. Even Winston Churchill, the late British Prime Minister during World War II, had bipolar disorder, but could still run his country.

It’s important that employers do not focus on our PMI employees’ illnesses, but on their strengths. If employers are not open to hiring PMIs, they will lose out on their unique talents.

Here at Club Heal, about a third of our staff are PMIs, and we call them Peers. They have more empathy for clients due to their lived experience, and they can engage with our clients very well. They also have particular strengths: two of our best writers, Sumaiyah and Yohanna Abdullah, are PMIs, while our senior programme coordinator, Junainah Eusope, is great at pottery and handicrafts.  

It’s our duty to treat all our staff well, whether or not they have mental illness. Our Peer staff have their own doctors and therapists, and if they need to take time off and medical leave due to illness, so be it: they deserve to be valued and respected like everyone else.

Employers should train their staff to be literate in mental health, and there are resources available to help them with this.

First, they should get up close and personal with PMIs, to understand what they go through. One way to do this is through our Healing Friends’ Training: a one-day course on mental health which many participants have found useful and enlightening. It costs $10 per participant, and is a good investment in employees’ wellbeing. Other mental health organisations like Silver Ribbon Singapore and the Singapore Association of Mental Health (SAMH) also offer such courses. 

Reading books on the subject of mental health is also useful. Silver Ribbon, has published Mental Health Matters: A Handbook For Employers and Employees to promote positive mental health in the workplace. It helps employers and employees recognise signs and symptoms of mental health issues, and encourages them to seek early treatment if they need help. Club Heal has also published books like Shattered, Mind at Peace, and A Place in the Sun, which help readers understand the challenges and recovery journeys of PMIs. 

I would like the stigma associated with mental illness to be completely eradicated. And I think it’s important for employers and colleagues, as well as families and loved ones, to support PMIs in their recovery. 

Over the years, I’ve noticed that the stigma around PMIs in the workplace is less. As more PMIs open up and speak about their experiences, it’s helped change people’s perceptions and open their minds to what PMIs can do. 

There’s no shame in mental illness, and PMIs need the support of those closest to them. We should give them our empathy, understanding and love, so that they can thrive in their work and personal lives, and contribute to society.

 

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* This finding was from the Singapore Mental Health Study 2016, where 6,126 Singaporeans and permanent residents were interviewed on mental disorders. 

 

Pictures provided by Sumaiyah, NCSS and Club Heal. 

 

To support the Beyond the Label campaign by NCSS, visit https://www.ncss.gov.sg/Our-Initiatives/Beyond-the-Label or https://www.facebook.com/beyondthelabelsg/ 

To learn more about Club Heal or make a donation, visit http://www.clubheal.org.sg/ 

 

This is the second part of our series, “Mental Health: How are we talking about it?”. Check in next Thursday, 22 October, for the third story about understanding mental health among youths.

If you or your loved one is in need of support or a listening ear, you may contact Samaritans of Singapore (www.sos.org.sg), Silver Ribbon Singapore (www.silverribbonsingapore.com) or Singapore Association of Mental Health (https://www.samhealth.org.sg/). For caregivers, you may find resources and support at Caregivers Alliance (https://www.cal.org.sg/).


 

Writer’s Note:

My name is Lisa, and you can find me at @lisatwang on the Dayre app. On my personal account, I’ve written about my own mental health struggles, such as  balancing a hectic job when my daughter was still a baby, and how I’m still learning to manage my anxiety since COVID-19 struck. 

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