Symptoms of mental illness generally present themselves in a person’s behavior and personal habits, such as changes in mood, eating or sleeping habits, and personality. While a single symptom or isolated event is rarely a sign of mental illness, a symptom that occurs frequently, lasts for several weeks, or becomes a general pattern of an individual’s behavior, may indicate the onset of a more serious mental health problem that requires treatment.
Although employers are not expected to diagnose or treat an employee’s illness, they can play an important role in helping an employee recognize and deal with an existing performance problem. Employers will be most successful in this process if their discussion remains focused on job performance and on the need to find a way to regain the employee’s previous quality of work. All performance problems must be related to the established performance standards for a particular job. If employees are not comfortable discussing their difficulties, deny the problem, or cannot see a way to overcome the problem, the employer can then recommend consultation with an Employee Assistance Program (EAP) or physician. Some of the most significant indications of a possible mental ill ness include:
• marked personality change over time
• confused thinking; strange or grandiose ideas
• prolonged severe feelings of depression or apathy
• feelings of extreme highs or lows
• heightened anxieties, fears, anger or suspicion; blaming others
• social withdrawal, diminished friendliness, increased self-centeredness
• denial of obvious problems and a strong resistance to offers of help
• dramatic, persistent changes in eating or sleeping habits
• substance abuse
• thinking or talking about suicide
In reality, these symptoms are not always readily apparent. Employers and supervisors may, however, be able to notice significant changes in their employees’ work habits, behaviors, performance, and attendance, such as:
• consistent late arrivals or frequent absences
• low morale
• lack of cooperation or a general inability to work with: colleagues
• decreased productivity
• increased accidents or safety problems
• frequent complaints of fatigue or unexplained pain
• problems concentrating, making decisions, or remembering things
• making excuses for missed deadlines or poor work
• decreased interest or involvement in one’s work
People who experience problems, such as those listed above. may simply be having a bad day or week, or may be working through a difficult time in their life. A pattern that continues for a long period may. however, indicate an underlying mental health problem.
Mental illnesses often require professional help in order to establish a diagnosis and plan for treatment. Individuals who are experiencing symptoms of mental illness are most likely to pre sent their problems to a family physician. The physician may treat the illness, or may refer the patient to a specialized mental health ser vice provider. In other instances, particularly when the problem is work-related, an individual may contact an Employee Assistance Program (EAP) at work for a referral. Reliable referrals also can be obtained through medical school psychiatric departments, psychiatric hospitals or clinics, community mental health centers, and from local branches of the American Psychiatric Association and the American Psychological Association.
The following descriptions provide a general introduction to some of the mental health care providers available to individuals seeking treatment. A person’s insurance can be a determining factor in the selection of a qualified provider, since the policy often spells out exactly what type of services (or service providers) will be reimbursed. It is important to establish a good rapport with a therapist, and some individuals may change service providers until a comfortable or effective “match” is found.
Physicians – Physicians are medical specialists who have an MD degree from a college of medicine. Psychiatrists are medical physicians who specialize in the diagnosis, prevention, and treatment of mental dis orders. As physicians, psychiatrists are the only mental health professionals licensed to prescribe medications.
• Psychologists – Psychologists hold a degree in psychology from an accredited university. In order to be licensed to practice, in most jurisdictions, a doctoral degree, national and/or state exam, and additional supervised practice are also required. Psychologists are qualified to administer and interpret psychological tests.
• Social Workers – The social worker receives a profession al degree, ordinarily the MSW (Master of Social Work), from a school of social work. The psychiatric social worker takes specific training in social case work techniques for rehabilitating psychiatric patients and may choose to be certified after two years of practice and an exam (ACSW or LCSW).
• Nurses – Nurses generally complete a two or four year course of study in a school of nursing. A psychiatric nurse is trained to work with patients with mental illnesses, usually in hospitals. Licensed nurses are qualified to administer medication under a physician’s direction.
Treatment may be received at public or private hospitals, community mental health centers (CMHCS), health maintenance organizations (HMOs), or through the office of an individual mental health care. provider. In-patient treatment (hospitalization) may be necessary when symptoms are severe, but most treatment occurs in out-patient settings.