Work Leave For Mental Illness If You Are Not Naomi Osaka

Naomi Osaka’s decision to step back from her job for reasons of mental ill health has stirred up a lot of debate in the last week. And yes, it’s great that she is being open about her mental ill health being the reason for this decision.

But Naomi Osaka is not representative of most people who experience mental ill health during their working life. The main reason is that (financially) Naomi can afford to take enough time off to recover.

I don’t point this out to minimise her suffering. Mental illness doesn’t discriminate. It will make you feel equally shit whether you are wealthy or not. But the luxury of time off for an employee to recover fully from an episode of mental illness is not one many workplaces will or even can accommodate.

This week several experts have stated that it is illegal for employers to discriminate against employees living with a mental illness, that these employees have a right to time off and to have their work modified to accommodate that mental illness.

I have mixed feelings about this. I feel exasperated, bemused, and tired. Because these earnest, well intentioned experts have no idea how mental illness and work mix in the real world.

The first time I experienced mental illness (postnatal psychosis followed by rebound depression) I was hospitalised for close to four months. ‘Luckily’ for my employer I was on maternity leave, so absolutely no thought had to be put into managing my absence, because it had already been planned for.

After I recovered, I continued to work as a small animal vet for another 12 years before taking a break to have my book published. In those 12 years I experienced a severe Bipolar 1 episode on average every 2-3 years. When I say severe, I mean requiring hospitalisation for weeks or months on end followed by a gradual re-integration to life outside the hospital.

Here are the two deal breakers my illness presents to most work places:

Firstly, for me, the onset of episodes of illness is sudden – ie between 24-48 hours. There is no time to plan or find someone to fill in.

Secondly, when I’ve had to phone work to say I would not be in for my next shift, I’d have to follow that with ‘I have no idea how long I will need off’.

Again – luckily for my employers – in those 12 years I was a casual employee. This meant I was effectively fired each time I got sick.

The practice I worked for was not doing anything illegal, and from a practical and financial point of view they could not have indefinitely held a position open for me. Each time I eventually recovered, and because there is almost never a shortage of work for vets – new hours were found for me. But me being able to slot back into the same workplace each time was due to the nature of the industry, not due to any laws to protect my position and income.

I am privileged, and thankfully my husband could support our family without my wage when I got sick. But my survival and roof over my head have had absolutely nothing to do with my workplaces being able to accommodate my mental illness.

Just because it isn’t legal to fire people or make their life hell because they live with mental illness doesn’t mean it isn’t happening. I know plenty of people who live with this reality.

This injustice occurs because of a gargantuan power imbalance between an employee who lives with a mental illness and their employer. Whether employers are aware of it or not: They hold all the power. Here’s why:

Stigma still prevents many people from disclosing they live with a mental illness to their employer – especially when they are asymptomatic. Once that person becomes symptomatic, they are likely to struggle just to get through each day or hour. Symptoms such as poor concentration and memory, distorted thinking, irritability, a sense of hopelessness, panic attacks, and non-existent self-esteem, (to list just a few) make it incredibly difficult if not impossible to not only schedule a meeting with their boss or with HR, but then present at that meeting as a fully functioning human being.

And if they do, and their boss discriminates against them they often don’t have the mental resilience and the finances for a legal battle to bring their discriminating employer to justice.  

These employees will often just go quietly –because that is all they have the energy for. Then their employer gets to shrug their shoulders and say: ‘Well it was the employee’s choice to leave!’

I am grateful to Naomi Osaka for cracking open the conversation about mental ill health at work a little wider. If it causes even one employer to stop and consider that the playing field between them and an employee who lives with mental illness isn’t even, it will be a good thing.

But there is still a long way to go before people who disclose their mental illness at work can expect to be treated the same as anyone who discloses a physical illness.

To read a bit more about my work life, you might like to check out my recently published memoir: Book and how it came to life: Welcome To The World ‘Abductions’

Covid Lockdown In A Psychiatric Hospital

I recently encountered Covid  restrictions and a lockdown as an inpatient in a psychiatric hospital. And while the specifics are relevant, my experience was more complex than donning a mask and staying inside. But let’s start with the specifics.

There is the loss of the hospital dining room and its well-stocked salad bar. This normally bright spacious room filled with chatter and choice has closed, gone into mourning. The ability to choose your own food and sit where you liked – a small token of independence – replaced by a tray delivered to your room at 7am, 12 pm, and 5pm with a sharp rap at the door. You get little choice and a small window to eat before the kitchen staff are back to collect your tray.

There is not being able to leave the hospital grounds until discharge. No opportunity to test where you are at with a short visit home. Another small freedom lost, and you become totally reliant on visitors to bring you anything you might need from the outside world. Until restrictions turn to lockdown and the visitors are banned from visiting.

All staff start wearing masks, and the buzz of their anxiety fills the hallways like a swarm of bees. Within a few days patients are told to wear masks anytime they are outside their rooms.

For anyone who has lived on this planet for the last year, none of these restrictions or lockdown conditions will sound unusual. Everyone has lived some version of them.

But my experience of them as a psychiatric hospital inpatient was different to my experience of them when I’ve been well and at home.

Here’s why:

Even with access to an excellent private psychiatric hospital, being an inpatient strips me of autonomy and leaves me feeling as vulnerable as a slug on a busy highway.

The admission process alone – which includes providing a urine sample for drug testing and the thorough inspection of your bags (for any means of self-harm or suicide) by two gloved nurses – is a humiliating experience.

 It screams: ‘You cannot be trusted’ and whispers sharply: ‘We are in charge of you now.’

It’s made worse if the nurses attempt light conversation about the contents of my bag.

‘‘That looks like a good book…’

I don’t have the energy for it, and it makes me feel like a toddler they are trying to distract from something unpleasant.

As a patient in a psychiatric hospital I frequently lose the right to my feelings. For example:

One of my admitting symptoms (usually prodromal to mania) can be intense pathological irritability. It is completely different to feeling irritable in a normal context. And it is not the same as the irritability I feel when I am forced to interact with one of the nurses whose attitude grates on me even when I’m well.

 I try to be polite, but when my tone slides into curt, she cocks her head and says:

‘Your irritability levels are quite high today.’ before self-importantly noting this down as a symptom for the day. And I am powerless, because if I protest that would just be further proof of my mental illness to her.

And then there are the cringeworthy names I am called, mostly by nurses and kitchen staff:

‘Dear, Darling, Love.’

 I am ‘Darling’ to only my mother. ‘Love’ never fails to sound derogatory to me. As for ‘Dear’ – one of my worst and earliest hospital experiences involved being called ‘Dear’:

Fourteen and a half years ago when I was less than a week into my first episode of mental illness, I experienced a severe psychotic episode. I was led into the Special Care Unit (the highest security locked ward) of the psychiatric hospital by two nurses, one gripping each elbow.  On the way there, one of these nurses said:

‘Don’t worry Dear. You won’t remember any of this in the morning.’

The next morning I was so sedated by the (necessary) medication I‘d been given, I may not have looked as though I had any memory of the horrors of psychosis. But I remembered all of it. The proof is in the account of that night in my memoir being published this year.

If I knew where to find the nurse who called me ‘Dear’ (on that occasion), I would give her a copy to show her just how much a patient experiencing florid psychosis can remember.

There are many other factors that contribute to my sense of infantilisation in hospital. But elaborating on them would take me well over my word limit. So I’ll leave it here, for now.

Thankfully this recent admission was short (two and a half weeks) but the combination of the inherent lack of autonomy in being a psychiatric inpatient and the above mentioned  Covid factors hugely amplified my vulnerability.

And I have never felt so powerless.

You may also like to check out:

2020 Ends In Hospital

Visiting Someone In A Psychiatric Hospital?

On Uncertainty