Introduction
On December 12, 2011, Karen Mattonen posted an article, “Poor mental health harming productivity, with 1 In 5 workers suffering - how are you prepared?”[1] in Conflict Coaching Resources. As one living with, not suffering from, mental illness, the topic piqued my interest enough that I sent in a comment.

In a reply message, Karen asked if I would be willing “to share [my] story on www.ltsglobal.com/hirecentrix/hire as a Viewpoint article next week.” In particular she thinks, “maybe H.R. and recruiters should be more familiar of what they often turn down due to fear,” and that my story will reduce some of that fear.

As a result of her request and encouragement, I offer experiences with mental illness and employment difficulties. First, however, I will offer some basic information about mental illness and the effect it has on worker productivity, some of which will be surprising.

I will not pretend that I am writing an academic paper, so references and attributions to others will be very limited, and I apologize for this breach of conventions. What I share with you is based on prior research, observation of the work of mental health counselors and therapists, personal knowledge and experience. As a result, what I write might be disputed by professionals in the mental health field. I whole heartedly yield to their expertise.

Some Observations About Mental Illness and the Work Place

Far too often the mentally ill are stigmatized by society as freaks, weird, strange; people with mental illnesses are viewed with suspicion, anxiety, fear. These hundreds of thousands and millions of people are treated as “the untouchables” of today’s society. In biblical times, lepers were the “untouchables.” Lepers were required by religious and civil law to loudly announce their presence and disease, lest the non-leprous by-passers get too close to the leper, become “contaminated” with the disease, and have to go through a rigorous and time consuming process to prove themselves free of the disease. We now know that leprosy is not highly contagious. We, as a employers and as a society as a whole must understand that mental illness is not “contagious,” and that the mentally ill should not be stigmatized as they frequently are.

Separating myth from reality, mentally ill individuals are very much like you, my reader. Mental illness does not have any gender, racial, religious, ethnic or cultural biases. The person in the next office may be mentally ill, but does not show any symptoms.

The person in the cubical next to yours who is frequently crying or looks like she could cry at any moment may be experiencing a major depressive episode, needs someone to acknowledge her distress and give her the help she craves (a gentle word, or an encouragement to talk might be enough for the moment). Another employee is chastised for frequently arriving at work late, but no one pays attention when he complains about the stress he is experiencing at home, nor recognizing how his home life stress is compounded by the scolding he receives in the office for tardiness. Another employee is the life of the party. He always has a joke to tell or a story to share.

On the outside, he looks healthy and normal, the last person you would expect to be mentally ill. But if you could look inside his head, you would see the tsunami of emotions masked by laughter, jokes, kibitzing and other attentions getting defenses. Strange or unusual social behaviors, breaches of social conventions, rapid mood swings, erratic productivity and addictive behaviors are all signs of various forms of mental illness. The caring employer will take notice of these signs.

If mental illness in the work place were an isolated disabling condition, meaning having no commonality with other medical conditions, there would be little need for concern. Take, for example, the “common cold” mental illness: depression. Quoting a number of studies on mental illness in the workplace, Carolyn S. Dewa et al, in The Nature and Prevalence of Mental Illness in the Workplace state “in one year, between 4% and 6% of Canadians experience a major depressive episode.” Note to self: mental illnesses don’t pay much attention to international boundaries.

Note that the statistic refers only to depression. As you know, there are many types of mental illness ranging from “the winter blues” to major depression; from general anxiety to severe post traumatic stress disorder. Yet, but the prevalence of people with these mental illnesses is relatively low, compared to physical illnesses. As a result, conventional wisdom dictates that more money be funneled to those with physical illnesses, and less be allocated to those with mental illnesses.

However, this is a widespread assumption that few have really thought through. How many human resource departments are aware of or consider this reality: everybody in the world has at least one symptom of or precipitating event for mental illness? Simply put, the symptom or precipitating event is the stress everybody experiences day in and day out. Prolonged exposure to life stressors, be they good stressors (referred to as eu-stressors,) or unhealthy stressors (referred to as dis-stressors) long-time exposure to stress or short term exposure to one traumatic event can lead to “low-grade” depression, which might turn to major depression and even escalate to post traumatic stress disorder or any number of other severe psychiatric illnesses. What happens depends on the resiliency of each person, the severity of the stressor(s), the duration of the stressors and the assistance a person is given following the stressful event.

Mental Illness: Is It an Illness of the Mind or Body or Both?

Mental health professionals and physical health professionals have long acknowledged a link between psychiatric illnesses and physical (somatic) illnesses. Exposure to long-term stress is postulated as one of the key factors in this relationship. From what I have learned over the years, mental illness has been linked to a wide variety of physical or somatic complaints. These complaints are sometimes referred to as “morbidities.” According to Medline Plus, a morbidity is a “diseased state or symptom.”[2] A patient with more than one disease or symptom, has “co-morbidities.” The combination of a mental illness and/or one or more physical illnesses are co-morbidities.

Some of the somatic illnesses associated with mental illness are listed below. First, however, let me make myself clear. One who has one of these illnesses is not necessarily mentally ill, however, a mental illness should be ruled out. Somatic illnesses include:

$    cardiovascular disease;   

$    hypertension;    

$    obesity;

$    diabetes;    

$    surgical complications;   

$    migraine headaches and less severe headaches;     

$    various cancers; 

$    fibromyalgia;     

$    sleep disorders; 

$    painful intercourse or erectile dysfunction;

$    allergies, such as asthma;     

$    and the catch all category, a compromised immune system, which is linked to most, if not all, the above, and many other illnesses. 

The issue facing industry with regard to mental illness is not simply to acknowledge that there are mentally ill employees in the workplace, but that employees with physically illnesses may also have one or more mental disorders, co-morbidities, that keeps chronically ill employees in the workplace chronically ill. When a director of human resources realizes that physical and mental illnesses share a common bond, then he/she will have a greater appreciation for the most significant contributing factor to loss of productivity high absenteeism and frequent departures of employees from the workplace. When Human Relations departments take a serious look at the mental health of their employees, then serious and productive work can begin to turn the tide from employee sickness to employee wellness.

Mental illness in combination with somatic illness is the reason for low employee productivity, employee absenteeism, difficulty in retaining competent employees and increasing claims for disability benefits. Stress is perhaps the most important and frequent of other precipitating events that trigger a personal mental health crisis.       Reduction in work place stress, providing employees with tools to help manage stress in their personal lives, intentional efforts to make the workplace free from bullying and other coercive (stress inducing) behaviors will increase worker productivity, work quality and the number of projects completed on time.

In my mind, and I certainly might be wrong, a wise Director of Human Relations will see the benefits his/her employer will gain by becoming more proactive in addressing the mental health needs of the laborers in the company. I am a fan of Albert Einstein, especially some of his most famous quotations. My most favorite quote rings so true and is very appropriate for this topic. “Insanity is doing the same thing over and over again, expecting better results the next time.” Might Einstein be speaking to Human Relations departments in that statement? Perhaps it is something to carefully consider.

One of the most important steps a company can take in changing how things are to how they could be is to become very intentional in accepting the reality of mental illness among employees, to be conscious about connection between physical illness and mental illness and to be extremely proactive in providing a safe, understanding and welcoming place in the organizational structure for the care of employees dealing with emotional or mental health concerns. In other words, have on staff an individual who is knowledgeable about mental illness, the needs of the mentally ill and has access to resources for employees to use. In other words, create a paid position for one or more employees who have the responsibility to provide a supportive and entirely confidential environment for stressed and/or mentally ill workers. In other words, create a “third place”[3] or a safe place for individuals to go to sort through matters related to stress, stress management, and mental illness.

This is one reason why I am a strong advocate that Human Resource Departments become very educated about mental illness, especially the causes, symptoms, proper care for the mentally ill and taking proactive steps to reduce the potential of a mental illness surfacing in an employee’s life. After all, isn’t a company’s most valuable asset its employees?

One bit of the truth (this is what I told you I would return to early in my paper). Mental illness is contagious. Many types disorders are passed on from parent to child through genetic transference. Chief among these illnesses are bi-polar depression, major depression, anxiety disorders and schizophrenia. Of course there is the on-going debate of “nature (genetic) versus nurture (learned behavior),” but that does not change the reality that for the most part, the mentally ill become mentally ill from outside influences.[4] Most people who are mentally ill are ill because of circumstances beyond their own control. However, if one is mentally ill, the ability to do something is in their control. To do nothing about a mental illness is irresponsibility, at best. I love what one of therapists told me during a session. “Dale, everybody has a mental illness. The healthy ones are those who acknowledge it and do something about it.” This is my story about “doing something about it.”

My Story

This bring me to my own story about mental illness, employment and acceptance by peers, family and friends. I have been struggling with depression since adolescence. After two major depressive episodes at ages 48 and 55 and what I call a ½ episode at age 25, I was diagnosed with post traumatic stress disorder. PTSD is an acute depression and anxiety disorder normally associated with the stress military personnel experience in warfare. However, PTSD stems from many “real world” life situations.

In Assessing Psychological Trauma and PTSD, John P. Wilson describes PTSD as the psycho-biological effects of trauma: “Traumatic events are defined by the existence of stressors that have differential effects on organismic functioning. Traumatic stressors exist on a continuum. As defined by the current criterion A1 for PTSD in DSM-IV-TR (American Psychiatric Association, 2000), ‘the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of the self or others’ (p. 467; see Table 1.1[5]). In response to these stressors, the person’s reaction involves fear and horror (emotions), helplessness (a learned behavior),[6] or denial (cognitive alterations and ego defenses). These psychological reactions to trauma constitute criterion A2 for PTSD (see Table 1.1).”[7]

The therapist who gave me the diagnosis said my PTSD is the result of multiple trauma I experienced from the age of 4 or 5 until the present (2005-2006, at that time), with additional trauma since that time.

My anxiety and depression disorder is serious enough that I had to resign from my last two positions as a parish pastor, well known to be a high stress with little support profession. Being a parish pastor is a position I simultaneously loved and barely tolerated. That which I loved is a reflection of my mental health. The other parts of the career are related to my mental illness. After my second major "crash and burn," as I call the incidents, my ecclesiastical supervisor and therapist agreed I can no longer serve as a parish pastor.

One might make the point (and believe me, many have) that I should be able to find work quickly, given my intellect, talent and experiences. Why not take a different type of position in the church, one that will tap into that which you enjoy doing the most? (Gosh, I never gave that a thought!) Unfortunately there are two problems. First, a very high percentage of employment opportunities within my profession are for parish pastors. Second, the budgets for other types of ministry positions for which I qualify are very few and far between in a normal economy; in the present economy, para-church organizations are experiencing a dramatic decrease in donations, therefore there is limited funding for these positions.

The other side of the sword has to do with my educational background and employment experiences. I do have a Master’s of Divinity and a Doctor of Ministry degree. Both are for work in parish ministry or positions within the Christian church, with some opportunities in other areas, should a Human Resources director be brave enough to go out on a limb.

Even though I have much of the education and experience needed for a variety of professions, my education and experience disqualify me for consideration because I cannot be licensed by any state (in the United States, that is) to be employed.

My dilemma is in part of my own making. I am looking for a career in which I can use the tools God has given me and I have earned through honing skills over a great deal of time and with a good deal of effort. In addition, I am looking for work that is not overly stressful; a position in which my employer will care enough that I do well that I will be clearly, directly and politely told how I can improve in my work, and give me at least a small path to get started. I need a position with a job description that is not cloaked in crazy making “roles, rules and expectations,”[8] with an emphasis on expectations. Those are the duties “everybody” expects an employee to know without being told. Both requirements are important as they will reduce the probably of experiencing another "crash and burn." I’ve had enough experience with that side of my professional life. I’d like to try something different this time around.

My degrees and other not-for-credit class work, have equipped me with an ability to work in multiple specialties. But because my degrees are professional, and not academic, few doors are accessible. If a position description wants a prospective employee with a Master of Arts degree or Ph.D., my Master of Divinity or Doctor of Ministry degrees are not acceptable, even if I am able to meet the job requirements. The problem usually lies in not having the credentials required by state, regional or national certification agencies.                                                                                                    

I have tried just about every avenue for employment, from post-secondary educational settings to working at an entry level position fast food. Surprisingly, both extremes are not willing to employ me because I am under qualified. After all, a fast food restaurant can easily find someone with fast food experience, and therefore will need minimal training. I grew frustrated applying for work in a company I know would benefit from my education and experience, the frustration only grew more quickly when the company does not respond to my application.

Other Concerns and Considerations

When the issue of mental illness in the work place is raised, no doubt many eyebrows begin to wrinkle or squirm. It is one of those subjects “polite and refined people do not talk about.”

And those with mental illness(es) know this far too well. In pursuing my professional responsibilities, I was able to make my way around hospitals with little difficulty. I acted like I belonged there (and I did belong there), so nobody paid attention to me. However, there is one part of the hospital setting that has impermeable walls. Even though an individual asked me to visit him in this department, I could not. He neglected to put me on his “he’s an ok guy list”. When I tried to see him, the response was “I can neither confirm nor deny that this person is in this unit.” That is federal law, and failure to observe that law brings a great deal of messy stuff on the unfortunate employee and the entire hospital chain of command. The unit is, of course, the psych ward.

The “expectation” of the employment dilemma is do I tell or don’t I? If being hospitalized in a psych ward is so shameful that “I can tell you, but my life will become a living hell if I do” why would anyone want to disclose a mental illness in the workplace? What is the “unwritten” expectation of this work place, not the last one.

This is an incredibly important part of reality regarding how society views mental illness and the mentally ill. Don’t tell anyone, especially your boss. You don’t know how they will hold your “condition” against you.

In her request to write this View Point article, Karen Mattonen wrote, “You can remain anonymous if you wish.” In no way do I quote this out of defensiveness or other pretense. It is a clear example of what happens to individuals willing to give public exposure to their mental illness. Be careful in what you say! You never know how this might come back and hurt you!

Another individual commented on another message I posted about finding work in spite of having a mental illness something to the effect: “Thank you for sharing your story. I wish more people would be brave enough to share their struggles. So, if for no other reason, I’ll continue to share since someone needs to speak up.”

I’ll end this View Point article with a couple of stories. The first is made up. The second is real.

An employee who is obese, has high blood pressure and cardiac complaints resulting in absenteeism due to medical appointments, hospitalizations and the occasional “chill day” is usually paid at or, if especially qualified, above average pay grade. His physical condition easily explains his absenteeism, besides he is certainly getting things done.

Another employee, who appears to be in good physical health, but has a high rate of absenteeism due to psychiatric appointments, therapeutic or counseling appointments and the need to have an occasional “chill day” is paid a lower than normal wage due to his unexplained absenteeism. After all, in a climate of distrust and suspicion about mental illness in the workplace and marketplace, who can be trusted enough to maintain confidentiality and remain objective when told of the reason for the absences? And without a clear explanation, even an employee who is above average in his work ethic and produces excellent results, will be labeled irresponsible, lazy or insubordinate.

The second example comes from presidential politics in the United States. Ross Johnson wrote an article titled Mental Health Stigma And Presidential Politics: Some History. His opening reflection on the presidential election of 1972 resonated with me. His article reminded me that in the 1972, presidential election, Democrat Candidate George McGovern choose Senator Thomas Eagleton to be his running mate for the November election. Eighteen days later, Eagleton was removed from the ticket. The reason? Leaks to the press leaks raised questions about Eagleton’s competence due to an undisclosed history of psychiatric hospitalizations, including electroshock therapy.[9]

Why don’t we have the courage to elect government officials who acknowledge having a mental illness? Because, “we” think they cannot be trusted, they might say something that will embarrass the country, they might have a psychiatric melt down and have to be hospitalized. Pardon the humor, but don’t we have presidents in good mental health who have done and will continue to do the same things? Oh, yes, there is one exception. Presidents who are mentally sound are not hospitalized in the psych ward. They are hospitalized where the really sick people receive care.

Why don’t we openly talk about mental illness and to the mentally ill as people with real human needs? Why? What would the neighbors think?

-------------------------

Biography:

Dale M Kleimola is, as he says, from where ever he hangs his hat. From birth through high school he lived in Lamont and Westmont, IL; Hyattsville, MD; Clearfield and Emporium, PA; Hazardville and Enfield, CT; and Jackson, MI. He completed his undergraduate education at Concordia Senior College, Ft. Wayne, IN and his Masters of Divinity and Doctor of Ministry degrees from Concordia Seminary, St. Louis, MO. He has the distinction of being the only student at Concordia Seminary to complete an advanced degree with a final project that was accepted by the seminary faculty as a first draft submission since it was founded in 1838.

          In his professional life, he has served congregations in Cissna Park, IL; Danville, IL; Wausau, WI; and Milan, MI. Since his retirement from active parish ministry he has been a substitute teacher, an adjunct professor of religion at Concordia University, Ann Arbor, MI and worked for a brief time as the Assistant to the Academic Dean, curriculum developer, dean of men and instructor at Redeemer Legacy Institute, Hemet, CA. He currently lives in Jackson, MI and works as a substitute teacher and provides pastors with time off on Sunday mornings by taking their place in the pulpit.

      He is also the father of five adult children and the grandparent of three beautiful children.

      In his spare time he enjoys reading and studying about conflict, confession and reconciliation; he also reads to grow more familiar with family and emotional systems; and he enjoys reading political fiction; his hobbies include rock and fossil hunting, gardening, nature photography and playing golf using the “Kleimola rules of golf,” which is best played when the course is virtually empty.

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