For many years I worked successfully in a highly responsible and challenging job. Then, in 2009 I was diagnosed with Borderline Personality Disorder. My caseload included a number of clients who were classed as MDOs (Mentally Disordered Offenders). In seeking to secure psychiatric interventions, rather than imprisonment for many of my BPD cases I was disheartened to receive the repeated response, 'this condition is not treatable' and in one particular case '....is so problematic to handle that they are barred from A&E admission in the local area'. The provisions of the Mental Health Act 2007 had failed to make it to the Foundation Trust in which I worked. So, when I received confirmation that I had BPD and that my local NHS Trust were willing to offer me support and treatment I knew I was lucky. I also had a decision to make about staying in work and what I would tell my employers.
I decided that I would be open and honest with my employers about the nature of my ‘issues’. Given that I had taken time off since 2007, as I struggled with what then was an unknown problem, I believed that this would be the most productive way forward. I had had experience of trying to mask periods of emotional instability from previous employers – helped, no doubt by the fogginess of medical professionals, who seemed to believe that my ability to hold down responsible jobs meant that I couldn’t possibly be suffering from a complex mental health condition.
As I have said elsewhere in this blog, I had always been open with my Line Manager throughout the period of uncertainty about my diagnosis to the final conclusion and have found that, on an individual level both my manager and my colleagues were willing to learn and try to understand my condition and how it affected my work.
However, the sickness absence procedures themselves were applied as a ‘one size fits all’ solution to long term sickness, regardless of the intrinsic differences between physical and mental illnesses.
I don’t think a Senior Manager would ask of a Cancer sufferer, ‘A year ago you told us the 'Chemo' would work, so why have you gone off again and are now telling us that you need Radiotherapy?’ Unfortunately, having remained at work for 8 months following a difficult period, when my initial treatment failed, I was signed off again in 2011 and I was asked by the senior manager why the first treatment I had tried had not worked and was asked ‘what guarantee do we have that the new treatment they are suggesting will work and that you will not be signed off again?’
Now correct me if I’m wrong, but even the most highly regarded medical training does not include crystal ball reading, I believe that’s only on offer at Hogwarts! However such questions betray an underlying suspicion, or even prejudice, about mental illness, and that is: it’s all in my head! If you don’t fit neatly into the procedures, which again and again, I was told were there to support me to remain in work, then employers seem to waver between wanting to help, and threatening me with capability procedures. In the end it became impossible for me to remain in work, even on a part-time basis and engage in the intensive DBT programme I was offered a place on. I took voluntary redundancy in 2012 - the first wave of redundancies which have marked the dismantling of the Probation Service as a public service agency serving the community. I will therefore not be able to return to any role which would make direct use of my skills and experience, but that's another day and another story.
So can such Sickness Absence procecures deal with the paradox of the worker with mental illness whose work is characterised as ‘excellent’?. In the present climate the pressure not to disclose mental health issues will grow, but how can we educate employers to view those with mental health problems in the same way that they view physical health problems? With the same level of compassion and support?
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