When is a problem a problem?

When is a problem a problem?

We all have mental health and there is no health without mental health. As part of Mental Health Awareness Week 2017, I am presenting a series of articles covering a variety of issues around mental health to increase our knowledge of the subject in general. The first article answered the question “What is Mental Health?” and the second is “The Impact of Mental Ill-Health”. In this article, I am posing the question of when is a mental health problem a problem?

When is mental ill-health a problem?

A problem is not a problem until it’s a problem, is it? In a way, a mental illness could be compared to alcohol. Until the person is prepared to admit “Yes, I am an alcoholic,” or “Yes, I have a mental illness” the behaviors are not a problem (for the affected person at least).

Our mental health affects our behavior and the way we think and feel. So taking that one step further how would we know if our behavior, thoughts and feelings are on the side of ill health versus good health or somewhere in between? There are three pointers to bear in mind about the behavior (we may call it the symptoms):

  • Persistent – the symptoms continue firmly and obstinately
  • Pervasive – the symptoms are widespread, noticeable and entrenched; they affect every area of life (work, social and personal/family)
  • Problematic – constitutes or represents a problem, they are having a negative impact on life (at work, socially and personally)

Failing to admit there is a problem for them self can result in the affected person being sectioned – forcibly admitted to hospital.

As an example we can all be affected by sadness, feeling down or numb for a short time and then get over it, get back to our normal happy self. But if the sadness becomes overwhelming and the numbness affects all areas of our life and lasts for more than a couple of weeks, that sadness and numbness are becoming a problem. The problem IS a problem.

From the individual point of view, it is definitely time to get a doctor’s appointment. Don’t leave it until like John in the previous article you suffer a nervous breakdown and can’t cope with it anymore. The HR people tell me it costs a company in excess of £30 000 when a middle manager like John is signed off due to mental ill-health.

Is there anything a company can do to decrease the cost of mental ill-health in the workplace? Yes, most definitely, through mental health first aid training.

If a company trains staff in mental health first aid skills (in much the same way as it has physical first aiders) then mental ill health can be recognized sooner and appropriate help sought before a break down occurs. Once recognized sooner the company can support the person through recovery. If the person can keep working (and let’s face it there is a limit to how much daytime TV anyone can watch!), even if with some concessions in terms of hours worked, or workload carried, then they will recover faster. In addition, the business does not lose the knowledge, skills and experience of the affected person and that person’s self- confidence is maintained at a high level. Now if that is not a win-win, what is? Getting mental health first aid skills into a company is a no-brainer really.

Please use the Contact form if you would like to know more about the courses available to introduce staff to mental health issues through awareness and first aid training.

The next article in this series will take a look at balancing the risk around mental health. We will then move on to briefly examine some of the symptoms of various mental illnesses in future articles.

The Impact of Mental Ill-Health

The Impact of Mental Ill-Health

We all have mental health and there is no health without mental health. As part of Mental Health Awareness Week 2017, I am presenting a series of articles covering a variety of issues around mental health to increase our knowledge of the subject in general. The first article answered the question “What is Mental Health?” today we are looking at

The Impact of Mental Ill-Health

What impact does mental ill-health have on us as individuals? What is the impact on society and at work? What about the cost of mental ill-health on the national economy?

Let me tell you a story. John Smith is a sales manager for a manufacturing company. He is well liked by both his customers and colleagues for his cheery demeanor and the efficient way he and his team look after their territory. John is also a favorite of his employer Steve as he manages to beat his sales targets despite some ambitious increases in recent years. He is the first in most mornings and the last to leave most evenings. He is married to Jane with three children in primary school. Recently he has passed the odd flippant comment about his wife and in-laws being picky and demanding. A couple of weeks ago he was caught under the influence of alcohol whilst driving and nearly lost his license as a result. His department is working on new targets for the coming financial year and John has been adamant about not being able to squeeze any more out of it. Last week there was an out of character angry outburst between him and the production manager over a delay in the production schedule due to a breakdown in the plant. He is not the fittest person (it’s all that time working, at the desk and in the car, and the takeaway food he grabs on the run for lunch and even dinner when working late) and he doesn’t think about getting any exercise.

It’s Monday morning. John is late for work. When he arrives he is looking rumpled not his usual neat dapper self. He is preoccupied. His assistant Mary says “Good morning” in her usual way. John snaps back “Is it?” There is stale alcohol on his breath. He cancels the usual Monday morning team huddle (about who is doing what, when and where and who needs help and why). After several phone calls go unanswered Mary knocks on his door and goes in as per usual habit.  He swears at her, tells her to get out and to hold his calls. Mary realizes something is wrong; she waits an hour, makes John a cup of coffee and uses that as a pretense to go back into his office. To her shock she catches John swigging from a bottle. He bursts into tears.

John is having what we would call a nervous breakdown – a period of mental illness as a result of a period of severe stress, anxiety or depression. His wife is demanding he either helps her more with the children or gets out. His in-laws want them to go on holiday for a month with them and apart from the fact that he would loathe a month on holiday with them, they won’t accept that he can’t afford it either financially or in terms of the time off work. The alcohol has recently become a problem and is a means to cope at home and take the edge off the pressures on him – both in terms of work and the hours he puts in and at home and financial. He cannot remember the last time he felt “happy” or relaxed. It has been go, go, go for what seems like years. He sees no way out and no hope of change. He feels angry, frustrated, used and unappreciated – what else can he do?

Mary takes charge and gets John to his doctor for an emergency appointment. She then takes him to the chemist to get a prescription for anti-depressants filled and delivers him home to his wife. Outside Mary has a few quiet words with Jane about what has happened to John and the fact that is quite a sick man and really needs a lot of support at the moment. As Mary goes back to work Jane slumps down on the doorstep, bursts into tears and wonders what is she supposed to do now? That morning she opened the post to discover 3 final demands for payments on store cards and a letter advising her that they were behind on the mortgage.

Back in the office Mary goes to the boss and fills him in. Steve is dumbfounded. He had no idea. What are they supposed to do now, without John?

“When will he be back?” he demands of Mary.

“When he is well again.” She intones “Maybe in 2 months, maybe in 4 months. Maybe never. I don’t know and the doctor can’t say either. He has been referred for counseling, but that will take at least 6 weeks to start. And the antidepressants will take at least 3 weeks to start taking an effect.” As she goes back to her office Mary hears Steve swear loudly.

What options does Steve have? Does he get the other 2 sales managers to take over half of John’s work each in the interim? But they are all as pushed right now as John was. They don’t know his staff, his customers, or his projects. Can Steve himself take on the work? But Steve is equally pushed – they are in the process of buying another company and he simply doesn’t have time. Dare he let them get on with it themselves – is there someone in the team who could step up? He didn’t think so and if John comes back in a couple of weeks, then what? Should he employ a sales manager on a temporary contract? What will that cost? The cash flow is pushed enough without finding and training someone in the gap created. Steve picks up his phone and calls their HR consultant. What he learned surprised him.

The impact of mental ill-health is widespread. Mental health is more common than he had ever thought.

*        1 person in 4 will experience some form of mental health issue in any year. (MHFA England, 2016)

*        1 in 6 employees are likely to experience problems with stress, anxiety or depression at any one time – (e.g. sleep problems, fatigue, etc) which do not meet the criteria for diagnosis. (MHFA England, 2016)

*        A further 1 in 6 working age adults experience diagnosable mental health conditions (e.g. depression, anxiety, etc) at any given time. (the Royal College of Psychiatrists: Mental Health and Work, 2008)

Steve mused that perhaps they needed to think about how they are working and their corporate culture, because

*        Stress, anxiety and depression are responsible for 70 million sick days every year. (MHFA England, 2016)

Those are the recorded sick days. What about absenteeism (let’s call it duvet-ism)? And no one has any idea about the cost of presenteeism – the folk who go to work but are ill and shouldn’t be there.

*        In 2009-2010 the health and social care costs of mental health issues was put at £21.3 billion. The cost of lost economic output was £30.3 billion, and the human cost of mental health issues, representing their negative impact on the quality of life was £53.6 billion.

*        The total cost of mental ill health in England is estimated at £105.2 billion. (NHS England, 2016)

That equates to some £1206 per employee per year. How can the economy afford that on an ongoing basis? The impact of mental ill-health is huge. What can we do about it? In the next article in this series, I will cover the issue of when a problem is a problem and what we can do about it from a business point of view.