Mental health leave of absence — Guide for 2023

The current generation of working adults has always been taught to visit the doctor when they feel sick or unwell. However, a very small percentage knew or understood that the same goes for mental health.

Nowadays, taking care of your mental health is perfectly normal, and the stigma surrounding it is extinguished. 

In fact, the World Health Organization notes that around 12 billion working days are lost every year to mental health issues, either due to absence from work or lack of productivity.

Many organizations and employers around the world understand how a mental illness can affect an employee’s overall wellbeing, which has led to introducing mental health leave of absence.

Therefore, many employees might want to know the following:

• What is a mental health leave of absence?
• How do you recognize you need a mental health leave?
• What are your options for taking such leave?
• How do you ask for a mental health leave?
• Why should you take a mental health leave?

What is a mental health leave of absence?

Simply put, a mental health leave of absence represents time off from work (paid or unpaid) that employees use to deal with an underlying mental condition.

Generally, such leave is characterized by taking the time to: 

• Diagnose the mental condition at hand,
• Seek professional treatment,
• Treat the mental condition, and
• Recuperate.

Most employees that are eligible for taking a mental health leave do so for self-treatment, but nowadays, many employers and institutions include policies that allow employees to take the said leave to take care of a family member with a mental condition.

For that purpose, eligible employees may use the US Family and Medical Leave Act (FMLA) to take a mental health leave. This act protects all employees across the states, whether they’re struggling with a physical or mental disease.

It is important to note, however, that the FMLA provisions apply when the condition in question is “serious.” 

According to the FMLA, a serious condition may involve:

• Inpatient care (hospital treatment that requires admission), or
• Continued treatment by a healthcare provider.

However, there are different types of labor laws and provisions that protect employees across the world where different conditions apply, but we’ll talk more on that in the following paragraphs.

Mental health statistics in the workplace

Before we go into details regarding the intricacies of mental health leaves of absence, it might be good to go through some statistics regarding mental health issues in the workplace, and how mental disorders affect employees all around the world:

• In June 2022, the World Health Organization published an extensive report that serves as an overview of mental health issues globally. The statistics in the report show that 15% of all employees have a diagnosed mental disorder.
• Not showing up for work and losing valuable working hours due to taking mental health leave ultimately costs money. According to the World Health Organization, mental disorders cost the global economy over $1 trillion in lost productivity annually.
• A study found that working women are two times more likely to have a common mental health problem than employed men — 19.8% vs 10.9%.
• According to a post-pandemic survey conducted in 2021, 87% of employees reported they believe that employers could help minimize the effects of stress they deal with on a daily basis.
• Due to the stigma surrounding mental health issues, most workers are generally not open to talking about the physical illnesses and issues they might face. On the other hand, according to a study from OHW+, only 14% of employees are open to discussing their mental health issues in the workplace.

How do you recognize you need mental health leave?

In one way or another, we all go through different types of mental difficulties on a daily level. That can be stress and anxiety over work or something more extreme, such as diagnosed mental disorders.

Once you feel like your work is suffering and you cannot focus on the task at hand, this may be a sign you need a leave of absence. But, how do you know for sure?

You can oftentimes recognize that someone is battling with a debilitating mental illness through physical and emotional signs. Some could seem harmless, while others can be cause for alarm.

If we’re talking about physical signs, some of the most common ones include:

• Weight fluctuations (major changes in eating habits/frequency),
• Lack of energy (tiredness),
• Various and frequent headaches,
• Nausea, and
• Changes in sex drive.

However, since most of these signs could point to something else, people tend to disregard them as symptoms of a mental illness. 

On the other hand, emotional symptoms are usually direct indicators that an underlying mental disease could be the root of your problems.

The most frequent emotional signs of a mental disease include:

• Mood changes,
• Sensitivity or apathy,
• Irritability,
• Sleep cycle fluctuations,
• General stress and anxiety, and
• Uncharacteristic behavior.

Still, diagnosing a specific disorder from these symptoms is highly unlikely since many mental diseases exhibit in similar manners. Therefore, it’s important to note to visit a doctor to determine what the disease in question is.

On that note, the World Health Organization (WHO) finds the following as some of the most common mental disorders:

• Anxiety disorders,
• Depression,
• Bipolar disorder,
• Post-Traumatic Stress Disorder (PTSD),
• Eating disorders, and
• Disruptive behavior and dissocial disorders.

In any case, the first step to determining what the underlying problem is should be visiting a doctor’s office and performing all the necessary tests. Once the root of the problem is diagnosed, it’s time to focus on getting better and taking a break.

Can you take time off of work for mental health?

Most countries around the world offer the most generalized sick leave (paid or unpaid) to their employees to tend to their health. Now, depending on the place of your employment, laws and policies will vary, and employers do have a say in some regulatory measures.

Still, physical health has the upper hand when it comes to sick days and leaves of absence, but mental health is slowly catching up, as is the case with US and FMLA. Some of the more advanced countries in the world have taken measures to ensure that no differentiation has been made between the two, such as the UK.

For example, a UK employee has the right to take up to 28 weeks of unpaid leave per year to tend to a disease, whether it’s physical or mental.

Also, Dutch employees are entitled to 70% of their paycheck during sick leave that can last up to 2 years with no repercussions. The Dutch government sick leave policy makes no distinction between physical or mental wellbeing when it comes to absence from work.

Furthermore, there are 12 US states that offer state-approved paid FMLA plans for employees and/or their loved ones that deal with mental issues.

All in all, your work contract will probably state if your employer offers any days for mental health issues, so checking with them is your best option.

How long can you take off of work for mental health reasons?

The exact number of days you can be absent from work depends on two factors:

• Country/state policies regarding mental health, and
• Employer-set policies.

Also, an important factor that can affect your absence is the disease itself. If continuous treatment is necessary for your type of disease and you cannot work until it is completed — i.e. you’re not capable of working — most policies will classify you as “incompetent to work” and you’ll be granted sufficient time to recuperate and get back to work.

Again, your contractual obligations set by the employer might state otherwise, which is why you should always contact your HR or your employer directly.

What are your options for taking time off of work for mental health reasons in the US?

Mental issues pose physical problems, and most physicians will list out the physical symptoms as the “culprits” for your leave of absence. If your place of employment does not include mental health conditions for leave of absence, the doctor’s note will most probably include a physical condition that could grant you a temporary leave.

However, this will not always be the case, and you’ll have to resort to mental health leave policies. Some of the most common policies in the US include:

• Federal Family and Medical Leave Act,
• State Family and Medical Leave Act,
• Employer-set mental health leave of absence policy, and
• Premium insurance policies.

Federal Family and Medical Leave Act

As previously mentioned, the FMLA entitles all eligible employees to take job-protected unpaid leave of absence for family-related reasons, or in our case, a mental health condition. Under Fact Sheet #280, a mental illness is considered a serious illness, and therefore, employees can use the FMLA to tend to diagnosing and treating a mental condition.

Under the FMLA, an employee can take time off to tend to:

• A serious illness (characterized by inpatient care and/or continued treatment) that renders them incapable of performing the essential functions of their job (12 weeks),
• Take care for a family member with a mental health condition (12 weeks),
• Take care for an adult child with a mental health condition (12 weeks), and
• Take care of a covered service member and eligible veterans with a serious illness (26 weeks).

It should be noted that the eligibility for taking time off under FMLA for mental reasons is the same as for physical conditions, which include that:

• The employee has worked for a covered employer for at least 12 months,
• The employee has completed at least 1,250 working hours in the span of 12 months, and
• The employee works in a location with 50 other employees within 75 miles.

State Family and Medical Leave Act

The FMLA applies to all US employees but if the state plan offers more benefits to the employee, it will take precedence.

In fact, there are 12 US states at the moment that offer paid Family and Medical Leave Act that includes mental health absences:

• California, 
• Colorado, 
• Connecticut, 
• Delaware, 
• Maine, 
• Maryland, 
• Massachusetts, 
• New Jersey, 
• New York, 
• Oregon, 
• Rhode Island, and 
• Washington.

Still, eligibility for each of these states differ, and you should check your local labor laws to find out more information regarding mental health leave of absence.

Employer-set mental health leave of absence policy

Many employers offer benefits and extended leaves of absence when it comes to mental health. That’s why you should always talk to your employer first and see if the employer-set policy offers better benefits than the FMLA.

For example, famous names such as Microsoft, Walmart, and Nike offer paid vacation and personal days for employees struggling with stress and overwork.

Premium insurance policies

Unfortunately, the US FMLA does not require employers to offer paid leave of absence, which is why many employees resort to paying premium insurance policies that include mental health protection. It’s not the best solution, but it does offer some financial support in times of need. 

How to tell your boss you’re struggling and ask for a leave of absence?

After diagnosing the problem and choosing the right option for your leave of absence, the next natural step is to tell your boss and ask for the said leave.

So, what is the best approach?

The first step should be realizing you’re both human and full of understanding. It might seem cliche, but it’s in your boss’ best interest that you are healthy and ready for work. However, bear in mind that there are certain expectations from you as an employee, which is why finding a compromise should be your top priority.

Therefore, plan out the conversation in advance and think of the following:

• How comfortable are you to speak about your mental issues?
• Is the work itself the problem or is it an external factor?
• Can you find a way to help yourself and your employer?

Since it almost always depends on the situation at hand, there is no definitive answer on how to approach the conversation, but hopefully, these questions will lead you in the right direction.

However, when it comes to asking for the leave itself, there are a couple of tips that should help you.

Tip #1: Be honest

Naturally, talking about your health problems is hard, especially if you’re struggling mentally. However, you need to understand that what’s said between you and your employer, stays between the two of you under the confidentiality of your employment contract.

Also, honesty in such situations could be the best approach since it evokes empathy and respect for being candid, and it will almost always pan out.

Tip #2: Be respectful

Asking time off for a projected period of time is reasonable, but do not abuse your position. If, for example, your physician believes that the treatment shouldn’t last for more than 2 months, ask your employer for a 2-month leave of absence.

Reaching a compromise will go a long way to establishing trust with your employer, and it will also strengthen your relationship, which will surely come handy in the future.

Tip #3: Choose a specific time to ask for a mental health leave

It might seem arbitrary but choosing the right time to speak with your employer could be beneficial, especially if you’re asking for an employer-set policy leave. Request the meeting when the workload is light and find a private area to discuss your leave.

Tip #4: Prepare the necessary documents for your leave

If your boss is stickler for the rules and regulations or simply wants to know if everything you claim is legitimate, you should have all your medical documentation ready. 

This could include:

• Doctor’s notes,
• Prescriptions, and
• Inpatient documentation (if any).

Tip #5: Delegate your tasks

Even if you already suspect that your employer will approve your leave of absence, it might not be a bad idea to find a colleague that will cover some of your responsibilities while you’re away. Such action could show resolve and determination that your boss will appreciate and you’ll return the favor to your colleague in the future.

What can you do on your mental health leave?

Needless to say, the most important thing is to take care of yourself and focus on your or a family member’s wellbeing. On the other hand, taking a prolonged leave gives you time to focus on some other aspects of your health and life.

Tip #1: Take care of your physical health

Improving your immune system and your overall physical health will do wonders for your mental health as well. Working out, detoxing, and taking vitamins could be the way to improving your health score.

In fact, a study from the National Center for Biotechnology states that regular physical exercise can have mental health benefits, including:

• Better sleep,
• Stress relief,
• Increased energy,
• Weight reduction, and
• Reduced tiredness.

Tip #2: Find a support system

You can use the extra time you have on your hands to join a support group for mental illnesses. Of course, it all depends on the type of condition you have but it’s always a good idea to talk with other people and hear what they are going through.

Furthermore, building a strong system of support and people around you will help you deal with the problem you’re trying to solve.

Tip #3: Reconnect with your family and friends

Spending time around loved ones is always good for the mind, no matter the mental condition. 

In fact, being around people you care about goes a long way in:

• Reducing your stress levels,
• Boosting your self-esteem, and 
• Eliminating loneliness.

How do you explain absence due to mental health?

Naturally, your colleagues will wonder where you are, especially if you have a relationship with them outside of work. On the other hand, dealing with mental health issues is a big part of your privacy, which is why there has to be a middle ground, in terms of what you should and shouldn’t share.

Here’s some advice on what you can say or do in such situations.

Advice #1: Share what you’re comfortable with

In most cases, you’re obligated to notify your superior and HR on the exact nature of your mental health issue and your leave of absence. However, you don’t have to be as specific with your colleagues if you don’t feel comfortable.

If you feel embarrassed or uncomfortable speaking about your condition, simply say you’ve taken some personal time to tend to private issues.

Advice #2: Write a letter to your colleagues

Writing your thoughts and emotions might seem over the top but it can be helpful in expressing yourself and letting others know how important the upcoming period is to you.

Furthermore, writing a letter eliminates the need for live conversation, which can help you open up and be more relaxed while talking about your issues — if you choose to share the details.

Advice #3: Ask for discreetness

If you work in a large company, it’s only natural that you don’t want everyone to know what you’re going through. In that case, you will probably share the details with the colleagues you talk or see on a daily basis.

If you have a solid relationship with them, be honest and ask them to be discreet with the information you’ll share with them.

Frequently Asked Questions regarding mental health leave

Finally, we come to the FAQ section with some of the most common questions you might want to read about mental illnesses and employee leaves. 

Can mental health leave be paid?

Depending on your place of residence and employment, yes, your mental health leave could be covered by:

• Your health insurance,
• Your employer, or
• State-issued mental health plan, such as FMLA.

However, you should always read your work contract and check with your employer before you ask for the leave of absence.

Can mental health leave be part of employees’ compensation?

If a strong case can be made that working conditions have caused the mental illness or condition, you could be eligible for compensation. Still, such cases are rare, and they usually depend on various factors, such as:

• State and place of employment,
• Type of work,
• Working conditions, and
• Employer policies.

What famous companies provide mental health leave?

Naturally, most employees wish to work for top companies that offer the best benefits. Since mental health importance is slowly picking up, the “top” companies have started offering both mental health days and leave of absence in some cases.

Some of the most popular names you’ve probably heard of include:

• Nike,
• Walmart,
• Pinterest,
• Microsoft,
• Drip,
• Linkedin, and
• SAP.

Of course, the absolute list is much longer, so if you’re suffering from a mental disease and you’re applying for a job, make sure to check with the HR department if the company offers mental health leave of absence.

What are some of the most common reasons for taking mental health leave of absence?

As we previously mentioned, according to WHO, some of the most common mental health issues for taking a leave of absence include:

• Anxiety,
• Depression,
• Burnout,
• Stress,
• Bipolar disorder,
• PTSD, and
• Disruptive behavior and dissocial disorders.

What is an employee assistance program?

An employee assistance program (EAP) represents a work-based community that offers help to working employees to deal with individual problems and needs.

In most cases, companies and employers hire consultants and professionals that offer courses and counseling sessions for employees in need. Nowadays, such programs exist outside the office, and their purpose ranges from work-related issues and violence to many extreme issues.

Final thoughts: Mental health leave is equally important as any other leave of absence

Recognizing the significance of mental health in their professional lives, employers and employees are embracing the idea that mental health challenges are as valid as physical ones — deserving of attention and support.

Mental diseases are nothing to be ashamed of, and there is no reason to hide them. If you feel like you’re regressing and not giving it your maximum due to illness, it’s time to get help. And, don’t worry, your job will be waiting for you.