Taking Time Off Work for Mental Health

Taking time off from work can improve your mental health whether you take the time as sick leave, family leave, or vacation.¹ Your specific situation and that of your family dictates when and how you take that time off. Let’s explore — is taking time off work for mental health an option for you?

Mental Health Reasons to Take Time Off Work

Nearly half of all adults in the US will experience a mental health issue in their lifetime.²

That impacts the workforce. Add to that the mental health needs of your family and it’s no surprise that workers may need to take time off. That time may include nothing more than a few hours for a therapy appointment. Or, in the case of a serious psychiatric event affecting a family member, you may need to take weeks or even months off work.

Here are some valid reasons people may need to take time off work for mental health:

• You’re experiencing side-effects from your antidepressant and need to lie down
• A domestic conflict has triggered your anxiety and you need a few days off
• You have therapy appointments each week to manage an emotional issue
• Your child is acting out and his psychiatrist recommends a battery of tests
• You’re helping your mom move into a medically-supervised dementia care unit
• Your last work project resulted in a meltdown, and you need time to recoup
• Fire alarms are going off, and it’s triggering your PTSD
• Your doctor suggests that you attend a group therapy workshop next month

Fortunately, many mental health time-off requests are covered by workplace and labor laws meant to support workers dealing with psychiatric issues. It’s crucial that you, as an employee, know your rights and are aware of the various programs available that allow you (legally) to request time off for mental health.

Know Your Rights

You’ll need to research at least three areas to better understand your specific rights to take time off for mental health. Your mental health time off options will depend on the size of your company, the location of your company (which state you work in), and the specific company policies of your employer. These can vary widely.

• Company Size: affects whether state and federal leave laws apply
• Company Location: some states offer more employee protections than others
• Company Policy: your company policies often dictate any time-off benefits

For example, firms over 50 employees are required to provide FMLA benefits to full-time employees who have worked for them at least one year.³

However, in some states, like California, Paid Family Leave⁴ extends those benefits to include issues beyond traditional mental health issues, such as domestic violence.⁵

Can I Use FMLA for Mental Health?

The Family Medical Leave Act (FMLA) can be used for mental health leave like any other medical leave you might need to take for yourself or your family. Whether you yourself are eligible to apply for FMLA and use it depends upon whether you meet the FMLA requirements.

It also depends on the size of your employer. Under the federal FMLA program, employers with fewer than 50 workers aren’t required to offer FMLA.

FMLA Requirements

FMLA requirements are set at the federal level. However, some states extend FMLA benefits to a broader audience. Therefore, it’s crucial you understand your state family medical leave program options as well as what’s documented in your company’s employee handbook or FMLA policy.

The FMLA rules require that you as an employee are eligible for FMLA benefits if you meet the following conditions:⁶

• You work for an employer required to provide FMLA
• You have worked for that employer for at least one year
• You have completed at least 1,250 work hours with that employer
• Your time off request meets FMLA health (including mental health) guidelines

Paid vs Unpaid FMLA

FMLA at the federal level is designed to protect your job while you’re on unpaid family medical leave. That means unless you have banked sick time or unused PTO you’re likely to have to take your time off unpaid. On the plus side, you can take up to four months’ leave without losing your job.

Fortunately, about 13% of firms will pay a portion of your leave, but that’s optional and up to your company.⁷

If you need to be paid for the time off, check with your employer — your manager or someone in human resources (HR) — to see if you can get paid for any of the time off you need to take for your mental health.

Intermittent FMLA

Another option, depending on your mental health situation, is what’s referred to as intermittent FMLA. Instead of taking days or weeks at a time off work, you request the amount of time off you need each day, week, or other timeframes. That may make sense if the time you need off is for periodic appointments or therapy sessions.

Your company may have FMLA leave request forms, including an FMLA intermittent leave form like this one:

Example of an Intermittent FMLA time-off request form from Texas Municipal Human Resources Association

Examples of when intermittent FMLA makes sense:

• Taking off 2-hours per week for your weekly psychiatric appointment
• Taking time off work one day a month for an autistic child’s equine therapy
• Taking one day off each week to care for your parent struggling with dementia
• Taking off 30 minutes early from work three days a week to attend a therapy group
• Taking off every other week in the summer to care for a mentally disabled child

States With Their Own FMLA Laws

In addition to federal FMLA laws that govern family and medical leave benefits for employees of larger companies, some states extend family leave benefits to victims impacted by crime, people in drug and alcohol rehab, and families dealing with domestic violence.

A few states require firms smaller than 50 employees to offer FMLA-like programs:

• Vermont: 15 employees
• Maine: 15 employees
• Washington DC: 20 employees
• Minnesota: 21 employees
• Oregon: 25 employees
• Georgia: 25 employees
• Michigan: 25 employees
• New Jersey: 30 employees

As labor laws change frequently, it’s best to check with your company. In addition, businesses attempting to attract and retain employees may offer more generous leave benefits than what’s mandated by FMLA or local family leave statutes.

Can I Use Sick Leave for Mental Health Concerns?

In most cases, if your company offers sick leave, it’s designed to be used for your medical sick time—that includes your mental health sick leave needs. However, sick leave isn’t a federal employment requirement, and nearly 25% of workers have jobs with companies that don’t provide sick leave benefits.⁹

Some states mandate that businesses with employees in their state must provide sick leave benefits. But in most states, there’s no such sick pay mandate. That means you need to review your company’s sick leave policy to learn whether you get sick leave, can use it for mental health, and how to request it.

Questions you may want to ask your employer are:

• How much paid sick leave do I get per year?
• If no paid sick leave is available, is there an option for unpaid sick leave?
• Can I save (and rollover) sick leave hours if I don’t use all the hours this year?
• What is the process to request sick leave? (Email, text, call, fill in a form?)
• How much detail do I have to provide when I want to take sick leave?
• Can I use sick leave to care for a family member (child, spouse, parent)?

Chances are, your company doesn’t need to know that you’re taking time off for mental health. You simply request the time off you need as “sick leave.” Your employer, due to medical health information protection laws, shouldn’t need to know the specific issue.

Paid vs Unpaid Sick Leave

Paid and unpaid sick leave is a benefit a company can provide to offer time off, and many provide it as paid time off to their employees. However, relative to all firms, smaller employers and those hiring entry-level workers are less likely to offer paid sick leave. In those firms, unpaid time off may be the only option when you need to take time off work for mental health.

Paid Sick Leave for Mental Health

Paid sick leave means that you’ll be paid for the time you take off for your mental health needs. It’s common for paid sick leave to be offered in larger firms, including office and professional environments. These companies may have an online system in which you request sick leave time off by indicating the dates you wish to take off work. Most won’t require you to describe what the sick time is for, so there’s no need to mention that it’s a mental health day off, for example.

Unpaid Sick Leave

Unpaid sick leave means that the employer will allow you to take the time off, but you won’t be paid for any days you take off work. Since you aren’t being paid, there’s little reason to tell the employer why you need the time off, other than to say, “I need to take an unpaid sick day off.” Unpaid sick leave is common in service jobs, restaurants, fast food, and retail type jobs.

Can I Use PTO for Mental Health Concerns?

The good news is that many firms have moved away from traditional sick leave programs. 57% of businesses offer paid-time-off (PTO) programs to be used for any variety of reasons, from vacation to mental health days. 29% of private firms offer PTO to part-time workers, and 4% provide unlimited time off.¹⁰

If your company, union, or government employer offers PTO, you can take advantage of the earned or accrued days available, using that time for yourself and often for your family members’ mental health needs, too. Keep in mind that PTO, like sick leave, isn’t mandated by the feds. It’s best to review details of the PTO program offered by your employer and go from there.

Unlimited PTO and Mental Health

Some startups and innovative employers offer their staff what’s called “unlimited PTO.” If that benefit is an option for you, it’s a great way to ensure your mental health needs are met. Of course, unlimited PTO doesn’t mean you’ll get paid for not working.

What unlimited PTO typically means is that you can take time off as needed—for vacation, appointments, mental health—as long as you meet your work goals and responsibilities. Unlimited PTO is more common in professional jobs that rely on productivity metrics rather than work hours. It’s rarely available to hourly employees.

Unpaid Time Off

If your firm doesn’t have a sick leave program, doesn’t offer paid time off, or you’ve exhausted all your PTO hours for the year, you may still request unpaid time off from your employer if you need that time to address a mental health issue.

However, if you’re eligible, applying for FMLA may be a better option than taking unpaid time off. That’s because FMLA can protect your job, while a request for unpaid time off may not be approved. If you take unapproved time off, even for a mental health issue, from a company that doesn’t offer sick leave, your company may choose to terminate your employment.

Can I Use Short-Term Disability for Mental Health?

If your psychiatric issue rises to the level of a disability covered by your short-term disability (STD) insurance, it’s possible you could use that insurance (provided by the state in some locations) to take the time off you need. In general, STD kicks in after 14 days and requires a doctor’s attestation and a good bit of paperwork.

Short term disability can be managed by the state or private insurance carriers and typically provides you with payments equal to about 60% of your regular salary. The specifics vary. You will need to check with your manager or HR rep to determine whether your company’s STD insurance covers mental health, what the requirements are, and how long it pays—up to six months is common.

Can I Use Work Comp to Take Time Off Work for Mental Health?

If your mental health issue is caused by an abnormal work event, such as workplace violence or an industrial accident, your time off may be covered under worker’s compensation insurance.¹¹ For example, PTSD caused by events in the workplace may well be covered under your employer’s work comp policy.

While not common, industrial accidents occur and may have mental health consequences. An employee who witnesses the death of a co-worker on the job, or who has been victimized, such as during a bank robbery at their financial institution, may be entitled to use worker’s compensation benefits to address their mental health time off needs during recovery.

How Much Time Can I Take Off for Mental Health?

Your mental health provider is the person best qualified to determine how much time you may need to take off from work due to a mental health issue. However, it’s your employer’s sick time, paid leave, and FMLA policies that dictate how much time you may be able to take off work while still getting paid.

Here are some examples of how much time you could take off from work under different programs:

Company Sick Leave or PTO Policy Example

Your psychiatrist suggests therapy sessions at 4 PM on Tuesdays. That’s 52 hours a year. Your company’s sick leave policy allows for 5 days a year; that’s only 40 hours. You may need to take some of those hours off work unpaid, shorten the therapy sessions to 45 minutes, or reschedule some of your visits after work or over your lunch hour to accommodate your mental health needs. Unpaid time off may also be an option.

State Law Mandated Sick Pay Policy

You live in Arizona where three days paid sick leave is provided to full-time employees per year. Your doctor wants you to take two days off work to check in to the hospital and stabilize your medication. Three days (24 hours per year) is what you have available to take in your state. You’ll have eight hours left for any visits scheduled during work hours for the remainder of the year.

FMLA or State Family Medical Leave Program

You have been with your large firm for years. When your adult daughter is diagnosed with a serious mental health issue, you’re asked to travel cross-country and help her recover. You can request (unpaid) FMLA leave for up to four months of time off to help stabilize her mental health condition, help her find a new living situation, and monitor her medication if needed.

No Sick Leave Policy

The bad news is that working for a small employer who offers no sick leave can be risky to your mental health and your employment stability. Your company may not approve your time off request. If you take the time anyhow, they may be able to discipline you and/or terminate your employment for failure to do the job, due to a violation of company policy, or by applying the at-will employment doctrine.¹²

How to Approach Your Boss About Time Off for Mental Health

Anytime you need to take for your own or for a family member’s mental health is protected under federal laws, consistent with the similar time you might need to take for a physical issue. Larger employers typically provide sick leave benefits to their staff. Few require that you disclose the exact reason you need time off, other than to say it’s for a “health-issue.”

However, because there’s no federal law that requires your employer to pay you for sick time or mental health days off, you may want to err on the conservative side when you ask for time off. Check out our article, How to Ask Your Boss for a Mental Health Day Off, for tips on ways to request to take time off for mental health.

How you request time off depends on the type of time off of work you’re requesting:

Sick Leave

If your firm offers sick leave, as many do, you’ll want to read your company’s leave policy to understand how many paid days off you’re entitled to and what the time-off request process is. If your firm doesn’t offer paid sick leave, you may be able to take time off unpaid, with your employer’s approval.

PTO

Some firms provide a program that groups sick leave time off, and vacation time off, into one bucket of accrued time that you can use for pretty much any reason—including a mental health day, or even a beach day. In firms like that, asking for the day off requires little more than advance notice. The company won’t often be concerned with why you’re taking that time off.

Disability Leave

For the purposes of family and medical leave, mental disabilities and psychiatric conditions are covered just as is time off, i.e., for back surgery or maternity leave. Most firms with over 50 employees have a formal disability leave request policy consistent with FMLA. You’ll often find the process to request leave included in your company’s employee handbook.

FMLA Leave

Taking time off from work under FMLA requires you to complete an FMLA request form with your employer. These forms may be available in the company handbook, your online HR software or you may need to request the paperwork from your manager or HR rep.

Additional Resources for Mental Health in the Workplace

• Mental Health First Aid: Provides educational resources to deal with mental health
• Society for Human Resources Management: Offers HR workplace best practices
• US Department of Labor: Clarifies laws with guidance and FAQs for employers/employees
• Center for American Progress: Promotes workforce-friendly practices