The health-care sector is an important context for understanding the experience of workers with mental health and/or addictions issues.
Concerns have been expressed regarding growing rates of mental health-related absenteeism as well as presenteeism among Canadian health-care workers. Although the extent of the problem has been documented from a managerial perspective, little is known about the problem from the perspective of workers themselves, or about how their experiences are shaped by the organizational context within which they work.
Findings will be presented from a study conducted within a large mental health-care facility. An institutional ethnography method of inquiry was adopted, including interviews with 32 workers and workplace stakeholders, and a review of organizational texts related to health, illness and productivity. Analysis of the transcripts and texts revealed how institutional practices of silence were enacted at all levels of the organization, often communicating that it was not acceptable for staff to be ill. Discourses related to stigma, staff-client boundaries and responsibility for action shaped the practices of silence.
The pervasive, complex, often paradoxical nature of silence surrounding the mental health of health-care workers will be discussed, as well as the role that silence serves in maintaining institutional order.