Mapping Mental Health

for Managers

“Sharing effective wellbeing initiatives is at the heart of what we do.
The most compelling motivation for us is the results.”

Insights

Welcome to our mental health portal which provides a single point access for you to use. The resources highlight your learning from our online learning session. This space also provides PRACTICAL exercises and reading to further your knowledge. Committing your time to this acts as a great consolidation step. Enjoy!

Mental Health Awareness

Having a conversation about Mental Health is something many of us don’t feel equipped to do yet as managers we are in a strong position to offer support and make a difference. 

  • Develop a good understanding of the vast topic of Mental Health
  • How to recognise signs of ill mental health
  • Gain practical guidance to underpin a conversation to support and signpost someone confidently
  • Manage your own wellbeing

1. Why address Mental Health in the workplace?

  • Legislation Equality act 2010 (1) UK Specific (Currently around 25% of countries have no mental health legislation according to the WHO)
  • De-escalation
  • Corporate Social Responsibility
  • Reduction is staff turnover, absence
  • Being a healthier workplace. If people can talk about mental health as part of your culture, a good place to work but also retain talent
  • Because we care and we want to support each other
  • Sharing knowledge in this topic grows awareness which in turn aids early intervention. The earlier the intervention, the more effective the recovery. Like physical health e.g. Early detection of cancer greatly increases the chances for successful treatment.
    Source: WHO

2. The impact of Mental Health issues

  • One in four people in the world will be affected by mental or neurological disorders at some point in their lives. (2)

  • 75% of mental illnesses start before a child reaches their 18th birthday, while 50% of mental health problems in adult life (excluding dementia) take root before the age of 15. (4) UK Specific

  • Depression is the leading cause of disability worldwide. (5)

  • Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. (6)

  • Every year close to 800 000 people take their own life and there are many more people who attempt suicide. (7) 

3. What is Mental Health?

“Mental Health is a state of wellbeing in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.” Source: WHO

  • There is a difference between Mental Health and Mental Illness
  • We all have mental health
  • Mental Health is relative to everyone, it is individual
  • Mental Health changes all the time and can be affected by a range of factors
  • There is overlap between physical and mental health, they reinforce each other

4. Mental Health as a journey

A good visualisation for mental health is to see it as a bus journey on a road with different stops along the way.
 

  • Think about Mental Health as a journey – there is no end destination
  • There is no right or wrong destination
  • Sometimes we remain in one area because we are unsure what help is available, who to ask for support or perhaps stigma and discrimination mobilises us
  • Take the prefix “poor” and “positive” mental health away and we are all left with mental health 

5. Protective vs risk factors

Put simply a protective factor is something that helps to prevent issues whereas a risk factor is something that contributes to issues.

These examples are not exhaustive and are not to be used as a check list or diagnosing.

Risk Factors

– Family history of ill mental health
– Chronic medical conditions
– Use of alcohol or drugs
– Poor nutrition
– Unmanaged stress
– Traumatic life experiences
– Abuse or discrimination

Protective Factors

– Prioritising wellbeing
– Reliable support and help
– Emotional self-regulation
– Good coping skills
– Security (economic, financial, emotional)
– Access to support services
– Strong values and belief system

Talking about Mental Health

6. Why is talking about Mental Health so difficult?

Many people find something something something here just to tidy things up.

  • Stigma
  • Resultant discrimination
  • Judgemental outlooks
  • Different cultural perspectives
  • Different social expectations
  • Different values, beliefs and perspectives
  • Lack of education on the topic of Mental Health
  • Afraid to say the wrong thing

 

7. Our language and perspectives of Mental Health

We want to be sure that we do not label a person by their mental illness. Colloquialisms/jokes/misused terminology can trivialise mental illness and stop a person from seeking help. (8)

Inappropriate

– “mental patient”
– “nutter” or “lunatic”
– “psycho” or “schizo”
– “deranged” or “mad”
– “prefix an or a e.g. they are an anorexic”
– “crazed”

Appropriate

– “living with” mental illness
– “has a diagnosis of”
– “is being treated for”
– “experiencing poor mental health”
– “low levels of wellbeing”
– “experiencing depression, anxiety…”

8. Clarifiying some myths

MYTH: Once you experience mental illness it means it stays with you for life.

FACT: Most people will recover fully, especially if they receive help early. Recovery will be different for everyone and some people may require ongoing treatment to manage their illness.

Some people have only one episode of mental illness and will completely recover. For others, symptoms associated with mental illness occur only occasionally with years of being well between episodes. (9)

MYTH: Mental illnesses are all the same.

FACT: There are many types of mental illness. Simply knowing a person has a mental illness will not tell you how well or unwell they are, what symptoms they are experiencing, or what impacts the illness is having on their life.
Though a particular mental illness will tend to show a certain range of symptoms, not everyone will experience the same symptoms (10)

MYTH: People who live with mental illness are violent.

FACT: Research indicates people receiving treatment for a mental illness are no more violent or dangerous than the general population. People living with a mental illness are more likely to be victims of violence, especially self-harm. (11)

MYTH: Someone experiencing mental ill health won’t be able to cope at work.

FACT: Neither a diagnosis nor the severity of the symptoms predict the severity of someone’s symptoms. Most people who have experienced, or are experiencing, mental ill health can work successfully. (12)

9. How does stress affect Mental Health?

Stress is our body’s way of responding to any kind of demand or threat. When we sense danger—whether it is real or imagined—the body’s defence mechanism kicks in, an automatic process known as the fight, flight and freeze response.

The stress response is the body’s way of protecting us. It can be useful to help us reach a deadline, stay focused and energised. In this form it is otherwise known as Eustress.

In emergency situations, stress can save your life—giving you extra strength to defend yourself, for example, or spurring you to slam on the brakes to avoid a car accident. This is otherwise known as Distress.

In modern day life we can tend to perceive everyday stress as a threat, resorting to using our fight, flight and freeze too frequently. There are researched links between this overuse of the stress response and ill health.

PRACTICAL: Management Style Framework

Management style and practices can help promote staff mental health and minimise stress

As a Manager you can develop a framework of tools to access which are recognised as reducing stress at work. This is a “competency indicator” put together by The Health and Safety Executive (HSE), Chartered Institute of Personnel and Development and Investors in People. This does entail answering 50 questions and gives a comprehensive report.

Talking about Mental Health

Using the HSE framework

This does entail answering 50 questions and gives a comprehensive report. Click here to visit the HSE page and you will find the following four areas to focus on:

  1. Respectful and responsible: Managing emotions and having integrity
  2. Managing and communicating existing and future work
  3. Managing the individual within the team
  4. Reasoning/managing difficult situations effectively

Outcomes of questionnaire

From the outcomes of answering this questionnaire honestly, you are then offered guidelines to improve.

In the example shown on the right, being personally accessible as a manager is the lowest score and would be the starting point for improvement.

Maybe another point here which takes up no more than these two lines to balance the section.

10. AN INTRODUCTION TO MENTAL HEALTH ILLNESS

Depression

Depression is a mood disorder that makes you feel constant sadness or lack of interest in life.

Many of us feel sad at times – it is a normal reaction to life’s challenges. Depression is intense, ongoing sadness including feeling hopeless, helpless, and worthless. It lasts for many consecutive days to weeks and impacts on your day to day life.

Some of the symptoms lasting for at least 2 weeks include:

  • Low mood all day
  • Feeling tired and having no energy
  • Feelings of worthlessness
  • Difficulty in focussing and remembering details
  • Sleep is impacted negatively
  • No interest in everyday activities
  • Thoughts of suicide
  • Feeling restless
  • Weight fluctuation
  • Sad, anxious empty feelings
  • Physical aches and pains

This list above is not exhaustive and is not to be used as a checklist. Not everyone will have the same symptoms.
While these symptoms are common, not everyone with depression will have the same ones. How severe they are, how often they happen, and how long they last can vary.

Anxiety

Anxiety is a feeling of unease and fear which can be mild or very severe. We all have feelings of anxiety at some point in life. When the stressful incident passes, the anxiety leaves too.

For some people they find it hard to control their worries. This anxious feeling is constant, and it impacts their day to day life.

“Anxiety” is an umbrella term encompassing many Anxiety Disorders.

Common Anxiety Disorders

  • Panic Disorder
  • Phobias
  • Generalised Anxiety Disorder
  • Acute Stress Disorder
  • Post Traumatic Stress Disorder
  • Obsessive Compulsive Disorder

Symptoms will vary with each person. These can range from:

  • Racing heart
  • Unsettled stomach
  • Feeling out of control
  • Disconnect between mind and body
  • Panic Attacks
  • Restlessness
  • Difficulty concentrating
  • Disturbed sleep
  • Rapid breathing

Other Mental Health Illnesses

.Self-Harm

Self Harm is a behaviour when someone harms themselves on purpose. It is usually because something feels wrong and this is a way to let those feelings out and feel better. It is very common in young people, statistics highest in 15 – 16 year olds. It can happen if someone is feeling anxious, depressed, stressed, bullied and doesn’t know how to manage these issues. It does bring about temporary relief.

Eating Disorders

An eating disorder is when someone has an unhealthy approach to food which can impact their life and make them ill. The eating behaviour has links to thoughts and emotions causing pre-occupation with food and their body weight.

Eating disorders often co-exist occur together with disorders like anxiety, panic, obsessive compulsive disorder and alcohol and drug abuse problems.

Anorexia Nervosa: Someone tries to keep their weight as low as possible by not eating enough food

Bulimia: Eat a lot of food in a very short space of time and then are deliberately sick or use laxatives to binge.

Binge Eating Disorder: Lose control of eating and eat portions until you feel uncomfortably full feeling guilty.

Psychosis

Psychosis (also called a “psychotic experience” or “psychotic episode” is when someone perceives reality in a different way from the people around them. The most common types of psychotic experiences are hallucinations, delusions and disorganised thinking. It affects people in different ways sometimes in short episodes and others can be affected most of the time.

Diagnoses that fall under Psychosis include:

  • Schizophrenia
  • Bipolar Disorder
  • Schizoaffective Disorder
  • Paranoid Personality Disorder
  • Postpartum Psychosis
  • Delusional Disorder

Dual Diagnosis

Someone experiences mental health problems in combination with problematic substance misuse e.g. alcohol and/or drugs.

Suicide

Suicide is the most serious crisis associated with Mental Health. Suicide is the act of taking one’s own life. For it to be announced as suicide it must be declared by a coroner; the death being of unnatural causes; the action resulting in death self-inflicted and the person who injures themselves has the intention to die.

If someone talks about suicide, this is the one time to break confidentiality. Acting means getting someone the help they need. If the person is in imminent danger, call your local emergency number, Stay with the person, remove any source of danger.

    PRACTICAL: SAVE Support Framework

    11. The SAVE Support Framework

    One of the most powerful things you can do as a manager is know your people.

    You are well positioned to notice signs – it can be difficult for someone to notice these signs in themselves.

    Noticing signs at an early stage makes it easier to signpost to appropriate help and support recovery. 

    Talking about Mental Health

    SPOT THE SIGNS

    How can I tell the difference between stress and ill mental health? We all experience stress some of which can be helpful to our performance. When left unmanaged for a period, stress can become counterintuitive. In conjunction with other risk factors it can contribute towards ill mental health.

    Specific workplace behaviour

    – Not getting things done and missing deadlines
    – Erratic behaviour, anger and irritability
    – Emotional and complaining about workload
    – Being withdrawn
    – Inability to concentrate and lowered confidence
    – Absence or conflict with the team
    – Taking on too much work and working long hours
    – Presenteeism
    – Any change

    Physical signs

    – Often ill
    – Headaches
    – Difficulty sleeping
    – Weight gain/loss
    – Change in appearance
    – Skin conditions
    – Shaking
    – Crying
    – Looking tired

    APPROACH AND ASK

    Getting to know your team means regular interaction be it meetings, appraisals, progress updates, informal chats.

    Providing your staff member with opportunities to talk is important.You could consider a regular wellbeing review aside from performance reviews.   

    Getting a conversation going when you have noticed signs:

    – Consider a good time of day that works for both of you
    – Factor in extra time so you don’t feel rushed and you aren’t perceived as coming across as hurrying the conversation
    – Share your concerns – be specific with examples and dates
    – Be careful to frame your discussion to “I” rather than “we” to avoid the staff member getting the impression that the team/company are talking about them.
    – Reassure that you are there to help, this is not a disciplinary meeting nor a performance review.
    – Before you try and “fix” or jump into action, LISTEN.

    VALIDATE BY LISTENING

    When you truly listen to your staff member, their feelings will be validated.

    There are four different types of listening. These are evaluative, comprehensive, appreciative and empathetic. The listening style should be chosen accordingly to provide the best platform for your particular conversation. 

    What stops us from listening?

    – Advising: “I think you should….”
    – One-upping: “That’s nothing! Wait ‘till you hear…”
    – Educating: “This could be good if you just…”
    – Storytelling: “That reminds me of when…”
    – Sympathising: “Oh, you poor thing…”

    Adopt and empathetic approach

    – Consider Tone, Body Language and Words
    – Use open body language- show you’re listening
    – Reflect back and paraphrase what you hear:
    – “So what I hear you saying is…”, “It sounds to me …
    – ”Allow some pauses and silence and be present
    If your staff member does not want to talk reassure them that you are here and available to talk to when they wish to.

    If it becomes apparent someone is blatantly at risk of suicide call emergency services. Consult HR for support for policy and practical support.

    Once you have listened and allowed the space for your staff member to be heard, some questions that could be helpful:
     

    • Can you recognise anything that you think may help you now?
    • Is work a contributor to how you are feeling?
    • Are there any issues outside of work that you want to talk about?
    • Ask if there is anything you can do to help
    • Ask if they can identify with any reasonable adjustments that many be helpful
    • Discuss what they want their colleagues to know
    • Record all your conversations accurately sharing this with the staff member. This is helpful in monitoring progress and agreed actions.

    ENCOURAGE SUPPORT

    Just like we schedule appraisals consider a regular “wellbeing check-in.”

    This can be an informal conversation asking how your team member is doing.

     

    a. Managerial support

    a. If it emerges that your team member is under too much pressure and not coping, consider the Employee Support Plan template.

    b. Available support at Insights

    Make your staff members aware of the following:
     

    •  EAP
    • Occupational Health
    • Wellbeing initiatives
    • Mental Health First Aiders etc
    • Flexible work practice
    • Wellbeing Intranet
    • Workplace social and connecting opportunities
    • Other

    c. Professional Help - a GP/Doctor who may refer to counselling or prescribe medication

    Types of counselling

    – Individual CBT
    – Group-based CBT
    – Interpersonal therapy (IPT)
    – Behavioural activation
    – Psychodynamic psychotherapy
    – Behavioural couples therapy

    Professionally prescribed medication

    – Depression: Serotonin and noradrenaline reuptake inhibitors
    – Anxiety: Benzodiazepine and Betablockers
    These medications are amongst many carefully weighed up by a medical professional considering each individual’s circumstances and health.

    The above lists are not exhaustive and offer a very small example of vast options
     

    • Mental Health websites and resources
    • Text support
    • Mental Health Charity Resources
    • Samaritans and Emergency Helplines

    d. Self Help

    • Managing stress; fostering healthy self-esteem, connecting with others, work life balance, finding your purpose, exercise, good sleep, healthy nutrition
    • Encouraging prioritisation of hobbies, interests, recommended reading
    • The Five Ways to Wellbeing offers useful steps to promote positive mental health 

    12. If someone goes off with Ill Mental Health

    Not being in contact with a person off ill may add to their lowered confidence in returning to work. Contact with your staff member off work is essential. Consistent and sensitive touch points will be encouraging for that person. It could be that your organisation has a written absence policy – checking this could be helpful.  

    •  Agree a preferred time to keep in touch
    • What is the best means of contact?
    • Ask them if you are their preferred main contact
    • If your staff member is too unwell for interaction, is there a family member or someone else who you can keep in touch with?
    managing team

    13. Managing the rest of the team

    When a staff member goes off this inevitably affects the rest of the team.

    The team could be impacted by the person’s symptoms, reasonable adjustments made and increased workload.
     

    • Where confidentiality allows update the team of changes
    • Identify any resultant workplace stressors on the rest of the team due to the change
    • Encourage the team to share concerns and impact on day to day work
    • Monitoring the entire team wellbeing is important.

    14. Return to work plan

    • Have a return to work discussion with your staff member so you can agree, rather than impose a support action plan
    • Consider a phased return to work like a few hours a day, gradually building up
    • What reasonable adjustments need to be put in place
    • Agree how progress will be monitored
    • Before return to workday, schedule a meeting to update the staff member on what has been happening and bring them up to speed
    • All the while continue to check in with how they are feeling
    • Adjusting work for their transition back and offering support will not only help them recover fully but reintegrate them soundly into the team. Remember it can take time to reach performance levels

    Depending on your organisation, consulting HR on this could be useful.
     

    • Can the job still be done with the adjustment?
    • The cost and budget
    • Does this adjustment work for the whole team?
    • Examples include phased return, re-arrange responsibilities, shared duties, autonomy on time, time off for professional help, allow time to prioritise wellbeing.

    15. Looking after yourself

    By taking care of yourself, you are taking care of others.

    When you prioritise your own wellbeing this not only puts you in a position to make decisions effectively and perform well, it also role models the need to focus on health to the rest of your team.

    Wellbeing is subjective and means something different to everyone. Focusing on the following areas offers a robust framework.

    PRACTICAL: Reflection

    Managing my own wellbeing...

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    Mental and Emotional

    Finding ways to manage your stress levels, boost self esteem and make sense of emotions

    Physical Energy

    Including a well-balanced diet, enjoying some exercise and getting a good night’s sleep

    Communication

    Ensuring regular touch-points to include meaningful conversations both inside and outside of work

    Balance

    Being able to work on the right things at the right time and still have energy enjoy leisure time after work

    Purpose and Meaning

    Identifying the purpose and meaning of your work – how your role makes a difference to you and your organisation

    Health of your Wealth

    Uncovering knowledge to support day to day and long-term financial plans

    References:

    1) https://www.gov.uk/guidance/equality-act-2010-guidance
    2) World Health Organisation
    3) www.mind.org.uk
    4) www.mind.org.uk
    5) World Health Organisation
    6) World Health Organisation
    7) World Health Organisation
    8) www.everymind.org.au
    9) www.MentalHealth.org
    10) https://theconversation.com/people-diagnosed-with-the-same-mental-illness-can-be-quite-different-and-research-must-address-this-82254
    11)  www.timetochange.org.uk
    12) www.mind.org.uk

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