In the middle of a work project at a global corporate consulting firm, Katherine Switz was gripped with a debilitating bout of anxiety. Her body froze, her heart raced, her chest tightened, and her mind went blank, which made it nearly impossible for her to concentrate on a computer screen and do her work.

The anxiety lasted three months, likely related to her bipolar disorder. During that time, she felt unable to ask for help from her employers or co-workers, afraid that her poor performance would get her fired or passed over for promotion.

“I didn’t know how to ask for help. I didn’t know what to do,” said Switz, 48, who was working as an associate business consultant in Washington, D.C., when the episode occurred.

At work, an admission of a psychotic disorder might elicit judgment, fear and avoidance among co-workers. And even if such illnesses are not talked about much, 1 in 5 adults in the U.S. have a mental health disorder, and 1 in 22 adults live with a serious mental illness, such as schizophrenia, major depression or bipolar disorder, according to the National Institute of Mental Health.

The Americans With Disabilities Act of 1990 prohibits discrimination against people with disabilities, which includes certain mental health conditions, and requires employers to provide reasonable accommodations to help them get their jobs done. Some employers also offer mental health support for employees through employee assistance programs, known as EAPs, which provide services such as short-term counseling and referrals to treatment for substance use.

Even with those federal protections and existing employer programs, some employees can be reluctant to ask for help at work. An estimated 8 in 10 workers with a mental health condition don’t get treatment because of the shame and stigma associated with it, according to the National Alliance on Mental Illness.

As a result, the pressure is growing on employers to adopt better strategies for dealing with mental health.

Some companies provide health coaches, mental health awareness training for managers and peer support groups in the workplace, hoping to build an atmosphere of understanding, so people feel comfortable talking about their conditions and asking for help. Some even have on-site meditation services and wellness centers to help employees access mental health resources, such as free counseling sessions, financial counseling and mobile apps that teach stress-management techniques.

San Francisco-based Levi Strauss & Co. has recently given employees access to counseling immediately after emergencies at work. And some companies are creating online mental health awareness courses for all employees that will highlight what it is like to live with a mental illness.

Another way companies have been working to support employees is by pressuring their insurers to offer a more robust array of mental health benefits.

“Employers can often feel that they’re at the mercy of health plans. But employers have the power of the pocketbook,” said Angela Kimball, acting CEO of the National Alliance on Mental Illness. “They have an enormous ability to change the market by simply demanding better.”

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Content from Kaiser Health News was used in this piece