What We Talk About When We Talk About Mental Health at Work
It’s World Mental Health Day.
I’m not the type of person who usually knows these sorts of things, but I am the sort of person who tries to know about mental health—so apparently that makes me the type of person with an inbox full of World Mental Health Day emails.
“Be gentle with yourself.”
“Celebrate what makes you, YOU.”
“We’re here for you.”
Apparently, every app I’ve ever downloaded is thinking of my mental health today.
I think about it every day. My own mental health, that is. It’s the first thing I think about each morning when I take the medications that changed the course of my life. I think about it when the sun starts to set, and I drag myself out into the cold for the exercise that keeps me from crying over touching commercials. I think about it when I journal, and stretch, and breathe.
Lately, employers are thinking about it too. Especially today. As a contractor lurking in clients’ Slack instances, I saw it everywhere this morning: posts about psychological safety and reminders to capitalize on therapy benefits.
This kind of discourse isn’t brand new, but in the grand scheme of things, it sort of is. Our parents never heard about anxiety from their employers, and their parents’ employers wouldn’t have even known how to make sense of it. That we can talk about feeling overwhelmed at work is an honest win.
On the whole, I’m all for this new age of employers caring about mental health. The therapy stipends, burnout seminars, manager trainings where twenty-eight-year-olds are taught how to ask twenty-four-year-olds how they’re really doing—it’s all well and good. Well and great, even.
But on days like today, when employers and boutiques and rideshare apps are all talking to me about my mental health, it always makes something hurt inside of me.
Because we may be talking about mental health. But we’re still not talking about mental illness.
I get that “World Mental Illness Day” doesn’t have the same ring to it. Mental illness isn’t great email-campaign material, and I suppose that’s part of the problem. But in these moments when everyone is talking about mental health, it’s important to remember that we’re not automatically talking about mental illness, as we very seldom are.
Mental health is a state of mind characterized by emotional well-being, good behavioral adjustment, and relative freedom from anxiety and disabling symptoms. It is a state that many of us flow in and out of regularly, pulled by the daily tides of life’s triumphs and hardships.
Mental illness, on the other hand, is a medical condition characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour. Like other diseases, symptoms can ease or return, but a mental disorder isn’t a mindset that improves with willpower or good news.
We blur these two conceptually, partly because of how we talk about them. The modern workplace (which we will localize this critique to since this is, in fact, a newsletter about work) is fluent in therapy-speak. We talk to our managers about triggers and boundaries while our colleagues describe their emotional bandwidth. Our friends talk about their codependency, and we share how our boss gaslit us. We take resilience trainings but still have trauma responses, all while our managers learn to foster workplace psychological safety.
Whether this language has no place in the workplace is a conversation for a different time. But as we grab for our favorite internet therapist’s words to capture what it feels like to be unwell at work, we risk erasing the gulf that lies between distress and true disorder. Conversations about mental health start to sound like conversations about mental illness. Over time, it becomes hard to remember there’s a difference.
To complement this discourse, workplaces have also started offering new accommodations. We have trigger warnings, boundary exercises, and wellness rooms—and, to be clear, those things are all good. But what accommodation do we have for catatonia? What perk program for psychosis?
The benefits and conversations workplaces celebrate today are built for mental health, not mental illness. They help people manage stress, prevent burnout, stay well—and, with the right adjustments, keep on working. Because that is their goal, ultimately: for you to keep on working.
But work requires a baseline ask—that you be functional, stable, and at least “okay enough.” The question we’re still not asking on mental health holidays is what about the people who aren’t?
What happens when someone needs more than a few weeks? When medication trials haven’t worked yet? When an outburst ruins trust that can never fully be rebuilt? What answer does a seminar on vulnerability have for someone who hasn’t slept in three days because they hear voices in their house?
I’ve never been so mentally ill that I couldn’t hold a job. But in my early twenties, I was a proper mess. Manic episodes that lasted months. Migraines from anorexic spells. Panic attacks I could only end by going home and submerging myself halfway in the bathtub. In those moments, meeting deadlines should have been the last thing on my mind, but we live in a world where people work. And so I worked. I was performing, but I was also disintegrating. And HR has no answer for that.
FMLA exists—if you qualify, if you can afford unpaid leave, if you’re well enough to fill out the paperwork but sick enough to justify using it. Deadlines can be pushed, but only so far. Performance reviews still happen. Your reputation still matters. You can take a mental-health day, but you can’t take six months. You can high-function through sickness for longer than should be possible. But you can’t do it forever.
The day I knew I needed more serious help, it was because I messed up at work. Work—the one thing I had to be good at, and the one place I couldn’t turn to for help.
Where I turned instead was treatment: months on a waitlist, great insurance, a psychiatrist who got it right, and—luckily—mild reactions to high-side-effect medications. Today and forever, I will consider the success of that treatment the single greatest blessing of my life.
Mentally ill people don’t need wellness perks. They need treatment—real treatment: psychiatrists, medication, therapy that lasts longer than six EAP sessions, and time to find what works. That’s not an employer’s job to provide, and it shouldn’t be. As much as I love a wellness day, we cannot let mental health care become the responsibility of employers.
The problem is, we’ve built a system where accessing treatment often depends on employment. You need a job to get insurance, insurance to see a psychiatrist, and a psychiatrist to get stable enough to keep your job. Fall out of that loop, and you can fall into dark places that, if you’ve never seen, I hope you never do.
This doesn’t mean workplaces should do nothing. Therapy stipends help. Flexible schedules help. Mental-health days do help! These things keep people well, and that matters. But we live in a society where work and mental illness have not learned to coexist. So when we talk about building workplaces that are supportive of mental health, let’s not mistake support and decency for inclusion. We offer help for people who are well enough to work. We should call it what it is.
While this may read as a condemnation, I only mean for it to be a call for honesty. What mentally ill people need can’t be offered through email promos or Slack. We need healthcare that doesn’t depend on employment and disability systems that don’t require you to be sick enough to qualify but well enough to navigate bureaucracy. We need social support that catches people before they lose everything. These aren’t workplace problems—they’re societal ones. But the way we talk about mental health at work is how we talk about it elsewhere. And that makes it our problem.
So on World Mental Health Day, as I click through the emails and announcements, I’m grateful to be in a world that wants people to be well. And still, I can’t stop thinking about the people who aren’t at work today—not because they’re taking a mental-health day, but because they can’t come back.
My only ask is that you consider what it would mean to recognize them too—and remember that while we’ve gotten good at checking in, we still don’t know what to do when someone says, I’m not okay.