The Family and Medical Leave Act (FMLA) is designed to allow employees unpaid time off work to care for their physical health and/or mental health, as well as the health of their families. Below, we’ll look at the guidelines of the Family and Medical Leave Act and other options for employees needing time off for stress and mental health disorders.

Sometimes, the demands of mental health issues like stress, serious mental health conditions such as anxiety, depression, or other physical and mental health challenges can make work an overwhelming place. However, you don't necessarily have to give up and walk away from your job if you're having a difficult time coping. FMLA leave allows for employees to take time to address mental health disorders, and to care for their mental or emotional health. 

What is FMLA?

FMLA is a law that gives 12 weeks of paid or unpaid leavefromwork each year to eligible employees for family and medical reasons, allowing them to care for themselves or a family member with a serious health condition.

Although this is unpaid leave, and you may have to pay health insurance premiums out-of-pocket, the federal law ensures your employer will keep your job until you return when on FMLA mental health leave.

This means you cannot be fired or laid off or have your position taken away from you because of your absence. If, for some reason, the same job is not available at the end of the FMLA period, your employer must find you one within the company.

Situations in which the FMLA may apply include:

• The birth of a new baby (time also may be used for pregnancy-related complications)
• Adoption or foster care placement of a child who will live with the employee
• Care for serious mental health condition, personal illness or health condition 

A serious health condition is one that renders someone incapable of working, going to school, or performing other major life activities. In some cases, it may require ongoing medical treatment. Routine examinations, treatment for illness (unless it meets the criteria above), and cosmetic procedures do not usually qualify.

Complications from a chronic condition, acute illness, or an intensive procedure may be eligible for FMLA if they cause an employee to be unable to work and the employee has a regularly scheduled appointment with their healthcare provider.

FMLA availability

There are a few qualifying factors that make someone eligible for FMLA leave. Employees must:

• Have worked at their place of employment for 12+ months (not necessarily consecutively)
• Have accrued 1,250 hours of work in the past year
• Work for a company that has more than 50 employees within 75 miles of your place of work

In addition, employees of non-public employers can use FMLA leave if the company employed 50 or more employees in 20 or more workweeks in the current or preceding calendar year.

However, FMLA doesn't cover everyone. New employees, part-time or temporary staff, and workers in companies not considered covered employers are usually excluded. In some cases, there are other options available for those who need time away, such as state medical and family leave laws for employers and employees. 

FMLA for stress and mental health conditions

In some cases, FMLA can cover stress, stress-related conditions, and other mental health challenges. FMLA may help those going through extreme stress or mental illness if their symptoms or poor sleep patterns affect their ability to function or their daily mental health.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Per the Department of Labor, conditions that require continuing treatment can include:

• “Conditions that incapacitate an individual for more than three consecutive days and require ongoing medical treatment, either multiple appointments with a health care provider, including a psychiatrist, clinical psychologist, or clinical social worker, or a single appointment and follow-up care (e.g., prescription medication, outpatient rehabilitation counseling, or behavioral therapy); and
• Chronic conditions (e.g., anxiety, depression, or dissociative disorders) that cause occasional periods when an individual is incapacitated and require treatment by a health care provider at least twice a year.”

What mental health conditions qualify for FMLA?

Not all mental health conditions may be eligible for leave. Certain serious mental health conditions (previously known as mental illness) apply, including:

• Major depressive disorder

• Bipolar disorder

• Post traumatic stress disorder (PTSD)

• Obsessive compulsive disorder (OCD)

• Severe anxiety disorders

• Other mental health conditions identified under the Americans with Disabilities Act

FMLA and Physical health conditions

Certain physical health conditions that require ongoing medical treatment also qualify for FMLA. Some of these include:

• Traumatic brain injury (TBI)

• Chronic conditions that require continuing treatment (for example, kidney disease, cardiovascular disease, or diabetes)

• A serious injury that impacts physical health

How FMLA supports families and caregivers

In certain cases, FMLA not only supports the individual, but can extend to family members. These include family and medical situations such as: 

• An employee’s adult child cannot support themselves due to serious medical or mental health conditions, and may require family counseling sessions, as well as financial and medical support
• Military caregiver leave for active military
• Supporting a military family member who was injured in military service overseas.

Support for military families under FMLA

The FMLA extends its support to families of service members, including those on active duty, through the provision of military caregiver leave.

This type of leave allows eligible employees up to 26 work weeks of leave in a single 12-month period, specifically to care for a covered service member or veteran who has suffered a serious injury or illness.

Eligibility for this FMLA leave is broad and may include the service member's spouse, son, daughter, or parent. For example, if an employee’s spouse was injured during military service overseas, they could apply for FMLA military caregiver leave to provide care.

Support for an adult child with a mental health condition

When a serious mental health disorder affects an employee’s adult child, the FMLA provides a safety net. It acknowledges the challenges faced by parents of children over 18 who, due to serious mental health disorders, are unable to care for themselves.

The FMLA extends its provisions to cover such scenarios, using the definitions provided by the Equal Employment Opportunity Commission's (EEOC) regulations under the Americans with Disabilities Act (ADA).

This means that conditions like major depressive disorder, bipolar disorder, and schizophrenia are recognized as disabilities that can greatly restrict major life activities, thus qualifying for FMLA leave.

FMLA application process: Start with your primary health care provider

The U.S. Department of Labor provides all the information eligible employees need to request FMLA. In most cases, you simply need to make your employer aware that you have a qualifying situation for job protected leave, and your human resources department will likely walk you through any paperwork or procedures they require for a formal request.

If you believe that you’re unable to work due to stress-related conditions or a serious mental health disorder, consider making an appointment with your doctor or a mental health care provider to discuss your options for this condition and acquire medical certification before applying through FMLA. 

For planned leaves that will be covered by FMLA, it may help to let your human resources department know 30 days in advance if possible. For unplanned FMLA leave, you can alert your employer as soon as you can. However, you may want to give them enough information about the situation to show them it qualifies for FMLA.

Once you submit a FMLA request, your human resources department will likely look at the details, ask clarifying questions, and use any additional information you offer about your mental health issues to approve or deny your leave through FMLA. Your employer has five days from your initial request to decide. If your request is denied, the employer must provide at least one reason why.

Medical certification from your primary health care provider

Your employer may want proof of any physical or mental health disorders to understand the medical reasons behind the leave with FMLA.

This is called medical certification, and it must include the following information:

• The date the condition started and made you unable to work 
• The expected duration of the condition
• Facts about the condition, which may include doctor’s visits, symptoms, hospitalization, medical treatments,and referrals)
• Whether the request is for continuous or intermittent leave

However, you might want to avoid providing more information than what is requested and sending sensitive details in employee medical recordsto co-workers, direct supervisors, or your management team when applying for health benefits or FMLA. 

What FMLA covers for mental health treatment

There are a number of treatments that may be considered for leave when managing a sanctioned mental health condition. Some of these include:

• Inpatient care or inpatient treatment at an inpatient facility

• Outpatient rehabilitation counseling

• Overnight stay or more for rehabilitation in a residential medical care facility

• Time off to attend regularly scheduled appointments with a clinical psychologist or clinical social worker

Medications and ongoing treatment under FMLA

Leave under FMLA can also include certain ongoing medical treatment to manage mental health conditions that are approved. This continuing treatment can include monitoring and managing side effects from prescription medications prescribed by your healthcare provider or medical professional. 

What happens when FMLA ends?

When you have come to the end of your job protected leave period, you return to work either in the same job, or one which shares similar essential job duties. To fully enjoy the health benefits of an extended mental health leave, continuing treatment as directed by your mental health or medical professional can be imperative. This may include follow up appointments with a therapist, prescription medications, or following certain lifestyle habits. 

Alternatives to FMLA, and how FMLA can work with other laws and benefits 

Some individuals may not be considered an eligible employee for different reasons; part time employees are not, and some small businesses may not be considered a covered employer, or offer private health benefits. If you do not qualify for FMLA for stress or mental health, either because you do not meet the requirements or do not work with a company that offers the FMLA benefit, there are other options you can explore, including other short-term disability or medical leave options.

ADA accommodations for mental health and workplace protections, including emotional support and job adjustments

The Americans with Disabilities Act, or ADA is a law developed under Equal Employment Opportunity Commission’s purview alongside other public agencies, and it supports every worker, no matter how long they have been in their position or their full-time status. It allows workers to request reasonable accommodations that make doing their job easier if they have a disability.

The ADA may cover stress and mental health disorders if something about the work environment or amount of stress prevents the employee from fully performing essential job duties, or substantially limits their ability to do so. There are usually no strict medical requirements as there are with FMLA, but you may need a note from your doctor to get approval for any mental health accommodations you need.

If you don't qualify for FMLA or ADA, consider taking leave. This option is like FMLA in that you can take unpaid time away from work, but it doesn't usually come with the benefits that FMLA offers. Unprotected leave is a risk because you may be terminated at any time you are away.

However, if there is no other option for a stress or mental health leave at work, negotiating terms of leave with your employer is likely better than continuing to experience harm to your mental health. If you want to know more about your case at a specific company, an attorney or court services can likely help you better understand your rights.

Short-term disability and FMLA for mental health recovery, extended leave, and emotional stabilization

Your employer may offer short-term disability as part of their group health benefits. This benefit typically allows you to continue receiving a percentage of your income while you recover from a disability.

Some companies may not allow short-term disability for an employee’s mental health disorder or behavioral health concerns. 

If your company does allow this, it’s recommended that you read your policy carefully. There may be certain requirements you must meet or mental health diagnoses you must prove with employee medical records to take advantage of the benefits. 

There are some instances where FMLA allows eligible employees to also benefit from short-term disability.

If short-term disability isn't a possibility for you, you might check the details of some of the other benefits you are paying to see if you might be covered elsewhere.

Employee assistance programs for stress and mental health support, including therapy referrals and crisis services

If stress or a mental health disorder, like major depressive disorder, is affecting you at work, you might consider checking your employee handbook to explore your assistance options. Some companies offer programs geared toward improving the mental health of their workers, such as an Employee Assistance Program (EAP).

An EAP may help workers receive free mental health counseling to address personal problems happening at home or work. Some EAPs offer group classes in yoga, meditation, or resiliency or host workshops to improve overall well-being and mental health. 

Vacation for burnout, balance, and mental health, plus time away to reset and restore emotional wellness

A paid vacation can allow you to keep earning money while taking some important self-care time for you. Many companies allow employees to use vacation time for those who are experiencing hardship or health concerns. You may be able to ask for additional hours through an assistance program.

If you want to use your vacation time as a stress leave at work for mental health, it may help to remember that you don’t have to go anywhere. Stress can negatively affect your body, and sometimes, just changing your routine and making time to relax can help.

Help with stress and mental health through online therapy