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Recognising the signs of mental illness

South African workers’ most common mental and behavioural disorders for which referrals are received for disability and incapacity management are depression, bipolar disorder, post-traumatic stress disorder and anxiety, according to Alexander Forbes Health Management Solutions. Mental illnesses affect an individual’s mood, thinking, feelings and behaviour and are experienced in all areas of daily living, from their social life to their personal and work lives.

One in six South Africans affected

As many as one in six South Africans present with anxiety, depression or substance abuse according to the South African Depression and Anxiety Group. However, less than 16% of sufferers receive treatment, which suggests a constrained mental healthcare system.

Work stress is often a precipitating or perpetuating factor for many employees who are referred for incapacity management. Often individuals are not referred to an appropriate specialist such as a psychologist or psychiatrist, and as a result they do not receive adequate treatment and this may arise in excessive utilisation of sick leave or even a disability claim. At times, employees are just too scared to advise their managers that they have a mental and behavioural condition in fear of losing their job.

Effects of Covid-19 on mental health

There is increased concern about the mental well-being of many South Africans in relation to the Covid-19 outbreak and resultant economic recession. Disability claims for mental and behavioural illnesses are likely to increase. Uncertainty, social isolation, and the fear of visiting medical practices and facilities create barriers for people diagnosed with mental illness.

Bhekisisa Centre for Health Journalism says one in four people reported anxiety and fear of infection, and excessive worry over the pandemic. People diagnosed with mental health conditions struggled to access treatment during the lockdown, possibly resulting in relapses. Support from family, friends, prayer groups and work colleagues was also limited due to social distancing. Moreover, the Covid-19 infection itself could lead to psychiatric symptoms in some patients as reported in recent research published in the Wits Journal of Clinical Medicine.

Within Health Management Solutions’ client base last year, we found that 60% of companies experienced an increase in claims for incapacity leave and disability on the basis of mental illness, whereas other companies recorded a 40% reduction in these claims.

This reduction in claims could, to some extent, be linked to the positive mental health-related benefits of working from home that some people are experiencing. This could include less emotional exhaustion and cognitive stress, more online support from colleagues, less travel and a less stressful office environment.

To mitigate the negative effects of work from home on employees’ mental health, regular communication between managers and their teams as well as organisational support are imperative. Negative effects include:

  • work overload

  • invasion of privacy

  • lower job autonomy

  • constant electronic contact

  • limited organisational support

Be aware of warning signs

The decrease or underreporting of incapacity and disability claims can also be related to the challenges in monitoring employee’s productivity while working from home. It is important to be aware of the signs and symptoms of these conditions as we are challenged by the psychological strain of the Covid-19 pandemic and the new norm with altered work environments and personal circumstances. Employees also need to be aware of the signs and symptoms to seek early diagnosis and relevant interventions.

Warning signs of mental illness are:

  • excessive paranoia, worry or anxiety

  • long lasting sadness or irritability

  • extreme changes in moods

  • social withdrawal

  • dramatic changes in eating or sleeping patterns

  • alcohol or drug abuse

Some of the signs and symptoms at work are changes in:

  • work habits – increased absenteeism and affected punctuality

  • physical appearance and demeanour – outbursts and mood swings, social withdrawal and avoidance

  • cognitive function – inability to concentrate and focus, mental fatigue and difficulty with problem solving, resulting in decreased productivity

Monitoring of employees

It is essential for companies to employ health professionals or service providers who can assist with advice on absenteeism and incapacity management. In this way, they can proactively manage employees who may be presenting with signs and symptoms of mental illness at work.