When to Appropriately Fire an Employee with Mental Health Issues

According to the National Institute of Mental Health, nearly one in five U.S. adults lives with a mental illness. This equates to an estimated 54 million Americans who have some form of a mental illness in a given year.


It’s therefore important for organizations to be proactive in understanding how to support mental illnesses and mental health in the workplace. This includes providing education on the scope of mental illnesses, examples of accommodations, and what procedures Human Resources and managers should follow when making the difficult decision to let someone go.


What is a mental health issue vs. mental illness?


Are mental health and mental illness the same? These terms are often interchanged, but are different from one another. Everyone has mental health, but not everyone has a mental illness, which according to Mental Health America. Mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.


There are currently more than 200 classified forms of a mental illness. Some of the more common disorders and mental health conditions are provided below. They can sometimes be recognized by their symptoms that   include changes in mood, personality, personal habits and/or social withdrawal:


  • Depression
  • Bipolar disorder
  • Dementia
  • Schizophrenia
  • Anxiety disorders

Mental health conditions may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, they are often physical as well as emotional and psychological.

Causes can include reactions to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. It’s important for organizations to understand that with proper care and treatment many individuals can learn how to cope and can recover from a mental illness.

How to tell if someone has a mental illness


There is currently no medical test that can accurately diagnose a mental illness like you would for diabetes or cancer. A mental health professional would need to assess the symptoms and make a diagnosis for the individual that may be impacted by the disability.


We are often asked if mental illnesses can be acquired. According to the U.S. Department of Health and Human Services, the first onset of mental disorders usually occurs in childhood or adolescence with treatment typically not occurring until a number of years later.


How to support individuals with mental health issues with accommodations


Organizations have a legal obligation to consider all reasonable accommodations that could help all of their employees, not just those with mental health issues, in being successful in doing their jobs. These accommodations may include:


  • A designated office space or devices like noise cancelling headphones that create a quiet environment
  • Permission to work from home or specific shift assignments
  • Changes in supervisory methods
  • Providing awareness of certain benefits like counseling services

Employee requests for reasonable accommodations could also include asking to be reassigned to a different role, if one is available.


How to fire someone with a mental health illness


According to the Equal Employment Opportunity Commission (EEOC), the process to fire someone at your organization should be the same for all individuals. It should be based off of performance and the value they’re bringing to your organization.


Employers cannot discriminate against workers because of mental health conditions, but also have the right to let go of individuals who are unable to do their job or those who pose a "direct threat" to safety.


Before terminating an individual's employment on these grounds, the business must be able to provide objective evidence that the person in question cannot perform their duties or represents a safety risk.


If an organization decides to terminate a person's employment after exhausting all possible allowances and accommodations, the individual in question may still file a charge of discrimination if they feel their rights have been violated. Charges must be filed within 180 days of the alleged violation, or 300 days if the employer is also covered by a state or local employment discrimination law. Investigations are conducted by the EEOC.


Unfortunately, it is possible that even with support and accommodations, people with certain mental illnesses may not be able to perform their jobs, and may have to be terminated. It is important for employers to regularly and constructively provide open and honest feedback to employees on their performance. This ensures that all employees are treated the same, and gives those with mental illnesses the same opportunity to be successful in their role. Terminations for any employee, including those with a mental illness, will therefore be done on a lawful basis.