Hacker News new | past | comments | ask | show | jobs | submit login

Great article. A few years ago (at a previous job) I took a sick day for "sanity", but told them I wasn't feeling well. I felt guilty about doing it. I think part of it is the association of sick leave with externally visible medical issues, and the corresponding "straightforward" medical verification.

In other words, if you have a temperature or are vomiting, that's obvious. Many infections or physical injury can be trivially verified by a doctor. But a "sanity day", as truthful and necessary as it might be, is neither of those.

Out of curiosity, I checked my current employment contract. It says sick leave is for "A personal illness, injury or medical disability that prevents the employee from performing his or her job, or personal medical or dental appointments." or "Exposure of the employee to contagious disease when attendance at work would jeopardize the health of others." There's a dozen or so other cases listed in the contract, mostly about allowing sick leave to care for sick family members/children. Our contract also allows for verification, "If the Employer suspects abuse, the Employer may require a written medical certificate for any sick leave absence."

I've never heard of anyone here being asked for a verification, but it would tend to discourage people doing the "sanity day" sort of thing.




>> I've never heard of anyone here being asked for a verification, but it would tend to discourage people doing the "sanity day" sort of thing.

I suspect that the lack of trust this indicates on the part of the company (not to mention foster on the part of the employee) is probably a sign that you're past the point of no return. I suspect a company that asked for verification was not doing so to see if you were genuinely ill, they're doing so because it's already a problem and they want a nice paper trail for when they terminate you. Of course if you are abusing it, I think that's totally reasonable.

But I think most of my employers (except for one, where I quit for exactly this kind of disrespect) would have had no problem with me saying, "hey I just need a mental break day in order to keep doing this job - I'm taking one of my sick days". If one significantly exceeds allocated sick days, then the reason starts mattering more.


You're generally correct for the folks who have decent salaried careers. If I got asked to justify a regular random day or two I took off as PTO I'd tell HR to pound sand as anyone rightfully should.

Get into hourly low wage stuff and you are treated like children, many shops require a doctor's note for any and all absences with 1 or 2 dermits until you're fired.

This has reasons from both ends of course. When I was younger I saw the need for this sort of policy or you'd get eaten alive by the low-wage masses abusing it (and abuse it they did). But on the flip-side, these policies tend to simply be abused by management once enacted - with no leeway for people to be human.

In the white collar arena it's pretty damn trivial as a manager to tell who is abusing a PTO policy and who isn't, so only the shittiest of companies enact such policies. Managerial laziness is definitely creeping into this area of life as well too though.


Culture can matter a great deal as well. In my experience working in Japan and Taiwan, everyone is considered an immature child that must be babysat minute by minute.

My go-to story: Friend in Japan's train route was significantly delayed by a suicide. Rather than sit in the train station for ~2 hours waiting for cleanup, he leaves, gets on his motorcycle, and rides to work. Shows up 30 minutes late, but his pay is docked those 30 minutes, because unlike everyone else that showed up 2 hours later, he didn't have the little ticket they give you in Japan when your train is delayed. Regardless of him telling HR the situation, showing his house on the train route, etc, nope, he didn't have the slip from mommy, so his pay got docked.

I love working there, but the work culture is infuriating.


If the work culture is infuriating, why do you love working there?


Because Japan is fun and the food is good.

Also Japan is just about the most photographical country I've ever been to.


Not OP, but besides the work culture, there is also the actual work. Which you can love doing :)


I have friends and family working in Japan and requiring a stamped slip for metro delay (not sure if it's still stamped or just printed) is just a cultural thing everywhere, or so I'm told.

That kind of tradition means a lot more to Japan society than it does for some Western countries, I suppose. You can search for articles on "Japanese corporate bureaucracy" for different perspectives.


And appeal to tradition is a logical fallacy


There is more to a job than the culture?


Depends on if you are working in a big corporation or no.


Another reason blue color jobs might be stricter about attendance policies is that many rely on someone's physical presence. If there's nobody there to make the sandwiches, the sandwich store can't open. If I'm not there to make progress on my code on a particular day, who cares.

Not advocating treating people like shit for missing work once in awhile, just sayin'.


It's not just managerial laziness -- if you want to terminate someone for abusing the paid time off policy, there needs to be a paid time off policy in place. Otherwise it would be relatively easy to claim wrongful termination.


>by the low-wage masses abusing it (and abuse it they did).

This feeds directly into the popular narrative that the working poor somehow lack moral fortitude. Do you have evidence to justify this claim?


I'm not the person you're asking, but I have my own experience which mirrors theirs.

Only 5 years ago I was working hourly just above minimum wage in a job I disliked. The management had a very strict tardiness and absence policy, and a strike system that meant if were absent without proper excuse more than 2 times in a 3 month period you were terminated.

I didn't exactly have a traditional support system while I had that job. Lived with some friends, but couldn't reach out to family or the like for help. That's how most people were at that job. Independent, but broke. Still though, the job was miserable. I think of myself as a work-loving sort of guy but I dreaded every day of it. So we all were absolutely looking for any way to get out a day. Even if it meant we didn't have a 40 hour paycheck, when you loathe your job it just doesn't matter. Maybe you'll not eat lunch or dinner for a couple of days - but at least you'll be free.

I used my hatred of that job to propel me into something more. A lot of people in those positions are held down by other forces which did not affect me. I hope they can find their own ways out someday.

I don't think people like that lack moral fortitude. Going to work is not inherently morally righteous. Nor is a perfect attendance record. But, in my experience, people who have bad jobs that they dislike will game whatever systems are available to get as much time away from them as possible - even if it hurts their financial bottom line pretty badly.


I think your post articulates what I was trying to say much better, without going into the tangents I typically do.

Absolutely mirrors my experience to a T. I wasn't intending to put a moral stance on any of this, but you did a much better job at explaining that.


If his experience was anything like mine it isn't the working poor. It is the young workers who are not poor. They are still living at home: they do not need to pay for their room, meals eaten at home, health insurance. That is every penny they earn is pure spending money and so despite making minimum wage they are rich with no need to work as many hours as they do.

When I was working minimum wage there was also the working poor: they needed every penny. If they called in sick you knew they were sick. If you asked them to work overtime they did their best to take it because the extra money was needed (they often couldn't find a sitter on short notice though). They didn't stay in minimum wage for long, their efforts were noticed and they were offered promotions to management (not all accepted because management often meant moving away from family, but in that case they still got maximum raises until they reached the top of the pay scale).

Note that many of the working poor got themselves into that position because of their choices, generally they had a kid at 16 and dropped out of school as a result (at best finished at the bottom of their class). They were failing to dig themselves out of the hole of their bad life choices because that kid takes the time needed to get a better education. In short they lack moral fortitude in that they were (and are...) sleeping around, but not in that they are not working hard for their employer.


> Note that many of the working poor got themselves into that position because of their choices, generally they had a kid at 16 and dropped out of school as a result

The vast majority of teenage mothers in the United States do not choose to get pregnant and do not have the choice of terminating their pregnancy. They either do not have access to abortion providers - the majority of women in the United States do not have access to abortion clinics because of fundamentalist Christian activists and politicians: https://www.guttmacher.org/united-states/abortion/state-poli... - or they are coerced by their fundamentalist Christian parents into not having an abortion.


Everyone has access to birth control though. It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options. If you miss that you got plan b. Let's set aside your personal vendetta against the pro lifer Christians. How can you claim that the vast majority of pregnant teenagers don't choose to get pregnant?


Respectfully, I'm not sure you fully understand these issues that you seem to have a very strong opinion about.

Teenagers around the US do not as a rule have convenient access to contraceptive pills. That's because the FDA refuses to approve them for OTC sale, despite their safety relative to many other OTC meds. The stated reason for refusing OTC sales is that allowing them would prevent women from seeing their doctors for other medical issues (this is also the reason you can't buy extremely useful and safe meds like Ondansetron OTC). I feel like I'm on firm ground when I add that this is unlikely to be the only reason you can't buy OTC contraceptive pills.

Meanwhile, about half of US states require parental consent for most minors before doctors can issue prescriptions for birth control.

As a fun additional wrinkle, churches, and in particular the Catholic church, run some of the largest hospital and health chains in US metro areas. Church-run hospitals routinely refuse to provide access to contraceptive services. In Chicago, the Loyola health system --- an otherwise well-regarded health services chain! --- won't prescribe contraceptive pills to adults even for non-contraceptive reproductive health purposes!

I don't think we need to spend too much time talking about Planned Parenthood clinics; the issues there are obvious to anyone familiar with the state of reproductive health in the US.

So, no, I don't think it's reasonable to argue that any teenaged girl in the US should be expected to be fully armed with all the tools of modern contraception.


The lack of access to chemical birth control is a major issue, I agree. However, to the best of my knowledge, condoms are still fairly universally available to members of both sexes - which, while not ideal for a number of reasons, are certainly more effective in preventing the transmission of STIs as well as being effective in preventing unwanted pregnancy. Perhaps that might be a more charitable interpretation of the grandparent post, even if it's clearly not correct on the whole.


Beyond pointing out the obvious fact that teenaged girls in the US are living in a society that goes to some lengths to actively obstruct them from using the most reliable forms of contraception, I'm not really interested in digging further into the details here.


Fair enough.


You didn't mention the most obvious solution which is condoms. I bought them easily as a teenager 18 years ago. You can get them for free in many places these days.

You're also giving teenagers a pass for having unprotected sex as if they don't know there's a risk of 1) getting pregnant and 2) getting an STD.

Certainly some birth control measures are less accessible to teenagers, but what I'm arguing is the parent's claim that "The vast majority of teenage mothers in the United States do not choose to get pregnant"

That's not accurate unless what is meant is that "the vast majority of teenage mothers don't want to get pregnant (but choose to forego readily available birth control / condoms)". I'd believe that.


Without getting into any of the rest of this comment: that's not what you said. You blamed teenaged girls in part for not taking advantage of contraceptive pills. Specifically, you wrote:

It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options.

That's simply not a reasonable argument. Don't move the goalposts now.


I'm not moving the goalposts. If you're a teenager and you don't use a condom or other means and get pregnant - that's on you. You wrote a long retort which ignored condoms. That's unreasonable.

If you don't use a condom no matter what age you are and get an STD - same thing - that's on you too.

Your argument about post-conception options - I agree that not everyone has the same access. But I'm not talking about that.

Condoms work. Teenagers know the risk. They're just being dumb and it's on them.

Now - your argument that making birth control more available - sure I think that's a good thing too. But the notion that "the vast majority of teenage mothers in the United States do not choose to get pregnant" is irresponsible because almost all of them got pregnant by being wreckless while viable options are readily available. Specifically condoms.


The comment that you wrote and that I quoted from just now is still right there for everyone to read. It's weird to write as if it wasn't.

(The comment I just replied to was edited extensively after I replied to it. That's OK; I said what I wanted to say.)


I just added more to it. That's all. If you want to ignore condoms, then we're at an impasse.


Ondansetron is associated with long QT. The FDA does not like that side effect for OTC meds.


Easy: a lot of states teach abstinence-only sex education, and there's a prevailing set of social norms (often imposed by "pro lifer Christians") that makes frank discussions of birth control, sex, reproductive biology, etc. all but impossible. It sounds crazy - and, IMHO, it is - but large parts of the US operate as de facto theocracies, especially where it comes to education.

Under those circumstances, it's not surprising that teenagers have sex, don't know how to do so safely, and end up pregnant without meaning to. That is: a teenager absolutely can choose to have sex without choosing to get pregnant, simply because the society around them has conspired to make sure they don't understand how one leads to the other.


[flagged]


That's exactly the line of thinking that leads to societies where women must be accompanied by men in public.

It's strategic: prevent women from accessing the tools and knowledge to keep themselves safe, then justify denying them rights "to keep them safe."


You had the kernel of a sensible point a while ago, but now you're just digging in. Acting as if most teenage pregnancies occur because the woman involved doesn't understand how babies are made is asinine unless you've unearthed some population I don't know about; and claiming that frictions standing in the way of perfectly convenient birth control absolves a person from all consequences is both asinine and actively insulting to the agency of human beings everywhere.

Things could be better, of course, and that's worth talking about, but your argument has turned into a caricature.


Americans don't have universal healthcare, can't just go walk in some clinic / pharmacy and get a doctor / pharmacist to Rx you some birth control.

You also have minimal->zero private money and come from a poor background so it's too expensive. Your parents are religious and it's difficult to privately have & use birth control. Copper IUDs create pretty bad periods and are more painful to insert if you never given birth. Giving yourself a megadose of hormones with other implants is pretty freaky.

But your 16 years old and have a lot of hormones...

That is part of the reason why the entire obamacare free birth control fight was pretty emotional in the USA.


I'm pretty sure that you can buy condoms in America. They're not that expensive and work reasonably well.


Last I checked condoms were the only birth control that prevents STDs. All the other birth control named is not appropriate for teens who are unlikely to have settled on a lifetime monogamous partner.


So basically you're boiling it down to sex and laying down the guilt at the feet of the healthy young adults whose behavior is all but unexpected.

Wouldn't you rather call it the failure of a community - a society - to prepare its new members to the complexities of life?

Oh but it's easy to climb up the high horse, brandish the sword of Morals and throw the erring off the tower (incidentally, it's the same ISIS does to its own "deviants")


It's nothing to do with morals. Unsafe sex at an early age is just plain a stupid dangerous decision, and there's plenty of people to tell you that. Sure - I feel bad for the people who are now going to be paying for the consequences for the rest of their lives, but it's not some arbitrary religious code. It's not so different from experimenting with drugs in that regard.


Kids make stupid and dangerous decisions because their brains aren't fully developed, they don't have the same sense of perspective that they will (hopefully) have as adults. Once upon a time, this was part of why we had a separate judicial system for them, too.

Religion comes into play because the lobby against making birth control available to teenagers is also the lobby against abortion clinics (and any clinics that offer health services and birth control to teenagers) is also the lobby to teach abstinence in schools (or not teach sex ed. at all), and that lobby gets most of its funding from religious organizations.

So, the slightly awkward week in sixth grade where my teacher gave us anatomy lessons and a birth video is something my daughter didn't get to experience, even though I brought my family back to my hometown. Instead, she gets the even more wonderfully awkward talk from her parents, which my wife likes to paraphrase as "your mouth won't get pregnant" (thanks Bill Clinton).

Teen pregnancy is not currently a common issue (it has been declining since 1990), but that doesn't mean it won't start going back up if we continue making it more difficult for young women (and men) to have access to birth control and education about safe sex.

We even had some discussion in school about how to reduce the risks of experimenting with drugs, though I don't think many people followed those directions.


Religion _was_ the birth control for a long time. It appears to have stopped working sometime in the late 1960's though.


In the old days they used to say "First babies can arrive whenever they want, the second baby better take nine months". Which is to say they knew unmarried people would have sex, but any girl that got herself pregnant was expected to marry the father before the baby was born and stay married.

Religion never worked great, but it was all they had.


Expecting kids to wisely abstain when their brains aren't fully developed yet and their bodies are telling them that having sex is the most important thing they could possibly do is foolish. Giving them ready access to contraception and sex ed so they don't harm themselves or others is easy and effective, and there's no good reason not to do it.

You are looking at a problem with a simple and well-understood solution, and instead of talking about implementation you're going "Tsk, tsk, it's their own fault for being stupid." So, yes, you're absolutely moralizing.

> it's not some arbitrary religious code.

Giving teenagers worthless abstinence education instead of proven sex ed is the definition of an arbitrary religious code.


I think you missed the part where I said unsafe sex. I'm trying my darndest to find where I said abstinence, but gee golly I just can't do it. But I guess it just has to be someone else's fault somehow.


You said: "Unsafe sex at an early age is just plain a stupid dangerous decision, and there's plenty of people to tell you that." In the US there are major political lobbies whose goal is to prevent kids from hearing that in favor of abstinence-only. You can't just gloss over that and say that kids should know better when people are actively trying to keep them ignorant.


There is more than sex involved, but that was the biggest factor - at least in my experience which could well be different from typical.

I carefully avoided passing a moral judgement on their acts. However the fact is sex at 16 immediately jumps into moral issues (not just Christian - most world religions encourage marriage). I did my best those to focus on the fact that as a result of that choice they have eliminated their ability to get a head.

YOU are the one placing moral judgement on their choices and trying to make it look like my judgement.


In what way does sex at 16 immediately jump into moral issues exactly?

I don't buy for a second that being sexually active as a teenager somehow equates to lack of moral fortitude.

There's plenty of teenagers that are aware of birth control and use it appropriately. Do they lack moral fortitude, too?


Having a kid at 16 will screw you up. Most people have a moral objection to screwing up their life like that, as well as the practical objection. Most religions of the world have some form of moral objection to sex outside of marriage, it can be easily argued that the moral objection comes form the practical issues. (most religions predates any form of effective birth control. Today you can argue that the moral is obsolete)

Or put it another way, you cannot talk about kids having sex without everybody bringing their own different morals up. The two are very intertwined.


Yeah okay that doesn't exactly equate to lacking moral fortitude. Think you're projecting a bit there.


fair enough. I should have put moral fortitude in quotes.


20th century+ humans have reliable birth control. There is a very strong anti birth control meme in the US.


>> That is every penny they earn is pure spending money

I never looked at it as pure spending money - it was mostly saving for an education and a start in my adult life. Might be why I'm one of the few of my generation that doesn't think the entire economy is stacked against them?


With the exception of a Nintendo DS, 1 game, and some beer, all of my money from 4 years of jobs went to rent,food, and the tiny little bit left over went to tuition. Anyone going to college in the past 20 years was not paying for it all with a job you could hold while going to classes


graduated with a B.S. 5 years ago debt-free with no help from parents. It's possible.


Id certainly believe that it's possible to do so. However, in the same way that anyone could be president, not everyone can be. Lots of colleges don't even have enough jobs in the area to support every student working, and the number of hours you'd have to work can prevent anyone with a difficulty major from doing so

Edit:I did say _anyone_ in the past 20 years so that is some unfortunate hyperbole on my part


> Lots of colleges don't even have enough jobs in the area to support every student working

This doesn't make a lot of conceptual sense. If 100,000 people move into a town of formerly-3000, they will severely outnumber the open job slots from before they moved in, but that doesn't mean no work is available for any of them. Most of them will find work just as most people everywhere find work.

Work is available to anyone who can do something productive.


The bar for "something productive" keeps rising though.


Step 1: Study somewhere that is not the US ;-)

Some US based acquaintances recently discussed the college options and choices of their kids. A year at the cheapest college they discussed cost more than twice (tuition, without a room) as much as my German B.Sc. and M.Sc. combined: that is, 5 years of study (or longer - I decided to study part-time and earn real money in parallel. It costs little extra).


My post was focused on those who were skipping work. As I recall the majority of the kids had enough work ethic to show up every day. They probably were saving a fair amount of their pay check, but we never discussed that.


That's a stereotype.


> the working poor somehow lack moral fortitude

NOPE. More like they feel abused by society, so they rightfully abuse it back by taking as much as they can and giving as little as possible. Of course, the result is a vicious cycle they can't get out of: if you play the lazy parasite once, you do get some kind of "abuse" back (even if it's just passive-aggressive attitude from colleagues) even if you mostly get away with it and as we're all wired up to do you then have to "retaliate".

Of course, people who don't have a history of being abused by the system, eg. people who've had good managers, don't feel the need to abuse the system themselves, so no problem here.

And breaking an established cycle requires a great manager (hint: probably the one you're not going to hire, because it makes more business sense to spend more on legal, accounting, or even a developer...), assuming not very stubborn employees and no underlying mental issues.

Most socio econ systems fail because some people feel abused and abuse the system back. Abuse your workers well enough an you get, surprise, communism, when they abuse you back. Circle of life and all that shit...

(And don't get me wrong, I think it's good that a sizable percent of population is pre-programmed to "abuse-back", this prevents us being turned into a mindless remote controlled flock of sheeple... And I kind of think lighter collar "information jobs" people should learn a thing or two from the abuse-back attitude of blue collars because nowadays they tend to be sheepified too, and some "abuse-back feedback" would help the system!)


I'd say there is a simpler thing that also contributes.

The poor have much less leeway in their lives. Sometimes, they need to choose between 'abusing the system' or e.g. dealing with a family emergency. Say your car broke down and you need to get it fixed. Do you call in sick and get it done or do you bus it until you get some free time when the mechanics are working?


With a request like this, the best you can hope for it lots of data points (ie anecdata).

What I've seen is that in the jobs filled by younger people with little skills on the worker side and near-exploitative conduct on the employer side, was a) a rather shallow loss function ("what if I lose this job? I'm underpaid, it's a dead-end, and I can easily get another job like this", that they often still live in their parents' basement exacerbates that effect) and b) a feeling of justification for these actions ("They exploit me, I'll exploit them back").

And those weren't simply rationalizations, so I'm not sure if it's a matter of moral fortitude or lack thereof, just of a different set of morals that (are understood to) underlie that type of job. There was a strong sense of moral in the people I worked with, just along other axes (eg. stronger loyalty between peers, but much weaker up and down the hierarchy).


I've seen the same rationalizations from salaried well-paid people.


Yea, it's not really a lack of morals to fuck over someone whose actively fucking you over like many low end jobs do. The few bosses I had that didn't exploit people ended up with much higher loyalty and rule following on the employee end. The other employees helped enforced it with social pressure too, as no one liked seeing the good boss get advantage taken of them


> This feeds directly into the popular narrative that the working poor somehow lack moral fortitude.

Not really. Not every bad job is held by an oppressed proletariat. Many times they're held by mischievous PFYs who still think they're immortal and that $20 is a lot of money. Youthful indiscretions are one the most common sources of this type of behavior. It's extremely common to not have a professional attitude in your "first real job", or to not even consider most minimum wage jobs as a "real job". There's an entire genre of movies that relies on this culture. Slacker culture has been part of pop culture for decades, now. When you don't have any actual responsibilities it's pretty common to treat any new ones like a big joke, or as "suggestions".

And it doesn't just happen at work - there are people with extremely cavalier attitudes towards education. I had a conversation with my kid about other kids getting around attendance rules in high school by showing up to class and then "going to the bathroom" and not returning to class again. Skipping class to go smoke, race, shop, etc has been a thing for at least 50 years. It's kind of telling, though, that most slacker movies were about college-age (or younger) kids. Ones for adults (e.g. Office Space) are pretty rare and rather niche.

It's important that we recognize that professionalism is not a natural (or an exclusive) trait. Babies don't pop out of the womb screaming "Please advise." The teenage years are full of people pushing boundaries to learn how they fit into society. We expect mistakes at that age, and those expectations are frequently met.

I've literally met hundreds of people who blew off classes because they weren't the ones paying for it, or who called in sick after a hangover or because they didn't like their job. I've stood around at parties listening to people tell stories of how they ditched work. I had a co-worker call in sick because he "couldn't get his car out of the garage." And having six dead grandmothers in a year is a trope now. It's not everyone, for sure, but it happens. It's just that people do it less with the jobs that they value in the careers they've invested into.

That said, we do need a lot of labor reforms around hours worked, employee rights and privacy, cost of living adjustments, etc. And we need better safety nets for citizens. But those will always extend far more slowly to a job that can be filled by 90% of the population. The supply of entry-level workers far outstrips the demand.


>> by the low-wage masses abusing it (and abuse it they did).

> This feeds directly into the popular narrative that the working poor somehow lack moral fortitude. Do you have evidence to justify this claim?

I wouldn't be surprised if it's far more common among low-wage-job-holders that aren't poor, actually.


That would make sense if we were talking about unpaid time off, but we're talking about PTO.


Sorry, I don't follow. The working poor have a lot to lose through abusing PTO -- losing a job is devastating for them. So I would expect them to be less likely to abuse it. Contrast it with the non-poor who work low-paying jobs... losing a job isn't that huge of a risk for them. So naturally there's a lower barrier to abuse. This is true regardless of whether the time off is paid or unpaid. Or I guess even whether we're talking about time off, or about anything else at work really.


It was pretty clear he was talking about his own experiences. Does he need evidence to justify his claim that management also abused their powers?


> It was pretty clear he was talking about his own experiences.

And I'd like him to elaborate on those, rather than make a broad generalization. Thanks.


I'd say its the other way around.

It only takes a few people abusing this before it becomes a problem. At the same time, those who lack moral fortitude are more likely to have low-wage jobs because those are the only ones they can hold down.

So, the shitty people end up over-represented at the low-end of the job market, so those jobs need to consider them more.


> Do you have evidence to justify this claim?

Sure, I worked a lot of retail/physical labor/etc. type jobs in my younger years. I was out of the house at an early age, and took these jobs very seriously since they paid my bills. My co-workers for many reasons did not, at least a very significant minority of them.

I don't think it's really "out there" to say that the typical minimum wage worker is not as high quality as the guy 4 years in making $20/hr. That is reflected in their pay, after all. The folks I worked with were either generally reliable and usually job hopped quite a bit every 6-12mo for raises, or they were just workers who barely had enough value to not get fired. The latter were more common, in my experience. Despite what you hear on HN and elsewhere - there are a significant number of people who have zero interest in working, and only do so to pay bills. If they could sit at home all day doing nothing, they absolutely would. Working with them is not fun, and until I found the whole computer/on-line community thing (in the early 90's) I felt extremely alone spending most of my day with those types that had zero ambition to improve their lot in life.

And I think it's more of a "masses" problem - not necessarily class based. Maybe investment based. You likely don't really care much about your $7/hr job, at least a significant portion of people do not. That same is not as true for the $100/hr job. It's simply a filter.

You see the same issues in other "body shop" style white collar offices too. Even relatively highly paid folks like insurance call center workers have to be treated like children, or you'd have half the office call out on a friday before a long weekend. Been there, done that as well. I imagine Infosys and similar companies have policies that look very similar to someone like Walmart.

I'm obviously having trouble describing my thoughts here - but in the end I'd say it's something like professional careerists vs. a just a job. The latter there is very little skin in the game for the average employee comparatively - and those that have that motivation generally don't stay in that socioeconomic class very long. You see the same effects in any space open to various segments of the public. The higher your admission fee the less you have to pay for people destroying things. More skin in the game.

Edit: I think it's important to state these are generalities. The actual working poor tend to be by far the hardest working most reliable folks out there. If they had issues making it to work - it was usually something huge in their lives. The thing is though? These folks typically got promoted or much better paying jobs elsewhere, so it's again a self-selection thing. Sort of like stack ranking your employees and only the lower 50% get to stay in your company.


> I don't think it's really "out there" to say that the typical minimum wage worker is not as high quality as the guy 4 years in making $20/hr. That is reflected in their pay, after all.

One other thing, is that minimum-wage jobs are often (not always) filled with entry-level workers. These are people who have never had a regular job. They don't know, or may have unrealistic ideas about the importance of being on time, showing up when scheduled, not taking random time off with short notice, etc. So policies are strict because many workers need to be "trained" about what to expect.


I remember at 19 having a summer job picking orders for a school book supplier. Order comes in, you pick it, then you laze around until the next order comes in. Now, I like to laze around a lot, but it still blew my mind the level to which some people would avoid work - they would spend more physical and mental energy 'not being around' when the pick came in, hiding somewhere in the stacks and keeping their 'radar' out for incoming picks... than just doing the pick and then lazing out relaxedly. There seemed to be additional value in specifically not doing work.


That's an aspect of minimum wage I haven't considered before - if I'm not feeling inherently passionate about my work, there's always the realization that I could get fired and have to take a lesser job somewhere else. If it's minimum wage you're more or less down to a binary situation. You might get fired. And then unless literally no one is hiring, you can get a similar job somewhere else. The long-term relative effects of not working short-term aren't as pronounced. I'm guessing a lot of minimum-wage employers don't do a ton of due diligence.


A technical analogy that people on HN people might understand better, is there's a difference in quality of service between paying a IT guy $100K/yr to keep your stuff like a webpage up, vs paying a discount hoster $3/month to keep a webpage up. Worst case situation will result in behavior where an outage is worth $100K/yr or the cost of sales of a $3/month AAS provider. I worked in engineering at a AAS provider a long time ago, and the realization that what I can do to fix something as a normal sysadmin is enormously greater than what I can do for less than the cost of sales of replacing the customer at a AAS shop is pretty shocking.

This effect extends thru the entire economy.

From observation its not that people who are poor have no ambition, they just have ambition in areas not involving getting lots of money from work or "reward" from management recognition. They want a happy family life, sex, be cool, get drunk often, ambition in all manner of things, just not into working 10x harder for 2x more money. I probably work 100x harder mentally than when I was a high school kid working at a supermarket and I barely make 10x as much money. For me working 100x harder is not a big deal because supermarket work is not exactly rocket surgery, but I can see a lower ability normie not seeing 100x harder work as achievable without excessive stress for them at their performance level, or perhaps being impossible for them. The "sit at home" under a UBI scenario seems incredibly unlikely. You might not agree with or appreciate the effort of "being cool" or posting high score posts on facebook or obtaining sex, but they will certainly sweat a lot of effort into achieving it. Playing video games is not very profitable but it is somewhat ambitious and takes a lot of effort.

To some extent a marketplace that doesn't meet the participants needs is a failure of that marketplace, which describes a lot of our labor system for a very large fraction of the population. Its not really their fault the system is irrelevant to their interests.


PTO is not the same thing as sick leave. Generally PTO, be design, does not require any justification whatsoever. I don't see how your anecdotal experience is relevant to this discussion.


>I suspect a company that asked for verification was not doing so to see if you were genuinely ill, they're doing so because it's already a problem and they want a nice paper trail for when they terminate you.

Eh, probably not. Some companies do it to everybody especially when they have an employee that they want to get rid of, but is in a 'protected class'. This so they can show HR and the unemployment commission they treat everyone equally and fairly. Unfortunately this leads to the average employee that does their job feeling they are being treated unfairly. The larger a company gets, and the more surface area the company is exposed to lawsuit abuse to, the more commonly these rules are applied to all people in an unfair manner.


I've seen people routinely abuse sick days and they considered it normal (they brag about it). Others coincidentally are "sick" for exactly 10 days a year, year after year. They think management doesn't notice, and wonder why they don't get much in the way of raises or promotions.

Basically, you're right. The verification thing is invoked to provide convenient evidence to get rid of someone they already want to get rid of.

Trust only goes so far. If a company does not have good cost control and verification procedures, they can and will get robbed blind. Heck, the cash register was invented by a bar owner who suspected the bartender was embezzling in a blatant and ruinous fashion.


What's wrong with people taking 10 days off per year? Why is management so short-sighted as to make promotion decisions based on ~4days/yr of presence (<2% of productivity)?

Why does it even matter why they take the time off?

Make a stupid policy, get a rational response from employees.


Another way of thinking about this, rather than "mental vs physical" or "healthy vs sick" is "how much discretion does your employer give you to balance work with your own well-being".

There are plenty employers who are willing to accommodate you if you have an actual DSM-diagnosed mental disorder but are skeptical of a "sanity day".

Likewise, there are plenty of employers who will let you take time off if you're actually chucking mucus across the room. But what if I just suspect my immune system is a bit weak from the long hours I've been pulling, and that going into work today is likely to trigger a cold? Or what if, in order to keep up with work, I've been drinking 8 cups of coffee a day and eating nothing but microwave meals because I don't have time to figure out healthier options? Technically, nothing prevents me from performing my job. It doesn't require a doctor's appointment, nor is there some illness that's easily verifiable. I'm not broken yet. I just have a hunch I'm breaking down.

And then there are a whole host of issues that might not qualify as "health issues" but are things I need time to deal with if you want me to function at my best later: childcare, DMV appointments, legal issues, car repair, etc.


I dunno man, any of those things and I'm just not feeling well, so I'm staying home.

There's absolutely something preventing me from doing my job on those days, by the simple expedient that I don't feel like doing it that day. If that doesn't happen more often than I have sick days, I don't see the issue.


You should learn a little about the politics around the DSM before assuming that anything in the DSM is "real" (and everything not in it is "fake").


I've seen some companies in the UK operate what they call a "duvet day" policy. It's basically just two floating holidays a year you can choose to use at any time, doesn't require explanation and doesn't count as a sick day. I personally haven't worked somewhere with such a policy, but know some people who do, using it largely as a "sanity day" as you describe. They really seem to appreciate it. I'm in no way trying to demean or imply mental illness isn't real and not deserving of 'real' sick days, but it's nice to have a range of options.

https://en.wikipedia.org/wiki/Duvet_day


Correct me if I'm wrong, I think that's called a personal day here in the states. They usually give you two a year too, along with sick days.

Though I do agree, that there's stigma towards taking it for personal sanity, mind healing.


Are sick days still a thing?

At my job we get PTO and holidays (floating depending on the year), but no specific sick days.

Apologies for any naivete.


CA has a sick leave regulation: https://squareup.com/townsquare/californias-new-paid-sick-le...

When I was at Yahoo, we had unlimited sick days (and my manager aggressively enforced that), but after this law passed they asked us to mark any sick days we took off to comply (still unlimited, but somewhat tracked).


I think sick days are generally a good idea as they encourage people that are sick not to come in, thus helping stem epidemics. If they're regular time off, people come in sick to save them up.

You might try to make a distinction between contagious and non-contagious diseases, but it'd probably be unwise as often people don't know if they are contagious or not, and anyway encouraging healing isn't a terrible idea even if they aren't.

That said, you shouldn't be cheap on the vacation days either.


As someone from Holland I read the comment from malnourish in the opposite way.

Why limit the amount of days your allowed to be sick? What happens if you are sick for more days than what your contract allows?

I would think that a finite amount of sick days will have the opposite effect of what you are describing. People will come to work even when they're sick, just in case they get even more sick later in the year. Except for the end of December of course, can let those unused sick days go to waste!


> Why limit the amount of days your allowed to be sick?

The number of days you are allowed to be sick is not limited; the number of days of paid leave to deal with being sick is limited.

> What happens if you are sick for more days than what your contract allows?

Depending on the nature of the illness and other factors, you may be eligible for unpaid (by the employer), job-protected leave under FMLA or similar state laws, and may be eligible for disability payments during that leave under state law. The employer may, even if that law does not apply, extend paid or unpaid leave beyond what it is committed to in your contract, but is under no obligation to do so.


> What happens if you are sick for more days than what your contract allows?

They threaten to fire you for taking too much sick time, and they don't pay you for the additional days. They complain that you aren't reliable enough and that they need someone who is reliable.


I found this interesting article that claims that flu days / sick days reduced the number of workplace cases by 6% by reducing the in-workplace transmission rate by 25% for one day and 40% for two days of time off.

https://www.sciencedaily.com/releases/2013/06/130613161831.h...


PTO is just merging sick days with vacation, usually to mask the low combined total (the nominal “benefit” to employees compared to classic separate sick plus vacation policies is that the whole amount can be used for vacation.)


I don't disagree, it was a bit alarming and while our PTO policy is better than many, there are still lots of competitive employers who offer better benefits wrt time off.

It is nice to never actually need to provide a reason/note to be out, but I think the combination does stress some of my coworkers (e.g. "I don't want to take vacation because what if I get sick", "Oh great, I'm sick, now I can't take vacation").


Depends on the company. I've been at places that separates them and places that don't. Before our acquisition we had 20 PTO and 10 sick days and after the acquisition we are at 25 PTO days with sick time included in that. My previous employer had unlimited sick time that was completely separate from PTO.


The USA is one of the few countries that doesn't enforce some amount of paid sick leave allowance[1].

[1] http://d3i6fh83elv35t.cloudfront.net/newshour/wp-content/upl...



Technically I think so, but from what I've seen some people use PTO days for sick days (or to go to the doctor)?

We have 6 holidays + 1 floating that we can use, and they don't roll over from year to year.


That's even worse than Amazon!


> Are sick days still a thing?

Why wouldn't they be? I assume they're mandatory in most countries.


In most (western, don't know otherwise) countries, you stay home when you're sick, and get paid because it's outside of your control. No matter if that is day 1 this year or day 20.


So employers need to be careful not to hire sickly people?


It's illegal to discriminate against someone because of their medical background or disability unless it's critical for the job. For medical background they wouldn't be able to get the information anyway.

Sickness is just part of the cost of doing business with people, not robots.


> So employers need to be careful not to hire sickly people?

Wow. O.o

So in US employers just whip sickly people into coming to work or how does that line of reasoning work?


Well here in the UK you don't have a limit on the number of sick days. You get sick you go off work. It's separate from normal PTO allocation.


I thought "personal days" are when they put sick days and vacation in the same bucket (which a lot of companies do)?


There's something like this in Poland, but it's four days and it's mostly used for emergencies. Using it deducts the planned holiday days.

http://polishemploymentlaw.com/index.php/tag/day-off/


I felt guilty about doing it.

You shouldn't feel guilty at all. They should feel guilty for making you need to take that day off.

Your workplace should be a refuge, where you charge your batteries and build sanity. Not a constant drain on those resources.


Your workplace should be a refuge, where you charge your batteries and build sanity.

That's a refreshing perspective, I haven't thought about it like this. Indeed, when you're solving tough problems, you'd better concentrate at the private office (which is nowhere to be found, so work from home it is), and the workplace is the place where you go to discuss your difficulties with colleagues to broaden your perspective, and ask senior ones for practical advice. Makes perfect sense.


Orthogonal to my other comment, I feel like most of those reasons for sick days are really good reasons to have your company set up to facilitate remote work. When my wife was on maternity leave, I was more willing to be flexible with when I took leave because I could be at home anyway and help her when she needed while she recovered (which was just occasionally throughout the day). Same with when my kids have been ill. When I have a contagious illness, it hasn't mattered because I just work from home. I don't remember the last time I actually took a full sick day because I personally felt like I couldn't actually perform mentally. Because my company is set up to make remote work almost seamless, I take fewer days off but can tend to the needs of my family even better. Win-win.


I ejected myself from my own business of ten years as my mental health and resultantly my physical health was failing. Stress does really bad things in the long term.

My co-founder was relentless in applying guilt and pressure while I vomited for years for weeks at a time - multiple hospitalisations due to severe dehydration. He denies that mental health is even a thing.

So - it's not just an employee thing - even business owners can be severely impacted by uncaring colleagues.

A year out of work and I haven't puked in eight months.


Yeah, that sounds like stress...


Throwaway.

My work requires a medical certificate for certain situations. No exceptions.

Sometimes it's easier for me to simply turn up to work sick for a day, than try and get a cert.

I'd feel worse about doing this, but I am pretty sure other people do this too.

And it's an open plan office of course, so diseases just spread through the office.

You should simply get a large pool of personal leave that accrues and you can take it when you need to.


I worked for an employer who had a large percentage of union employees. All employees were held to the same rules and as a result, you could only be out sick twice in one year. The third time meant you were written up. If you were out more than a day, you had to have a doctor's note. I had a procedure done and was so terrified about the rules, I went to work. The pain was unbearable and they sent me to the on-site doctor. He looked at my stitches and asked why the hell I came in. I could barely laugh through the pain at the irony of it.


I'm sorry you had to go through this. I do hope you are in better health now and don't have to endure this kind of an atmosphere again.

Good luck mate!


Thank you for the kind words!

I am happy to report I left that position after 13 months, but consider the plight of the skilled tradesmen who work under those conditions and do physical labor. I was just sitting at a desk programming.


My beloved works in health care (currently with oncology patients, previously hospice and Alzheimer's). The idea of taking days off for mental health is pretty normal and well accepted within the industry. Then again, it's a culture where mental health is treated as a health issue and sucking it up for the dollar is recognized as unsustainable over the long term.

Well that and even the bosses are ready to acknowledge that the job people are paid to do sucks at least sometimes. Many industries and businesses pretend that that's not the case.


Anecdotal, and on the opposite end of the spectrum, I've a friend who works in healthcare in the UK. Even though the official line is that they're not to come in to work while ill, not turning up ends up putting them under an incredible amount of pressure, and they have to justify every sick day to the post where even when she had some quite serious issues she was still working rather than face up to her management


There is a mental overhead from work piling up whenever a person in a line position takes a day off for whatever reason. Illness, vacation, holiday...it doesn't matter.


Medically speaking a mental illness is no different than a physical illness.

Mental illness does not have to be severe just as physical illness does not have to be severe.

Sick leave policies typically only require a doctors note/visit if you are absent for multiple days.

Taking a single day off for mild mental illness, something like elevated stress levels causing anxiety that interrupts your sleep, seems perfectly consistent with most of the corporate sick leave policies I have read.


There are two major differences between mental diseases and typical physical diseases.

First, "sick days" generally are a policy for handling acute disorders; e.g. last week I didn't have disease X, today I do, and next week I'll be healthy again. You can't "wait out" a mental disease; taking a day or two off may reduce elevated stress levels but that is not the disease, the underlying problems aren't going to be solved when you come back.

The second issue is that many common physical issues are contagious, and there's a strong benefit for the employer and the society for sick people to "quarantine" themselves instead of going to offices and infecting coworkers and customers.

Mental diseases generally all are chronic and not contagious, and so they're similar in workplace (mis)treatment to things like arthritis or diabetes complications; things that don't map neatly to "x days to get cured" but instead need ongoing maintenance and unscheduled downtime forever.


> First, "sick days" generally are a policy for handling acute disorders; e.g. last week I didn't have disease X, today I do, and next week I'll be healthy again. You can't "wait out" a mental disease; taking a day or two off may reduce elevated stress levels but that is not the disease, the underlying problems aren't going to be solved when you come back.

In the UK time off to manage a long term condition could be justified as a "reasonable adjustment" under the equality act.


>Medically speaking a mental illness is no different than a physical illness.

I am a proponent of taking time off for mental health, but I have to nitpick here. Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.


Afraid that's not true. Around 60-80% of diagnoses in primary care settings are made purely on the basis of the patient history (followed by a brief clinical examination which usually aims at eliciting subjective responses)[1]. In principle it's true that you could find a pathological explanation for all somatic ("physical") diseases which in practice are diagnosed off patient histories (with the exception of diseases for which the pathogenesis is unknown, f.ex. fibromyalgia, IBS, CFS, etc). However - in principle - the same goes for mental illnesses, although the pathogenesis of mental illnesses are generally poorly understood. If you don't think there's a physical basis for mental illnesses though, skim through the figures in this article[2] for a prime example of the ways modern medicine is disproving that. Diagnoses of both mental and somatic illnesses are heavily based off subjective factors, and both mental and somatic illnesses have very real pathophysiological etiologies.

[1] Source: medical school. Not finding a study with exact numbers from a quick search. [2] https://www.nature.com/nm/journal/v23/n1/full/nm.4246.html


>fibromyalgia, IBS, CFS

There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

>If you don't think there's a physical basis for mental illnesses though, skim through the figures in this article[2] for a prime example of the ways modern medicine is disproving that.

There are physical symptoms of mental illness, but as yet there is no proof of physical causes, which is why the chairman of the Department of Psychiatry at Duke University School of Medicine and the DSM-4 stated "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". You'll find no objective biological tests in the DSM.

https://en.m.wikipedia.org/wiki/Allen_Frances


>There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

Nothing good, sadly.

My wife was in banking for twelve years and worked her way up from a teller to a fairly senior position. Her work ethic was spectacular - she had just two sick days in the previous five years and she was promoted almost yearly, always receiving an excellent review.

A few years ago, she went from having occasional discomfort to waking with fairly severe pain daily. It got so bad that she had to take time off, and eventually took FMLA for a full twelve weeks to see if it would help. It didn't and she was fired soon after.

She filed for disability after being diagnosed with Fybromyalgia. Our lawyer sent her to bother specialist doctors and independent testing labs to get complete documentation. They had her complete various tasks like screwing in a screwdriver, raising a weight above her head for X seconds etc. and then asked her to rate her pain levels and other self-reported things.

In the end, she was denied for disability, mostly because disability is no longer about actually being disabled - it's now about essentially filling the gap between welfare and medicaid. In the written opinion however, the stated reason was that all the evidence was self-reported, implying she could be making it all up (because who wouldn't want to give up a successful and lucrative career for some minimal-level disability payments).

Anyway, I learned two main things:

1. There are no commonly accepted objective tests for pain - it's almost all self-reporting.

2. The disability system in the US is heavily used as supplemental welfare.


> There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

No, objective tests are in these cases used to exclude other causes to the symptoms, not to diagnose the mentioned illnesses. These are diagnoses of exclusion[1].

> There are physical symptoms of mental illness, but as yet there is no proof of physical causes, which is why the chairman of the Department of Psychiatry at Duke University School of Medicine and the DSM-4 stated "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". You'll find no objective biological tests in the DSM.

I'm not disputing the fact that it's not possible to do pathophysiological tests for mental illnesses in current clinical practice, but you're creating a false equivalence by implying that being unable to test for a pathophysiological factor is the same as that factor not existing. There are plenty of pathophysiological changes that occur in mental illnesses [2-4], but for obvious reasons it's not feasible to haphazardly take biopsies of the brain to test for them, especially when the patient history and subjective examinations suffice to make a diagnosis in most cases.

Conversely, my point still stands that the vast majority of somatic illnesses are diagnosed off subjective symptoms - doctors don't bother doing objective lab tests for a cold or a sprained ankle when the diagnosis is glaringly obvious based off subjective symptoms.

  [1] https://en.wikipedia.org/wiki/Diagnosis_of_exclusion
  [2] https://en.wikipedia.org/wiki/Mechanisms_of_schizophrenia#Pathophysiology
  [3] https://en.wikipedia.org/wiki/Biology_of_depression
  [4] https://en.wikipedia.org/wiki/Causes_of_schizophrenia


>it's not feasible to haphazardly take biopsies of the brain to test for them

It is feasible post mortem but scientists still have no conslusive proof from such examinations.

>Conversely, my point still stands that the vast majority of somatic illnesses are diagnosed off subjective symptoms - doctors don't bother doing objective lab tests for a cold or a sprained ankle when the diagnosis is glaringly obvious based off subjective symptoms.

That is not in dispute because a cold and sprained ankle are objectively diagnosable post mortem. Mental illness is not.


You're creating the same false equivalence again by stating that an objective post mortem diagnosis not being practically feasible is the same as an objective cause(s) not existing. In my previous post I linked to multiple pages listing objective causes/mechanisms for two mental illnesses. Diagnosing a mental illness post mortem isn't as simple as finding rhinovirus in a person's nasal cavity, but just because the current knowledge of the disease isn't sufficient to create a satisfactory model that can reliably make a diagnosis post mortem doesn't mean that it can't be done. And if you don't think mental illnesses subside in molecules and physical structures in the brain, where exactly do you think they come from?

Oh, and you kind of can diagnose certain mental illnesses post mortem: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181616/


>if you don't think mental illnesses subside in molecules and physical structures in the brain, where exactly do you think they come from?

No ones knows for sure because no one can objectively explain the nature of consciousness and the mind in the first place. That is of course not to say that chemicals do not have a strong influence on the mind.

>Oh, and you kind of can diagnose certain mental illnesses post mortem: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181616/

The study has no control group and therefore is not objective. If you read the Methodological Issues section, you'll see that this is essentially a study of the neurochemical effects of antipsychotic drugs.


> No ones knows for sure because no one can objectively explain the nature of consciousness and the mind in the first place.

True, but I'm still waiting for a single proposal as to where a mental illness would subside other than physical structures/molecules, because the only other explanation I can think of are in the realm of the metaphysical

> The study has no control group and therefore is not objective. If you read the Methodological Issues section, you'll see that this is essentially a study of the neurochemical effects of antipsychotic drugs.

The article isn't a study/original research, it's a review based off of existing research - generally - in which brains from individuals with schizophrenia are compared to the brains of individuals without schizophrenia (controls). Antipsychotic drugs as a confounding factor is definitely an important factor in these studies though. There are however a number of factors that are are not affected by antipsychotics, notably genetics[1, 2]. Certain genetic variants strongly increase the risk of mental illnesses - by what mechanism does this work other than by translating to proteins that exert an objective, physical effect? (Note that studies on this are primarily GWAS based on large populations, not simple hereditary/familial studies in which one could argue that environmental factors were confounding)

  [1] https://en.wikipedia.org/wiki/Causes_of_schizophrenia#Genetics
  [2] https://en.wikipedia.org/wiki/Bipolar_disorder#Genetic


This is partly because when a specific physiological cause for a "mental illness" is confirmed, it usually becomes its own diagnosis in a different specialty. This happened relatively recently with anti-NMDA receptor encephalitis, which is believed to be responsible for some cases diagnosed as schizophrenia (and, historically, as demonic possession).


> Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.

Isn't this just because we don't actually understand medical illnesses nearly as well as we understand physical ones in general? I don't we actually know that there is anything innate about mental illness that makes it different from physical illness in this sense. That being the case, mental illnesses are just like those physical illnesses that we have yet to understand as well no?

Please correct me if I'm misinformed as this is a topic that I am very interested in.


As a counterpoint, there are no objective scientific tests for, say, back pain or neck pain or nausea or menstrual cramps.


That is because pain is not a disease, it is a subjective experience (or symptom) generated by the nervous system.


So? A disease (or injury) is what causes the pain. Why the specious distinction?


Fair point. Counterpoint: in the sense that it is dis-ease (the absence of feeling well and easy going) it may still be a sufficient reason to take a day off work.


Agreed. You shouldnt need a diagnosis to take a day off work


A doctor administered evaluation or a patient self-survey is just as objective as any other test.

These tests take a measurement and based on peer-reviewed statistical studies make a determination as to whether or not the measurement falls into a pathological range.

This is exactly the same as measuring blood pressure or cholesterol. You read a number and decide if there is a statistically valid correlation between that number and an identified disease.


This isn't true. These tests are NOT objective if the patient has an incentive to lie about their self-reporting, either in the stoic "it's fine" sense or in the "I want more opiates" or "I want to get some paid sick days" sense.


>patient self-survey is just as objective as any other test.

Subjective: based on or influenced by personal feelings, tastes, or opinions.

Objective: (of a person or their judgment) not influenced by personal feelings or opinions in considering and representing facts.


What is the difference between being depressed and "feeling" depressed?

What is the difference between being schizophrenic and having the "opinion" that Satan speaks to you through your neighbor's cat?

Mental illness is defined by what a person feels and believes.

What you feel and believe is subjective but you can objectively establish that a particular cluster of subjective feelings and beliefs is abnormal vis-a-vis a populate.

Then when you ask people the same questions and their cluster of responses fits the abnormal definition you can objectively say that they have a mental illness.

The objectivity does not come from the doctor observations or patient self-survey, it comes from the study that created the questions and proved that a certain score or cluster of responses is statistically abnormal.


> >What is the difference between being depressed and "feeling" depressed? >What is the difference between being schizophrenic and having the "opinion" that Satan speaks to you through your neighbor's cat? >Mental illness is defined by what a person feels and believes.

Honestly, a lot of the time it comes down to observable impact. If a patient comes to a doctor and says that they feel depressed, that's one thing, if they have lost their third job this year because they can't do anything but lie in bed and seem to not care about their own lives (especially if they used to not be like this in the past) that's something else.


Not what you asked exactly, but response to drugs sometimes leads to an (objective) differential diagnosis: if someone is depressed and flips out in a manic attack when starting antidepressants... that's not Major Depressive, that's Bipolar.

How do you objectively verify "manic"? You can track hours slept. No one fakes sleeping two hours a day for a month while having, say, good motor skills in the daytime.

This matters because recurring brief hospitalization is necessary for some people to get back on their axis. This is NOT "sanity days" or "mental healing", it's a clear cut medical issue.


Is "asking a patient how much they sleep" the same as "watching them to measure how much they sleep"?


> Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.

Not all “physical” (the term is not really the correct distinction, since all illness, including mental illness, is physical) illness is diagnosed directly in that manner (not all physical illness can be, because not all is understood well enough to have definitive tests, and it's not always clinical practice to do so even when it is possible in principle.) And, on the other side, some psychiatric conditions have lab tests of the same sort available.


>some psychiatric conditions have lab tests of the same sort available.

Which ones?

"psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests" -Allen Frances

https://en.wikipedia.org/wiki/Allen_Frances


Schizophrenia had one on the market briefly, and there is one for bipolar disorder that is (or was, as of last year) in clinical trials.

See, e.g., http://www.thedailybeast.com/can-a-blood-test-diagnose-menta...


Do you have a source for these claims? Because the DSM-5 says otherwise

>Diagnosis is based on observed behavior, the person's reported experiences, and reports of others familiar with the person...As of 2013 there is no objective test. [5]

https://en.m.wikipedia.org/wiki/Schizophrenia

Edit: the source you edited in simply states the corollary to what I've been saying all along: that scientists are still searching for a biological test for mental illness but as yet still do not have one


wow. ummm... yeah, that's straight mythology. you should read up on brain scans before spreading old falsehoods.


>Given how much we've learned about the role of the brain in mental illness, many people are surprised to learn that we can't know what psychiatric diagnosis a person has—or even if the person has any diagnosis—by examining that person's brain.

https://www.scientificamerican.com/article/can-brain-scans-d...


> Medically speaking a mental illness is no different than a physical illness.

I'm sympathetic, but don't make the discussion worse by throwing falsehoods like this around.

Besides the fact expressed by others that physically illness is more diagnosable, you typically don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

Physical illness is a different situation. That's why my workplace offers near unlimited sick time for this reason. As much as we'd love you have to working, we don't want your diseases.

---

(Granted, having an anxiety attack in the middle of work may not do wonders for the mental state of your coworkers, but blithey asserting this "no different" is dubious at best.)


>you typically don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

You also don't get physically ill from being in proximity to someone with a non-contagious disease or a sprained ankle, so that's an irrelevant distinction.

Sick days are not just for flus and colds that are contagious...


> Sick days are not just for flus and colds that are contagious...

Agreed. I meant to mention that.

> so that's an irrelevant distinction.

Flus and colds are by far the most common uses of sick days, so I wouldn't say it's "irrelevant."


> Besides the fact expressed by others that physically illness is more diagnosable, you typically don't get mentally ill from being in proximity to a mentally ill person.

Contagious diseases (and, a fortiori, those that are contagious on casual contact) are a distinct subset of so-called “physical” illness.

You don't get cancer from being in proximity to someone with cancer, either.


If I recall correctly, Morgellon's Disease is a mental illness that spreads via social interactions with an affected person, or journalism featuring such a person.

The disease itself is a delusion, regarding microscopic fibers in the skin. Sufficiently impressionable people simply hear about it, convince themselves that they have it, then they go on to try to convince others that it is a physical ailment rather than a mental illness.

If you are politically incorrect enough to classify religions as mental illnesses, many of those appear to be contagious as well.

But on a smaller scale, workplace morale is definitely infectious. If someone is having a particularly stressful day, they may be rude to someone else, who then feels worse as a result, and may propagate that to yet another co-worker. Of particular interest is that such transmission need not take place in person. A person with a common cold could work from home to keep everyone else from catching it, but someone with malaise or anxiety could transmit that via any medium that can include emotional undertone, such as a voice or video call.


As far as I've read, Morgellons is only "contagious" in the sense that people who already had symptoms of delusional parasitosis or undiagnosed/misdiagnosed skin conditions gravitate toward it as an explanation.


Contagions always spread through only the susceptible fraction of the population. Prior to mass communications, there were too few susceptible individuals in any given population for it to spread. The herd was immune, because any infected person would die before ever meeting another susceptible person.

Enter the Internet. Now all the susceptible people can aggregate around their own forums/boards/podcasts/groups/subreddits and infect each other with their unique strains of madness.

There's no more herd immunity, because all the susceptible people can find each other instantly.


Sorry, I should have been more precise: they are both recognized as treatable illnesses by the health care professionals, the government and insurance companies.

In the sense that you can go to a doctor, get diagnosed, get treatment, get that treatment paid for by an insurance company and get legal protections under laws applying to health care they are "no different."

Since we are talking about how corporate HR policies apply to mental health and not the philosophy of medicine I would argue that these are the similarities that actually matter.


> You don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

I tend to agree with you, but the concept of "contagion" is widely used in mental health settings. Self harm, or suicidality, can be "contagious".


Mental illness can cause physical illness. Anxiety can cause gastrointestinal disorders for example. So should someone having an anxiety attack not take the day off just because they weren't exhibiting any physical issues? And many gastro disorders can happen without being obvious until the situation worsens.

Waiting until the worst happens isn't sustainable and just makes things harder to recover. Perhaps burnout isn't just simply mental but a larger, systemic degradation of the body.


> Our contract also allows for verification, "If the Employer suspects abuse, the Employer may require a written medical certificate for any sick leave absence."

That sounds pretty standard in any contract here in Denmark, and we have some very strong unions which have created good conditions for employees. I personally think it's fair for the employer to ask for a doctor's note if he/she thinks an employee is skipping work just for the hell of it. Though said unions have made it so that the employer has to pay for the doctor's note, when they request it, so it happens rarely.


I work at a place that has "Paid Time Off" or PTO. It's used for vacation and sick days, and I get about 25 or so a year (haven't checked the number recently).

On my particular team, we can call in day-of often, if we don't have imminent deadlines or important meetings. "Hey, not feeling good, PTO". No one questions it. It's not abused, in that I have never felt it impacts the team's work.

And I guarantee I've used it for sanity days, especially recently!


Every company I've worked for has required a doctor's note for 3 or more consecutive days of sick leave.

It means that I cannot simply take care of myself, but that I have to go to a doctor and have them tell me that I'm sick and to do the things that I'd have done anyhow, like get plenty of rest and take some Nyquil at night.

The end result is that I almost never take 3 sick days in a row, even if I'm really sick. I end up coming to work, getting others sick, and getting nothing done. (Or worse, doing damage that I later have to repair before I can get work done.)


I'm diagnosed w/major depressive disorder so I could take any day as a sick day... even though a daily ssri keeps the depression/anxiety/panic attacks in check.


Basically they want to align sick leave with FMLA. It's not really evil.

The alternative is PTO, which is usually worse because sick leave gets mashed with vacation.


I'm a bit confused, how is a mental sick day different from just taking a day off? Right now I can just request a day off with no explanation required as long as it's one day in advance. Is a "mental sick day" like waking up, going "!@#$%@#^! I'm sick of dealing with work" and calling in sick on the same day?


There are times when I get a really bad night of sleep and mentally can't function the next day. I could take the day off get rest and come back the next day at 100%. Or I can come in anyway working at 10% mental capacity not get any rest and likely still not be at full capacity the next day.

The problem is that this scenario is socially viewed as my foult or being irresponsible; I should have seen to it that I got good sleep. If I slip off of my porch and hurt my back no one questions me not coming in; No "You should have used the handrail" or "maybe de-ice your steps regularly"


No, an example of a mental sick day would be someone who has been diagnosed with an anxiety disorder having a severe anxiety attack that prevents them from doing their job so they take the day off to try to recover.

Mental illness is a real thing, it is not just "I don't feel like going to work"


It's the difference between using a vacation day and not using one




Registration is open for Startup School 2019. Classes start July 22nd.

Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact

Search: