Managing Time Off Work: How to Talk to Your Employer About Extended Leave for Mental Health
If you’re feeling anxious about talking to your employer about mental health leave, know that you’re not alone. Thousands of people have needed extended leave for mental health treatment and felt exactly the same.
Studies in 2024 show that mental health and well-being are in a steady decline.¹ For instance, a report by the National Institute of Mental Health tells us that one in five people in the US lives with some type of mental health concern.² One of the highest reported mental health concerns is anxiety, with 42.5 million Americans diagnosed with it. That’s before we even look at statistics for other mental health conditions and issues, such as burnout.
Mental health conditions such as anxiety and depression can affect a person’s ability to work. While you have legal rights for mental health leave, you’ll likely want to approach the subject with your employer correctly, and that starts with knowing how to request mental health leave in the first place.
If you think you might need time off work to look after your mental health, a mental health professional can talk you through the process of requesting leave from your employer. This guide can also help by discussing:
- What your rights are as an employee with mental illness
- If you can lose your job if you need time off work for mental illness
- What the employer duty of care for mental health is
- How to talk to an employer about mental health leave
- The steps to requesting mental health leave
What Are My Rights as an Employee With Mental Illness?
People applying for jobs or who are already working are protected by federal law when it comes to mental health. The Americans with Disabilities Act (ADA) helps ensure that employees with mental health conditions aren’t treated unfairly and can request reasonable support at work.
There’s also the Family and Medical Leave Act (FMLA), which gives certain employees the right to take mental health leave—up to 12 weeks per year—if they’re dealing with a serious mental health condition or caring for someone who is.³ But rights are not universal. FMLA only applies if you work for a company with 50 or more employees, and you must meet certain criteria, including how long you’ve been employed there.
However, employers within this category must provide eligible employees with up to 12 weeks of unpaid leave per year if they need the time to cater to a serious health condition.
For a mental health condition to be considered serious enough to require time off work under the FMLA mental health leave process, the employee must need one or both of the following:
- Inpatient care where an overnight stay is required in a hospital or at a mental health facility
- Continuing or long-term healthcare for conditions that incapacitate someone for 3 or more days and require treatment by a psychiatrist or psychologist. Chronic conditions like depression, anxiety, and dissociative disorders often fall into this category.
What Is an Example of a Reasonable Adjustment for Mental Health?
While employer mental health leave policies differ from one company to the next, there are several reasonable adjustments employers can make when trying to cater to employees with mental health concerns. Some examples of reasonable adjustments for mental health include:
- Adjusting working hours and patterns for flexibility
- Changing roles and responsibilities by reviewing tasks and deadlines
- Catering to different or unique communication styles
- Being flexible with policies
- Changing the physical working environment
- Providing additional support
Mental Health and Job Protection: Can I Lose My Job?
This is a tricky one to answer because while the ADA and FMLA protect employees who need workplace mental health leave, it’s important to note that they don’t apply to absolutely every situation.
In some cases, if a person’s condition seriously affects their ability to do their job or puts others at risk, an employer may still decide to end their employment. This isn’t about firing someone because of a mental health diagnosis. It’s usually about whether the essential parts of the job can still be done, even with reasonable support.
However, before that happens, employers are expected to explore accommodations and adjustments. Dismissal should be a last resort.
To put it as simply as possible, employers must make reasonable adjustments before opting for the dismissal of an employee who needs time off to attend mental health treatment.
- Adjusting working hours and patterns for flexibility
- Changing roles and responsibilities by reviewing tasks and deadlines
- Catering to different or unique communication styles
- Being flexible with policies
- Changing the physical working environment
- Providing additional support
What Is the Employer Duty of Care for Mental Health?
There’s no one particular law that states what an employer must do to promote an employee’s mental health. However, there are a variety of federal protections that set expectations. Some companies observe these but include more levels of protection through their own health and safety policies and wellness initiatives.
Here’s what an employer’s duty of care may look like:
- Compliance with the ADA to support workers by making reasonable adjustments and not discriminating.
- Observing the general duty clause that’s part of OSHA (Occupational Safety and Health Act), which states employers must provide a work environment free from serious harm. For instance, they must aim to eliminate or reduce harassment, burnout, and long-term stress.
- Aligning with the Family and Medical Leave Act (FMLA), which ensures employees get 12 weeks of job-protected leave (for companies with 50 or more employees).
- Following best practices and ethical duties of care sees employers providing access to Employee Assistance Programs (EAPs), mental health days, access to therapy, and a psychologically safe work environment.
Even if employers are not legally required to make accommodations for employee mental health, neglecting employee mental health can lead to:
- Increased absenteeism and staff turnover
- Lower productivity
- Potential legal risk if issues escalate to harassment, discrimination, or ADA violations
How to Talk to an Employer About Mental Health Leave
How you approach your employer can make all the difference to how you feel about your upcoming treatment. Whether you need extended leave for depression, anxiety, or any other condition, it’s best to know what process to follow.
Start by educating yourself on the Family and Medical Leave Act’s qualifying reasons for mental health accommodations, so that you can indicate that your request for leave falls under these. Of course, you don’t have to ask for FMLA leave for mental health, but making sure your employer is aware it’s covered by FMLA is a good starting point. Additionally, to ensure that your leave is definitely covered by the FMLA, you need to provide as much detailed information as possible to your employer..
FMLA is one option. But keep in mind that it provides unpaid job-protected leave. Another option is to ask your employer for a different type of leave, such as paid time off (PTO), vacation time, sick time, or similar. Under such circumstances, the usual rules for those types of leave will apply, as per your employer.
It’s a good idea to ask your employer if you have any PTO, sick, or vacation leave to use in conjunction with some or all of your FMLA leave.
Next, you’ll need to discuss health insurance. If your employer provides you with health insurance, it’s your right to have this continue during your FMLA leave. Both you and the employer will need to keep up with the usual contributions.
While you need to give your employer enough information about your treatment, you don’t have to share your actual diagnosis or medical history. However, your employer may require a medical certificate from the healthcare provider.
Legal Rights for Mental Health Leave
All employees in the United States are protected from unfair dismissal and discrimination due to mental health conditions. You have the right to:
- Request accommodations
- Take the required leave for treatment
- Return to your job after 12 weeks without penalty
Mental Health Work Leave Eligibility
Figuring out whether you can take time off work for your mental health isn’t always straightforward. Not every job gives you the same protections when it comes to taking time off for your mental health. Some people are covered under federal rules, but only if they’ve been in their job a while and work for a company that meets certain size requirements.
If you do qualify, you can take time away—sometimes up to a few months—to focus on getting better, and your job will still be there when you return. This protection also means your health benefits continue while you’re off.
Issues like anxiety, depression, PTSD, or anything else that makes day-to-day functioning hard can all be reasons for taking leave. But even if your workplace doesn’t fall under the federal rulebook, this doesn’t mean you’re out of options. Some companies allow personal leave, disability coverage, or a combination of paid time off that can be used for treatment.
It’s best to ask what’s available. Every workplace handles this process a little differently, and knowing what you can access is the first step toward taking care of yourself.
A lot of workplaces offer short-term disability, personal leave, or ways to use vacation or sick time. It’s worth asking HR (human resources) what’s available, as not every employer follows the same playbook.
How to Request Mental Health Leave
Asking for time off for your mental health can be stressful, especially if you’re not sure what to say or what your rights are. Approaching it with a clear plan can make the process smoother and help you feel more in control.
Before you talk to anyone at work, it helps to get a handle on what’s available to you. Not every company offers the same options, and these options depend on things like how long you’ve been there and what kind of leave policies they follow. Some people are covered under federal law, while others might have access to short-term disability or personal leave built into their benefits.
Once you’ve done a little digging into your options, your next step is to check in with your healthcare provider. You’ll need them to document that you’re receiving care and that time off is part of the treatment plan. This paperwork doesn’t have to include personal details or a diagnosis—just enough to confirm that the leave is medically necessary.
And if you’re not working with a provider yet or need help figuring out where to start, Mission Connection can support you. We work directly with individuals and families to connect them with care and can walk you through the process of getting the right documentation in place.
When you’re ready, it’s time to talk with someone at work—usually HR or your manager. Remember: You don’t need to go into specifics. Just let them know you’re requesting medical leave related to your health. Keeping it simple, but clear, helps everyone stay on the same page
Here’s what to do, step by step:
1. Know Your Rights
Nearly half of Americans use sick leave to attend to mental health challenges.⁴ These people know their rights. Start by reviewing your eligibility for leave under the Family and Medical Leave Act (FMLA) or any applicable state laws. If your employer offers short-term disability or additional benefits, check those too. Understanding your options will help you approach the conversation with clarity.
2. Talk to a Healthcare Provider
To qualify for FMLA leave or similar, you’ll need documentation from a licensed medical or mental health professional. Let your provider know that you’re seeking time off and ask them to complete any required forms your employer provides. They don’t need to include your full diagnosis, just that leave is medically necessary.
If you don’t currently have a provider or need support connecting with one, Mission Connection can help. We work with individuals and families to navigate mental health treatment options, provide referrals, and guide you through the documentation process with clarity and support.
3. Notify Your Employer
You’re required to give your employer at least 30 days’ notice that you’ll need time off.⁵ If you have less than 30 days available, you must let your employer know as soon as possible.
Once you’re ready, speak with your HR representative or direct supervisor. You don’t have to share the specifics of your condition, only that you’re requesting leave for a health issue covered under FMLA or another policy.
If possible, put your request in writing and include:
- The type of leave you’re requesting (FMLA, PTO, sick leave, etc.)
- The estimated start and end dates
- Any documentation you’re including or plan to submit
4. Submit the Required Forms
Your employer may ask you to complete a formal request or give your healthcare provider a certification form. Respond promptly and provide the necessary paperwork to avoid delays in approval.
5. Clarify Your Health Insurance and Benefits
If your employer provides health insurance, it should remain active during FMLA leave for mental health. Ask about your contributions and how to continue payments while you’re out.
Also, check whether you can use paid leave (like vacation or sick days) to cover part of your time off, especially since FMLA is unpaid.
6. Create a Communication Plan
Decide how much communication (if any) you’re comfortable with during your time off. Set expectations with your employer so you’re not surprised by emails or calls unless absolutely necessary.
7. Follow Up as Needed
If your situation changes—like needing more time or returning earlier—let your employer know as soon as possible. And, once you’re ready to return, ask for any support or adjustments you may need to transition back to work.
Get Support for Your Mental Health
Getting support for your mental health shouldn’t be an overwhelming process. At Mission Connection, our team is well-versed in helping people understand the process of taking time off for treatment and getting on the path to healing. Our mental health programs, which include inpatient care, partial hospitalization (PHP), intensive outpatient (IOP), and standard outpatient therapy, are designed to meet you where you are in your healing journey.
Ready to get started? Call Mission Connection today at 866-888-5074 to learn more or take the next step toward the support you deserve.
References
- Robinson, B. (2024, August 10). Mental health-related leaves of absence up 300% since 2017. Forbes. https://www.forbes.com/sites/bryanrobinson/2024/08/10/mental-health-related-leaves-of-absence-up-300-since-2017/
- National Institute of Mental Health. (n.d.). Mental illness. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved April 11, 2025, from https://www.nimh.nih.gov/health/statistics/mental-illness
- U.S. Department of Labor. (2022, May). Fact Sheet #28O: Mental health conditions and the FMLA. https://www.dol.gov/agencies/whd/fact-sheets/28o-mental-health
- BambooHR. (2023). Guilty until proven sick: Why US workers don’t take sick leave. https://www.bamboohr.com/resources/data-at-work/data-stories/2023-sick-guilt
- U.S. Department of Labor. (n.d.). How to talk to your employer about taking time off for family and medical reasons. Wage and Hour Division. Retrieved April 11, 2025, from https://www.dol.gov/agencies/whd/fmla/how-to-talk-to-your-employer-about-leave
