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Mental Health as a Dimension of Inclusion

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

March 3, 2023
By Tanya Settles

One of the most recent and important focal points for public administration is long overdue attention to mental health as part of professional service. Public administrators have dual responsibilities to address mental health in terms of how we interact at work and through the design of public policy that supports communities we serve. As a result, mental illness has risen to the top of many public agendas. At the same time, addressing mental health as a dimension of organizational belonging is often overlooked. 

When bad things happen in the public sphere, there’s often a call to shift focus toward mental health.  Every conversation after a mass casualty event typically ends with the promise to look at mental health, thereby implying that mental illnesses and the people who experience them are scary, unpredictable and dangerous. Dismantling the stigma of mental illness begins by supporting inclusive work environments where the myths and stereotypes are separated from reality. But even public sector organizations that adhere to a policy structure designed to ameliorate inequity related to disability are all too ready to place blame on mental illness, often placing those who experience mental health conditions in the “bucket of otherness.” The stigma associated with mental illness is real, and the impacts are felt by people who live in fear of exposing a condition for which they are entitled to protection and accommodation. 

Mental Illness and Intersectionality

As many as 1 in 5 adults in the United States experience mental illness or conditions that affect their thinking, feeling, behavior or mood. For about 5 percent of adults in the United States, mental illness creates a serious functional impairment and substantively limits at least one major life activity. For comparative purposes, the percentage of adults who experience serious mental illness each year is about the same as the percentage of people who have serious hearing or visual impairments.

Mental illness itself doesn’t differentiate between who it strikes and who it doesn’t, but the interconnected nature of dimensions of diversity with one another, is a factor when we look at nuanced relationships between elements of diversity. People who identify with 2 or more races are more likely to report serious thoughts of suicide; Asian youth with major depression are less likely to receive specialty mental health care; and although prevalence for schizophrenia is similar across races, African Americans are more likely to be diagnosed with schizophrenia compared to Euro-Americans. Unacknowledged intersectionality makes it easier to put people with mental disorders in the “other” category. Defining people by their “otherness” creates opportunities to let fear get in the way of seeing the whole person, thereby increasing the risk of making decisions based on stereotypes and inaccuracies.

3 Steps to Dismantling Stigma at Work

Step 1: Know the Law. Mental health discrimination is costly, and public entities are not insulated from the risk of liability. A 2022 mental health disability discrimination lawsuit against a state House of Representatives resulted in a jury award to the plaintiff of over $3.3 million, including compensatory and punitive damages. Moreover, the web of laws and regulations that cover disabilities can be complicated.  As a result, governments may need to provide extra support to managers so that they better understand mental health conditions that qualify as disabilities and avoid stereotyped decision making.

Step 2: Edit Or Audit People Management Practices. Relying on myths and stereotypes creates liabilities for public organizations in terms of internal operational policies as well as public policy. It is incumbent upon governments at all levels to lead by example and take a close look at how internal people-management policies are written and carried out. Expecting private organizations in the communities we serve to engage in inclusive business practices when we don’t use the same lens to examine ourselves is unrealistic and disingenuous. 

Step 3: Banish Stigma From Organizational Culture. Build a workplace culture that creates opportunities for all people to thrive, including efforts that dismantle mental health discrimination. First, be cognizant of language that refers to people as “crazy” or other derogatory terms that may be triggering to people who experience mental health conditions. Second, recognize the prevalence of mental health conditions and create positive and safe environments for employees. Options may include establishing employee resource groups (ERGs) as a place for camaraderie, creating opportunities for shared learning among the workforce and gaining deeper understanding about the negative impacts of stereotypes. 

With work and compassion, public sector workplaces can gain the capacity for inclusion and equity and at the same time, lead communities in recognizing that mental health issues do not need to separate us from one another. Welcoming all people with different perspectives, abilities and experiences makes public organizations stronger and that in turn, supports the communities you serve. 

Author: Tanya Settles CEO of Paradigm Public Affairs, LLC.  Tanya’s areas of work include relationship building between local governments and communities, restorative justice, and the impacts of natural and human-caused disasters on at-risk populations. Tanya can be reached at [email protected]. The opinions in this column and any mistakes are hers alone.

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