Employees’ guide to bipolar
disorder and employment
Bipolar UK
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Contents
• Foreword • Coping with Bipolar at work
• Working with Bipolar • Warning Signs
• Examples of different Warning
• Medication
Signs
• Support • Examples:
• Return to work • Access to Work
Appendix A – The Disability Discrimination, Health and
Safety and Equality Acts.
• Unlawful discrimination in • What is meant by unlawful
employment discrimination?
• When is less favourable
• About the Equality Act
treatment justified?
• Code of practice • Reinstatement
• Case studies • Where to find help
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Foreword
One in four people will be affected by mental illness at some time in their
lives. An estimated one in a hundred people will develop bipolar disorder
– otherwise known as manic depression. Yet despite the high incidence of
mental illness, it is still little understood or acknowledged.
In 2006, mental health disorders accounted for 41% of those on incapacity
benefit in England. Alongside stress, mental health problems are now the
leading cause of absence from work and it is estimated that at least 35%
of all GP consultations involve a mental health problem.
Sick leave is no longer considered the best solution – for employees or
employers. The chances of those individuals signed off sick returning to
work after a period of six months is only 50%. After one year this drops to
25%, and after two years only 5% return to work. In recent years, there
has been a move away from sick leave towards a more optimistic plan of
work-based recovery. Taking prolonged time off lowers an individual’s
confidence, motivation and sense of identity.
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Piloted in Wales and now rolled out throughout the The most
UK is the government-endorsed ‘Fit note’ important step
programme. This approach sees work as a is to inform
prescription towards recovery. The Fit note highlights your employer
areas of suitable employment in respect of an that you have
identified illness. The Fit Note aims to encourage bipolar
communication between doctor, patient and disorder.
employer and help to facilitate a return to work as
soon as possible. Without this
knowledge,
This guide is designed to advocate best practice in they cannot
the employment of people who have bipolar disorder reasonably be
by providing guidance on how to manage a successful expected to
return to work and highlighting the rights that help make provision
protect a disabled employee. for you and
your medical
Coping with bipolar disorder at work condition.
If you have bipolar disorder and you’re finding it hard
either to get to work – or to do your work when you’re there, take heart;
you’re not alone.
Taking prolonged time off can lower your confidence, motivation and
sense of identity.
Working with bipolar
People with mental health problems such as bipolar disorder are often
confronted with prejudice in the workplace. This is usually born out of a
lack of knowledge and understanding.
An employer has a duty to provide a working environment that
encourages good mental health. They must also combat any damaging
practices that may lead to ill health, such as bullying.
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Mental health promotion in the workplace can strengthen the individual
through increasing their resilience and self-esteem and providing support
to those who need it. By educating staff about mental health,
preconceptions can be challenged.
Your employer can improve staff retention by challenging mental health
issues in the work place. Failing to prioritise staff health and well-being
can have legal consequences for an employer.
Warning signs
Different work environments and professions will result in varying levels of
associated stress. To maintain a healthy and productive working role it is
important to feel that you have control over your work, as well as
understanding the demands of your job. Other important factors are the
support you receive from managers and colleagues and how the company
manages change in the work place.
The most common causes of work stress and mental health problems are
increased work intensity, less security, less autonomy, target-driven work
cultures, bullying and harassment.
Look out for warning signs (see list) that your work is being affected by
your condition.
If you start to notice any of these warning signs, then it’s time to get some
support. Talk to your manager or the HR department and they should
work with you to make any necessary changes.
Avoiding the problem will make things worse; it’s best to deal with any
issues earlier rather than later.
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Examples of different warning signs:
• decreased concentration and
• repetitive thinking
memory
• difficulty in decision making • negative thinking
• thoughts of escape • lack of objectivity
• nervousness, fear or sadness • frustration and irritability
• headaches, digestive
• weight fluctuation
disorders and chest pains
• working late or early, or missing
• sleep disturbance and fatigue
work to avoid the stress
• being less agreeable with
• taking risks with your health
others
• increased use of substances
Medication
There may be times when you change your medication on the advice of
your GP or consultant psychiatrist. It can take a long time for a new
medication to work. It is therefore important that your employer shows
understanding and recognises that you may require extended periods of
absence.
If adequate support and encouragement is given during this period of
adjustment, you should soon be back in a normal working routine, causing
minimal disruption to the organisation.
Self-management
Self-management is about recognising triggers of an episode of mania or
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depression and managing your lifestyle around avoiding them. Some of
the most common triggers are sleep deprivation, bereavement,
relationship problems, and in some cases, a reaction to excess amounts of
caffeine, alcohol or cigarettes.
The majority of these can be avoided and managed properly. For
situations beyond our control it is important that safety nets are in place
to avoid illness. For example, being allowed time off to attend outpatient
appointments or counselling can help head off an episode of manic
depression.
An employee with bipolar disorder has a
responsibility to know their personal
management needs and to inform their
employer about their condition.
The employer’s responsibility is to
recognise that the individual is attempting
to manage their illness and to put simple
policies in place to prevent unnecessary
stress or anxiety for all their employees.
Support
Making even the smallest adjustments in the workplace can have a huge
impact on an individual’s well-being. Adjustments may be temporary or
permanent, and may improve the working environment for everyone, not
just the individual. Bipolar is covered by the Disability Discrimination Act
and Equality Act. (see appendix A).
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When discussing any adjustments with your employer, bear in mind that
changes must be reasonable and possible to achieve. The aim is to reduce
any disadvantage you are experiencing in the workplace because of your
bipolar disorder.
Examples:
• Providing technological or human assistance in a role
• A personal mentor system
• Providing a clear and detailed job description
• Arranging for work requests to be put in writing
• Receiving positive as well as negative feedback during appraisals
• Office environment modification for those who have trouble
concentrating or those who feel isolated
• Provision of time off for specialist appointments
• Use of sick leave for emotional and cognitive reasons, not just
physical illness
Return to work
If you have been on sick leave, it is useful to arrange a Return to Work
meeting to discuss your needs and your employer’s expectations. You may
be able to include your consultant psychiatrist in this meeting and have
the right to request support and that a union representative is present.
During this meeting discuss and agree any adjustments that need to be
made. Agree how progress will be monitored and what your colleagues
will be told. You should ask your employer to identify specific tasks and
roles for your return. Finally, agree the support systems available to you
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in and out of work and confirm a suitable starting date.
Remember, when it comes to support, your workmates can be your allies.
The most important factors for a successful return to work are that you
believe you are ready to go back and that you are actively involved in
organising the terms of your return to the workplace.
Access to Work
Access to Work is a Department for Work and Pensions scheme designed
to financially assist employers with costs beyond that of reasonable
adjustments, helping to produce a more efficient support system in the
work place.
Examples can include awareness training for staff, sickness cover for those
with a fluctuating condition and specialist equipment to assist in adapting
your role to your disability.
Although the Access to Work Scheme assists greatly in providing support,
the employer is still responsible for complying with their legal duties under
the DDA. To enquire how Access to Work may be of benefit to you please
contact the MDF Employment Service.
You must be in employment to qualify for Access to Work. Please visit
www.direct.gov.uk for more information.
Further and more detailed information packs on mental health in the
workplace, the Disability Discrimination Act and practical interventions
are available from:
Bipolar UK
2 Macon Court, Herald Drive, Crewe , Cheshire. CW1 6EA
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Appendix A
The Health and Safety at Work Act, the Disability
Discrimination Act and the Equality Act.
Under the Health and Safety at Work Act 1974 all employers have a duty
of reasonable care for their employees. This includes the mental well-
being of an individual. Employers must assess all health and safety risks,
take preventative action and carry out health and safety training in the
workplace.
Monitoring these acts is the Health and Safety Executive (HSE). The HSE
can assist the employer to carry out Risk Assessments and implement risk
reduction measures. The HSE is also able to serve improvement notices
and set deadlines to encourage development.
The Disability Discrimination Act (DDA) was passed in 1995, and amended
in 2005.
Definition of disability under the Disability
Discrimination Act
The Act provides protection to those persons who have a ‘disability’. It
states “a person has a disability … if he has a physical or mental
impairment which has a substantial and long term adverse effect on his
ability to carry out normal day-to-day activities”.
According to the DDA a disabled person may suffer from any of the
following: blindness, severe disfigurements, progressive conditions such as
HIV, cancer etc, physical disabilities and mental impairments including
bipolar disorder. The 2005 Act added that a mental impairment need not
be clinically recognised.
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Long-term means any impairment that has lasted or is likely to last at least
12 months.
Normal day-to-day activities can be the things that we take for granted
such as mobility, manual dexterity, physical coordination, continence,
speech, hearing, eyesight, concentration etc.
The DDA covers all employers regardless of size. It also protects agency
staff and job applicants.
The only exclusions to the Act are:
• members of the armed forces
• those with addictions or dependence on substances not medically
prescribed
• those with seasonal allergic rhinitis
• people who have tendencies to set fires, steal or abuse others
• people with conditions such as exhibitionism and voyeurism
• those with tattoos and body piercing
Unlawful discrimination in employment
The DDA makes it unlawful for an employer at any establishment in Great
Britain to discriminate against those with a disability in areas of
applications for employment, promotion, training and development, terms
and conditions, benefits and the dismissal process.
What is meant by unlawful discrimination?
Discrimination occurs when a disabled person is treated less favourably
than someone else and:
1. the treatment is given for reasons relating to the person’s
disability and that reason does not apply to the other person
(comparator) and
2. this treatment cannot be justified.
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Under the DDA an employer can discriminate against a person in the
following ways:
• Direct discrimination: by treating a disabled person less favourably
on the grounds of disability. Examples include refusing to employ
someone when they declare their disability or a blanket ban
policy: internally advertising but stating that no-one with a
disability may apply.
• Disability related discrimination: by treating a disabled person less
favourably for a reason related to their disability. An example
would be an employer dismissing an employee if they took three
months sick leave after a relapse of bipolar. They are dismissed
not because of their illness but for a reason related to their
bipolar.
• By failing to make reasonable adjustments to the workplace or
working arrangements.*
• Victimisation of a person (whether or not that person is disabled).
*NB: Also, the UN Convention on the Rights of Persons with Disabilities
makes it a Human Right to have workplace adjustments made.
New ways of claiming disability discrimination have been introduced with
the Equality Act - ‘Discrimination arising from a disability’ and ‘Indirect
discrimination’ replace the current ‘disability-related discrimination’
under the DDA.
Direct discrimination and harassment based on association (an individual
whom is associated with a disabled person) or perception (an individual
who looks as though they have a disability which they do not have) under
the Equality Act is also unlawful.
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About the Equality Act
The Equality Bill was designed to strengthen and unify all discrimination
law, tackling case laws (see Case Studies: Malcolm) that have previously
damaged discrimination protection and brought into question the integrity
of the Disability Discrimination Act.
On 8 April 2010 the Equality Bill was given Royal Assent and successfully
introduced as an Act of Parliament. The Equality Act has the support of all
three major political parties and under its law there is no justification
defence for failure to make agreed reasonable adjustments.
When is less favourable treatment justified?
There is no set answer for whether discrimination can be justified. The
reason for less favourable treatment has to be a substantial one and
decisions are made on a case-by-case basis. Generally, whether the
treatment can be justified will depend on the nature of the person’s job,
the size of the employer and how the disability affects their capability to
do the job.
Example: An employer could probably not justify dismissing a disabled
employee because they are sometimes off work due to their disability, if
the amount of time taken off is little more than what the employer
accepts as sick leave for other employees.
Code of practice
The Government has published a code of practice, under the DDA, to
provide practical guidance about the elimination of discrimination against
disabled people in the field of employment.
A Code does not impose legal obligations, but industrial tribunals and
courts must take account of the Code, where relevant, when considering
complaints.
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Reinstatement
Reinstatement is an option that a tribunal can adopt in disability cases.
Given the difficulties that disabled people have in obtaining employment it
might be an important consideration for the disabled person to consider
reinstatement rather than compensation.
Case studies
Malcolm Case Law.
An individual with schizophrenia sub-let his council-owned property. As this
was against the signed agreement the council served notice and brought
about proceedings in order to repossess the property.
The tenant fought this decision on the grounds of disability discrimination,
arguing that his actions were a result of schizophrenia.
As the council’s actions would have been the same for any other individual
that sub-let their property, the courts ruled that there was no direct
discrimination.
This had a detrimental effect on the Disability Discrimination Act and
warranted a review of its purpose. With the introduction of ‘indirect
discrimination’ the Equality Act intends to rectify the damage to disability
discrimination claims caused by the Malcolm Case.
Coleman Vs Attridge
Sharron Coleman claimed that she was forced to quit her job after
requesting time off from work to care for her disabled son. Managers
accused her of being lazy and she accepted a voluntary redundancy.
In 2005 Coleman brought a claim for constructive dismissal and disability
discrimination. In 2009 Coleman won an Employment Appeal Tribunal
case. By dropping its challenge of this appeal her employer confirmed
without doubt that discrimination by association is unlawful.
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Where to find help
Bipolar UK National Office
11 Belgrave Road, London
SW1V 1RB
Email: info@bipolaruk.org.uk www.bipolaruk.org.uk
Tel: 020 7931 6480 Fax: 020 7931 6481
Bipolar UK Member Services
To join please call us on: 020 7931 6480
If you subscribe to member services you can call a dedicated helpline to
assist with one off immediate needs.
Bipolar UK
Clarence House
Clarence Place
Newport
NP19 7AA
Email: walesinfo@bipolaruk.org.uk
For enquiries in the Midlands and the North of England - and for all
enquiries relating to self-help groups and employment please contact:
Midlands and the North of England Office
Bipolar UK
2 Macon Court, Herald Drive, Crewe, Cheshire
CW1 6EA
Email: groupdevelopment@bipolaruk.org.uk
Telephone: 0845 434 9970 or 01270 230260
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