Ruby Wax is a well-known and respected campaigner for mental health issues. Imagine my surprise, therefore, to open my Times Online this week to the headline “Don’t tell your boss if you’re mentally ill, Ruby Wax advises” (http://www.thetimes.co.uk/tto/education/article4488813.ece – behind a paywall).

I was sure that this was the Times Online taking a quotation out of context to generate ‘clicks’. However, in fact it was merely reproducing Ms Wax’s musings, of which this is an extract:

When people say ‘Should you tell them at work [that you suffer from a mental illness]?; I say ‘Are you crazy?” You have to lie. If you have someone who is physically ill, they can’t fire you. They can’t fire you for mental health problems but they’ll say it’s for another reason. Just say you have emphysema. Mental illness is like the situation used to be with gay rights…..mental illness is now the taboo instead.

Far be it from me to query Ms Wax’s advice on the health side of this, given her own past history of mental health issues, Degree in Mindfulness-based Cognitive Behavioural Therapy and position of Visiting Professor in Mental Health Nursing at Surrey University. I would however take issue with the employment piece – even if her point is merely an over-simplification of the disability legislation, the fact remains that employers can and do dismiss on grounds of both physical and mental ill-health. Our perception would be that the greater reluctance to do so actually lies on the mental illness side, not as Ms Wax suggests. Either way, is non-disclosure really the best advice?

Leaving aside the suggestion that employees lie to their employer about their illness (which will surely be discovered the moment the doctor fills in a ‘fit note” or provides a medical report), her statement seems to fly in the face of one of the mental health campaigns with which she is most prominently involved – Time to Change.

As you may know, Time to Change’s stated aim is “to start a conversation… or hopefully thousands of conversations. We empower people with mental health problems to feel confident talking about the issue without facing discrimination. And we want the three quarters of the population who know someone with a mental health problem to talk about it too.” A truly laudable aim and one which has been echoed by developments in HR and employment practice. At its most basic, the objective is to encourage workers and managers to ask colleagues “How are you?“, the corollary being that this should allow them in turn to be honest with their feelings and health. The idea is that most employers would rather know that someone is unwell and see how they can help them, rather than have employees suffer in silence at who knows what cost to them and the business.

But what of Ms Wax’s advice? In our experience, hiding an illness will likely lead first to ‘presenteeism’ (where an employee turns up to work regardless but their performance suffers), then absenteeism and damaged relationships between the employer and the employee – if not irreparable harm to the employee’s mental health.

So which approach is the best? Hiding in plain sight, or just plain old openness? The answer may depend on who you speak to:

For employers, the correct approach in our view has to be to encourage staff to tell you of their issues. At least then you can consider what adjustments can be made to help them. Deliberate ignorance is quite definitely not bliss in this regard.

For employees, the issue would seem to be more nuanced, as Ms Wax suggests. On the one hand, the fear of stigma would seem to encourage employees to hide their issues, or to blame phantom physical illnesses. On the other, failing to disclose an illness could easily lead to your employer inadvertently making the situation worse and could simply increase the pressure on you at a difficult time. Where you come down on this question will likely depend on the trust and faith that you have in your employer. Our experience is that only a tiny minority of employers would cook up spurious grounds to get rid of someone for the mere fact of his having mental health issues. Many fewer, in fact, than would regard an employee’s dishonesty about his state of health as possible grounds for dismissal.

Regardless, when considering Ms Wax’s comment that mental illness is as taboo as homosexuality used to be, one wonders if we would have had such advances in gay rights over the last 40 years if campaigners had recommended staying ‘in the closet’, as Ms Wax recommends to those with mental illness.