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HEALTH • November 30, 2015 15 working together that they start to see some confi- dence come back as far as employment." To help members make the jump back into the working world, Genesis Club offers a transitional employment program. Members work part-time, with the clubhouse offering support and training. Clubhouse staff also train for the job so that they're able to provide coverage if a member's illness forces them to be absent. Some clubhouse members are young adults who might have assumed they'd never be able to hold a job. Others are trying to figure out how to return to work after a major episode of illness. Bradley said the clubhouse works with about 35 employers in the Worcester area, including the Worcester Art Museum, Saint-Gobain and food ser- vice companies that serve local colleges. Breaking down barriers Bill Tsaknopoulos, director of auxiliary services at UMass Medical School, is in charge of food service, mailroom and janitorial areas that employ Genesis Club members.Tsaknopoulos said the club mem- bers, which presently total 22, are typically good workers eager to earn a living and be respected for the work they do. And he said a bonus for the school is that the workers' presence helps dismantle stereo- types that others on campus sometimes hold. "We started breaking down these barriers for our staff," he said. Finding and keeping work can be a serious prob- lem for many people with psychiatric diseases. The National Alliance on Mental Illness has found that the unemployment rate among people getting public mental health services is about 80 percent. A drain on productivity? Meanwhile, those who have stable jobs face their own set of challenges. A recent report by NAMI's Massachusetts chapter found that one of the greatest impediments to workplace productivity is psychiat- ric illness, particularly depression. According to its analysis, mental health conditions accounted for 62 percent of the days that workers were unable to do their jobs. Adding up absences, medical care and lost productivity, the report finds depression incurs the highest total cost across the economy of all mental and physical disorders. Part of the reason that mental illness can be more expensive than physical disease is that it's more likely to go unaddressed. NAMI finds that the big- gest costs of mental illness come from "presentee- ism," the situation where workers show up but are too ill to perform at their best. Employees may not want to bring up psychiatric problems with their bosses or human resource departments, while super- visors may not know how to broach the subject even if they notice a worker is struggling. Stephen Rosenfeld, president of NAMI Massachusetts, said an honest conversation with a manager can help an employee find the support they need. Without it, they may continue to suffer, believ- ing they need to hide their illness. "Things just evolve and get worse from there," he said. Rosenfeld said the problem is not that CEOs are actively creating a stigmatizing environment for workers with psychiatric illnesses but that they don't fully understand the issue. "It's inattention," he said. "It's just not appreciating the impact of stigma, and also not being sure what can be done about it." CEOs stand up against stigma That's why NAMI Massachusetts launched a "CEOs Against Stigma" campaign this June. The idea is to provide leadership at the top of organizations to address the obstacles that people with psychiatric disorders sometimes face at work. The campaign asks CEOs who sign up to pledge to do several very specific things, including opening communication with their workforce about the issue, making sure their company offers strong men- tal health benefits, and helping inform other CEOs about the program. It also asks them to bring NAMI's "In Our Own Voice" presentations, in which people who have lived with psychiatric problems tell their own stories about life on the job. Joyce Murphy, CEO of Commonwealth Medicine, the Shrewsbury-based consulting division of UMass Medical School and an early signer of the CEOs Against Stigma pledge, recently helped organize these trainings for her employees. "I had so many employees coming up, telling me it was really the most important training they had ever had," said Murphy. "Many employees disclosed that they or family members had really struggled with mental illness." Like Murphy, Ed Manzi, CEO of Fidelity Bank in Leominster, was an early Central Massachusetts signer of the "CEOs Against Stigma" pledge. Fidelity has long done community service work aimed at addressing mental illness, helping to spearhead the SHINE Initiative, which supports mental health pro- grams for young adults. Manzi said he likes the "CEOs Against Stigma" approach because it's backed by NAMI's data about the prevalence and costs of mental illness. "Most business leaders like to make decisions based on data, not just anecdotes," he said. To Manzi, the point of the effort is straightfor- ward: to make sure that mental illnesses are treated just like physical ones. "This is just another type of health problem," Manzi said. Murphy echoed that sentiment, saying coworkers and managers should support an employee with a serious mental illness just like someone with cancer. They may need moral support, help with employee benefits and time off to seek treatment. If Commonwealth Medicine workers feel uncom- fortable going to their supervisors with personal health issues, Murphy said, they can work with the human resources department and the organization's employee assistance program. There are also licensed psychologists and social workers who can make sure workers get whatever assistance they need. In addition to the importance of treating workers kindly and fairly, there's also a simple calculus for employers when it comes to being open and helpful about mental illness, said Murphy, who cited a statis- tic from a 2014 PricewaterhouseCoopers report that found every dollar spent addressing workers' psychi- atric disease leads to $2.30 in recovered productivity and other benefits to the employers. The report, based on an analysis of Australian employers, determined that effective interventions could reduce presentee- ism, absenteeism and compensation by 33 percent. Murphy said it's clear that taking action on the job is a smart move for employers. "If we're not looking out for our employees, we're not going to be a good employer, and we're not going to be able to achieve our mission very well," she said. Paul Fontaine has been able to hold down a job and continue his education with the help of Genesis Club, a Worcester organization that helps people with mental illness find work, but he says there's a persistant stigma around mental illness in the workplace. PHOTO/EDD COTE