Adam has a secret. He's shared it with his family and close friends. In fact, he would like to talk about it more openly. But he doesn't want to use his real name in this story because he fears that people at his new high-tech job will see it and think less of him.
Adam has depression. Since high school, the 27-year-old South Bay resident occasionally has suffered periods when he is more than just blue; he has no energy to get out of bed, and feels hopeless and like he's "been hit by a truck."
A few months ago, he considered allowing a reporter to mention his depression in a news story about a community project in which he was involved. His depression was one of the reasons he got involved: "I guess I was tired of feeling like I have to hide this piece of me," he says.
But he was job-hunting at the time, and friends worried that prospective employers would see the story online and toss his application. The pragmatist in him conceded, and he asked to keep his depression out of the story. Coming off two years of unemployment in a tough economy, he needed a job. Also, he didn't just need to work to pay his bills; having a job was crucial to his sense of self-worth.
Was Adam being overly cautious? After all, many of us think we live in enlightened times when people don't lose jobs or opportunities because they have depression, anxiety, obsessive-compulsive disorder, bipolar disorder or schizophrenia. But that's not the case. Bay Area mental health advocates point to studies that show people with mental illness have the highest rates of unemployment of all disabled and that half of U.S. employers are reluctant to hire someone with a past psychiatric history or currently undergoing treatment for depression.
The issue reflects our culture's understandably ambiguous feelings about mental health issues.
In one news cycle, a celebrity such as Catherine Zeta-Jones or film such as "Silver Linings Playbook" is hailed as courageous for presenting positive images of people with mental illness. But the next day's stories dwell on how the latest suspect in a mass shooting was hearing voices, fueling the belief that people with mental illness are unreliable, emotionally unstable, even dangerous.
"We still have a long way to go," says Lisa Smusz, executive director of PEERS (Peers Envisioning and Engaging in Recovery Services), an Alameda County-based nonprofit working to end mental health stigma and discrimination.
One in five
More of us are dealing with various forms and degrees of mental illness than we may realize, she says. Nearly 46 million adult Americans -- one in five -- experienced a diagnosable mental, behavioral or emotional disorder in the previous year, according to a 2012 report by the U.S. Substance Abuse and Mental Health Services Administration.
But while mood and thought disorders are prevalent, they usually are less understood because they are "invisible," says Nadine Dixon, a former member of the Berkeley/Albany Mental Health Commission. In a workplace, a person's condition may only show up in subtle behaviors, or in gaps in his work history.
At the same time, the ability to work is an important part of recovering from mental illness -- along with getting medication, a good therapist and family support and living a healthy lifestyle, says Brian Hill of Black Men Speak, an organization that helps African-American men with mental health challenges.
Work allows people who tend to isolate and feel inadequate to engage socially and feel needed and successful, experts say. But several Bay Area residents say they've lost jobs or work opportunities, in a range of industries, because of their disabilities.
A 54-year-old Foster City woman said she was fired from her sales job in March 2013 when her boss said the time she took off for medical appointments -- which included visits to her therapist -- prevented her from meeting her quotas.
Like Adam, she asked that her name not be used because she doesn't want it associated with her diagnosis in online searches.
Dixon, of the health commission, understands the challenge firsthand. She received stellar reviews for the 13 months she worked at an East Bay program that provides housing for low-income single mothers. She figured that her life experiences made her a strong advocate for her clients. She raised a daughter and worked low-wage jobs. As her mental health stabilized in her late 40s, she went to college and earned bachelor's and master's degrees in economics and public policy from Mills College.
But a new boss came in, and Dixon lost her job a month later. Since then, she's heard from colleagues that a new supervisor was making inaccurate statements about her condition. More recently, Dixon interviewed with a global consulting firm and was told that they really liked her, but the company only offered her a temporary contract because they didn't think she "fit into the culture."
Like others interviewed, Chris Velarde, 33, of South San Francisco, would like to be open about his bipolar disorder. He receives plaudits for regularly sharing his story with Bay Area medical schools and community organizations as part of the San Mateo County-based Stamp Out Stigma.
But being candid during an interview for a personal trainer job at a gym did not go over well.
"I told them because I wanted them to know there might be special issues. I wanted to be an honest employee and figured they were going to find out eventually." His interviewer told him, "We don't have the time for that."
The lesson for Velarde? He won't be an "honest employee" again -- at least not until after he's landed the job.
State and federal laws prohibit discrimination against people with mental illness in the workplace and in hiring, says Chad Saunders, an Oakland attorney who is also interim president of the PEERS board of directors.
Still, employers simply may choose not to consider an applicant they suspect has a mental illness, and workers are hesitant to ask for time off or other accommodations for their illness, Saunders says. This is especially true for people who work in any field -- from law enforcement to high tech -- where depression or anxiety could be viewed as "a weakness."
By law, employers must provide "reasonable accommodations" for people who can perform the functions of the job. Accommodations can include flexible hours, modifying how feedback is given or allowing someone prone to anxiety to work in a quiet room rather than a noisy open office.
On a positive note, Saunders adds that in most disputes he's handled between an employer and a worker, "we've been able to work things out."
Often it's just a matter of helping an employer understand that a mental illness doesn't lessen a person's ability to be a productive employee, he says.
For employers, they may be frustrated by an otherwise good worker who is calling in sick, lacks focus or is not "being a team player," says Marcas Miles, director of programs and communications at Employers Health, a national Ohio-based employer coalition. "But they haven't before had a way to address the subject. It's a hands-off topic," he says.
He also cites figures from the Centers for Disease Control and Prevention that depression costs employers as much as $44 billion a year in lost workdays. Realizing their bottom line could improve by helping workers, employers are starting to get on board with a new initiative to reduce stigma around mental illness, Miles says.
The initiative, the Right Direction, was created by Employers Health and the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation. The Right Direction website includes a downloadable tool kit that provides businesses with strategies to reduce stigma in the workplace.
A new host of anti-stigma campaigns have also been launched at the state and county levels and involve people with "lived experience" sharing their stories in a variety of public settings, including workplaces. These campaigns are funded by Proposition 63, the Mental Health Services Act. Proposition 63 also aims to close the employment gap by training mental health "consumers" to work in mental health organizations.
Julian Plumadore worked for 30 years in Oregon's state government but is much happier in his job as a community advocate for the Mental Health Association of San Francisco. For one thing, managing his schizoaffective disorder -- a condition that features symptoms of bipolar disorder and schizophrenia -- is considered an asset.
"It's the first place where I've been able to be completely open and honest about my past and present," he says. "That's cool for me personally, that I've been hired not despite of my experiences but because of those experiences."
Research shows that people who have disclosed aspects of their mental illness report an enhanced sense of empowerment and self-confidence that allows them to achieve personal and professional goals, according to the Coming Out Proud manual.
The manual, however, notes that disclosure is risky, especially in the workplace. If you're job-hunting, sharing information about your illness can hurt your chances of getting hired, which is why Oakland attorney Chad Saunders, who specializes in employment discrimination, usually advises people to not say anything until they've secured the position.
If you open up about your condition in your current job, you could be shunned by co-workers, denied opportunities for advancement and even let go, the manual says. On the other hand, co-workers might help you out -- dealing with a difficult boss, for example. Co-workers also might reveal similar challenges, and you may find a boss willing to help you stay in your job and succeed. The manual, which has a workbook that helps people weigh the pros and cons of disclosure and strategies for effectively sharing their stories, is available at www.stigmaandempowerment.org.
The Federal Americans with Disabilities Act (ADA) and California's Fair Employment and Housing Act (FEHA) prohibit employment discrimination for those with mental health challenges at public and private employers with five or more employees. Legally, employers must provide reasonable accommodations to an employee or job applicant with a disability when that person can perform the essential functions of the job.
For more information on the ADA or FEHA, visit Disability Rights California, www.disabilityrightsca.org.
Employers can find strategies to address mental health issues and reduce stigma at the Right Direction website, www.rightdirectionforme.com. The website, with a downloadable toolkit, was created by Employers Health and the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation.