Mental illness…. if you haven’t tried it, don’t knock it.

Full disclosure time:

1. I don’t apologise for the title. It’s deliberately provocative to stimulate your interest in a debilitating ailment.

2. I do not profess to be an expert. I am not a doctor, specialist, therapist or in any way academically qualified in the field of mental illness. This is my personal opinion, as an individual who has mental illness, and is currently receiving treatment.

3. Even during my ongoing recovery, some days are hellish. However, in general terms even the worst ones are still a massive improvement from when I hit “rock bottom”.

4. This is not “my story” of despair and helplessness, but rather a cathartic exploration of my general views and opinions on mental health in the workplace.

In recent years, mental health awareness has gained worldwide attention. The World Health Organisation currently quotes “as many as one in four people in the world will be affected by mental or neurological disorders at some point in their lives”. That’s a staggeringly serious problem.

We’ve all read newspaper headlines reporting well-known and apparently happy, wealthy, headline celebrities who have committed suicide, following a secret battle with mental illness. We seldom see similar headlines for the numerous “ordinary people” who have suffered the same fate. Mental illness doesn’t discriminate by wealth, popularity, success, status or any other matrix. Let me repeat that in even simpler terms. It doesn’t discriminate. Full stop.

Let’s just take some time to look back at that media headline and think about what the headline means, but doesn’t actually say. Lets reflect on the reality.

• Someone has suffered beyond their ability to cope.

• They themselves could neither eradicate the cause nor escape the symptoms.

• They could hide their illness no longer.

• Their only focus was to be rid of the suffering.

• Their only perceived option was to end their life.

That might sound brutal, but that doesn’t make it any less true.

To the untrained, or non-sufferers, that thought process seems utterly irrational. How can anyone think that ending their life is a solution. What about those left behind?

The very nature of the illness however can affect normal reasoning and logic to such an extent that in certain cases, some normally irrational thoughts seem to be perfectly rational and logical. Even to the extreme of suicide.

It is commonplace for non-sufferers to think: But help is only a question away. Why not ask for it? You should speak to someone. Can’t you discuss it with your friends or family? A problem shared is a problem halved. Make an appointment with your doctor. Or worse still – just pull yourself together. At the risk of being flippant, suggesting someone with mental illness “just pull themselves together” is no more helpful than asking a deaf person to listen more closely.

Another easy mistake to make is automatically associating “mental illness” with depression. More often than not, you will be right, but they are not interchangeable labels. If only it were that simple. Unfortunately, the causes and symptoms of mental illness are many, varied and take many guises. The treatments are bespoke and protracted. The recovery in most cases is long, slow and difficult with almost daily variances in the level of debility, even during recovery and subsequent workplace reintegration.

Mental illness can strike anyone, at any time, without warning, for a multitude of reasons, and manifest itself in as many different ways. Anger, anxiety, bipolar, borderline personality disorder, depression, insomnia, OCD, panic attacks, PTSD, schizophrenia and stress are only a few of the more common ones. Sometimes the symptoms of one can cause the development of another, leading to complex, synchronous and sympathetic treatments. Often medicinal intervention has unwelcome side effects including, but not limited to, drowsiness, introversion, loss of social function, weight change, reduced focus, lack of concentration, inability to perform simple tasks all of which add to the already heavy burden of the sufferer.

Mental illness is incredibly complicated and so much more than just “feeling a bit down”. In the past, many employees across the world perceived the role of their respective corporate services/human resources departments as limited to recruitment, salary payment, terms and conditions of employment, statutory leave and sick pay. That makes it sound very simple. It’s not. These teams do an immense amount of work that falls under the radar of most, and for which all employees should be very grateful.

One of the many duties of any CS/HR team is to monitor and record staff absenteeism, with particular regard to employment law and contractual obligations. It seems natural therefor that they take ownership of promoting and monitoring mental health awareness, wellbeing and recovery.

Until relatively recently, many employers shied away from the mental wellbeing of staff, other than to justify any absence through self or medical certification. Let me add at this point that I don’t advocate CS/HR managers should have access to staff medical records or have the right to require, or even request, personal medical information.

Thankfully, the recent trend is for employers to recognise their corporate obligation for staff welfare, including mental health. Some have been offering genuine support and care for many years. Many others are only now starting to following. This positive development is both enlightening and very welcome. Not only have employers acknowledged their duty of care, but in many cases now offer genuine and continuing un-intrusive support to staff whilst they are off sick (whatever the illness), through impartial occupational health specialists. Moreover, there is an increasing realisation that prevention is better than cure, even when the proximate cause is not necessarily or directly work related.

I sincerely hope that the development of mental health awareness and mental health first aid in the workplace will continue help to reduce the stigma so very wrongly attached to the illness. I also hope that staff affected by mental illness will seek assistance with confidence in confidentiality, long before their own developing symptoms reach the point of hopelessness and no return.

The purpose if this writing is to highlight the need for staff and employers to come together through experience and a genuine desire, to promote mental health awareness and to ensure a suitable and workable policy is put in place to reduce the circumstances at work that can lead to, or exacerbate, staff illness.

In the UK, we’ve had workplace health and safety legislation since 1974. Perhaps few ever considered that it is as relevant to mental illness as it is to physical health and safety. Early identification of MH issues is vital, but from personal experience, I can say that it is one of the most difficult illnesses to identify, even for those affected.  Many suffer in self denial whilst trying to hide it, not only from their friend and family, but also from themselves. There is self doubt, embarrassment, and the fear of stigma, discrimination and distrust. Even after acknowledging their own illness, most hide it away for many of the same reasons, and put on a false front at work. A different, but still false façade is displayed in public, and yet another mask is worn at home with friends and family. It is all too often a problem that is known only to the sufferer who is reluctant to admit it and seek help.

The recent introduction of Mental Health 1st aiders is a very welcome move in the right direction, but I add a word of caution. They are very important, but form only a part of a sensible corporate approach to welfare responsibility. There is a risk that some less scrupulous employers will see them as a solitary solution to corporate obligation.

Don’t get me wrong. I’m not knocking MH 1st aiders. They have an infinitely difficult balancing act to perform.  One the one hand, they have relatively brief and basic training in an infinitely complex illness, yet can be expected by employers to offer a solution through early and accurate identification and intervention.  On the other hand, they face becoming the “blame hound” who fails to protect the organisation if they don’t successfully identify a deliberately hidden illness, or even worse, if the suggest to a non-sufferer that they may be displaying warning signs!

MH 1st aiders have a valuable yet thankless task that need protection from exploitation and support from both management and from their peers. They are vital, but form only a part of the MH awareness approach. They should be widely advertised within the workplace. They should be available and approachable, but never critical. They should be able to offer a confidential listening ear and advise on potential sources of professional medical treatment. Ideally, they should, in my opinion, have an understanding of the issues, through personal experience. They should offer encouragement to seek professional help, but never imply they are a treatment or cure. It’s an exceptionally difficult job. Don’t judge them.

Organisations also need to understand and appreciate the timescale involved in both treatment and recovery. They should, where appropriate, prepare contingency plans to accommodate long term sickness absence, especially for specialist staff. Treatment often includes medication, hypnotherapy or psychotherapy and often more than one type of treatment at a time is necessary.

Waiting list for counselling prolongs suffering and delays recovery. Identifying the underlying cause(s) can be traumatic. Recognising your own behavioural changes can be worrying and unsettling.

In relation to mental health, I now see a different organisation to the one I joined in 2012. I see an acknowledgment of responsibility. An attempt to understand just what mental illness is, and a transformation in outlook regarding staff welfare.

From an anonymous source….

. …… One day at work, an employee found himself in a hole. The walls were so steep he couldn’t get out. His line manager passed by and the guy shouted up, ‘Can you help me out?’ The manager threw down a shovel and told him to dig his own way out, but be quick, there’s work to do. After a while his department head passes by and the guy shouts up, ‘Can you help me out?’ The department head says “ do what your line manager says and dig yourself out. I don’t pay you to mess about in holes all day”. Later, a colleague comes along and the guy shouts up, ‘Help me, I’m down in this hole. Please help me out. The colleague offers words of encouragement but moves on. Finally a friend walks by, ‘Hey, Joe, it’s me can you help me out?’ The friend jumps in the hole. Our guy says, ‘Are you stupid? Now we’re both down here.’ The friend says, ‘Yeah, but I’ve been down here before and I know the way out.’

The recovery process begins with the recognition of a problem.  The recovery path however can be long and slow, and often very undulating.

If you know of, or suspect someone of suffering, lend them a hand. Help them out of that hole.

It’s not heroic.  It’s humane.

So far, I’ve been very fortunate to have had many offers of a listening ear.  I needed the knowledge that people were prepared to help, but for a very long time was unable to accept help and speak to anyone about it.  The best piece of advice I got was to talk to no-one. Literally.  Speak to an empty chair in private, or the mirror, or anything at all, but talk.  Say what needs to be said even if there’s no-one there.  It’s the first and most difficult step to being able to speak to someone, be that a friend or doctor.  It breaks down the false facade that sufferers hide behind and allows the true feelings to be voiced. Only then can help be allowed in.


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