The key to supporting employees with chronic mental illness: flexibility and trust

More than 20% of Americans will be diagnosed with mental illness in their lifetimes. They will, that is, experience conditions that influence the way they think, feel, and act—and that may initially seem incompatible with the demands of work.

Our new research suggests that what people living with chronic mental illnesses need most to succeed at work is for their managers to be flexible and trust them.

This includes the freedom to adjust their schedules and workloads to make their jobs more compatible with their efforts to manage and treat their symptoms. For that to happen, managers need to trust that these workers are committed to their jobs and their employers.

We’re management professors who reviewed hundreds of blog and Reddit posts and conducted in-depth interviews with 59 people. And those are the most significant findings from our peer-reviewed study, published in the October 2025 issue of the Academy of Management Journal.

Scouring Reddit posts and conducting interviews

We gathered our data from three sources: anonymous blog posts from 171 people, Reddit posts from 781 people, and in-depth interviews with 59 workers employed in a variety of jobs across multiple industries.

All these people worked while dealing with chronic mental illness, such as major depressive disorder, generalized anxiety disorder, and bipolar disorder. The blog posts were maintained by a nonprofit concerned with the experiences of individuals living with mental illness. We focused on posts tagged “work.”

To identify relevant data on Reddit, we searched using a combination of the word “work” with several terms associated with mental illness. Additionally, we restricted our data collection to unsolicited narratives published prior to mid-March 2020 to avoid overlap with the employment changes that occurred during the COVID-19 pandemic. Because this data was gathered from the internet, we couldn’t obtain details about participants’ gender, age, profession, or education.

We also recruited people to interview through social media postings, advertising in a public university’s alumni listserv, and contacting an organization that focuses on men’s mental health. We also made requests of those we’d already interviewed to see whether they had recommendations for other people to possibly interview.

The interviews took place in 2020 and 2021.

Speaking with people from all walks of working life

About 37% of the people we interviewed identified as women, and their average age was 41.5 years. Approximately 80% of them identified as Caucasian, 3.5% Black, 3.5% Hispanic, and less than 2% identified as either Indian, Korean American, mixed race, or Middle Eastern and North African. About 3.5% chose not to answer.

They held a variety of jobs, including lawyer, professor, touring musician, consultant, teacher, real estate manager, chief technology officer, salesperson, restaurant server, travel agency manager, graphic designer, tester for manufacturing plant, chemical engineer, and bus driver. Several worked in tech fields.

When the employees who we studied were trusted and given flexibility, they became better able to do their jobs while also attending to their well-being.

Employees who had lived with their condition for years used what we call “personalized disengagement and engagement strategies” to manage their symptoms. That refers to the fact that people with mental illness respond best to different coping strategies depending on their own preferences and symptoms, instead of using generic techniques they learned from self-help resources or peers.

Examples of personalized disengagement strategies ranged from leaving workspaces to meditate to taking a walk to finding a quiet space to cry.

Engagement strategies included immersing more deeply into work and having conversations with co-workers. These coping strategies will sound familiar to most people, including those without any chronic mental health conditions. But workplaces don’t always give employees, regardless of their disability status, the flexibility and self-determination necessary to enact their strategies. In fact, a recent survey by Mind Share Partners found that nearly half of employees didn’t even feel like they could disconnect from their jobs after working hours or while on vacation.

Many employees also told us that they benefited from trust and flexibility in the period after they were diagnosed, when they needed to explore different therapies and treatment techniques.

When managers allow for flexibility, trust workers to do what they need to do to address their symptoms, and convey their compassion, employees with chronic mental illness are more likely to keep their jobs and get their work done.

Affecting most employers

Mental illnesses became more prevalent in the aftermath of COVID-19, especially among adolescents and young adults.

So, if you’re an employer, chances are that our research is relevant to your workforce.

Depression, a common mental illness, had an estimated cost of US$1 trillion annually in lost productivity in 2019, the World Health Organization has estimated.

People with anxiety and mood disorders, including bipolar disorder and major depressive disorder, may periodically have symptoms that interfere with their ability to do their jobs.

And while doing those jobs, they risk being stigmatized by co-workers who may know little about mental illness or be judgmental about people with those chronic conditions. That adds further stress beyond what others would experience at work.

Employee assistance programs could be falling short

In response, many employers offer benefits to help employees cope with mental and emotional problems, such as employee assistance programs, mental-wellness app subscriptions, and stigma-reduction efforts.

These one-size-fits-all initiatives can help improve functioning for those with occasional or short-term emotional problems, and they can help improve leaders’ ability to respond to employees’ distress, which is crucial.

But as a whole, they are not enough to solve the problem.

Employee assistance programs, which nearly all big companies offer, have not proved systematically helpful to workers in achieving their goals. One study found that they reduced employees’ absences but did not reduce their work-related distress.

Another study even found that workers who used these programs became more inclined to leave their jobs.

Not missing out on peak performers

Contrary to stereotypes, people with chronic anxiety and depression, such as those we studied, are generally as capable of success in the workplace as anyone else in the right context.

Extremely high performers, such as the late actor Carrie Fisher and the Olympic swimmer Michael Phelps, are two such examples of people with a mental illness who were top achievers in their field.

If you were a manager, wouldn’t you want people of this caliber working for you? If so, then it’s important to create the right conditions, which many employers fail to do despite their best efforts.

Needing more mental health support

Companies will face increasing pressure to support those with mental illness and other mental health challenges.

Monster’s 2024 State of the Graduate Report found that Gen Z employees (people born between 1996 and 2010 and are currently in their teens and 20s) are increasingly prioritizing support for mental health at work, with 92% of 18- to 24-year-olds surveyed wanting a job where they are comfortable discussing their mental health at work.

This trend suggests that employers wishing to attract top entry-level talent will need to effectively support mental health, highlighting the importance of continuing to research this issue.

Sherry Thatcher is a Regal Distinguished Professor of management and entrepreneurship at the University of Tennessee.

Emily Rosado-Solomon is an assistant professor of management at Babson College.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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