What do leaders and HR professionals need to know about mental illness?

Employee experience

Michael Hempseed, HRNZ PD Programme Facilitator, looks at what people need to know about mental illness and how this knowledge can support our journey of business recovery and healing.

Many people think the psychological impact of disasters such as COVID-19 will be worse at the start then it will get better. Research suggests the opposite is true. The Canterbury Charity Hospital Trust found that if people needed counselling immediately after the 2011 earthquakes, on average, they needed two-to-three sessions. The Charity Hospital found five years later if people needed counselling, on average, they needed 22 or 23 sessions. They found it wasn’t so much the effect of the earthquakes that people needed counselling for, it was the long-term hassle and frustration of things like battling insurance companies and moving offices multiple times.

We need to understand the long-term effect of disasters

When a disaster strikes, many people have a significant amount of energy and resilience to fight it. As the months and years wear on, their energy and resilience can be slowly worn away. International research suggests the biggest psychological impact of disasters often hits threeto-five years later. The same applies to someone who has experienced the death of someone close to them.

Employers should be aware of this. If staff say they are struggling with the longer-term effect of a disaster or personal tragedy, employers should not think, “Aren’t you over this by now?”. Instead, they should offer support and ongoing understanding.

Addressing this effectively, requires a whole team approach

I was recently asked to speak at Gore District Council, to discuss preventing mental illness and overcoming failures. The council allowed anyone to attend the talk, no matter what their position in the council. I was impressed to see staff who work at cemeteries attending. While this may sound like an odd choice, it was a good one. The cemetery staff had come across someone who was visibly distressed at the loss of a child. We never know where we will meet someone who is showing signs of distress, mental illness or suicide. We need to teach people, at all levels and in all jobs, to know how to respond.

Powernet took me to every one of their sites, even really small places such as Palmerston (in the South Island) and Lumsden. This was excellent to see, because often rural communities have double the rate of suicide, per head of population, as larger communities. Mental health training must include everyone within an organisation, no matter where they are in the country.

Mental illness is more than just feeling sad

We often use the term mental illness to mean depression, but it covers a range of conditions from addiction to eating disorders, anxiety, schizophrenia and post-traumatic stress disorder (PTSD), to name a few.

We often think that, if someone experiences depression, they will feel sad. Most people with moderate to severe depression report feeling numbness or no emotions, they can have difficulty concentrating, sleeping, they can feel drained of all energy, feel worthless and even experience a lot of physical pain. We need to be very clear that there is so much more to depression than feeling sad.

The same is true for anxiety. When someone with generalised anxiety walks down the street, even if it’s a sunny day and the birds are singing, they don’t see it as a wonderful day. They can be filled with fear – fear that they’re going to get lost or someone is going to attack them. You might think when they’re safe at home in bed, then they can finally relax, but when they try to go to sleep, they can be filled with the same worry. They might think, “Did I leave the oven on? Is the house going to burn down? Is someone going to break in and attack me?”. As you can imagine, living filled with fear makes life incredibly difficult.

The costs are staggering

We now know that mental illness is a leading cause of disability, 1 staff turnover 2 and lost productivity. 3 The costs to employers vary from workplace to workplace, but the research cited above suggests the costs are staggering. The Royal Australian and New Zealand College of Psychiatrists estimated for New Zealand and Australia, in 2014, the cost of mental illness was $115 billion ($17 billion for New Zealand and $98 billion for Australia). 4 With the costs being so high, it is an excellent investment to address mental illness within the workplace.

We must focus on stories of healing and recovery

In 2019, I gave 200 talks around New Zealand on mental illness and suicide prevention. I spoke to medical doctors, army medics, social workers, lawyers, accountants, health and safety companies, university students and many others. One common misunderstanding among most people in these groups is that they believe recovery from mental illness is rare or people don’t recover, they just learn to live with it.

We have had at least 20 years of public education on mental illness. Despite the countless media articles and stories, I find many people don’t know that recovery is possible. Depression, for example, tends to be episodic rather than chronic. Most people who experience depression will have relatively short episodes (six to 18 months), then recover completely. Having said that, some people do have ongoing depression, so we must acknowledge that everyone has a different path to recovery.

If people do not know recovery is possible, they will not try to get help.

Over the past 30 years, we have started to get much better at treating mental illness. We now have a wide range of evidence-based treatments available, from counselling, eye movement desensitisation and reprocessing (EMDR), art, drama and music therapy, medication, ecotherapy and animalassisted therapy.

It is not simply enough to raise awareness of the problems. We must raise awareness of the fact that, with the right help and support, many people do get better.

Asking are you okay or telling people to speak up doesn’t work

We often tell people to ask their mates, “Are you okay?”.

The problem is, in the Western world, when someone asks us, “Are you okay?”, we tend to say we’re fine, even when we’re not. Instead, you need to say, “I have noticed…” or “I am concerned about you”, to get a better response.

Telling people to “speak up” usually doesn’t work either. The problem with moderate to serious mental illness is it significantly affects someone’s ability to think clearly. Often, people don’t realise they have a mental illness. Instead of expecting people with mental illness to speak up, we need to teach everyone in the community to recognise the signs and symptoms of mental distress, illness and suicide, and to know how to help someone.

It’s worth doing your research

In the past few years, New Zealand has seen an explosion of mental health providers. Some are excellent and offer fantastic work, while others are missing the mark. We have never found that one form of treatment or help works for everyone. For example, counselling may do wonders for some people, do nothing for others or even make the situation worse. I therefore recommend various forms of help and treatment such as counselling, volunteering, art, drama and music therapy, mindfulness, play therapy, expressive writing, sensory objects, ecotherapy, EMDR and chronotherapy.

Group therapy may not help everyone

While group therapy can be helpful for some people, it has left others worse off. Trauma is complicated; there is no quick fix. The causes, symptoms and treatment of trauma are unique to an individual. Even if two people have been sexually abused, the way it will have affected their individual lives will be vastly different.

A form of group therapy, known as critical incident debriefing, has been found to increase PTSD. 5,6 This also applies to attempted grief therapy for large audiences or whole workplaces.

Talks to large audiences should include possible signs and symptoms and a clear pathway to help, but any attempt at group therapy is never safe.

Conclusions

Mental distress, illness and suicide are having a significant impact on New Zealand businesses. Some employers believe if they ignore this, then it will go away. Sadly, this is not the case. Employers must have the courage to address this. Courage is not being foolhardy. It must be addressed in a carefully planned and thought-out way, with providers that really know what they are doing.

Don’t assume employees will not be interested. Provide a supportive environment where mental health challenges are acknowledged and supported, not mocked. Attitudes to mental illness and suicide are changing rapidly in New Zealand. We need businesses to have the courage and good judgement to address this in a way that will change lives for the better.

On this page I have a step-bystep guide about how to help someone who is suicidal: http:// www.beingatruehero.com/ samplechapter.html

Michael Hempseed is author of Being A True Hero: Understanding and Preventing Suicide in Your Community. The book is being used by the New Zealand Police, Fire and Emergency NZ, general practitioners and counsellors, as well as many parents and teachers.

Michael is a facilitator for HRNZ PD courses, virtual courses and webinars. Go to hrnz.org. nz/pd to see upcoming courses.

He has trained everyone from army medics to social workers to health and safety companies. Michael gained an honours degree in psychology from the University of Canterbury in 2008.

E: michael@ess.org.nz W: www.beingatruehero.com