Navigating through a mental health conversation

QUESTION: An employee has disclosed a mental health condition, what are the best practices for navigating the conversation?

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Reading your question brought a smile to my face because it is asked frequently. In Kenya, most young people are at peace with a diagnosis of a mental health condition. This is a new and very healthy turn of events.

This then brings us to you and your employee and how you can navigate the ‘explosive’ news that he has developed one of the 300 or so mental disorders.

These conditions range from what we call common mental disorders (CMD) such as anxiety and depression to the more severe and chronic conditions such as schizophrenia. These are as different as day and night in the causes and outcomes of treatment. Which of these disclosures has he made?

To make the point dramatically, has the employee disclosed that he has the mental health equivalent of a common cold or that he has the equivalent of cancer of the lungs that has spread to his bones?

This extreme example is intended to get you to appreciate that disclosure of any medical condition must be followed by your understanding of the meaning and consequence of such disclosure. The understanding of the course of the condition is at the core of what you might be expected to do.

To take another extreme example, the travelling salesman might make such disclosure so that you know that he has ‘flying phobia’ and is no longer able to perform the regional sales job that you hired him for because he can no longer fly. As could happen, you might have a vacancy in the training school where he could continue to serve the company. Problem solved!

In a similar vein, the disclosure might be that a member of staff has been diagnosed with postnatal depression and advised to take some time off her job as Chief of Surgery.

In yet another example the 59-year-old employee might disclose the diagnosis of early onset dementia related to his chronic alcohol use and might be asking to be allowed to retire one year earlier than contractually mandated.

For the sake of clarity and emphasis, two things come glaringly from the question you raise. The first is that there are many different types of mental disorders with many different potential outcomes.

The other point is that your use of the word “disclose” connotes the possibility that there is a matter of secrecy between the staff member and the company. As you contemplate this point, just remember that up to 25 percent of all of us will suffer one type of mental disorder or other in our lifetime. Might you be one of them?

Dr Njenga is a psychiatrist and mental health consultant who has authored several scientific papers and books