“You’re so young, why do you need therapy?” was Tulika Bhattacharjee’s boss’ reaction when she finally decided to open up about suffering from anxiety. Back then, she was just 24, straight out of college, and had jumped into the workplace — a space with people she didn’t know but with whom she had to spend a major part of her day.

Bhattacharjee’s condition is fairly common. As of today, at least, 38 million Indians suffer from diagnosed anxiety, which is characterized by feelings of worry or fear strong enough to interfere with one’s daily activities. Yet, talking about it or accepting someone else’s condition positively is something Indian culture is still coming to terms with.

“I’m an introvert, so for a long time, I didn’t tell anyone that I was stressed and feeling overburdened with work and that was adding to my anxiety. It took me a lot of courage to get to that point when I felt the need to tell someone about it,” Bhattacharjee said. “I remember it was when my anxiety started manifesting physically — I had headaches, severe migraines, and gastrointestinal problems — that I thought to myself, ‘how do I report to work with all this?'”

Fearing the same dismissive reaction, many people like Bhattacharjee don’t open up about their mental health problems at their workplace.

Take S.J., a 28-year-old media professional, for instance: “My anti-depressants can cause insomnia and other side effects that might hamper or impede my work. I had to let someone know about it,” S.J. said. So, he decided to tell his immediate senior about his depression first. “Although she was very understanding, she asked me not to tell anyone else or our boss about it because it could’ve impacted their impression of me or my work. She said they could even use it against me by citing it as a reason for my poor performance and reducing my chances of promotions. So, till date, my boss doesn’t know I suffer from depression.”

The Mental Healthcare Act, 2017, states that no employees shall be discriminated against for suffering from a mental health condition. It has even made it mandatory for all insurance companies to offer provisions for the treatment of mental health-related illnesses.

But in the same year that India’s mental health law was enacted, a study published in the Indian Journal of Medical Research exploring workplace attitudes toward mental health across 35 countries, including India. It stated that, “about two-thirds of employees who had suffered from depression either faced discrimination at work or while applying for new jobs.”

Another study conducted by the World Health Organization found that for every dollar invested in an employees’ mental health, there’s a four times return for employers.

But, according to Optum Health International, a health services company, only 1,000 of the 1.7 million companies registered in India run a formal mental health support program, according to its country head, prevention and wellbeing, Amber Alam.

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Such programs are sponsored by an employer to help employees and their families deal with emotional, behavioral and well-being needs that impact work and life.

But Sakshi Mishra, an HR professional at a Mumbai-based media house, says the truth about employer-sponsored mental health programs in India is that although many companies offer them, in many cases, either these programs are implemented poorly or don’t end up reaching the employees who need them. “Employees themselves hesitate to open up about their mental health because of the stigma associated with it. Or even if they do, not all managers are aware of or know how to respond to an employee’s mental health problem to be able to refer them to an employer’s program,” Mishra said. “Sometimes, the HR [professionals] themselves are unaware of the program or don’t consider it as serious as other tasks they are responsible for.”

In companies like hers, where the supportive program is active, not only has HR initiated a process to cover treatments related to psychiatric and psychosomatic illnesses but also implemented a 24/7 confidential helpline and anonymous surveys to gauge the mental health status of staff. Mishra’s company also has a list of experts to whom employees can reach out for consultations or treatment. In addition, the company also has regular mental health sensitization programs to help all its staff understand various illnessesand conditions and guide staff on how they can be of help to a struggling coworker.

“Since implementing the program, we’ve seen a lot more employees talk about mental health, and they have told us that understanding colleagues and managers have helped them manage work and life better. Andthat’s our real success. No numbers or profits can match an employee’s happiness,” Mishra said.

But many companies don’t adopt such programs for various reasons. They may instead offer other activities such as team-building exercises and games to help employees de-stress, but nothing targeted at mental health per se. This may be because, “While it may seem well-intentioned to monitor the mental health of your employees with their best interests in mind, it raises multiple legal and ethical questions. It is after all the feelings and emotions of an individual that the employer would be monitoring in the workplace. Such data would be accessible by the employer and possible third-party service providers and can be easily misused,” Sourya Banerjee, a lawyer, told The Health Collective.

For instance, should an HR manager, or an individual’s direct manager, know about the mental health condition of their employee, it might raise chances of unfair treatment, including reduced prospects of promotion, them becoming a target of gossip or facing rejection or being ostracized in the workplace.

“Although these risks associated with disclosing one’s mental health condition might be true, there are some benefits of going ahead and talking what an employee is suffering from too,” says Mishra.

These include the potential to reach enabling compromises with an employer such as flexible working hours or changes in the nature and scope of one’s work. Most importantly, sharing one’s mental health state may help explain a behavior pattern that might otherwise be misinterpreted by colleagues, according to Mishra.

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Take IK’s case for example.

“Recently at drinks with coworkers after a meeting, I told my boss that I had an anxiety disorder, and I went to therapy for the same. He was very respectful,” said IK, a graphic designer based out of Mumbai. “Actually, I even had an appointment rescheduled once after a particularly rough weekend, which would mean I’d either have to leave for an hour during my workday or book another next week — which would not be ideal. I let my boss know and he was more than happy to let me go to my appointment. He saw I was stressed out and that was very reassuring.”

In banking professional MK’s case, after opening up about his anxiety, initially his boss was hesitant to give him time off to go to therapy during work hours. But later, he became very considerate about it and said he had seen a difference in productivity when he allowed him to take breaks when he wanted and helped him in whatever way he’d asked for.

“I won’t lie, but the first thought that struck me when MK confessed it was how it’ll affect work, productivity and how it’ll ultimately end up affecting us in meeting our targets,” said M.K.’s boss. “But not being understanding and accommodative of someone’s mental health is as good as being inconsiderate of a person suffering from any physical ailment. Can someone deny anyone a sick leave when they have a fever or dengue? Why can’t mental health be taken that seriously?”

Assuming that mental health is an issue that is spoken about a lot more nowadays and hence more people know about it, the above should be a common and natural reaction from any boss when it comes to their employees and their well-being. Therefore, consultant psychiatrist Dr. Natasha Kate, with Mumbai’s Masina Hospital, says she always encourages her patients to talk about their condition with their bosses but the change in attitude regarding mental health has been a slow process.

“In so many years of my practice, I have seen more patients talk about it than before but not as many bosses or managers have been understanding or accommodating of their employees’ disclosure,” she says. “There’s a lot of stigma associated with it and this is the case when it comes to mental health even outside of the workplace. But in offices especially, the first thing bosses think is how a mental health condition will affect their employee’s performance rather than thinking that being supportive of it will actually end up in better results.”

It’ll be long before all of India’s workplaces adopt measures such as sensitizing and training its staff regarding issues about mental health that will end the stigma associated with it in a manner that it doesn’t cross the fine line between offering support and ensuring that knowing an employee’s mental health condition will not be used against them.

Meanwhile, employees who do choose to share their mental health conditions with employers are leading the way for a conversation with an employer that needs to be addressed even if they may not want to. In doing so, not only are they ensuring their own well-being, but also of the company’s because a better state of mental health does impact productivity and focus. And also in doing so, they are enabling others to open up about it.

“Revealing a mental health condition, for one, might end up relieving you from stress that comes from hiding it, it might also end up improving your relationship with the manager,” says Dr. Kate. “In addition to making workplace adjustment like flexible hours or allowing work from home, managers might also temporarily re-allocate tasks that an employee is finding stressful or difficult reducing overall stress. They might also guide you to get some mentoring.”

This has been true at least in MK and his boss’s case.

“My boss has been extremely supportive and a large part of my anxiety has been taken care of after I spoke up about it because there was no more lying about absenteeism, or why a certain task was not done on time,” says MK. “But I ensure that I don’t use it as an excuse to get out of a certain task or for not finishing an assignment. If my boss has trusted me enough to give me support and be understanding, there is no way I’m going to take advantage of it. In fact, I think his support has pushed me to work harder so I can become a role model of sorts, for others to see that I’m not being excluded out of assignments or discriminated in any way,” he adds.