Siobhan Bishop: Welcome to our podcast on Mental Health in the Workplace Mental Health is a very current and ongoing issue. Most people think they know what mental ill health is but do they recognise it in the workplace and know how to deal with it? We held an interactive seminar on this topic and in this podcast, we'll look at some of the issues for recognising and improving management of mental ill health and we'll bear in mind the legal framework which we have to set this in.
We'll also cover how to review the situation and reduce distress and improve relations and performance of those employees. I'd like to introduce Vivienne Reeve, who is an associate in the Employment Team here. We are also delighted to be joined by Dr Mike Drayton, a Consultant Psychologist. Vivienne, poor mental health is one of those issues that people find really difficult to deal with. But it need not be as daunting as people image if they remember a simple strategy.
Vivienne Reeve: That's right. It can be difficult to recognise the signals of mental health distress and, if you do, then it can be sometimes a little intimidating knowing what to do about it. The best way to tackle this is by following this simple moniker: RADAR. This means Recognise the signs, Acknowledge that something needs to be done to help, Discuss with the employee, Act and seek advice from medical professionals, if that's appropriate, and then Review and follow through.
Siobhan Bishop: Thanks very much Vivienne. Now, we are joined by Dr Mike Drayton to discuss how you can improve mental wellbeing in your workplace. Mike, firstly, can set out the scale of the problem please?
Dr Mike Drayton: The extent of the problem is absolutely staggering. I think poor mental health is a major health issue facing society and certainly facing employers over the coming year, because we are coming up to Christmas and the New Year now, so let's think about 2016. Now, did you know that in 2016 a quarter of people listening to this podcast are likely to experience an episode of poor mental health, that's 25% of the population and 25% of your employees?
Furthermore, research by the Sainsbury's Centre for Mental Health has found that one in two people experiencing poor mental health don't want to talk about it because of stigma and because they feel embarrassed and ashamed. So, in your business, at 25% of your employees are at risk of suffering poor mental health and maybe going off sick with poor mental health, it is going to have a major impact on your business.
Siobhan Bishop: So could you tell us what kind of things might trigger a poor mental health episode?
Dr Mike Drayton: Yeah sure, the two kind of broad categories of things that trigger poor mental health, the main category is domestic, so certainly most sickness absence from poor mental health is caused by domestic issues such as relationship difficulties, family issues, bereavement, financial problems, so that's at home.
Within the workplace the major cause of poor mental health, which you probably won't find very surprising, is change and that isn't just change in the organisation, because people like to predict how things are going to happen and where they are going to be in two years, but other changes, such as recent promotion. So somebody may be very technically good at the job but they get promoted, where they have to manage people, and they find that terribly difficult. So they're two issues that trigger poor mental health in the workplace.
Siobhan Bishop: And how can you spot the signs of somebody experiencing poor mental health?
Dr Mike Drayton: Well in some ways it is quite difficult because you know because of stigma that people tend to put a mask on. So, you might speak to somebody who is really suffering and when you ask them how they are they might say, "I am absolutely fine, thank you very much", but deep down inside they are really, really struggling. So, how do you spot the signs?
Well, one way of spotting the signs is to observe the person's behaviour and any noticeable significant change in their behaviour from baseline might indicate they are having a problem. For example, has one of your employees started coming particularly early, you know they might start work at 9.00 but have they started coming in at 7.00 because their mental health problem is affecting their concentration and memory, so they are having to work long hours just to keep up. Other signs might be irritability, where people are complaining about the employee being grumpy. Poor mental health will affect people's physical function, so it affects people's sleep and appetite. So, for example, if you have employee coming to work who is tired all the time that could possibly be a sign that they are struggling. Similarly, if you have an employee who stops eating lunch or seems to gain a lot of weight or lose a lot of weight that is often a sign of poor mental health. But essentially, I mean the rule of thumb is, if it is significant, that's significant in the sense that it is noticeable to you, that it stands out, if there is a significant change in their behaviour, that's worth you know maybe looking at and maybe asking them about.
Siobhan Bishop: So, if you do recognise the signs of poor mental health and get to see 'behind the mask' that people present to the world, why is it important to act on those signs?
Dr Mike Drayton: First of all I think most people find it difficult to act. Managers and leaders who I speak to will say things like, "Yes, I noticed something was going wrong, but I didn't want to say anything because I was worried about saying the wrong thing. I was worried about opening up a can of worms". Or conversely, they might say, "I didn't want to say anything because I was worried the person would think that I was being intrusive or being too nosy". So, often the early warning signs get missed until the poor metal health problem escalates into a crisis and the person ends up going sick. So, it is really really important to intervene early as soon as you spot something going wrong.
Siobhan Bishop: So prevention is clearly better than cure but what obstacles are there to intervening and helping people?
Dr Mike Drayton: Well there are at least three obstacles. The first one I have mentioned already, which is lack of confidence in that the manager or the other person is not quite sure what to do for the best. The second obstacle is that poor mental health is still a very stigmatised subject. People are often very embarrassed and ashamed about it both the person suffering the poor mental health and also the people surrounding them, you know it is a difficult topic to talk about. And thirdly there are a number of unconscious psychological processes that can often get in the way to intervening. One of these is called bystander effect and this is the situation where, you know, we might see something going wrong or see an accident in the street but we don't do anything because we think that somebody else will intervene and somebody else will do something and, of course, the other people are thinking the same about us. That can often be an obstacle to helping the person with poor mental health.
Siobhan Bishop: Okay, so if you have decided to intervene in some way, what should you actually say?
Dr Mike Drayton: I think the answer to that isn't so much you should say it is what you shouldn't say. I think the most important thing and often the most helpful thing to a person who is experiencing poor mental health is to be actually listened to and not to have the manager try and solve their problems in an hour's session. So, what you are actually saying in practical terms is, "How are you?" So you express concern. The second thing that you could do to try and open up the conversation is comment on some observable behaviour so for example you could say, "I'm a bit concerned, I'm a bit worried about you because, you know, you have got a really good attendance record but you have been late three times this week and I am wondering if there is anything I can do?" So, the thing to do is express concern, maybe comment on the behaviour, on things you can see, and then offer help, offer practical help, and then be quiet and listen and don't be frightened of silences.
One thing you mustn't do, one thing you shouldn't do, that is incredibly unhelpful is to start commenting on the person's psychological state or internal world because people find that very threatening and very intrusive. So, for example, it is probably a bad thing to say to someone, "Look, I am really worried about you, I think you are depressed or I think you are anxious", because you don't know how they feel, and you don't know the causes of these problems. So, just comment on what you've seen yourself. Try to connect with them on a human level by expressing your personal concern rather than, you know, I am doing this as part of my job.
So, you say, "I am really concerned about you but I have noticed that this is perhaps not great or this is going wrong, is there anything I can do to help?" and sit back and listen to what the person says to you and try and help them. One thing I would add as well, people are often understandably very worried and a bit frightened of this. But from my years and years of experience, if you approach that person with a bit of common sense and a bit of human compassion, it is very, very unlikely that you are going to say the wrong thing. It is very, very unlikely that you are going to make things worse. To actually make things worse, I think, you have got to purposely want to try really hard to make things worse. But if you just approach that person as another suffering human being and try to do your best for them, you are going to help.
Siobhan Bishop: Thanks very much Mike you have explained how to recognise mental ill health and also that a personal acknowledgement is really important for that individual. So Vivienne, what are the next steps?
Vivienne Reeve: So, going back to our moniker we have recognised the next stage is to acknowledge. So that's a personal acknowledgement, so just acknowledging what's in front of you, look at the situation objectively and don't assume anything you don't know, as Mike said what is going on in their internal world, whether they know that they are suffering or whether they have even been diagnosed with anything so just take a step back. One of the reasons why people find it difficult to address mental health issues once they have recognised there may be something, is that they often approach it worrying that they don't know how to fix it. That's way along the line, what we need to do first is acknowledge it and then the next stage is to discuss with the employee and, as Mike said, the key is being ready to listen, but before you get to that meeting, it is important to plan it. So this means thinking about three things, who should lead the discussion, where should it be and when should it be?
It is likely that the appropriate person to have that discussion is probably going to be the employee's manager because they should an oversight and be spotting these things as they come up. In some situations that may not help if there is already a conflict of personalities or issues between them. So in that case it might be best for another manager or even HR to be involved.
Think about whether the individual who's going to have the meeting is suitably skilled to have the discussion, as Mike said, it is not likely that if you approach it as a compassionate human being you are going to do much harm. But equally you don't want to push somebody into having that discussion if they are not in the right mind-set or they don't feel adequately skilled enough to have it. And I think the last thing on the who is, thinking about their mind-set.
The individual could react in any number of ways, they may be stressed, upset, defensive, in denial, and so you need to bear that in mind when you are considering where and when to have it. I think probably at this stage it is not appropriate to invite other third parties such as companions or HR because it changes the dynamic from something informal and supportive to something a bit more formal. So, the next point is where and when to do it and this really is the planning point. There are a number of options.
You might do it somewhere quiet and private at work, you might think popping down to Starbucks is an idea if it's quiet. You might want to go for a walk because sometimes difficult conversations are more easily had when you are not actually sitting opposite somebody looking at them face to face but walking alongside them and you have a bit more freedom and a bit less confrontation. When to have it is really important, there is a balance to be struck between scheduling it as soon as you can so that you don't leave things to fester, as Mike said, you don't want to leave it until it becomes a crisis, but equally you need to give yourself enough time to have the conversation. So, you mustn't squeeze it in between meetings, you don't want to be checking your phone, you don't want to be checking your watch to see what time it is.
You need to build a safe place where this individual can trust that you will take on board what they are saying and they feel able to tell you things. If you interrupt that because your phone rings or you have to go, that could have a really detrimental effect and, if somebody was just opening up to you, that shuts that communication right down. So, it is about planning ahead, thinking who should have the conversation and where and when.
Siobhan Bishop: Thanks very much Vivienne, so bringing this together, what are the common pitfalls that can arise from a legal point of view?
Vivienne Reeve: I think the first thing is what Mike touched on in that people do sometimes recognise issues but don't know what to do about it, and feel that they have to try and resolve it on their own. I think the crucial thing to recognise is that it is okay to ask for help and actually, to be complying with your duty to ensure a safe workplace and potentially make reasonable adjustments, it is likely that you will need to ask for expert medical assistance, often that is an independent medical expert. When you seek advice from the expert it is crucial to get the balance between not asking general fishing questions but asking precise questions relevant to that individual's condition and their ability to do their job.
The next point is planning and discussing with the employee how appropriate it is to discuss with any other managers or colleagues so that they have some degree of control over what's going on. And lastly, I think we have talked about recognising, acknowledge, discuss, act, the last thing, which is crucial, is to review and to follow up. If somebody has been courageous enough to open up about their internal world and the problems that they are having to deal with, you must follow up and make sure that whatever adjustments you have agreed with them are working and to see if they need any other help.
Siobhan Bishop: Okay, that's a really helpful summary, but there is a bigger picture here as well about ensuring you have a psychologically safe workplace.
Vivienne Reeve: That's right Siobhan, I think it is worth remembering that there is a ripple effect here and you are not just dealing with one individual. People around that individual will see how they are treated, even if they don't talk to their colleagues about it. So you need to bear that in mind because it sends an important message to everybody else about how safe and secure they can feel about raising concerns.
Siobhan Bishop: And Mike what are your top tips for an employer wanting to build a psychologically safe workplace?
Dr Mike Drayton: Okay, I've got three top tips for you. First of all I think in the past workplaces used to be physically dangerous places, certainly before the Health and Safety at Work Act. Now, most workplaces are very safe physically but I think now the problems have become quite psychologically dangerous places, that result in poor mental health. So, I think my three tips, looking at the problem from different levels in the organisation.
So first of all, at a more basic kind of interpersonal human level, I think it could be really helpful to train managers in recognising the early warning signs of mental distress and also what to do once they have recognised those signs. I think that can be incredibly useful, because it will head off this crisis and stop smaller problems developing into bigger problems and sickness absence. Secondly, I'd echo what Vivienne said, in that often when we think of poor mental health, we think of it being located within the individual. In some senses it is, but in another sense it isn't because it is not a problem just for that person, it is a problem for the whole team and for the people who surround that person.
Vivienne described this as a ripple effect and that's true because if you've got somebody suffering with poor mental health, it can really affect the performance of the team within which they work. And secondly, your response to that person with poor mental health will also be seen by all of the people that that individual works with and that can have a good result or a poor result. Finally, I'd say that just the absence of poor mental heath in an organisation doesn't imply a psychologically safe and healthy organisation. So at a strategic board level, I think organisations should be thinking what they can do to change a culture in an organisation to make it a more positive nurturing and safe place to work.
Siobhan Bishop: Great, thank you very much indeed. I hope you have found today's podcast useful and interesting and raised some of the really important issues for today's organisations. If you have any questions or would like to discuss any of these issues in more detail, please feel free to contact Vivienne Reeve.