The effects of mental health on performance – Problem employee, or ill employee?

The effects of mental health on performance – Problem employee, or ill employee?

Background to the problem

The prevalence of mental illness in the general population is alarming.  The World Health Organisation (WHO) predicts that by the year 2020, depression will emerge as one of the leading causes of disability, globally.  The cost of mental illness on the workplace is equally as alarming.  Many studies cite the negative financial impact as well as the impact on team morale and productivity.  A study completed in 2009 indicated that workers assessed as having severe to moderate depression were absent from the workplace more often than non-depressed employees, and were rated as having higher levels of underperformance than non-depressed employees.  The estimated cost of this in the U.S., in terms of worker productivity losses and human capital costs, are estimated at nearly $2 billion per month.

In Australia, research conducted by Lim et all (2000), found that depression, generalised anxiety disorder and personality disorders were all predictive of work impairment.  Mood disorders and anxiety-mood disorders were associated with the greatest amount of work impairment, through work cut back and under productivity.  Interestingly, only 15% of participants in the study with any mental health difficulties sought help.

What are the mental health difficulties we’re talking about?

Mental illness can range from minor issues to very severe psychotic episodes.  Generally, these can be classified according to:

  • Mood disorders: depression, bipolar;
  • Anxiety disorders: general anxiety, panic attacks or social phobia;
  • Personality disorders: narcissistic personality disorder, borderline personality disorder or antisocial personality disorder;
  • Psychotic disorders: schizophrenia; and
  • Eating disorders: bulimia or anorexia nervosa.

Symptoms and signs of psychological disorders differ depending on the type of disorder.  Typically, symptoms of behavioural and mood disorders are more frequent.  They can significantly impair a person’s ability to function in the workplace and in society in general.

The impact on the workplace

The symptoms of mental illness can vary, but typically affect thoughts, emotions and behaviours.  Examples in the workplace could be:

  • Confused thinking or reduced ability to concentrate, therefore unable to complete tasks, or failing to complete tasks to optimal performance;
  • Excessive fears or worries, so requiring additional supervision or support to complete tasks;
  • Significant tiredness, lethargy and low energy which can be interpreted as low motivation;
  • Taking more than average days off sick;
  • Inability to cope with daily workplace stressors and tasks and catastrophising minor setbacks;
  • Overreaction to workplace requests, resulting in excessive anger or hostility;
  • Highly sensitive or tearful when discussing any element of performance;
  • Perception of bullying and harassment in seemingly neutral instances;
  • On-going physical problems such as stomach pain, back pain, headaches and migraines;
  • Reporting thoughts of suicide or self-harm to work colleagues;
  • Having a “I don’t give a damn,” attitude;
  • Inflexible thinking patterns causing relationship difficulties and team problems;
  • Odd or eccentric behaviour or dramatic erratic behaviour causing alarm to colleagues;
  • An inability to accept any level of perceived criticism or the suggestion of performance improvement; and
  • Being the ‘sad sack’ that no-one wants to be around.

The difficulty for workplaces is trying to distinguish between when an employee just has a performance, motivation or attitude issue, and when a mental health difficulty underpins any of these.  Both areas can be effectively managed, however both require different techniques and levels of support.

Mental health difficulties are unlikely to resolve on their own.  Most individuals will require some level of psychological and possibly medical intervention to get their lives back on track.  The good news is that mental health difficulties are very treatable.

What can workplaces do?

  1. The first thing workplaces need to do is encourage a positive work environment to ensure they not causing or contributing towards employee’s mental health difficulties. This includes creating a supportive work environment with transparent and open communication, adequate training, recognition, tolerance for mistakes during learning periods and an understanding of people’s uniqueness;
  2. Look for trends in behaviour, odd behaviours or actions and reactions that just don’t seem to fit the context e.g. one hostile outburst does not mean an individual has the mental health difficulty. However, on-going hostility in bland or harmless situations may indicate something else is going on for the individual;
  3. Provide psycho-education in the workplace to reduce the stigma related to mental health difficulties. Encourage conversations about mental health and mental illness and provide adequate support for those experiencing difficulties.  This may involve engaging the services of an Employee Assistance Programme (EAP), that can provide short-term, confidential psychological treatment.  Make sure your EAP provider employees Psychologists to undertake assessment and treatment as the quality in the market can be variable;
  4. Don’t be afraid to talk about mental health and mental illness. A performance related conversation should be about improvement and this may require targets related to an employees’ mood, perception and general presentation.  Work with and employee’s treating practitioners to work out the best way of supporting them in the workplace.  This could include their; Psychologist, General Practitioner (GP) and specialist, as appropriate;
  5. Be aware that mental illness should not be an excuse for poor behaviour in the workplace. Employees with a mental illness may need additional support and possibly workplace adaption, however this does not mean code of conduct and workplace policies can be breached; and
  6. If a workplace remains concerned about an employee and has been unable to communicate effectively to bring about a resolution, they can request a Fitness for Work assessment (FFW). FFW’s should be conducted by Psychologists, or Psychiatrists with occupational assessment experience (i.e. not just psychological treatment).  A thorough FFW assessment involves the administration of psychological assessment tools and profiles.  It should provide information about a person’s current symptoms, behavioural observations during the assessment and a comment about a workers’ ability to return to work.  In addition, it should provide guidance about the measures and processes the workplace should put in place to maintain the employee’s fitness in the workplace.  A Psychologist of quality will discuss treatment techniques and interventions with their client during an assessment, to enhance their recovery and to maximise their engagement in the workplace.  This may involve the employee engaging in psychological treatment, coaching, or workplace mediation to address the issues.


Anya Stephens | Director and Registered Psychologist, Perth

Anya is a Director of PeopleSense by Altius and is a registered psychologist (MSc Ed Psych – Brunel University), (BSc Psych Hons, London University). Anya is a certified trainer and assessor (TAE40110 – Cert. IV in Training and Assessment), full member of the Australian Psychological Society and WA Psychologists’ Board. Anya is also a qualified hypnotherapist.

Anya has over 20 years of experience and her areas of expertise include:  


Organisational Consultancy:

  • Goal oriented coaching;
  • Team development;
  • Workplace mediation;
  • Development and delivery of training
  • Human resource related issues.
  • Certificate IV qualified in training and assessment;
  • Conflict and Mediation;
  • Communication, Interpersonal Skills, and Emotional Intelligence;
  • Recruitment and Selection;
  • Performance Management

Vocational Rehabilitation:

  • Extensive case management experience in both the WorkCover WA and Comcare sector;
  • Ability to manage complex and difficult cases of both psychological and physical basis.

Psychological Services:

  • CBT (Cognitive Behavioural Therapy) for a wide range of issues;
  • EMDR (Eye Movement Desensitisation and Reprocessing)
  • Critical Incident Responses; and
  • Critical incident debriefing.

Altius Group provide expertise in people risk services including prevention and management of physical and psychological injuries. Altius Group consists of specialised businesses which cover a broad spectrum of individual health, wellbeing and rehabilitation interventions to ensure your organisation can realise the financial and commercial potential of a healthy, engaged team.



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