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Both employers and workers have incentives to keep discussions of mental health out of the workplace. Managers fear that learning about an employee’s depression, for example, could open the door to discrimination suits if the employee is disciplined later on. Workers fear being ostracized, held back from promotions, or even fired. Certainly, mental illness itself, especially if properly treated, doesn’t mean the employee will behave irresponsibly or dangerously on the job (Lake et al., 2017). In the U.S., laws including the Americans with Disabilities Act (ADA) prevent companies from asking job applicants about their medical status, including their mental health. Once a job offer has been extended, applicants or employees can be evaluated to see whether they can perform the requirements of the position. That can include both physical and cognitive or emotional evaluations.
Despite these advances, significant gaps remain. National data indicate only modest increases in the use of mental health services in the past decade. Half of adults in the United States (U.S.) who are diagnosed with common mental health conditions still do not receive treatment, and many never get diagnosed at all. As might be expected, individuals with health insurance coverage are more likely to utilize mental health services than those with no insurance, though cost remains a notable barrier, especially for those with private insurance (WHO, 2010). A top-cited barrier to seeking mental health treatment included concerns about stigma or the fear of being labeled. Prevalence of this well-established barrier to mental health treatment in a contemporary employer-insured sample further underscores a place for increased education about common mental health symptoms and indications for treatment as well as an improved culture around mental health. Stigma is a complex and multifaceted issue (Kaakinen et al., 2018). As a result, the burden of overcoming the barrier of stigma falls not only on the person with behavioral health needs, but also on society more broadly. There is a real opportunity for all stakeholders to come together to improve behavioral health literacy, educate about the high prevalence of behavioral health conditions, and the negative impact of not sufficiently addressing behavioral health needs for employees and others.
Nurses can get involved in getting more people who need attention into mental health care by acknowledging the issue rather than keeping the topic taboo. As healthcare professionals, the context in which a nurse frames certain conversation can help to bring issues such as mental health to light. Relieving the patient of the idea of being stigmatized may allow them to address their mental instability as a treatable illness rather than an inherited deficiency (Lake et al., 2017). The balance that the nurse must maintain while speaking to the topic is acknowledging that their patient is undergoing a disease process that may not be quantifiable with physical symptoms while informing them, they can still be managed and cared for with proper treatments. In doing so, they can give the patient the proper resources, help them find treatments suitable for them, and most importantly, understand that they are not the only ones going through mental hardship.
Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing theory, practice, and research (5th ed.). Philadelphia, PA: F.A. Davis Company.
Lake, J., & Turner, M. S. (2017). Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care. The Permanente journal, 21, 17–024. https://doi.org/10.7812/TPP/17-0
World Health Organization. (2010). Developing Nursing Resources for Mental Health. Retrieved from: https://www.who.int/mental_health/policy/mnh_nursing/en/
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