Is a Mental Health Leave of Absence the Answer?

An exhausted, stressed, overwhelmed workforce is an unmistakable sign of the current mental health crisis. There’s been a 65% increase in mental health leave of absence requests in the United States since 2022, surpassing those for long COVID and non-COVID physical health conditions. And although mental health stigma has lessened, there’s still a long way to go, which is one of many reasons taking a mental health leave of absence from work can feel agonizing.

As a therapist, I’ve had clients come in feeling desperate about their work situations. They want out, but they’re worried about repercussions in the office. I hear things like, “I’m drowning,” “I’m overwhelmed,” and “I have no motivation.” They don’t feel like they can keep working. Sometimes a medical leave for mental health is the best option. Other times, we can get to the other side of a very difficult time with mental health care and creative solutions that support mental well-being in the workplace.

What is a mental health leave of absence from work?

A mental health leave of absence is a period of time taken off from work to take care of your mental health or help a family member struggling with mental illness. A mental health leave can be short-term or long-term based on the severity of the mental health issue. Before taking a leave of absence for mental health, be sure to talk to your HR department, mental health professionals, and legal advisors since leave requirements can vary based on individual circumstances, workplace policies, and local regulations.

Short-term medical leave for mental health

What’s considered a short-term leave of absence for mental health can differ by company and state. It can involve using short-term disability or the Family and Medical Leave Act (FMLA). Short-term medical leave for mental health may last a few days to a few weeks. People usually take this type of leave to address immediate and acute mental health concerns, such as a sudden increase in stress, anxiety, or a specific mental health crisis like intense grief over the death of a loved one. Short-term leaves may involve therapy, medications, and building self-care and stress management skills. Sometimes short-term leaves can include time off specifically for attending mental health appointments.

Long-term medical leave for mental health

A long-term mental health leave of absence may span several weeks or months. These longer leaves are taken for chronic or severe mental health conditions that require sustained treatment and recovery time.

Long-term leaves of absence often involve the FMLA, which provides up to 12 weeks of protected leave. Long-term mental health leaves may involve a more comprehensive treatment plan, including ongoing therapy, medication management, rehabilitation programs, and significant lifestyle adjustments. The goal of long-term leave is to allow enough time to feel more stable, manage your condition, and gradually resume daily responsibilities.

Using FMLA for mental health leave

You may be able to use the FMLA for mental health reasons if your company meets the criteria for coverage set by the United States Department of Labor. The FMLA provides eligible employees with up to 12 weeks of unpaid, job-protected leave annually for certain family or medical reasons, including mental health conditions.

During FMLA leave, an employer is generally required to provide your regular health insurance coverage and hold your job, meaning you should be able to return to the same or an equivalent position.

What happens during a mental health leave of absence?

Taking a mental health leave is not a cure-all; it’s a process that requires intentional effort and self-reflection. I’ve seen people reach the end of their mental health leave and have regrets about not doing the work to better manage their mental health. It’s also important not to set unrealistic expectations during a medical leave for mental health. The goal isn’t to use the time to achieve grandiose feats but to prioritize and cultivate your mental health.

While it won’t make your work life perfect, a mental health leave can provide space to address work-related roots of distress, whether that’s undefined boundaries, a toxic work environment, or other factors. Talking to a mental health professional, building coping skills, and practicing self-care during this time can all help.

Why ask for a mental health leave of absence?

An estimated 15% of working adults have mental health disorders, which can affect their job satisfaction, performance, and ability to work. Globally, 12 billion workdays are lost to anxiety and depression each year.

Some reasons people take a mental health leave of absence from work include:

• Mental health disorders like severe depression or a substance use disorder that require treatment and recovery time
• Providing care and support to a close family member with a serious mental health concern, such as a spouse, child, parent, or sibling
• Entering an inpatient mental health program for 24-hour care or attending day treatment programs like partial hospitalization or intensive outpatient care, which entail being at a facility for several hours during the day
• Severe burnout, including extreme work-related stress, anxiety, panic attacks, and depression
• Mental health challenges that greatly hinder the ability to perform daily tasks at work and home
• Thoughts of self-harm or suicide

Should I take a leave of absence for mental health?

A medical leave for mental health can be the right option for some people. Others find that if they change aspects of their work environment and get mental health support, they’re able to manage their mental health needs without taking leave. If you’re thinking of taking a leave of absence for mental health you may want to consider these options:

Talk to your manager

If you’re overwhelmed, overworked, or overstressed, have a conversation with your manager. Discuss your challenges and brainstorm potential solutions to decrease stress.

Adjust your workload or schedule

Talk with your manager about temporary adjustments to responsibilities such as a reduced workload, modified job responsibilities, flexible hours, or telecommuting.

Use your company’s mental health resources

Some workplaces offer employee assistance programs or comprehensive mental health benefits like Lyra Health that provide resources and support. Many people are able to manage mental health disorders with therapy and/or psychiatric medications.

How to talk to your boss about taking a mental health leave of absence

You may worry about job security or being judged for your mental health condition if you’re considering taking a mental health leave of absence. Educate yourself and plan ahead to help ease your mind before you discuss a medical leave for mental health with your employer:

Know your rights

It’s illegal for employers to retaliate against you for seeking mental health care or requesting a mental health leave of absence. Your job should be protected.

Document your needs

Come prepared with letters from your health care provider. Working with your provider to outline the mental health difficulties you’ve been having and the ways they’re impacting your functioning helps clarify and communicate your needs to HR when the time comes to request a mental health leave of absence.

Consider your relationship with your boss

Your approach may vary based on your relationship with your manager. If you’re unsure whether they’ll be supportive, it’s a good idea to involve your company’s human resources department. They can help facilitate the conversation and ensure your rights are protected. Keep in mind that your manager may recommend you speak with HR directly so you get the support you deserve. Many times this is not a brush-off, but an acknowledgment that you have rights and they want to protect them.

Seek professional support

Consult with a therapist, psychiatrist, or doctor before approaching your employer about taking a mental health leave of absence. These professionals can help you create a plan to manage your mental health needs, whether or not that leads to a leave of absence. They can also help prepare you for conversations with your manager or HR and provide support after those conversations.

Tips for returning to work after a mental health leave of absence

It’s natural to feel nervous before returning to work after a medical leave for mental health. You may feel a lot of uncertainty (“What have I missed?” “What’s changed?” “How will people react to me?”). I’ve helped clients address those feelings by reviewing stress management techniques, talking about boundaries and what they’re comfortable sharing, and making a plan for returning with their team or manager.

1. Ease back into work

Return to work gradually. This could involve a midweek start, a graduated schedule, or telework options to help minimize the stress of a full-time return. For example, maybe you come back for a couple of days a week and work your way back up to your regular hours. Either way, discussing these options with HR as you get back to work is helpful.

2. Ask for a flexible schedule

Negotiate flexible start and end times. Plan work around when you feel your best. For example, perhaps you start late in the morning and work later in the day, or break the day into small chunks of time.

3. Communicate openly

It’s best to have open conversations with your manager and HR team about the challenges you may face as you re-enter your role, such as situations that trigger anxiety or depression symptoms, and work with them to find supportive arrangements.

4. Set boundaries

Establish clear boundaries around what you’re comfortable sharing. Prep answers to questions you might encounter—”I took time off for personal reasons, and I’m glad to be back.” You don’t need to elaborate.

5. Build healthy coping skills

It’s crucial to develop ways to manage stress. This might involve compassionate self-talk (“I’m doing the best I can, and I will get through this”), or self-care practices like exercising, mindfulness, getting enough sleep, eating nutritious food, journaling, and surrounding yourself with supportive people.

6. Give yourself compassion

Acknowledge your progress and accomplishments during your leave of absence for mental health. Give yourself permission to sit with uncertainty and give yourself grace for not being up to date on every email or company happening since you left. Take things one day at a time and focus on what you can control. Set realistic expectations—for example, reading and responding to the backlog of emails over several days, not all at once.

7. Manage expectations

A medical leave for mental health can be a step toward better mental well-being, but it isn’t an instant fix. Manage expectations about what you can realistically achieve during the leave and once you return to work.

FAQs about taking a medical leave for mental health

1. Can I use FMLA for therapy appointments?

If your company is FMLA-covered and you’re eligible for it, you can take FMLA to attend therapy.

2. Is there short-term disability for mental health?

There are instances when you can use short-term disability for mental health if you’re offered this benefit through your company or if you’ve bought private disability coverage. This varies greatly by plan and circumstance, so it’s important to check with your short-term disability provider.

3. Can you take FMLA for mental health?

You can use FMLA for depression, FMLA for anxiety, or FMLA for other mental health conditions like PTSD, eating disorders, or substance use disorders if your company offers FMLA and you meet the requirements for a mental health leave of absence.

4. Is a mental health leave of absence paid?

If you’re using FMLA for mental health, your time off of work will be unpaid unless you live in one of the handful of states that offer paid FMLA for mental health and physical health conditions.

5. Can you take a stress leave from work?

Stress is inextricably tied to our mental health, and you may be able to take a stress leave if it’s linked to a serious health condition that’s getting in the way of your job.

Prioritize your mental health

If you’re considering a mental health leave of absence, you may be facing challenges you’re not sure you can overcome. Know that there’s help available, and you can build resilience and coping skills to manage your mental health and thrive in your personal and professional life.