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Alcohol & Other Drugs

Mental Illness and Substance Use in the Workplace

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One in five of us will experience a mental illness or substance use problem at some point in our lifetime. It only makes sense that something that affects our everyday life can affect our work life, too. In fact, some estimate that half of sick days in Canada are due to mental health problems. Even though these health issues can affect the way we work, many people don’t seek help because they fear they will lose the respect of co-workers—or even lose their job.

How might mental illnesses and substance use problems affect you at work?

Depression and anxiety are leading causes of both short-term and long-term disability. Loss of productivity at work due to substance use problems has been estimated at over $24 billion a year in Canada. A mental illness or substance use problem can make it hard to do your job properly. Some people need changes to their workplace so they can continue to work while they recover, while others need to take time off work to manage their recovery. Some of the ways a mental illness or substance use problem affect you at work might include:

  • Fatigue—If you feel tired all the time, getting to work on time can be hard. It can also make it tougher to work. Medications used to treat your disorder can also make you feel tired or less energetic.

  • Thinking problems—This may make it harder to remember things, take in new information, concentrate and make decisions. You might also have a lot of negative thoughts. It’s easy to see how all of these things can affect your performance at work.

  • Feeling sad or numb—It’s hard to be excited about your work if you’re depressed or in distress. You can lose interest in your work and stop caring about the quality of your work. You may not even feel like working at all.

  • Judgment problems—Decision-making can be affected. You may feel more creative and more capable than usual, or have ideas that are larger than life. As a result, you might make choices that you wouldn’t normally even consider. Or you might may quick decisions without thinking of the consequences.

  • Anxiety—Most people feel anxious about work at some point, especially when they’re feeling a lot of stress. But day-to-day events or situations can be overwhelming for someone living with an anxiety disorder. There are different kinds of anxiety disorders, and they can look very different from each other. Anxiety problems may occur with other mental illnesses and substance use problems, too.

  • Paranoia—You might feel like others are watching you or talking about you behind your back.

  • Irritability—This can affect your relationships with your co-workers and your ability to work as part of a team.

  • Problems relating to others—Some mental illnesses make your thoughts very disorganized, or change the way you talk, act or react. This can make it hard for others to understand you.

  • Feeling physically sick—Mental illnesses and some medications can cause physical symptoms like stomach problems or headaches. Even if you aren’t using substances during work hours, you might still feel the effects of them at work.

Despite these possible negative effects, the news isn’t all bad. People recover from mental illnesses and substance use problems. In fact, workers who are working on their recovery and workers who’ve recovered from a mental illness or substance use problem may actually be better at taking care of themselves and managing their stress than other employees. This is because they use these same strategies to help prevent or cope with a relapse.


What do I do if mental health or substance use problems are starting to affect my work?

Whether you’re experiencing an episode of a mental illness, suspect you may have a mental illness or notice that your substance use is affecting your work, you may feel scared to tell others. Many people are scared they’ll lose their jobs if they go for treatment or tell their manager that they’re struggling. And many fear that co-workers will treat them differently if others know they’re dealing with mental health or substance use problems.

But it’s important to get help early for mental health and substance use problems. This might mean talking to your doctor or mental health professional, building a treatment plan and making lifestyle changes that support your recovery. In the case of work, it also means talking to your manager about difficulties or problems before they become major issues. Your manager may allow you to make small changes to help you work productively.


Does my workplace have to help me?

Mental illnesses and substance use problems are considered disabilities if they affect your ability to work. If a mental illness or substance use problem affects your ability to work productively, you may be able to receive accommodations at work. Accommodations are changes that help people living with disabilities work more effectively. Accommodations are often simple and inexpensive changes.  Some accommodations are long-term changes to help you at work. But you can also receive accommodations for short periods of time. For example, you may start working part-time hours when you return to work from an illness and gradually increase your work hours over a few weeks.  You can talk to your manager or union representative about accommodations.

You don’t have to tell anyone what mental illness you’ve been diagnosed with or what substance use problems you’re dealing with to receive accommodations, but you may need a certificate from a health care provider and you will need to describe what reasonable changes could help you do your job productively. Some accommodations or changes to think about include:

  • Reducing your workload—Your employer may be able to help lighten your workload by cutting back on non-essential tasks, giving some of your tasks to other employees or pushing back deadlines

  • Changing the way you get feedback—You might be better able to take in instructions or feedback if it is written down, rather than spoken. Ask if your supervisor or co-workers can email you when something is needed instead of asking in person

  • Changing your workspace—You may find it easier to work from home during your recovery, or you may need a quieter place at work. Some people find that listening to music helps remove background distractions and makes it easier to focus

  • Reducing your hours—If you don’t need to stop working completely, talk to your employer about working part-time or job-sharing.  It may be what you need to reduce stress while still staying connected to the workplace. You’ll also have more time to devote to treatment

  • Changing your start time—Changing the time your start work may help you cope with symptoms without reducing work hours. For example, you might start work later in the day if you feel tired in the morning or start earlier if you feel more alert in the morning

  • Take short breaks more often—If you’re having trouble concentrating or feel tired, taking breaks like a short walk outside can help give you energy 

Employers have to keep your health information private. The law (under the BC Human Rights Code) also says that employers have to make reasonable accommodations if you have a disability. If co-workers will be affected by your accommodations, you and your manager will have to figure out how you’ll let them know about the changes to work procedures. For information about the risks and benefits of telling your employer, visit and click the Employees tab.

Employers want people to stay at work and be productive, and there are a lot of reasons for them to pay attention to their employees’ mental health. The average company loses up to 12% of its payroll to employee disability through loss of productivity and sick leave,  and mental illnesses are expected to make up over half of all disability claims in the next five years. So it only makes sense that workplaces help employees when they need it.


Where do I go from here?

In addition to talking to your family doctor, check out the resources below for more information on mental health and substance use problems at work:

Employee Assistance Plan (EAP) or Employee Family Assistance Plan (EFAP)
EAPs and EFAPs are outside agencies that help employees cope with troubling situations, including mental health and substance use problems. You can receive confidential counselling and referrals to other programs and services in your community. EFAPs are available to an employee’s family members, so you may also be able to find help through your partner’s workplace. Talk to your workplace’s Human Resources to find out if they offer an EAP/EFAP and how to access it.

BC Partners for Mental Health and Addictions Information
Visit for info sheets and personal stories about finding help and managing your mental health. You’ll also find more information, tips and self-tests to help you understand many different mental health problems

Mental Health Works
Visit for valuable information about mental health in the workplace for employees and employers. Mental Health Works also offers training workshops, through the Canadian Mental Health Association, to managers and union representatives on effectively managing workplace mental health.

Antidepressant Skills at Work
Visit to download an excellent workbook that teaches you how to cope with depression at work.

Working Through It
Visit for videos on mental health in the workplace, including what to do if you start to notice problems, how to cope at work, how to deal with financial issues if you work less or take time off work, and tips for staying well. You can also watch video resources on related topics, like recognizing symptoms and working with your doctor.


Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.


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  • eVisions: BC's Mental Health and Substance Use Journal, a theme-based magazine
  • Healthy Minds/Healthy Campuses events and resources
  • Within Reach: Resources from HeretoHelp
  • Jessie's Legacy eating disorders prevention resources, events and information

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