Managing Mental Illness: The Business Case for Supportive Line Management

I'm pretty exhausted this week, honestly, because I did a number of evening engagements either related to work and mental health or work and the digital learning and change role that I have as my 'day job'. By Wednesday I had worked about 30 hours, travelled to multiple locations and talked a lot about mental health. And if you read my post last week on burnout, you'll probably be aware that too much of that busy-ness is not good for me (or any of us actually) in any respect - mental health, physical health, whatever.

Nike Self-tying laces (in honour of Back to the Future, of course!)
If Nike could also produce self-showering, self-dressing,
self-makeup, etc. I think they'd really be onto something...

If I am going to continue to be okay, then I have to recognise that whether I feel tired or not on weeks like that, to avoid a mega crash into depression or a buzzing anxiety that I can't shake.

And in case you've forgotten or didn't know, here are the stats:
I and everyone need to take care of our health, and
we need respect and support, not inequality and discrimination

So this is going to be (read: is intended to be, and then laugh at me 1000 words later) a short post, and I'm grateful to Isabella Goldie whom I heard present at DIDLAW's Mental Health Disabilities and Stress At Work conference on Wednesday, for providing me with all the fire for my #redefiningresilience engine. I came away from that conference buzzing in every particle by the inspiring people standing up and saying "we need to do more" to support colleagues, managers, peers, team members to live in a mentally healthy work environment and be able to seek help

without feeling ashamed or repulsed by themselves, or feeling shamed or unsupported by their employer for doing so.

When I was sick last year I had several experiences with line managers - some very, very good, and some not so good at all. At a critical point with my mental health where I absolutely knew that I could not carry on living with such symptoms of depression pervading my existence, I am fortunate enough to have had the following resources to help me reach for help rather than (perhaps fatal) harm. But without supportive line managers I might not be here writing this.

The key message of this post is: we need line managers (US readers, line manager = supervisor, i.e. the person directly in charge of you and what you do at work)  to make it their business to educate themselves about mental health; and if they are approached by someone to talk about mental health, then they don't need to demonstrate a working knowledge of Jeffrey Young's 'schemas' or practise CBT, but they do need to be empathetic, provide safe boundaries for people to share their mental health experiences and then continue to be treated with the same respect as before, while incorporating appropriate reasonable adjustments to continue with work.

I am a line manager with several team members working with me or for me, depending on how you look at it, on lots of different projects. I recognise that I am a small fish in a very big corporate pond. I've been managing teams or individuals for over five years now, and I admit I was highly ineffective in certain respects during my early experiences, and hope that I have now made sufficient improvements that can be seen by the people whom I manage as supporting, respecting and empowering them to succeed in whatever they are doing.

You and I and everyone we know has a responsibility to

 create supportive 'moments' which make our lives easier, healthier and allow us to thrive.

With a view to keeping this post short (for my health) here are some things that I've found helpful as an employee, and following that a few things I think are needed from line managers.

If line managers aren't supportive, I know from personal experience, employees like me don't recover well, may not recover, may leave the organisation, and may even consider / attempt suicide out of desperation. Please remember that - this is about life or death in some cases. You as a line manager have a chance to make the biggest difference of all to someone's working life.

Here are some anonymous real quotations from people about the negative impact of unsupportive or unhelpful behaviour from line managers at work:

Something similar to this happened to me. It made me feel:

• that the stress was all my fault and was 
• a point of performance feedback (even when I knew it shouldn't be)
• ashamed of having failed at work
• disgusted with myself
• a complete waste of time
• ready to die

I would find it hard to stay in a job where I wasn't supported to be me, depression and all, but many people do that and keep pushing even though they are feeling horrific. Which makes them more ill. It saddens me and angers me that people are not listened to and supported when a few small things could make a huge difference - and is both the right thing to do and the right "business" decision: the average cost of losing an employee through attrition (related to anything) is £38K. If we can stop people feeling unsupported and make people healthier and happier, everybody wins.

One of the commonest things I hear from people sharing their stories with me is the constant contact from work asking when they are coming back. Of course this question needs to be asked and contact - supportive, not harassing contact - is helpful. But does that question need to be asked that day/ every day? More tips on what to do below, but really, just consider how you'd feel if the day after breaking your leg, your line manager called you to see when you could come back to work (and you work in an active job, let's say). Appropriate? Absolutely not. Did you know that you can identify a family member to be your point of contact while you're out and recovering? You can, and totally stepping away from work when you're really ill might be the best medicine you can take.

There are many resources available to help you as a line manager to feel more comfortable that you understand the issues of mental illness to some extent, and that you also understand the role that you have to play as a line manager in engaging with mental health at work (either on an individual basis or in general) in such a way that you make it easier to talk about, reduce health problems associated with the strain of hiding such a condition or "presenteeism" and support those with more serious conditions with respect. By according them with dignity and helping them work as much as they can, they can feel safe in the knowledge that you are on their side just as much as on the side of the organisation you both work for.

1. Remember that 'employees' are people above all else. Listen to them. Respect them.

We are all going to have events in our lives that make work tough. I'm not just talking about mental health, I'm talking about life events such as having a baby, meeting a new partner, breaking up with a partner, losing someone, being ill physically, and so on... When you show that you are listening, rather than judging, or behaving as if having a conversation with your team is not valuable to you, you will build trust with your employees and in every way (including health, of course) you will make for a more flourishing team, who trusts you and feels so much more comfortable belonging at work.

2. Show and tell: make sure your employees know - from you - that you value them


Working long hours, with tight deadlines can cause us all to feel the pressure and at times we might not have a great day (or a great week etc.) because of this. Showing empathy to your employees and highlighting again and again that you value them and continue to value them provides a hugely supportive working environment. When I was teaching 11-16 year-olds, I was a strict disciplinarian, but having established those rules in my classroom my students felt 'safe' because they absolutely knew the status quo. From that structure of safe and firm boundaries they were able to be creative, try new things, be rowdy (sometimes, yes, I can still hear the ringing in my ears) and be their 'whole selves' in a way that helped them to learn and grow at school. We can do this as employers / line managers / colleagues and show people we are glad they're there, and we want them to stay.

3. Take some responsibility for your employees' wellbeing.

This might sound like a no-brainer, but the word 'resilience' which I'm campaigning to redefine is so, so often used as a term that it is expected that employees will demonstrate, relieving organisations of all responsibility. This is not acceptable. Every employee is responsible for taking care of him / herself. But every organisation is also responsible for providing support. Line managers are (literally) at the front of the line in terms of managerial hierarchies, and so must, must commit to providing a supportive work environment. As I said above, line managers don't need to be experts in mental health, but do, for example, have a responsibility to understand the organisation's sickness and absence policy, return to work policy and have some idea of the key contacts (like HR) who can sign off on supportive reasonable adjustments to make an employee's working life so much better whether they're in work, returning to work, or off sick. 

Also, manage your projects or your team's time effectively: in my opinion there's no excuse for poor project planning which mismanages everyone's expectations and can make people very sick. It also sets very poor expectations for clients- they think they can get x done for y price, but actually if they paid for all the hours really worked it might be double that... And so next time, trying to have a properly planned project, if you tell them the real cost, they won't want to pay. And as for your employees: if they're anything like me, (or how I used to be)  they'll work all hours to get it done for you at the expense of their life and their health. 

Returning to Work

4. Be Flexible and Make Reasonable Adjustments

I think this slide speaks for itself:

5. Ask for help - because you also deserve support!

No one expects you as a line manager to be able to do this all yourself either. Like I said above, this isn't about making the employee 100% responsible for his or her work life, but it isn't all your responsibility either, and you need to make sure you're okay too, as a line manager, as an employee. As a person.

There are many resources out there to help you which DIDLAW Education can help you to find, and the Mental Health Foundation, where I got these slides from, and from Mind, Mausdley Learning, Connecting with People, and so on. Your employer should also have some training available, or support you to attend training to learn more about this. You are not alone in this, and you can make a massive difference.

So as you go into Monday, please bear in mind the above, and remember that you and everyone matters - so please be kind, and be kind to yourself too, as always.

x

Burn Out Versus Balance: The (Almost) Eternal Flame

I have had a wonderful week in so many respects, despite having an horrific cold. Seriously, this time I think it was man flu. I genuinely didn't get out of bed last Sunday. It was the real deal. Scary.

Last week was the week after Inclusion Week at work and some wonderful experiences speaking on a Women's Network panel, a Mental Health 101 panel and more. Little surprise then that I would perhaps get sick and need to do more self care than usual. I wrote a long post about taking care (both of ourselves and one another) when we think about our mental health. Not just our mental health, in fact, but our entire health. Every bit of it. But for me I do want to treat myself as being an ordinary person, for whom depression is just one part - one - of who I am. One of the questions I was asked was: "What are some things that you do to take care of yourself?"

I have never been good at this. I've been hopeless at it in fact. If I set myself a goal, I'll want to achieve it, even if it means studying for longer, training for that marathon just a little bit harder, working extra hours, skipping breaks, all to get those goals checked off.

In reality this is not sustainable. To use the same sports metaphor I tell my colleagues - particularly the graduates coming in - life is a marathon not a sprint, whether at work or away from work: we have a long way to go and if we're going to have the best chance of making it to the end we have to take care of ourselves and find that balance between being ambitious and stretching ourselves, and trying to make sure that we don't achieve that (too often named) condition that affects every bit of us: "burn out".

I hate this phrase because it suggests that there's nothing left; a blackened match with no fire power left, completely useless. In some very extreme cases of burn out I imagine that people would need months (years maybe) to recover, depending on the personal circumstances of whatever led you to be there.

I have probably only burned out during a project in the USA where the clients were challenging, the hours punishing and the goals almost unattainable (I say almost because I attained them, but at tremendous personal cost to my health and wellbeing.)

Even in the above circumstance however, it wasn't as if there was nothing left at all: I could still go out for a meal, go for a run, visit a museum, walk in the park. I could even write my blog and carry on working. This is why I am so adamant that even with a mental health condition I can still be 'resilient' and why I'm working to make sure we have those conversations to #RedefineResilience : and not equating the word 'resilient' with bouncing back better and stronger than ever and never ever again having a slight off moment. Ever.

I don't bounce. I think I established that last year when I broke my back.

but I. Come. Back. Eventually.

Now, had I been a lottery winner, I'd be the first to admit that given the choice I would have just left work and booked myself at least a year of recovery time. But unfortunately, knowing that the chances of winning the lottery 1 in 32,441,381,280. 32 Billion - thanks Lotto for adding those extra numbers - I think I'll focus on a little thing I like to call REALITY.

So here's my a view of what balance looks like for me:

1. I eat some fresh juices courtesy of my own recipes and those of +JuiceMaster Jason Vale and @Joethejuicer Joe Cross) because the juices give me the vitamins I so need as well as reducing my anxiety levels and helping me to maintain a healthy weight. I also eat burgers with fries, onion rings and coleslaw. Because. I. Love. Them. And no matter that I will never have the waist of Kate Moss (that ship has sailed so far out I can't even see it. In fact I can't even see the horizon. Because I'm in a town.) I love good tasting food and for me it makes me happy to eat nice food.

   

   Yes, not my usual ingredients for a glass shaped like this. But juices help

   . 

   

   And NOW we are talking.

2. I see friends and go into the office because seeing people and having a chance to be social is good for me. If I'm in a slump it gets me out of the house and if I'm not it's energising. This assumes that I surround myself with people who are nice, mostly positive (or at least realistic!) and who are caring, kind, generally lovely and smart. In these cases my life is made immeasurably better by spending a few hours in their company. If, on the other hand, the people are rude, negative, life-haters, like Stuart the Virgin Trains man on the train from Manchester to London who once gave me a ten minute lecture for asking for the sandwich which (as someone who had a first class ticket) I had already paid for, finishing with "You know you're wrong. You ask your mother if I'm right..." then no, I won't feel better, and I tend to avoid these people like I would the currently rutting stags in the park.

   

   Yep. I'm not keen on these types of people.

   I might not die, but I'll certainly feel worse. On the other hand, I can't have too much contact with people because it is very tiring to be face-to-face all the time, so I have a couple of days at home each week at least, go to bed early and don't socialise too much, and spend a lot of the weekend having 'quiet time': hello Netflix and Kindle.
3. I exercise - for me it's running - a few times a week. I channel my inner Paula Radcliffe (the non-peeing-outside-part-of-Paula-Radcliffe, just to be clear)

   

   Did she or didn't she?

   and take to the streets or park for fresh air and fitness that will provide natural endorphins to boost my medication. I also walk up the escalators on tubes and walk around as much as I can. But I do not do too much. So I'm not currently running every day - more like 4 days a week (although clearly, see above, not with a cold...man flu no less!). And on those rest days I do, really, rest.
   
4. I work and love to work, but I don't work much outside of my 40 hour week.

   

   I also 'don't work'. I.e. I have a life outside of work. And I'm not just talking about writing this blog or talking about mental health. I'm talking real life outside of work stuff - whatever that is. Rest, painting, drawing, talking to people, watching Grand Designs and Bake Off and so on. I might make an exception to this, (the work, not Bake Off)

   

   Do. Not. Mess. With. My. Bake Off.

   but if I do, then I compensate for it. E.g. I recently went to a two day training course which completely shattered me. I therefore (suspecting this would be the case) took the day off the next day and spent it recovering. Eating, meeting my mum, sleeping. Feeling a bit better. I do make myself write a blog post every week because it makes me feel so good to be writing and - especially if I reach just one person and help them know that other people like me are also feeling a bit, frankly, rubbish, and that they deserve help, then that just makes me so happy. (Crying happy, smiley happy. The whole thing.)

Selfie fun with @Dawnoporter and @NimcoAli

For the last one - I should add that fun is in the mix. So with this in mind I went to Stylist Live on Thursday. I practically tackled Nimco Ali to the floor when I saw she was there, I pouted while taking selfies with Nimco and Dawn O'Porter (who I confirmed to that I didn't know who she was - or at least I didn't recognise her by sight!) and I told Stella I didn't know who she was, and then found out that Stella was Stella Creasy. And of course I knew! Surrrlightly embarrassed.

Dannie and Stella Creasy. 

But I did talk to all of them about mental health. I managed somehow to stand up in a room full of people and simultaneously 'come out' about my mental health (again, but this time...) to Caitlin Moran while I asked her what the last taboo was (that we could talk about) and she said she said 'everything' was still taboo - so a lot more work to be done! But the best thing about the day was talking to all of the great people there: Mosama, Zoe, Nancy, Fareeda, Linda, to @ThisWorks sleep and other beauty products) and to @YullShoes,

to Katie at Stylist Magazine and all the other amazing women (it was all women on this occasion) I met and who shared their mental health stories with me. Their brothers with anxiety, their husbands whom they call at lunch to help him get through the day, the antidepressants we've taken, the therapists we've seen, the bereavements we've had...everything. I always feel honoured by every person who shares a story about themselves or someone they know with me - it's like getting a present - and I hope that by talking about it myself I'm making this easier to talk about, and that we will make it easier for others too, and enable people to get help and feel that they deserve it.

This stuff really works by the way. Ahhh, a good night's sleep. 

A real rarity for me now less rate thanks to this!

I'm really tired now so signing off but please take care of yourself, and whatever you've got lined up for the week ahead, maybe consider a little balance. It can help.

Love xxxx Jessica

Everyone Matters and Deserves Dignity: Inclusion Week and World Mental Health Day 2015

I have just finished (as of four minutes ago as I’m typing this at 17:34 on Friday) InclusionWeek in the UK for @KPMGUK. I have to say I am rather shattered. But also absolutely elated. And tomorrow is World Mental Health Day 2015, with this year’s focus on #Dignity. I will be running the ParkRun (@BushyParkRun) and writing the run report with a focus on the stories of people who run either for their mental health or for other causes. I’ll repost it here when I finish it.

So, to reflect on the week, what a week it has been. On Monday I launched my campaign #RedefiningResilience: https://www.facebook.com/RedefiningResilience to share my story with the groups of people I know may be able to identify with what I’ve experienced. I want to help people to realise that if they are still going then they are resilient. You can read more about this on my page and in this post.

http://haslaptopwilltravel.blogspot.co.uk/2015/10/redefining-resilience-launching-my.html

I also participated in three of the many events I’m proud to say that the fabulous Diversity and Inclusion team at KPMG organised with support from all of our networks.

I spoke on a panel on Monday evening for #LeanInCircles, answering the question, “What would you do if you weren’t afraid?” with my experience of deciding to take the step (or leap) to be completely open and honest about my mental health at work. I was really proud to see how many colleagues then shared some of their own experiences with mental health within their groups – as I said at the time, the more that we talk about this, the more that we keep the conversation going, the more we will enable our colleagues to be better through that comfort to be honest, and feel supported and comfortable to get help if they want / need it.

Lean In Circles

On Tuesday morning I was back in at 8am on another panel for our Mental Health 101 panel discussion, where 160 colleagues attended to hear about “Everything you wanted to know about mental health but were afraid to ask”. The turnout was amazing and the questions and engagement from the audience was inspiring to me. I was joined on the panel by partners with lived experience of mental illness, our occupational health chief medical officer and the head of employee wellbeing. I tried to speak honestly about my experiences, highlighting that everyone deserves respect and support, that everyone should be supported if they choose to share, and that everyone has mental health and we all need to take care of ourselves.

I finished my contribution (in person) by sharing a stand with many other colleagues from our work’s network to talk about our internal #BeMindful network and the support that KPMG offers and advice on how to look after yourself mentally at work. All in all, a tremendously enriching and inspiring experience for me – to see my colleagues talking about mental health, many for the first time – and finding common ground where before they might have anticipated isolation and stigma.

As I said in my Monday post about #redefiningresilience, living and surviving with a mental illness does not always mean that you get better and ‘bounce back’. “I do not bounce,” I told Tuesday’s audience. “But I come back.” Slowly. So slowly, and it may take time, setbacks, tears, frustration, cake, pills and more. But I come back.

This week has also been a week of celebration. I met fellow shortlisted candidate @Jackie8 (Jackie Scully) for an inspiring chat on Tuesday night where we shared our various experiences of resilience. I am hoping Jackie will share her story of resilience (facing massively intrusive hip surgery, then breast cancer while being creative director of Think) soon on my #RedefiningResilience page.

On Wednesday night I attended the #Brummell30 @BrummellMag reception for those women who - like me - have been listed on their list of 30 most inspirational women in the city championing diversity. I was honoured to be in the company of such amazing women. 

Read the full Fundamental Facts Document

I’ve written a post on #Dignity for @MH_Voices as well https://mentalhealthvoices.wordpress.com/. (I'll post the link when it's up.) In it I explored the perspective of mental health from a professional employee’s point of view. I ended by stating what I believe we should expect our employees to never take away our dignity and always treat us with respect.

I like to think the best of all people – but I expect from everyone respect in the workplace, no matter your skin colour, (hair colour in my case!), religion, sexuality, disabilities or life circumstances. Dignity is defined as “The state or quality of being worthy of honour or respect”. In reference to our individual right to dignity, I like this example: To “stand on one's dignity” meaning to Insist on being treated with due respect. (references from OxfordDictionaries.com)

The Mental Health Foundation writes of the theme of ‘Dignity’ for this year’s World Mental Health Day (10th October 2015) “…An ill-informed and damaging attitude among some people exists around mental health that can make it difficult for some to seek help. It is estimated that only about a quarter of people with a mental health problem in the UK receive ongoing treatment, leaving the majority of people grappling with mental health issues on their own, seeking help or information, and dependent on the informal support of family, friends or colleagues.”

So, just in case anyone reading this would like to know what I expect from others in relation to mental health, it’s this: At the end of the day, as my colleague Greg is often reminding me when I'm resourcing our next project, resources or employees are still, actually and most importantly, people, and they deserve respect, support and never to feel undignified because they share at work that they have an illness or life challenge. In fact they should be applauded for their courage and given the support that they need.

1)      Ask people how they are, and actually mean it. “How are things?” “How have things been with you?” And if it means taking three ‘how are you?’ cycles to get to the point where the person can actually answer honestly, then three it is. Or four. Or five. And so on.

2)      When they tell you how they are, show them respect and support (whatever they say – this isn’t just about mental health). “I’m sorry to hear that.” “What can I do to help?” “I’m here for you.”

3)      If they don’t want to talk about their mental health in detail – even at all - that is okay – it is up to everyone whether they share personal information about themselves, but tell them, again, “I’m here for you.” “Let me know at any time if I can do something.” “I’m not going anywhere.” (It might be worth saying that – at work – you will get more support officially and this may mean you can adjust your work situation to accommodate your needs better when / if you’re well enough to be working.)

4)      If they talk to you about it, say thank you. “Thank you so much for sharing that with me. I imagine it might have been difficult for you, but I really appreciate you coming to me with this. I hope that I/we can help you.”

5)      If you feel you can, and you have experience of mental health – whether yourself or someone you know – share that. “You are not alone in this.” “I actually have depression myself, so I hopefully can understand something of what you’re going through.”

6)      Keep the conversation going. “How can we support you?” “What can I do that will help with this?” You sincerity and the fact that you are prepared to have a serious conversation about this will hopefully show your colleague or employee that you are in their corner.

And then – if this is my experience - I expect to get support as a follow up (occupational health referral, adjusted flexible working, time off, or whatever I need within reason). I expect to be treated with the same respect as everyone else in my company, whether I have a broken back or a broken spirit. I expect people to respect me because I am a professional, competent person and I am worthy of respect – whatever external circumstances I’m also handling. I respect other people in the same way. I expect openness and honesty rather than whispering about employees behind their back which will make them feel like they should be ashamed of what they’re going through. 

And finally – and this will come, and only now from the most exceptionally inclusive people – I expect praise for those people who have taken a deep breath and spoken up about their illness. People should stand on their dignity. Everyone matters. Everyone deserves respect and to dignity. So let’s make sure that happens.