Wednesday 6 May 2015

Mental Health and the Workplace

Hello readers. This is another slight digression from my usual patter, but bear with me because I want to get something off my chest (other than biscuit crumbs) and I promise to deliver Chapter 7 soon.

I don’t know if you’ve noticed, because it’s been kept pretty quiet, but there’s an election coming up, and mental health has been one of its focuses. In particular, there has been a lot of emphasis in recent months on getting people with mental health problems back into work. As far back as December 2014, the government pledged £12 million to the cause. The Liberal Democrats have promised, if elected, to spend £25 million over the next three years on it. In fact, every manifesto from the major parties includes something about helping people, either with mental health problems or disabilities in general, into work.

Now, while I wholeheartedly agree that anyone, regardless of disability, should be supported to be able to work in a job or career they enjoy, what happens when the job itself becomes the reason someone is unwell? I have been mentally ill, on and off (but mostly on) for years; I have OCD and depression. I also have a job, and as such I am not the target of any of these campaigns because on paper there’s no problem to be solved here. But there is; because simply ‘being in work’ shouldn’t be the pot of gold at the end of the psychiatric rainbow. Surely, the goal is to be in work and remain well, and that’s where I’m having trouble at the moment.

I’m not talking about not getting enough fresh air because I’m stuck behind a desk all day, or being tired because of a long commute, or bloated and lethargic from a diet of whatever I can grab and eat on the go (though, doubtless, these things don’t help); I am referring to things that should not happen in the workplace, but that often do anyway, which are unpleasant and stressful for anyone, but can be extremely damaging for someone with a mental health problem. Because if these types of things are not even acknowledged, let alone addressed, the issue will remain circular and more and more people, who want to work and who can, will be faced with the same choice that I currently have: my job or my wellbeing? Or worse: my job or my life?

Four short months ago, I had an interview for a new role at work; it was more responsibility than I’d had before and meant giving up my other job to go full time, but I was excited about the position and the chance to bring in new ideas and practise skills I hadn’t used before. I’ve never been a confident person but I wrote an impassioned application letter, gave a strong presentation and a blinding interview (apparently).  Shortly afterwards, full of nerves and enthusiasm, I started the job. However, within a few weeks, my mood had crashed; my OCD, which I’d been managing well, was worsening; my budding confidence had shrivelled and been replaced with self-loathing; I was exhausted; and dangerous, unhelpful thought patterns were returning. At first I ignored the correlation between my change in work life and sudden mental nosedive, but as the pressure mounted at work, things continued to get worse and I’m now at a stage where I don’t know how much more I can take.

So what happened? Like I said, I’m not a confident person. Self-berating and mental illness have a symbiotic relationship in my brain; they feed off each other and work to reinforce the appallingly low opinion I have of myself. People who haven’t experienced it can never know the impact that such self-doubt has on a person, day to day. It affected my schooling, it affects all of my relationships, it affects the speed at which I can get ready and leave the house every day, and – yes – it can affect my ability to perform at work. Despite this, I flourished in my previous job. I started out in a junior position and gradually amassed more responsibility and was given more creative and strategic tasks to do. After four years, when I was updating my CV and reflecting on the role, I was shocked and impressed by how much I had achieved, particularly because had I known that the job would evolve in such a way, I’d never have applied for it because I just never believed I had the ability to do such things.

You might assume that this was because my mental health problems were milder then than they are now, but they weren’t; most of the time I was in that job, I was battling awful OCD 24/7 and suicidal ideation was a constant feature of my thoughts. Still, in spite of my foggy mind and inner voice telling me I was useless, I took on tasks of greater complexity and coped with a mounting workload and conflicting priorities as well as the sanest sane person in the land. (Well, not quite but I never entertained suicide as a viable alternative to going to work or pulled out handfuls of hair as a result of workplace conversations.)

In contrast, despite having a much better starting point in my current job (for the first time in my life I had begun to see myself as competent), I now find myself as low and as hopeless as I’ve ever been. My mornings are a blur of cold sweats and diarrhoea; my days are spent fighting back tears and forcing myself to concentrate through heart palpitations, intrusive thoughts and a self-critic telling me I’m a failure; and in the evenings, if I’m not still at work, I’m collapsed on the sofa, locked in rumination about the day’s events and tomorrow’s deadlines. I have things I’d like to be doing instead, but I can’t, I’m stuck. 

And I’ve realised something: it’s not the deadlines, the workload, the criticism or the existence of an appraisal system that mean I’m not coping; they’re an inevitable part of any job and provoke some anxiety in most people. It’s the uncompassionate and punitive culture of my current workplace that’s the problem. Because a heavy workload is bearable when you’re trusted and appreciated – it only becomes a millstone when somebody’s breathing down your neck and talking to you like you’re a naughty schoolchild who didn’t practise their spellings. And criticism is useful when it’s delivered with an acknowledgement of strength (or at least effort) and tips on how to improve, but hurtful and demotivating when it isn’t. And when taking ownership automatically equates to taking the blame, it’s hard to feel pride in one’s job and easy to feel worried.

Recently there was talk of organising staff awards as part of a celebration event, but it was cancelled because senior management decided they didn’t have the time or resources. Fair enough, but they always find time to reprimand people when they think it’s needed. When you work in a culture that focuses on mistakes, but never on successes, you begin to focus on your mistakes. It would knock anyone’s confidence, but if you’re already lacking in self-belief and have a tendency to obsess over your errors, it’s crushing.

Even the appraisal system at my current job is biased against somebody who suffers from a mental health problem. Among other things, a person’s manager rates them as A, B, C or D on having a ‘positive and can-do attitude’. I’ve been told in the past I was a ‘C’ because ‘sometimes you’re very positive and pro-active, but sometimes you’re negative’. Funnily enough, depression tends to have that effect on a person; judging somebody on their positivity when they’re depressed is like judging a footballer’s skills when they have a broken leg. So now if I’ve had a bad day and burst into tears or not managed to grin like a Cheshire cat as actions are heaped upon me in a meeting, I start to worry about how this will affect my scores when it’s time for the dreaded ‘A’ word. I used to like appraisals at my last job; they provided useful feedback, focused on what I’d achieved and offered clarity on what I was going to do next. Now they’re another source of anxiety.

These might all seem like little things, but it’s something every workplace should be wary of, because one in four people do have a mental illness and if more people are successfully helped back into work, then there will be more need than ever for workplaces to be understanding and aware of the impact that negative comments and poor treatment can have on someone with a mental health problem. Because while being shouted at in a meeting might cause my colleague to send a bitchy text about their boss or update their CV, I want to grab the nearest pair of scissors and self-harm in the toilets. And while some people fantasise about their next holiday when they’re struggling to meet their deadlines, my mind tends to wander down the ‘plan my suicide’ path (it’s well-worn unfortunately and sometimes I’m halfway down it before I’ve had time to rationalise). People, particularly managers who have a duty of care to their staff, shouldn’t make assumptions about how small or large the effect they have on someone else is. As the wise and lovely Claire Greaves (@mentalbattle) put it, in a recent blog about internet trolls: ‘it’s like throwing a grenade over a fence, you can’t see the damage, you don’t even know if it’s hit them, but it has the potential to be deadly.’ And sometimes people do kill themselves because of work; I knew someone who did.

A word which gets thrown around a lot at the moment is ‘resilience’; it’s often found lurking in campaigns about reducing stress related sickness absence, getting people back into work and reducing service users’ reliance on the NHS. In the hands of a skilled psychologist, or on a Scrabble board, it’s a potentially useful word. However in the wrong hands, it becomes part of a victim-blaming rhetoric. It can be used to imply that a person would be completely fine with workplace bullying or unreasonable demands if only they were more resilient. But treating somebody unkindly and assuming they can take it because they’re resilient is like burgling someone because you know they have insurance – it doesn’t make it OK. Secondly, I am not lacking in resilience, but the very nature of mental illness means that it makes even the most ‘resilient’ people vulnerable.

However, it’s not just because of people with mental health problems that work places should be more compassionate. Do other people, who don’t suffer from mental illnesses, cope better with unpleasant bosses, heavy workloads and caustic environments? I’m sure they do. Nevertheless, that doesn’t make it alright to mistreat them, and it’s not the way to get the best out of anyone, keep people motivated and equip staff to do their jobs well. I didn’t swim in my previous job and sink in this one because my boss made adjustments for me there, which aren’t being made here. Yes, there were some things; being allowed to start later and finish later meant that when I struggled to leave the house on time because of OCD rituals, I didn’t also face anxiety about being in trouble for my tardiness. However, for the most part, she wasn’t making reasonable adjustments. She was just being reasonable. I was mentored through new tasks and aspects of my role with patience. I was given criticism on my work with useful explanations as to why it was wrong (not simply told that it was) and advice about how to make it better. Additional work was asked of me with an acknowledgement that it was extra work and thanks for taking it on, and deadlines were negotiated. Small, reasonable things such as this, as well as being beneficial for everyone, can be the difference between being able to stay in a particular job or not.

Because ultimately, people aren’t machines and while not everyone has a mental illness, everyone does have mental health. Yes – the person who made that mistake at work may have done so because they’re adjusting to a new medication, or the person who is fifteen minutes late might have had to check the house was secure several times before they left. But equally, the person who missed a deadline may have because too much was asked of them, or the person who forgot to do something might have just received some bad news. And the person who gets shouted at in a meeting might not go home to someone who tells them they’re lovely, so those words might be the only message they hear about themselves all day.

These things matter. For workplaces to be safe places for people with mental health problems and positive places for everyone, a little more compassion is needed.


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