Even at the most progressive firms, the stigma surrounding mental illness remains a barrier to effective care, experts say. A South African research poll sponsored by G.A.M.I.A.N. found that almost 24 percent of South Africans view seeking treatment for depression as an indicator of personal failure.
Michael Berk, professor of psychiatry at Wits Medical School in Johannesburg, said the findings aren’t surprising. In his private practice, he is seeing rising numbers of “stealth patients” – clients who come to him for therapy on the condition that he keep no records. They’re afraid of what their employers might find out and what will happen if they do.
“The popular notion is that what your brain does is under your own control, and the notion that it can go bad is not a user-friendly notion,” Prof Berk said. Research showing links between the brain’s chemistry and mental illness is beginning to slowly change attitudes, he said.
Employers should be prepared for the eventuality that some employees won’t take advantage of counseling or medical help, said Kevin Bolon, a psychologist. Up to 10% of the work force will experience depression at work. “It’s not the employer’s role in life to make sure employees have a rich and full life,” he said. Some individuals will manage to function acceptably at work without treatment, although personal relationships and physical health may suffer.
South Africa now has resources available to help people confidentially and free of charge. The Depression and Anxiety Support Group operates from 8 a.m. to 7 p.m. Monday to Friday and 8 a.m. to 5 p.m. on Saturday, and is available on (011) 884-1797 or (011) 783-1474/6.
Author Kathy Cronkite, believes she was depressed since early puberty. She said she structured her work to avoid her black periods, which usually started in the afternoon. Her most recent full-time job was as a talk show host, from 9 to noon. “I could drag myself to work….then at 12 o’clock, I’d drag myself home and collapse.” Relationships collapsed around her until a doctor made the right diagnosis and put her on medication. Her own experience, and her shame about mental illness, led to the book On the Edge of Darkness, published last spring, and a new career educating others about depression.
Roger’s depression was different. He crashed after a series of tragedies and changes – the breakup of a nine year relationship, a new job, a new home, his mother’s diagnosis of cancer and subsequent death. Roger knew enough to seek grief therapy for his mother’s illness. He met a new partner. Then in December, his partner, was killed in an auto accident. “It all came flooding back, my mother’s death, everything.” After two days of funeral leave, Roger returned to work. “I thought I was going to be OK, but I couldn’t focus.” He recalls an absurd incident when he was talking on the phone while trying to reach for an incoming fax. Doing both things at the same time suddenly seemed impossibly complicated.
Still, Roger believes his story shows that depressed people get well when they have support on the job. In his case, that meant access to care – plus the freedom to take six days off work without retaliation, just as he might have for a less stigmatised illness like bronchitis. He is back on the job, functioning with a combination of medicine, therapy and his own self-help regimen of exercise and religious faith. “I get up early in the morning, have my bowl of cereal and my anti-depressant. I want to let people know there’s a way to get through this. Lots of people have it,” he said. Just the other day, “I caught myself laughing.”