Getting back to work

Finding and maintaining employment

One of the biggest challenges for people with mental illness can be finding and keeping a job.

Sometimes people with a mental illness take time off work to focus on getting well. While some require weeks to recover enough to work again, others need months or even years.

For those who are out of the workforce for a long time, social isolation, reduction in income and sense of not contributing to society can damage their sense of self-worth and independence. This is in addition to the impact of the illness itself.

Why work?

For all of us, having a job is linked to how we see ourselves and our sense of contributing to society.

For many people, work provides them with a sense of purpose and helps them to focus on things other than their illness. It’s a reminder that although mental illness is very challenging, they are still active and capable people. Work also re-establishes a sense of self beyond that of being ‘someone affected by mental illness’.

Employment is also one of the most effective ways to help people recover, by providing income, independence and the dignity of a place in the community.

However, an essential part of being a productive and valued employee is making sure your symptoms are well managed, and that you feel understood and supported by colleagues and managers.

What about support?

Think about what support you would need to return to work, such as having a mentor or manager who understands your illness, flexible hours to attend appointments, or the opportunity of part-time work.

It’s important to remember that the degree of disability determines what’s possible and realistic when considering a return to work. Some people may only need to make small changes, while others may need to have significant workplace adjustments. For example, you may need to arrange for a later start time if you find that medication makes it harder for you to get going in the morning.

Write down some supports and changes that you feel would help you get back to work.

Know your rights

Be aware of your employment rights. It’s unlawful for employers to discriminate against a person on the grounds of disability alone, by not offering employment, not promoting them, providing less favourable conditions of employment or dismissing them from their job.

The most common adjustments needed for employees with a mental illness include providing relevant orientation and training to managers and co-workers; having a plan in place should someone become unwell; modifying the work environment to allow on-site support; allowing more flexible work schedules; restructuring job tasks and improving workplace attitu through education.

The Disability Discrimination Act (DDA)

The Disability Discrimination Act 1992 (DDA) outlines the legal requirements employers are required to follow when employing someone with a disability, including a mental illness.

The DDA states that if the person with the disability is the best person for the job, then the employer is required to make reasonable workplace adjustments so they can perform the essential requirements of that job.

If you think you have been discriminated against, you may want to make a complaint to the Human Rights Commission.

For more information about anti-discrimination laws and employment or the Commission’s complaint handling process, visit www.humanrights.gov.au or call 1300 656 419.

Getting back into the workforce

There are many practical steps you can take to make a start on getting back to work while looking after your health too.

Returning to a job

If you have a job and your employer is holding your position open while you recover, you may want to discuss with a counsellor, manager, or human resources staff about how to approach your return to work. Consider what support you may need – for example, working three days a week while you build up to full-time hours again.

You may also want help in deciding how you’ll discuss your absence with colleagues. Whether you choose to give a lot of detail or just say that you have an ongoing medical condition, discussing this issue beforehand will help you set boundaries about how much information you’re prepared to give.

Moving on

If you do not have a job – or it’s not possible or helpful to return to a previous position – there are people who can help you clarify what you’re good at, what you enjoy doing, and how work fits in with how your symptoms affect you.

Centrelink can refer you to specialist advice and assistance, or you may choose to visit a private career counsellor in your local area. You can also look for work yourself by checking newspapers and employment websites.

How Centrelink can help

Centrelink has specially trained staff (disability officers) who provide help for people with disabilities.

After a consultation with a Centrelink officer, you may be referred to a service or program.

Disability Employment Services (DES)

If you are referred to DES, this service can provide help in:

• Preparing you for work.
• Finding suitable jobs.
• Writing applications.
• Practising for interviews.

 They provide information about any subsidies or training opportunities and can provide on-the-job support in some cases.

DES may also provide a Personal Support Program, with individual support to help overcome barriers, which may stop you getting back to work.

JobAccess

JobAccess provides information and support to help people with a disability return to work or find a job. Advisors can provide expert advice on a range of topics for job seekers, people returning to work, managers and co-workers.

For more information, call 1800 464 800 or the Centrelink Disability, Sickness and Carers number below, to see if JobAccess services would be appropriate for you.

Jobs in Jeopardy

Disability Employment Services can assist people who are at risk of losing their employment in the immediate future as a result of their illness, injury or disability through Jobs in Jeopardy assistance.

This service is not designed to assist with finding a job, but to help people in keeping their current one.

For more information on any of the above services, contact Centrelink on the Disability, Sickness and Carers line on 13 2717 or the Centrelink Employment Services line on 13 2850.

What helps people affected by mental illness

Get back to work?

There are three main factors which help people get back to work:

1. Availability of meaningful part-time work, which makes realistic demands and contributes to recovery rather than making it more likely someone will become unwell again.

2. Rehabilitation, training, job placement and support once they are in the job to help face the challenge of keeping a job they consider worthwhile.

3. A supportive and understanding workplace.

It also helps, as with any job, to have clearly-defined position descriptions and expectations, and an understanding that everyone makes mistakes sometimes – whether they have a mental illness or not.

The Mindful Employer Program

Training and information on mental illness can help to build workplace support and understanding.

SANE’s Mindful Employer program provides workplaces with helpful information and advice on how to support employees affected by mental illness.

With information on topics such as disclosure, workplace adjustments, flexible working arrangements and working while caring for someone with a mental illness, the program provides easy-to-understand advice and information for both managers and employees.

Find out more by visiting www.mindfulemployer.org.

Chris’s story

Chris works for a tyre company and recently spent time in hospital while his medication was changed. He asked his doctor to speak with Rachel, his manager, to explain why he would be off work for a while.

Rachel and Chris agreed to keep in touch to review his return to work. When Chris returned to his job, he began working two days a week, gradually building up to four days. Chris and Rachel also agreed that he would explain his absence to workmates by saying he has an ongoing medical condition that required hospitalisation.

Volunteer work

Being a volunteer carries similar responsibilities and obligations to having a paid job.

Voluntary work can be a good way to build up your skills in a meaningful way and help you get back into a routine – such as getting up early and travelling to work, for example – while also helping a good cause.

Organisations such as Volunteering Australia - www.volunteeringaustralia.org - may be able to help you find a position.

Once you have cleared the usual checks and identification process, you can be matched with a suitable organisation for an interview.

Temp work

Registering with a recruitment agency for temporary work can be a good way to ease back into employment, especially with short-term contracts. The work is often project-based or covering for a staff member who is on leave.

If you feel you need a break at the end of a contract before working again, you can do so and seek more work when you feel ready.

It is especially helpful if you don’t want or need to disclose your illness to an employer, and know that you’ll need some flexibility in the amount of time you spend off work.

Some people may also want to consider being self-employed if they have experience or skills which can be used in this way.

Staying positive

If you decide that you’re ready to return to work, it’s important to maintain a positive and realistic outlook during your job search.

Prospective employers pick up on a positive attitude and are attracted to it, while negative thoughts often lead to negative results. The more positive you are about your own abilities, job prospects, and life in general, the more likely you are to get the right job. This is especially important when you experience the inevitable knock-backs.

Some tips on how to do this:

• Ask someone – such as a friend or support worker at an employment service or rehabilitation program – to support you in staying positive, and share your goals with them to help you stay on track.
• Be prepared for some applications to be unsuccessful and to remind yourself that every ‘no’ is one step closer to a ‘yes’ – this is something that everyone experiences when they are looking for a job and the trick is not to give up. A supporter is especially helpful for when you experience a knock-back.
• Be patient, and don’t take it personally when there’s no response to your phone call or application, you won’t always get immediate results.
• Looking for a job can be hard work and requires a lot of energy, so try to keep your life in balance by doing the things that keep you well:taking medication and other treatments such as psychotherapy, being physically active, getting enough sleep, making time to relax regularly and socialising with friends and family.

Job applications

Effective job applications require time and effort, and are tailored to the job being applied for.

If you are a client of a specialised employment service, ask for help in preparing applications. There are also many books available from libraries on this subject as well as articles on the Internet, which can also be accessed via your local library.

The important thing for you to remember is to believe in yourself, and to sell your skills and experience in your applications.

Before you submit an application, get a trusted friend or family member to read your application for typing errors, to make sure it’s easy to understand and that you have fully addressed the selection criteria.

Accounting for gaps in your work history

There may be gaps in your work history when you have been unwell for some time. If you are a client of a specialised employment service, discuss with them how to account for this in the application.

Use a format that highlights your overall skills and accomplishments. Include any study, training, caring or volunteer work you performed while you were not working, to show that you were still active.

You may have gained additional experience while out of regular employment. Include this on your resume in a section called ‘Additional Experience’. Did you return to part-time or full-time study? Were you in a sports or social club or organise activities as a volunteer, for example? Were you also caring for someone else who was unwell during this period?

Referees

Think about people who can best talk about your skills and relevant work experience. Are they able to back this up with examples?

Don’t limit yourself to former managers, especially if you didn’t have a good relationship with them or you think they may speak unfairly. Former colleagues, clients and others may also be in a good position to give a more rounded account of your expertise, communication skills and ability to work with others.

It may not always be appropriate to use the same referee for each job application, or to use people you’ve not worked with for more than five years, especially if your skills have improved or changed in that time. They may be better giving a character reference.

It is important to remember, too, to check with people that they are willing to act as a referee and also that they will be available.

Practice for interviews

Ask a friend or former work colleague to help you by practising your answers with them. Your friend can play the role of interviewer and also give feedback about your responses, body language and overall presentation.

Prepare for interviews

When preparing for the interview, go through some likely scenarios in your mind. Think about the questions that are likely to be asked and visualise yourself as confident and self-assured, with the talents and skills you can bring to the employer. Think of some examples from your experience to demonstrate these. Play the part over and over again until you feel comfortable with it.

Imagine yourself preparing for the interview on the day it will take place. When you visualise arriving at the employer’s office, being greeted by the interviewer, notice that your emotions are calm and confident as you shake hands. As the interviewer begins to ask questions, imagine you answer them spontaneously and easily. With preparation, you will feel more confident and comfortable.

The more you use your imagination in this way to prepare for an interview, the more positive, relaxed and confident you’ll be when you take part in the real thing

Job interviews

Before your interview, make sure you get a good night’s rest. Your mind will function better in the interview if it’s not overloaded and tired from racing thoughts.

Decide what is most appropriate to wear, and get the clothes ready the night before. Leave plenty of time for travel as well. The last thing you want is to arrive at the interview flustered and panicked because you couldn’t find a parking space, didn’t have change, or missed a train.

You may want to travel the route you’re going to take beforehand, to familiarise yourself with it and to help reduce any stress you may feel on the day of the interview.

Slow breathing

You can also help yourself to keep calm and focused by taking slow, deep breaths while your eyes are closed. Listen carefully to each breath as you do. It doesn’t matter if your mind starts racing again, just bring it back to focus on your breath. This technique is helpful in clearing your mind of all thoughts and reducing anxiety at any time

Lily’s story

Lily is a 23–year–old shop assistant. Her anxiety disorder makes job interviews difficult, leaving her feeling rejected. She is plagued with unhelpful thoughts before an interview, so much so that she feels paralysed once the meeting is underway.

Through Centrelink, Lily is referred to a specialist employment agency to help her prepare for and find a job. Her doctor has referred her for psychological treatment so she can learn how to manage negative thoughts and feelings of panic. Lily’s mum has also offered to travel with her to interviews, to help her stay calm, and to keep her thoughts positive.

Tips for when you return to work

Going back to work can be a worrying experience at first. It can make all the difference to discuss with a supervisor, case manager or friend what the issues are likely to be and how to handle them.

Conditions that help a successful return to work include:

• A respectful and supportive relationship with your manager.
• Understanding from co-workers.
• Realistic expectations, clear roles and responsibilities.
• Timely and relevant feedback.
• The opportunity to ask for time out.

It’s also worth remembering that your illness may affect your energy levels, both physically and mentally, so pace yourself in the initial period.

Discuss realistic goals with your manager and make sure you acknowledge milestones such as the end of your first week back.

Keep your doctor or treating health professional informed and discuss how working may affect your mental health.

Handling disclosure

The term ‘disclosure’ is used to mean ‘telling an employer that you have a mental illness.’

There are arguments for and against this, depending on your individual circumstances such as severity of symptoms and nature of work. Talk to your doctor, a friend or worker at a specialised employment service, asking questions such as:

• Do I need to disclose my illness?
• When is a good time to disclose my illness?
• How will I disclose my illness?
• What are my rights and responsibilities?
• How much detail should I discuss?

Reasons for disclosure

Here a few good reasons why you should disclose your illness:

• Safety issues – would you be at risk or would you be placing other people in danger?
• Your employer may be understanding and prepared to help when you need time off.
• Your colleagues will recognise signs that you may be unwell and will be better able to help you.
• Feeling you have your illness under control and have support outside work when you are unwell.
• If the day comes when you need help or time off, you will need to have an understanding manager.

Reasons against disclosure

The reasons why you may choose to not disclose your illness include:

• You don’t believe it will affect your work and you wish to keep your condition private.
• Even though it is unlawful to discriminate on the basis of mental illness, you are concerned an employer may decide not to employ you.
• You are worried that telling your manager will mean you are treated badly or not offered a job promotion.
• You are worried that you will not be given the same work benefits and respect as other people.
• Maybe you have had bad experiences in the past when you have told people about your condition. Perhaps your employer focused on your disability and not on your abilities.
• Perhaps you are worried that your manager or supervisor will see you as ‘a problem’.

In an understanding workplace you would be able to reveal that you have a mental illness. After all, if an employer discriminates against you because of your illness, would it really be in your interest to work there in the first place?

Most people who disclose say it means they feel less stressed and employers are supportive. However, the decision lies with you and your situation at the time.

Joshua’s story

Joshua, 34, regularly worked long and stressful hours for a bank. He became depressed and chose to resign rather than tell his manager about his mental illness.

Following treatment, Joshua felt well enough to work again, although he wasn’t sure if he should return to the same sort of high-pressure job in case it triggered another episode.

Joshua spoke to his doctor and an employment counsellor about his concerns. He decided to look for a part-time job so he could better manage his illness, and that he would tell trusted work colleagues about his depression once he was in a new job.

Handling stress

Stress is a factor in the onset or worsening of symptoms of mental illness. It’s important to have a number of strategies to help you cope if you are feeling anxious. These could include:

• Walking away from your immediate work area to take some deep, slow breaths.
• Talking to a trusted colleague or calling a friend – you’re likely to find it easier to defuse anxiety as it arises rather than taking it home with you.
• Taking holidays and breaks is essential for everyone’s mental health, and especially so if you have a mental illness – make sure you take all of your annual leave each year and try to avoid spending the whole time on a busy holiday. Include some time to rest and rejuvenate as well.
• If you don’t have any holidays planned and you’re starting to feel unwell, take a day off to rest at home or schedule a long weekend. If it is difficult to tell your supervisor you are taking a ‘mental health day’, try to plan time off rather than ring in with an excuse on the day.
• It can be helpful to keep a journal in which to unload your thoughts at the end of a stressful workday – this gives your mind a break from racing thoughts and can help you relax, sleep, and prepare for the next day without feeling worn out.
• Schedule time in your week to do something you enjoy, meet a friend for lunch, or join a class to do yoga, meditation or something else that takes your mind off the anxiety.

If anxiety or stress becomes persistent, discuss this with your doctor, an employment service if you are a client of one, with your employer, or access an Employee Assistance Program if provided at your workplace.

Smoking and the workplace

If you’re a smoker, consider what impact this will have when you return to work, as well as its effect on your health. Laws about smoking in or near the workplace means that frequent cigarette breaks may not be possible. This could be a problem if you’re a regular smoker.

Talk to your doctor about making a plan before attempting to quit, and discuss using nicotine replacement therapies such as patches and gum.

Ben

Ben has a new part-time job at the local supermarket and finds it very difficult to wait until his break for a smoke.

Ben told his boss and his caseworker that he‘s feeling ‘strung out’ because he now can’t smoke as often as he used to. He really wants to keep this job, so with their support he has made an appointment with his GP to learn how he can manage his cravings so he can last between breaks. He will also call the SANE Help Centre to find out about resources to help him give up smoking altogether.

How to support yourself

Some tips on how to supporting yourself, on your return to work include:

• Make a point of looking after yourself once you’re back at work.
• Try to avoid becoming unwell by recognising early warning signs, regulating activity and asking for help.
• Ask a number of people such as a case worker, family and friends to be your ‘support network’.
• If you’re not a ‘morning person’, set your alarm clock half an hour early to allow more time to get ready.
• Choose and prepare work clothes the night before.
• Try to get the amount of sleep you need each night.
• Be prepared to say ‘no’ sometimes, otherwise you can quickly feel overloaded if you agree to everyone’s demands.
• Try to keep a positive outlook.
• Avoid stressful and unhelpful situations, such as malicious work gossip conversations.
• Make active use of lists and a diary to keep track of commitments and appointments.
• Spend time with positive people whenever you can.
• Drink plain water or non-caffeinated beverages (such as herb teas) rather than coffee during the day.
• Try to eat healthy foods and get some physical exercise a few times a week, such as walking in a park.
• Ask questions at work to reassure yourself that you know what’s going on and how systems operate.
• Avoid substance abuse, including alcohol and tobacco.
• Follow your treatment plan to stay well, including seeing your doctor or case worker regularly, taking medication and any other treatment such as seeing a psychologist.
• As far as possible, plan for absences, using sick leave and annual leave, and be selective and responsible about disclosure.

What if I become unwell again?

It’s ideal to have an agreed plan with your manager to deal with this possibility. This requires some disclosure on your part, however. It’s also helpful if your family or friends know about the plan as well. You’ll need to discuss possible scenarios with your manager and let them know beforehand what actions are helpful and those that aren’t.

In a crisis

In spite of the best plans, on rare occasions you may become acutely mentally unwell at work. You may experience panic or extreme anxiety. You may become confused, agitated or fearful.

Decide early in the job what action is appropriate and helpful for a co-worker or manager to take if this happens to you. The action may include providing a quiet space, or making a call to the treating doctor, crisis team or family. See How to help in a crisis for guidance on how people can help.

Take the first step in returning to work by going through this checklist to make sure you’re fully prepared:

• Prepare a plan for return to work for example, who can help, what sort of work do I want?
• Enlist support from as many people as possible.
• Think about the supports that will help you.
• Think about how you’ll manage your health and your return to work.
• Accept that a return to work may not happen as quickly as you want and that there may be setbacks.
• Understand that setbacks don’t last forever.
• Prepare and practice for interviews.

When talking to your manager about returning to work, discuss issues such as:

• What your tasks and responsibilities will be?
• Any activities that may trigger stress for you, such as customer service and busy work periods.
• What helps you reduce and manage this stress at work?
• How much you need to disclose to work colleagues so that they can help?
• What are the employer’s work, life and family policies?
• What are your entitlements, including family, sick and annual leave?

Once you’re in a job and need to discuss an issue related to your mental illness:

• Speak with your manager in private and ask someone to go to the meeting with you if this helps.
• Write down some dot points of what you would like to discuss.
• Try to be flexible, speak in a calm manner, and ask for clarification if you do not understand something.
• Tell your manager if you want to keep your discussion confidential.

Remember at all stages to try to keep your life in balance by doing the things you find help keep you well, such as getting enough sleep, exercise, taking medication and socialising with friends and family.

Contacts

Centrelink Disability Services & Carers Line
13 2717
www.centrelink.gov.au

JobAccess
1800 464 800
www.jobaccess.gov.au

SANE Help Centre
Information, guidance, and referral on mental illness and related issues
1800 18 SANE (7263)
www.sane.org

Australian Psychological Society
Referral service to psychologists in your area
1800 333 497

Lifeline
Provides 24-hour counselling service
13 11 14

Human Rights Commission
Discrimination complaints line
1300 656 419
www.humanrights.gov.au