• Tamar Balkin

Why Do We Still Need To Talk About Mental Illness At Work?

“Cause I'm way down in it and I can't breathe so I can't speak

I want to be strong and steady, always ready

Now I feel so small, I feel so weak

Anxiety

How do you always get the best of me?"


Anxiety Song by Jason Isbell (click here for the song)

It should not take the actions of high profile individuals to remind people to be aware of the need to look after their own mental health and that of their friends and colleagues. Yet the headlines this week of Osaka’s departure from the French open this week prompted me to change the content of my blog for this week. Unfortunately, it seems that every year there is headline that prompts me to write about mental illness (click here for my 2020 blog). To be honest, despite all the open conversations about mental illness at work it saddens me that we still have a long way to go to ensure that people access the correct support early.


Rather than speculate (like the journalists have) as to exactly why Osaka withdrew from the French open it is perhaps of more benefit to remember Keyes framework of mental health which provides a comprehensive understanding of the complexity of the interaction between wellbeing and mental health. Typically the model is use to remind people that a person can be languishing without being mentally ill or can have a diagnosed mental illness and be flourishing. (click here for my RUOK day blog)


What do we need to be reminded of?


Whether people are languishing or flourishing there is a large variation in the experience and manifestation of mental illness. The list below is not exhaustive but rather a reflection of some issues that have been drawn to my attention in the past week.


There are people who experience severe forms of mental illness yet somehow hide it from view and ‘appear’ to be highly successful. Experts caution that this group are particularly concerning as they may delay seeking help until they reach a crisis or breaking point. According to researchers they don’t seek help because they fear that they lack the time or prerogative to be unwell or receive treatment. In addition, as may be the case with high functioning anxiety, the anxiety has many positive ramifications including being focused at work; willing to help others when asked and have a busy social schedule. In fact on the surface the anxiety can be a driving, rather than paralysing force.


Whilst financial security enables people access support it does not mean they will access the right type of high-quality support for their particular circumstances for as long as the require assistance. Many GP’s are able to make a referral to an appropriately qualified clinical psychologist with the relevant expertise, therapeutic approach, and interpersonal style to suit you. Never the less, as is the case with any service, it is essential for people to pause and reflect to confirm that they are accessing the right type of mental health support.


Reasonable adjustments in workplace for mental illness are essential in all professional and spheres, for the individual, their colleagues, clients and stakeholders. Regular readers would be aware that reasonable adjustments require a culture of psychological safety to enable open conversations around: the aspects of work that impair and improve mental health; as well as discussion of typical signs of ill health and appropriate action to be undertaken when they emerge.


“Although his self-rating on wellbeing hadn’t changed at our weekly catch ups his demeanour and tone had. So I called him... there was a lot going on and fortunately I was able to encourage him to access the support she needed and not feel guilty about taking time from work to look after himself" Client


Hybrid work arrangements necessitate a more vigilant approach to observing the changes in people’s behaviour that may be an indication of a decline in their mental health.


Finally, we all wish for a quick fix for mental illness, and unfortunately it does not exist. However, regular readers would know that creating psychologically safe and healthy workplaces will minimise the likelihood of occurrence or exacerbation of mental illness and will increase the chances that people access the help they need.


What are your daily responsibilities ?

  • Create work environments where people can flourish. (See my blog for tips)

  • Talk to people you haven’t spoken to for a while and see how they are.

  • Get to know people at work so that you actually notice a change in their behaviour.

  • Notice a change in someone's behaviour and encourage them to get help. (For click here for my blog on How do you actually talk about mental health in life and work)

  • Remove the stigma of talking about mental illness at work. (Click here for my blog with tips)

  • Follow up on someone you have already spoken to.

Common reactions to being asked R U OK?

  • Silence

  • Denial

  • Anger

  • Sadness

  • Tears

  • Request for direct help from you

  • Sharing of their circumstances

  • Request for a referral from you

Important things to remember:

  • Your role is to encourage professional help not to provide it.

  • Remain empathic and non-judgemental. (click here for my blog on Empathy)

  • People often don't realise their distress was so apparent and could be embarrassed or shocked that you noticed.

  • You may never know if someone actually accesses help.

  • Don’t underestimate the positive impact of showing that you genuinely care.

  • Check in personally, regularly, and gently. eg "I've been thinking of you and wanted to know how you've been going since we last chatted."


Australian sources of help

All Doctors and Psychologists now provide telephone and/or online consultations.

  • Mental health crisis team- 1800 011 511 (24 hours)

  • Doctor

  • Clinical psychologist (Please ask your GP for a referral)

  • 000



Personal photo from last week when I swam in the ocean.


It would be remiss if I left you feeling as gloomy as Sydney's wet cold weather and with out a reminder that "the sun will come out tomorrow". (click here for the song). So please take a moment, maybe gaze at my picture of Bondi, reflect and then email me with what you can do to increase the useful conversations about mental illness in life and work.

 

References:

More available on request https://www.nytimes.com/2021/05/31/sports/tennis/french-open-naomi-osaka-quits.html https://www.thetimes.co.uk/article/stressed-but-holding-it-together-youve-got-high-functioning-anxiety-3fbzlp7sx https://www.verywellmind.com/what-is-high-functioning-anxiety-4140198 https://www.sciencedirect.com/science/article/abs/pii/S0306460318304301

Keyes, C.L.M (2005) Mental Illness and or Mental Health? Investigating axioms of the complete state model of healthJournal of Consulting and Clinical Psychology. ;73(3):539-48


Westerhof, G, J, Keyes C.L.M (2010) Mental Illness and Mental Health: The Two Continua Model Across the Lifespan. Journal Of Adult Development 17(2): 110–119

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866965/

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