Could the idea of a ‘mental health day’ just make the stigma around mental health worse?

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Published on Health24, 4 June 2018

In 2017, a mental health story went viral.

Madalyn Parker, a web developer in the USA, emailed her boss to say she would not be coming into the office – she was taking a mental health day.

The world applauded her courage and gave her boss a standing ovation when he told her to take the day. “You are an example to us all, and help cut through the stigma, so we can all bring our whole selves to work,” he said.

News24’s Facebook audience was less forgiving, however, and comments ranged from “Let her take a day, i don’t want to be a working with a psycho [sic]” to “Would tell her to go work at a mental institution [sic]” and “Request admittance letter to asylum”.

But in a world where more than 300 million people suffer from depression and close to 800 000 people die by suicide every year, should we be able to take a mental health day as opposed to a sick day?

The answer might surprise you – it’s a resounding no from experts. And with good reason.

Mental issues remain health issues

Although Dr Renata Schoeman, a Cape Town psychiatrist, believes that the idea of taking a mental health day is a good move because it creates more awareness around mental health, she (and other psychiatrists) strongly believes that mental disorders should not be treated any differently from other illnesses.

“If you have to take sick leave for a mental health condition, it should be sick leave. It is still a medical disorder like any other disorder and it should not be treated separately,” says Dr Schoeman. She adds that trying to say that you must take mental health leave adds to the discrimination.

“Why should we distinguish between anxiety or depression or hypertension or diabetes?” she says. “We are concerned about calling it a mental health day because that’s almost stigmatising it more.”

The other issue is where one draws the line. “Is it just someone waking up blue in the morning?” Dr Schoeman asks. “Or is it someone who is actually depressed?

“As psychiatrists we are objecting to the idea of a mental health day. We believe there should be more compassion towards leave for any type of compassionate needs.” She says there needs to be an increased awareness of employees’ need to take care of their mental health.

But, she adds, “Part of the stigma of mental illness is that people treat it differently – it’s a biological condition.”

The dangers of extended sick leave

Dr Schoeman says we should focus on prevention and manage our mental health before we reach the point of needing sick leave for a mental illness.

People are often booked off for longer periods of time because there is no work accommodation. “Take for example if you’re going through a depressive episode – during that acute, depressive episode, your concentration may be impaired, the medication you are taking may make you feel unwell and you may not be fully functioning for the first week.”

Dr Schoeman believes that you do not necessarily have to be booked off and spend three weeks in a hospital.

She also points to alarming research that shows if you’re away from work for three to four weeks, your chances of returning to full capacity at work is only 50%.

“So the longer we book people off, the less likely they are to become fully functional [at work] again. While you’re away from the office recovering, your work just piles up and you will probably return to stressors that make the problem bigger.”

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