Comedian Ruby Wax has become a leading voice on mental health issues in the UK, a high-profile campaigner who’s just been offered a new post as visiting professor for mental health nursing at the University of Surrey. So when she advises employees to never tell their boss about a mental health problem, people are going to sit up and listen.

What did Ruby say?

“When people say ‘Should you tell them at work?’ I say ‘Are you crazy?’” she said to The Times newspaper. “You have to lie. If you have someone who is physically ill, they can’t fire you. They can’t fire you for mental health problems but they’ll say it’s for another reason. Just say you have emphysema.”

Why is this a problem?

When employees hide their problems no-one makes any progress – it’ll only make things worse, making employers more suspicious. And what’s worse is that this is no minor issue. We’re not talking about the relatively rare cases of people with severe mental health problems, schizophrenia or manic episodes.

We know that at least one in four of us will experience mental ill health at some point in our life, and one in 10 of us will be likely to self harm in some way, so if all these employees are keeping silent about their concerns and their health, as Ruby Wax advises, that’s a lot of silence, secrecy and isolation in the workplace.

The underlying message in the comments is about the more private attitudes of managers. They might differ from the official line. Equality Act legislation in itself therefore can’t stop a boss from finding other ways to demote an employee if they don’t think they’re contributing.

The problem of ‘judging’

And here’s the crux of the issue. The negative ‘judging’ from a manager tends to happen when a member of staff comes to them with a difficult problem, spilling out their anxieties and emotions. Bosses can’t be expected to understand or take any responsibility for people’s personal lives, or have the ability to act as a life coach.

On the other hand, it’s reasonable for them to expect that a paid employee meets a particular level of performance in their role. So here’s the tension which leads to concern and uncertainty on both sides.

Taking control

The key message for any employee worried about their mental health is to take control and make sure they are fully prepared with ‘solutions’ before talking to their line manager. They need to have spoken with a mental health professional.

A GP is good but a more specific professional is better, an EAP advisor or someone from a support organisation like Mind or Rethink. It’s vital that the employee understands their own diagnosis and prognosis of their condition, and the impact that will have on their behaviour and performance at work. The employee needs to be articulate about the triggers for episodes of anxiety or depression for example. They need to develop their own support network – including family, friends, local support groups and professionals.

The employee also needs to think carefully about whether their mental health issue is, in practice, going to affect their day-to-day ability to do their job and how. There are plenty of physical ailments that don’t affect people’s work and it’s the same with mental health. There’s a fine line between those mental health conditions that make everyday working impossible and those that contribute to performance and dedication at work.

The role of the line manager

Being able to go to a line manager openly, setting out concerns about a mental health problem discussed by a professional, and then going on to talk through what they’re going to do about it makes a huge difference in the nature of the conversation. It’s entirely to the credit of the employee that they’re honest, and demonstrate resilience in terms of identifying and dealing with adversity in a responsible, capable way. On their side, faced with this kind of open admission, employers have legal and moral duties of care to respond in the right way: to be similarly straightforward, open about their issues and reasonable in terms of suggested ways forward.

For the long-term, there needs to be a virtuous circle of people with mental health problems in the workplace. No more hiding away. The more people are open with managers, work through the issues and have a positive outcome, the more quickly the stigma and fear of psychological illness will wither away.

And instead we’ll have a situation closer to that of physical illness, where problems are identified and dealt with. Many more employees will be able to get back to work, keep contributing and benefiting from all the different rewards and positive influences that work has in people’s lives.