Breaking the last taboo

Would you even recognise if someone in your office was suffering with anxiety or depression? And if you did, what would you do? Would you stick your head in the ground and hope someone else sorted the problem, or would you indulge in a little armchair psychology? Perhaps you’d just remind them of their targets and suggest they ‘get a grip’?

Matt Cooper graduated first in his class at Princeton University in the US. He joined a management consultancy and was recruited by his first major client into a regional US bank. This he helped transform into Capital One Bank. It’s fair to say that Matt was the epitome of success.

In 2004 he was preparing for a cycle race over one of the toughest stages used on the Tour De France. He was cycling upwards of 300 miles a week and started feeling ill about two weeks before the event. But Matt, being Matt, continued with the race and continued working.

One day his fingers started tingling. He was prescribed anti-depressants, but soon experienced a full-blown anxiety attack. The doctor’s reaction was to double his chemical dose. Six weeks later, Matt found himself on a US psychiatric ward – where he remained for four months. There was no ‘why’ for his breakdown – it was a reaction to a combination of over-training physically and some bad doctoring.

For more than two years he was in a bad state, permanently feeling like he’d drunk 10,000 cups of coffee. Time and a better doctor seem to have been the key. Today he’s fine, on the boards of several companies and working to ensure mental ill health is better understood and no longer the last taboo.

the admission of mental ill- health is too often considered an admission that you’re “broken” – fit only for the corporate scrapheap

One of Matt’s close contacts is Jonathan Naess who was recently awarded the Radar Human Rights Person of the Year 2008 award for his work with the mental health charity Stand to Reason.

Radar is the leading pan-disability organisation that is affiliated with a wide range of physical disability organisations and activists and increasingly with the mental health sector too. And thereby lies the rub. While people with physical disabilities have been fighting for many years for their rights in an ‘able’ society, issues of mental health – not least in the workplace – have remained hidden; invisible because of the stigma attached and the macho culture of the workplace where the admission of mental ill- health is too often considered an admission that you’re “broken” – fit only for the corporate scrapheap.

The result is that around 80% of people who admit to their mental health problems are unemployed, and a far greater number of people struggle on in the workplace, concealing their illness.

“This has a massive detrimental effect on British business,” Jonathan explained. “Absenteeism and presenteeism – where people turn up for work, but fail to perform to their full capability – costs the nation around £26bn each year. If we could address that by investing in effective corporate mental health policies and spending time to demystify mental health and open up dialogue in business, we would go a long way to overcome the stigma, reducing both prejudice and discrimination.

“Our research shows that around 90% of people with mental ill-health want to return to work, and those given the chance can often turn into an organisation’s most loyal employees.”

Opening doors

For the past year and a half, Jonathan has been working with boards and senior management teams to open the mental health debate in the workplace through the charity he founded, Stand to Reason. His policy is that the best people to speak, educate and advise on mental health are those who’ve experienced mental ill-health. Jonathan, who has enjoyed a stellar career in law and corporate finance, has suffered periods of mental ill-health since his early 20s.

“I’m bi-polar and have had two psychotic periods – but recovered from each pretty quickly. I can self-manage my condition and can function perfectly well at the highest levels of business. But I’m lucky that I can speak up for myself, and have the confidence and experience to deal with prejudice.

“Mental ill-health is the elephant in the room. But, to mix metaphors, it’s not rocket science. Through the like-minded network we’ve built in Stand to Reason, we’re working with employers to overcome their fears about managing mental health issues, and with employees who may be too afraid to stick their head above the parapet.

“Equally, some of the laws pertaining to mental health go back to Elizabethan times and are incredibly discriminatory. So we have a lobbying side that’s tackling issues of fundamental rights. Do you know that you can’t be an MP, a company director, a JP or even do Jury service if you have been diagnosed with a mental health condition? You’re deemed ‘not competent’. Through our work, the Ministry of Justice has agreed to review the legislation.”

Good practice

Much of Jonathan’s workplace consultancy is around demystifying responsibilities and encouraging an open culture.

Employers need to create policies that encourage open, fair-minded dialogue between managers and staff. Managers need to understand that it’s not their role to diagnose or try to solve mental ill- health any more than it would be their job to fix a broken leg. We have professionals for that and the manager’s role is simply good practice: recognising when there are issues, and supporting their employees to overcome them and get back into work.
“Mental health is an issue that really fits into workplace best practice and employers need to consider three areas. First, there’s mental health promotion – and this needs to be aimed at all employees. This is all around work life balance, healthy lifestyles and making all employees fit for work.

“Second, when issues arise, the key is retention: what can you do to help someone maintain their role when they’re going through anxiety or depression, for instance, and how can you help the people around them to understand the issues, support their colleague and, as a team, get the work done.

“Third, beyond the immediate, there’s rehabilitation. What do you have in place to help those who’ve had to take time off reintegrate into your business. They may not be able to come back to the same role or work the same hours, so what can you do to accommodate them ? This is no different from managing the needs of someone with a physical disability, yet both organisations and employees somehow want to give it a different status.”

As Jonathan explained, there’s an onus on employees too to face up to their challenges. “Far too many people with mental health issues live in denial or concealment. There’s a real fear that they’ll lose their job if they own up to any manifestation of mental ill-health. “We have to create environments where it’s safe to speak up. The individual needs to take a risk, but also line managers need to look for signs, and if they see them, be prepared to talk supportively and without prejudice. It’s scandalous that of all the calls logged to employee assistance lines, only a tiny percentage relate to mental health when conservative estimates state that up to 30% of us will suffer mental health issues.

Continuum

“Mental health is a continuum not a black and white condition. And most of us travel back and forth along that continuum throughout our lives. In the workplace, it traditionally hasn’t been the thing to talk about personal feelings or to show emotions. But the signs in our colleagues when things are going wrong can often be quite clear. If someone regularly turns up late, stops dressing as smartly as usual or seems generally disengaged, this may be a sign they’re depressed.

“It’s a little different from workplace stress, though that may be a factor in their condition. The economic downturn is bound to have an impact too.

“However, without an open conversation, you’ll never know what’s behind their behaviour and won’t be able to help them. As a culture, we’ve got to be prepared to open that dialogue, and know we’re supported by the business. In most cases, managers will probably find that they’re dealing with the ‘worried well’, but in some, there will be deeper issues that may require medication or even psychiatric intervention.”

According to Jonathan, there are great examples of companies taking a positive business approach to mental health, citing Royal Mail, BT and Rolls Royce among others.
“BT has noted a 30% fall in absenteeism, and their investment in positive mental health has paid back many times over. They’ve now created the expectation in their business that people will be welcomed back into the workplace. And this kind of inclusiveness is standing them in good stead.

“Mental health is not sexy. It’s still little understood and too often the medical profession treats the symptoms not the causes. That’s why it has remained a taboo area for so long. Slowly we’re making inroads, and changing workplace attitudes will go a very long way to removing an unfair stigma.”

For more information www.standtoreason.org

This article first appeared in Connections magazine, Winter 2009