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Mental Illness is Expensive to Employers

I remember one job I had where I was open about my bipolar disorder. After being passed over for a supervisor position three times despite getting excellent reviews, I scheduled a meeting with my manager.

The moment I sat down to speak with her about not even being considered for a promotion she sad, “this has nothing to do with your problem.” Obviously, it did. But even excellent performance cannot mask the fact that the chronically ill employee may be very expensive.

Individual contributions help make companies successful, and surely people with mental illness contribute greatly to their employer’s success. However, people with mental illness may also contribute greatly to their employer’s health care and productivity costs.

All companies seek to minimize costs. In doing so they may limit opportunities available to those with a known mental illness in order to avoid the significant costs often associated with psychiatric conditions.

How much does an employee with mental illness cost? Consider the costliest disorder to employers, bipolar disorder: A study published by Laxman, Lovibond, et al collected data on a sample of 761 workers with bipolar disorder and 229,145 workers without bipolar disorder.

The annual cost of healthcare for an employee with bipolar disorder was $6,836 more than the control group average ($9,983 vs $3,147). And the cost wasn’t just skewed high due to the cost of psychiatric care. Many physical health conditions are co-morbid with bipolar disorder, so the group with bipolar disorder scored higher costs in every measurable healthcare cost category.

But these expenses only accounted for 20% of the total cost of bipolar disorder to employers. Indirect costs proved even higher.

The absentee rate for the bipolar group was 18.9 workdays per year. Workers without bipolar disorder missed 7.4 workdays. Because the number of missed workdays was so large, many in the bipolar group spent time on short-term disability, adding increases in insurance premiums and decreases in ratings to the cost of lost days of work.

Worker compensation costs were also significantly higher.

In terms of productivity, the output of the workers with bipolar disorder was 20% less than that of those without the illness. This was impacted by the decrease in performance brought on by working while cycling through a depressive or manic episode, and the impact of missed days of work.

As companies seek to limit healthcare and associated costs, we’re left with the cost to workers of stigma and discrimination. In fact, a majority of the workers with bipolar disorder interviewed reported that stigma in the workplace led to their being dismissed from positions, denied promotions, demoted, or held back in their career in other ways.

Because of the Americans’ with Disabilities Act employers are supposed to overlook a person’s chronic health condition when considering employing or promoting workers. But with an eye on the bottom line and a need to maximize productivity, many managers can’t.

Stigma is overcome when people prove themselves competent and dependable. Celebrating our qualifications and successes helps others to see us as able and desirable individuals, not stereotypes or statistics. When well, we’re called upon to shine a light for others walking the same path through illness toward success.

But on second thought, you may want to be cautious about doing this at work.

So here I am, an advocate for openness, acceptance and self-reliance, telling you to keep your illness from your manager. If you seek accommodations, do so through HR. Your boss and co-workers do not have to know the reason why.

There are ways that each of us can fight the stigma of mental illness. Only by each asserting that mental illness does not mean idleness or irresponsibility can stigma be overcome. But mental illness is expensive. Your job may not be the best place to wage the battle.



Mental Illness is Expensive to Employers

George Hofmann

After much of a life spent in and out of hospitals, jobs, and relationships, George has spent the last dozen years living successfully with bipolar disorder 1. He teaches meditation as an adjunct therapy for mental illness, and writes and speaks about the therapies of meditation, movement, and meaningful work. Visit George at or join the Facebook group Practicing Mental Illness

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APA Reference
Hofmann, G. (2019). Mental Illness is Expensive to Employers. Psych Central. Retrieved on April 6, 2020, from


Last updated: 12 Apr 2019
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