Then Ross lost her own job as a regional field worker at the National Alliance on Mental Illness in December. Since then, the 42-year-old Columbia mother with bipolar disorder has been struggling against the reflex to withdraw from society and with fears of becoming homeless.
Laid-off workers are having trouble adjusting to the displacement, emotionally and financially, while those who survived layoffs are left to cope with survivor's guilt, more work, lack of motivation and job insecurity, according to mental health workers and workplace consultants. That, in turn, has had implications for health care providers and employers.
Hospitals and counselors are straining under an increasing caseload as people suffering from job-related stresses seek help and often can't cover costs because they have lost jobs, income or health insurance. Employers are seeing a rising volume of requests to assistance programs that offer help resolving personal issues, including financial stress, as part of health benefits.
"For many American workers, this financial stress, uncertainty and anxiety can be significant, and it's important that they have places to turn for guidance and support," said Dan McCarthy, chief clinical officer at Magellan Health Services, which specializes in managing mental health benefits.
Magellan found that the use of services through its employee assistance programs, or EAPs, increased 10 percent nationally last year through the first quarter of this year. The company found that more people were calling with legal and money troubles, with concerns related to debt management, mortgage refinancing, foreclosure and job loss.
For Ross, the anxiety can be crushing. The mother of five has consistently worked during her lifetime, while managing the bipolar disorder that left her feeling very high or very low and sometimes hearing voices. She was diagnosed at 27.
"I am concerned about being on the street—that's my gut feeling," she said. "I'm concerned that my family won't have what we need. We're just barely hanging on."
After she was laid off late last year, Ross knew that she needed to continue weekly therapy sessions while tapping into disability insurance. She also is volunteer teaching a peer-to-peer support group through NAMI.
She hopes to turn her public speaking talent into a small business, Power Seminars; Coaching LLC, which she recently launched. Her goal is to use her experience with her own mental illness and her marketing background to speak to organizations about mental health issues.
"The best thing that's happened for me is to stay connected with my peers, those folks who have mental illness, those who know what it's like, those who can sit down with me for hours," said Ross. "They can laugh and cry with me. Those moments are priceless."
A survey last fall of more than 1,000 adults for two advocacy groups, Mental Health America and the National Alliance on Mental Illness, found that unemployed individuals were four times as likely to be coping with severe mental illness as those who had jobs.
And people who experienced a forced change in their work, such as a pay cut or reduced hours, were twice as likely to have symptoms of severe mental illness, the survey showed.
When such drastic changes occur in the workplace, "people are just dumbstruck," said Nancy Grunnet, a consultant for First Sun Solutions, an employee assistance provider in South Carolina. "They don't know what to think, what they're going to do."
Several large EAP providers, which also offer counseling for alcohol abuse, legal tangles and other problems that could hurt a worker's well-being and job performance, report that use of their services has steadily climbed during the past two years. This comes just as companies are under mounting pressure to limit expenses tied to rising employee health care costs.
The sharp jump in EAP use appears to be closely tied to the recession and to difficulties people are having with employment and stresses at home.
In a review requested by The Baltimore Sun, ValueOptions, a large national provider of EAPs to private organizations and government, found that the number of people reporting moderate or severe anxiety jumped 10 percentage points, to 53 percent, from September 2009 to February 2010. In general, anxiety rates had been rising since May 2008, the company found.
The timing of the increase corresponded closely to a steady rise in the national unemployment rate and the real estate loan delinquency rate, ValueOptions found. The company also said employees reported more difficulty coping with legal and financial problems, as well as personal relationships.