Learning to effectively accommodate employees with mental health issues and other non-visible disabilities is not only a legal obligation—it is a business imperative.

The National Institute of Mental Health estimates that approximately 48 million adults experience a mental health issue each year. The cost to employers of unplanned absence and lack of engagement as a result of employee depression alone is estimated to be around $23 billion by a 2013 Gallup poll, but some studies suggest the costs could be as much as $44 billion annually.

Effective mental health workplace accommodations can improve productivity, retain valuable employees, and avoid costly mistakes that can lead to litigation. Despite some progress in recent years, more than 25,000 charges of employment discrimination are filed annually under the Americans with Disability Act, and our analysis of these charges indicates that 12 to 15 percent cite a mental health issue like anxiety or depression.

Employers report that attitudes and stereotypes are less of a barrier to employing people with disabilities than they were just 15 years ago, but conscious and unconscious biases still exist that can impact employment decisions. While many disabilities are obvious, mental health conditions are often not obvious and not disclosed to an employer because the risks of disclosure may outweigh the rewards.

In a 2011 Cornell University study, many people with non-obvious disabilities reported that they would not disclose their disability at the time of hire because they felt that their disability had no bearing on their work or that disclosure will hurt their chances of getting a job. If an individual with a mental health condition who could be more productive with an accommodation does not disclose, they may not be able to reach their full potential in the organization. This also means that employers need to be proactively prepared to address mental health in the workplace, as emerging or recurring employee mental health problems can arise at any time.

It can be challenging to separate an individuals performance from a mental health condition. Even when a manager is trying to “do the right thing,” there is a temptation to over-focus on the mental health issue rather than actual job performance. Often, employers make assumptions about what an employee with a mental health disability is, or is not, capable of. This can have a limiting effect on the careers of people with known mental health disabilities, and could lead to charges of discrimination. Employers need to be cognizant of whether they are giving employees with known disabilities opportunities to advance or receive training and challenging assignments, or if they are letting an employee’s mental health disability stand in the way of obtaining those opportunities.

While many disabilities are obvious, mental health conditions are often not obvious and not disclosed to  employers.

On the other hand, when work is suffering in conjunction with an employee’s mental illness, there may be a temptation to try to “manage” the disability rather than their performance (by same token, employers cannot assume performance issues are related to the disability, there could be other things going on). People with all types of disabilities should not be held to either higher or lower expectations than others—so performance problems should be addressed the same as with anyone. You should not expect different behavior, either better or worse, if you know or suspect there’s a disability. Employees sense this and it can dissuade them from sharing their disability experience. Conversations about accommodations should be focused on what might be effective to help an employee maintain productivity and retain employment during a difficult time, and should not include unnecessary questions about exact diagnoses, types of medication, or specific details of medical appointments.

Considering Effective Accommodations

So what are effective accommodations for individuals with mental health conditions? That is a question that requires a dialogue between the individual and the employer. An accommodation may just mean offering flexibility in schedule or workplace. Accommodations are not one-size-fits-all and the needs of an individual change over time so revisiting and updating accommodations may be necessary. Demonstrating creativity, flexibility, a willingness to listen, and commitment to implementing the accommodation in a timely manner can help to build trust between the individual and the manager. In some cases, accommodations for people with mental health disabilities are not much different than what other employees may ask for (flexible workplace policies, schedules, etc.). In fact, 95 percent of requests for accommodations come from people without disabilities. Engaging in an ongoing, interactive process in a cooperative way helps alleviate the potential for an unsatisfactory result.

Employers who have contracts with the federal government are now working toward a goal of a workforce that includes 7 percent people with disabilities (including mental health conditions) across job categories. While anecdotally, we hear that most private employers only have 1 to 2 percent of candidates and employees self-identifying as a person with a disability, the reality is that the number of people with non-obvious disabilities like mental illness is much higher. Attention to the organizational culture, practices and policies related to employee mental illness can greatly impact the likelihood that persons with mental illness will voluntarily disclose to their employer.

As federal contractor compliance efforts evolve, so too does thinking about employee mental illness and the business case for accommodation. Many federal contractors are large employers and positive changes toward greater inclusion in those workplaces can have a ripple effect through the entire American workforce. These employers are learning that there are many reasons to think proactively about mental illness in the workplace, not the least of which is the bottom line.