Mental Health

A tale of three employers

John,* BA, MA

From "Workplace: Disclosure and Accommodations" issue of Visions Journal, 2018, 13 (4), p. 18

This is the story of how three employers responded to my mental health struggles and my request for accommodations at work.

Employer #1: the BC government

Some years back, I moved from the city to work for the provincial government in resource management in a beautiful remote town. The work was interesting, often in far-flung areas of BC, and largely involved working with First Nations communities.

But the depression I had struggled with on and off for several years, and which I had kept hidden from those I worked with, quickly became more debilitating than it had ever been. Sometimes I would be anxious and unable to concentrate, obsessing about what I wasn’t doing well in my life. When I got really low, I would feel my brain go numb and I was unable to work. My confidence sank, my efficiency suffered and I was less willing to take on more or move up within the organization.

I also had a sense of extreme physical discomfort—a lack of safety in my own body. I was aware of how my body felt all the time. I often felt as though I was falling in terror to my death, with my stomach clenched, throat tight, and with a sense of dread. I began to fear I would never escape these symptoms. It was hard to concentrate on anything else.

I began experiencing insomnia and struggled to get out of bed most mornings. I compared myself to colleagues who were up at 6 a.m. and somehow able to sparkle through the day. I struggled with physical fatigue as well as the consequences of my own negative self-judgement. In Buddhism, that’s called the second arrow. The first arrow is our initial pain, brought on by loss or something else, something we couldn’t have avoided at the time. Then we fire a painful second arrow at ourselves, an arrow of self-judgement and shame for experiencing that initial pain or sense of inadequacy.

With my continuous self-judgement and sense of hopelessness, I began having thoughts of suicide. Fortunately, I told my doctor, and he recommended I take four months’ leave to seek treatment. I was just taking on some new projects, I had just hired a team: it was a lot to give up. But I was in crisis, and he was persuasive; it turned out to be the right decision.

I told my supervisor. He was supportive and immediately called a meeting with the director. Both of them were shocked that I was struggling so much. What surprised and touched me most was that they were so concerned. Across the board, my colleagues were accepting, compassionate and devoted to problem-solving—not in a let-me-fix-you way but in a let-us-know-what-we-can-do-to-help way.

I went on short-term disability. Having already received a lot of counselling, I tried a three-month intensive program in a residential spiritual centre, where I studied yoga and Buddhism. Upon completion of the program, I made the difficult decision to leave government, my friends and colleagues and seek other work. I wanted to work with First Nations, but with their mandate, not the province’s mandate. Although my colleagues were sad to see me go, I felt supported in my decision making.

Employer #2: a resource management organization

A year after leaving my government job, I was offered work in my field with a small resource management organization. I was open about my mental health struggles. I started the job on a very part-time basis, with the organization’s full support. My colleagues were accommodating of my request to increase my workload slowly. Eventually, to my surprise, I was working full-time.

Because of that flexibility, I didn’t have to explicitly ask for more accommodation. If I didn’t work a full week, it wasn’t an issue, as long as I was still meeting our goals. Sometimes I would say, “You know, I’m not feeling great, I feel the numbness in my head coming on. I’m going to need to rest and recover and do this tomorrow.” I think that kind of flexibility should be part of any job. The amazing thing about mental health is that I would be really struggling one week and not able to get through full days at all, and then the next week I could concentrate well and work hard and more than make up for the hours I had missed the previous week.

When I worked for the province, that sort of flexibility wasn’t available. There, before I disclosed that I was having mental health struggles, I had requested a four-day work week. But I was told that if they did it for me, they’d have to do it for everybody.

After four years with the resource management organization, I decided to do a second master’s degree in a clinical health field. For almost two years, my employer let me take a day and a half out of each week to do work for my graduate program.

Then I needed to undertake a full-time practicum. Ironically, my experience of disclosure and accommodation during my internship as a practising mental health clinician is the most difficult for me to reconcile.

Employer #3: a clinical health centre

My internship was in a respected clinical health centre. While I was performing well in my work and studies, I still struggled underneath with low periods of despair. I explained the situation to my supervisors and asked if I could split my internship. I would still do the full amount of work, but in smaller, more manageable chunks of time over a longer period.

But there were no accommodation options. At the health centre, the interns have to commit to a full-time, year-long practice, with a heavy patient load. They reassured me that I was going to be okay and that they would provide me with a lot of support. So I thought, “Alright, I’m not at my best, but they know that and think I can do this, so maybe I can.”

In hindsight, I now understand that my intuition was telling me it was too much, that I needed to be humble and compassionate with myself and accept my limits. Within a few weeks, I started experiencing insomnia, along with intense bodily and mental exhaustion.

In all fairness, insomnia and exhaustion are pretty standard for many starting out in the clinical field: it’s really difficult work. But soon I began to experience full-blown symptoms associated with post-traumatic stress disorder (PTSD)—terror, insomnia, despair and intense anxiety. My clinical work had triggered deep memories of traumatic early-life experiences that I thought I had healed. My symptoms became worse and I began to have thoughts of suicide, even planning how I would do it.

I sat down once more and talked with my supervisors.

Initially, they were concerned but optimistic that I could take a couple of weeks off and return to my practice. But after a lot of internal reflection and counselling, I knew that I couldn’t continue my internship; I needed to seek intensive treatment.

In many ways, the situation was similar to what I’d experienced with the provincial government. Everyone was concerned and supportive when I disclosed that I was too unwell to do the job, but the organization hadn’t offered any preventative accommodation at the outset—accommodation that may have allowed me to do a job that I loved and was good at—in a way that better suited my capacities at the time.

While the clinical health centre was outwardly supportive, a few events left a bitter taste. When I said I needed time to heal and that I’d like to come back and finish my work, my supervisor’s response was essentially “No”—that I would have to start from the bottom and reapply.

I found out later, when I received my performance review, that she had given me a score of zero on the ethics measurement. She suggested that patients I worked with could be negatively affected by having to work with new staff, and that I bore the responsibility for that.

In hindsight, I think she just didn’t want to admit her own partial responsibility for the situation. I had been open with the centre about my mental health challenges at the outset and I had requested accommodation—but the supervisor’s report didn’t mention any of that.

So I left. It took me a year to heal my PTSD symptoms to a level where I could return to work. During that year I kept in touch, monthly, with my previous resource management employer, letting the organization know how I was doing. When I was ready to return to work, they told me they had kept my job for me. I think they saw me as a good employee and a good investment. They were willing to wait for me.

Today, I’m doing pretty well. I’m working full-tilt, more effective and with more responsibility than ever. I’ve healed much of my early trauma and I’m beginning to see my existing symptoms as a helpful warning sign to step back, go slower and take better care of myself. That includes accepting rather than punishing myself for times when my symptoms impact my productivity. I’m also starting to ask more assertively for things I need. I haven’t had to request many accommodations of my employer lately, but I know that if I needed to talk about something, my colleagues would be there in a heartbeat.

In my experience, it’s important to ask for the accommodation you need in order to perform your job as well as you can, and it’s better to ask sooner rather than later. When an organization hires an employee, it’s making an investment. Making minor accommodations so an employee can do the job they were hired to do does not need to be a significant adjustment for most organizations. But how an organization responds to your request for accommodation will help you decide how much of yourself you want to invest in your employer. It’s difficult to take on an advocacy role for ourselves when we are struggling deeply with our mental health, which is why I want to speak up now in support of making flexible accommodation policies for mental health commonplace across all fields.

*pseudonym