A PATIENT OF mine – a young man recovering from clinical depression and recently discharged from hospital – had agreed a plan that included a course of cognitive behavioural therapy (CBT) with a clinical psychologist.
A few weeks after discharge, he came to see me and I asked him how his CBT was going.
He replied that he had not attended because his boss had taken him aside after a meeting and told him that the organisation could not spare an hour a week for him to attend CBT. “We do not have space here for hangers on”, he was told. “You should go home and think about that.”
And he did.
Prevalence of mental health issues
The view of mental ill health as a sign of weakness still remains prevalent. Yet one in three of us will experience a mental condition during our lifetime. One in six has a mental condition right now, while one in 100 has a serious mental illness such as bipolar disorder or schizophrenia.
The World Health Organisation estimates that 350 million people worldwide have depression, making it one of the world’s leading causes of disability and a major contributor to the overall global burden of disease. According to a 2008 Mental Health Commission report, the estimated direct annual cost of poor mental health in Ireland is some €3 billion or 2% of GNP.
Perhaps my patient’s boss had never experienced mental illness first hand. But imagine the young man had instead broken a leg while skiing and (after a spell in hospital) had requested an hour a week to attend physiotherapy. Might his boss have offered a different response?
Fear of stigma
Mental illness is a societal issue that employers cannot afford simply to ignore. A recent survey by the UK anti-stigma organisation Time to Change found that two thirds of respondents saw fear of stigma as a reason not to inform their employer (or prospective employer) about their mental health problems.
In a similar study, more than nine out of ten members of the public believed that admitting to mental health problems would damage an individual’s employment prospects.
Sadly, Ireland is no different. See Change, the national stigma reduction partnership, surveyed more than 1,000 adults in relation to their attitudes to mental illness.
The worrying part is that, in some cases, they might be right.
Improving workplace responses
So, what should employers be doing?
The UK mental health organisation Mind recently published a document entitled Taking Care of Business: Employers’ Guide to Mentally Healthy Workplaces. It suggests strategies employers might utilise to create healthier workplace environments. Simply assessing wellbeing in the workplace is the starting point, for example through staff surveys.
The guide highlights the importance of work-life balance, flexible hours, positive interpersonal relationships and the encouragement of exercise and staff social events. Employers are advised to actively tackle the work-related causes of mental health problems such as excessive workload, unsuitable working environments, poor communication and employee isolation. In this regard, staff-mentoring schemes may help.
Finally, the guide behoves employers to support staff who become mentally unwell, citing honest and open communication that focuses on the individual (not the illness) and practical adjustments that might aid a return to work, perhaps on a phased basis.
Benefits of supporting good mental health
Such an approach does not merely help the individual; it also benefits employers by improving work productivity, preventing unplanned absenteeism and reducing staff turnover.
In an example cited in the guide, a company losing €1.8 million in annual productivity instigated an Employee Support Programme. Specifically, in addition to providing staff CBT, it trained over 1,000 managers to recognise psychological ill health among staff members thus enabling early intervention. The company saved nearly €300,000 annually and almost doubled job satisfaction responses. So, can employers in Ireland emulate this?
One approach employers might take is to train its managers in Mental Health First Aid, an initiative that has recently arrived in Ireland. Moreover, the Irish Business and Employers’ Confederation (IBEC) has published a document entitled Mental Health and Wellbeing: A Line Manager’s Guide, similar to Mind’s Taking Care of Business.
With the right approach, mental ill health need not prevent the right candidate from being recruited by an employer. Those already employed might not be so afraid of losing their job or of colleagues finding out about their illness. Such individuals often have valuable expertise, years of experience and a work ethic that can really benefit employers with a policy of supported disclosure and who value good mental health as a core value and not an optional extra.
Many Irish employers already do this. Perhaps my patient’s boss has some catching up to do.
Dr Stephen McWilliams is a consultant psychiatrist and author. He is clinical lead of the Psychosis Programme at Saint John of God Hospital, Stillorgan, Co Dublin.
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