There are days when it’s hard to face work, even when you aren’t physically sick. Should you take a day off for your mental health? If you do, should you be honest about it when informing your manager?

If you work for an organisation or in a team where you feel safe to discuss mental health challenges, you are fortunate.

Despite all the progress made in understanding and talking about mental health, stigma and prejudices are still prevalent enough to prevent many of us from willingly letting bosses and coworkers know when we are struggling.

Mental health challenges come in different forms. For some it will be a severe lifelong struggle. For many others the challenge will be periods of feeling overwhelmed by stress and needing a break.

Globally, the World Health Organisation estimates about 970 million people – about one in eight people – is suffering a mental disorder at any time, with anxiety-related disorders affecting about 380 million and depression about 360 million.

These numbers have jumped about 25% since 2019, a rise credited to the social isolation, economic hardship, health concerns and relationship strains associated with the pandemic.

But declining mental health is a longer-term trend, and it’s likely work demands have also played a role. Research identifies three main workplace contributors to mental ill-health: imbalanced job design when people have high job demand yet low job control, occupational uncertainty, and lack of value and respect.

This at least partly explains why depression and anxiety appear to be more prevalent in wealthy industrialised nations. In the United States, for example, it is estimated more than half of the population will experience a diagnosable mental disorder at some point during their lifetime.

Read more: Should you tell your boss about your mental illness? Here's what to weigh up

Managerial attitudes changing slowly

For the modern workplace, therefore, mental health is increasingly part of the landscape. But preconceptions and prejudices are hard to shift. People with these challenges are still seen as weak, unstable or lacking competence.

These attitudes make it even harder for those with diagnosed mental health disorders to find meaningful work and progress in their careers.

Business executives and managers, like the rest of the population, have limited knowledge of mental health issues, or skills to manage it in the workplace.

This blind spot is reflected in the management research literature. The best most recent study of managerial understanding of mental health issues dates from 2014. It found only about one in ten human resource professionals and managers felt very confident in supporting employees with mental health challenges.

Even when managers understand there are implicit biases against employees with mental health challenges, they may still not know what to do about it.

So it is hardly surprising many employees remain reluctant to disclose their mental challenges to colleagues and managers, fearing a lack of understanding and potential negative consequences to their careers. But keeping it secret and “soldiering on” can make mental health even worse.

Framing the conversation

So what to do about it? Our research shows leadership is key.

For all organisations, cultural change can start with leaders and managers speaking more openly about their own mental health challenges. This empowers others to follow suit.

Language choices are important too. How we talk about mental health can change how we think about it. Australia’s National Mental Health Commission, for example, refers to “mental health challenges” instead of “mental illness”. Such framing can help others to regard a mental health day as something that may be needed by anybody, not something for some who is “sick”.

Read more: 'It’s actually a human person, undergoing real emotions': how podcasts can impact attitudes around mental health

For larger organisations, one innovative idea is to have “mental health advocates” – employees with personal experience of severe mental health challenges.

Energy Queensland, a government-owned utility with about 7,600 staff who are responsible for maintaining the state’s electricity distribution infrastructure, did this in 2017. Two of its workers, James Hill and Aaron McCann, now work as full-time “mental health lived experience advocates”. Hill previously worked for the corporation as an electrician and McCann as a lineworker. Both have lived through deep depression and suicidal thoughts.

Our research – which involved surveying more than 300 psychologists, psychiatrists and others employed in mental health services – suggests “lived experience” advocates encourage more open organisational cultures, helping to break down the stigma stopping others from admitting their own mental health challenges.

Read more: Employers need to prioritize employee mental health if they want to attract new talent

And a small number of organisations globally have introduced “wellness/wellbeing days” – an allotment of “no certificate required” days off, which can be used at any time, no questions asked.

As the challenge of squeezing greater productivity out of service sectors intensifies and competition for skills and talent escalates, those workplaces that acknowledge and accommodate the mental health stresses of modern life will be the ones with the competitive advantage.