Nearly one-fifth of US workers describe their mental health as fair or poor, and twice as many say their job has a negative impact on their mental health, according to Gallup. At the same time, more than 20% of US adults have some form of mental illness.

While many workplace mental–health strategies tackle those two issues as one, new research in the Academy of Management Annals argues that supporting workers’ mental health and supporting workers with mental illness are two distinct tasks, requiring two distinct approaches from employers.

“People often conflate those things, mental health and mental illness. That’s really problematic, because workplaces need to do different things to address poor mental health than they do to address mental illness,” says co-author Emily Rosado-Solomon, an assistant professor of management at Babson College. “And when they’re conflated, we don’t really see a lot of opportunity for those sorts of nuanced discussions.”

For further insight, we spoke with Rosado-Solomon and Jaclyn Koopmann, another of the paper’s co-authors and an associate professor of management and entrepreneurship at Auburn University’s Harbert College of Business. Here are excerpts from our conversation, edited for length and clarity:

What gets lost when workplaces conflate support for workers’ mental health with support for workers with mental illness?

Rosado-Solomon: A lot of times people say that you either have mental illness or you’re in good mental health, and it’s a singular spectrum. And it’s really not. You could have a specific condition, like bipolar disorder, but you could be in otherwise good mental health and able to thrive at work. Or you could be in generally poor mental health, just like you can be in generally poor physical health but not necessarily have a specific clinical condition.

But what ends up happening is organizations hear, ‘Oh, depression is bad.’ And that promotes this ableist trope against people who have mental illness. There are lots of people who have mental illness who are great at their jobs, but a lot of the messaging is, ‘If your employees are going to be depressed, they’re not going to be able to do their jobs as well, or productivity is going to suffer.’ A lot of times employers misunderstand that and say, ‘I should stay away from people with depression or anxiety,’ when in fact that’s really not true.

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How would you characterize the different approaches organizations should take for each issue?

Rosado-Solomon: There are a lot of things about the way jobs are designed that cause poor mental health or exacerbate poor mental health. Things like a lack of clarity about what your responsibilities really are, or a lack of flexibility, or a lack of feeling ownership over making decisions in your work. In order to address poor mental health, those are the systemic things that need to be changed. We might need to redesign jobs. We might need to revisit the job description and make sure everybody understands what is expected of them. And what comes out of our paper is this opportunity that organizations have to really get in front of this, to not wait until their employees are burned out or their employees are feeling anxiety or depression in order to proactively fix things.

What we see, though, both in terms of practice and in terms of a lot of the experiments about how to fix this, are really reactive strategies. Organizations are looking at, ‘Okay, Bob is feeling depressed. We could send him to counseling or we could do something to help him,’ without connecting the dots that maybe there’s something about his job that could be changed more proactively.

Koopmann: It’s revisiting policies about being flexible with work schedules or building autonomy into positions, clarifying roles, eliminating any ambiguity in what someone is responsible for, removing excess demands that might be embedded within a certain role. Maybe there was a removal of a position in an org restructuring, and now one person is holding two jobs and it’s a really excessive workload. Find a way to make that person be doing just one job again, and find a way to spread the second job across people in a way that is reasonable. So it’s a lot of making sure that jobs are giving some empowerment or control or autonomy to employees, giving them some flexibility, making sure their responsibilities are very clear to them, expectations of them are very clear.

Rosado-Solomon: For mental illness, because it’s a chronic condition, organizations are likely not going to be able to solve it, but there are a lot of things that they could do to accommodate people with mental illness. Things like depression and anxiety are often episodic, so people with an anxiety disorder might be fine for months and then all of a sudden they have a panic attack. To support them is not necessarily a matter of clarifying their job description or redesigning their job. It’s something like, can they leave the office or can they work from home for a few days without having to feel like they’re forced to disclose to anybody why they’re doing that? It’s much more about accommodations, as opposed to a strategic redesign.

A lot of the guidance for managers in particular focuses on how to help their reports feel comfortable discussing mental health at work. But some recent reporting has highlighted the pitfalls of putting too much of that burden on managers to support workers’ mental health. How should organizations find the right balance?

Rosado-Solomon: There is this false assumption that a lot of organizations have, like, ‘I need to know about an employee’s mental health or mental illness to be able to support them.’ You really don’t. If you do the strategic proactive redesign, and you’re a little flexible, and you take your employee’s word for it when they say, ‘Hey, I’m having a problem, I need to work from home today,’ then they feel supported.

Koopmann: A lot of those proactive steps mean that employees don’t have to think about disclosing and take on the burden of worrying about, ‘If I disclose this to this person, will they look at me differently in the future? Will my boss be supportive?’ Built-in flexibility in the job is going to lead to a built-in ability for those with chronic conditions to take flex time that they might need, without having to fully disclose what their medical condition is.

Even if you create a safe environment for an employee to disclose, I don’t know that you would fully remove the vulnerability experienced by the employees in that situation. So it’s not necessarily that we want to make it a climate where everybody can fully disclose all their conditions that they need help with. It’s not bad to have a safe culture for that, but we should be really thinking proactively about it and making the organization the responsible actor for making sure that employees are well taken care of. They might not need to disclose a mental–health challenge, for example, if the organization has taken proactive steps to mitigate psychological hazard [features of work that have the potential to cause psychological harm].

Read a transcript of our conversation, including how workplaces can make mental–health support more intersectional and what to do when employees do choose to disclose a mental illness.

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