Mental Health in the 21 st Century Workplace Hazards & Defences Dr Adrian Massey

1. Mental Health in the 21st Century Workplace Hazards & Defences Dr Adrian Massey Islington Headteachers’ Network Summer Conference 2014

2. Overview • Concepts • Disease, illness, sickness • Neurosis, psychosis, personality • The medicalization of life • Practicalities • Workplace risks to mental health • Healthy work

3. Health Warning • “Psychology – The study of people who do not need to be studied, by people who do.” • Variously attributed

4. Disease, Illness & Sickness • Disease Disorder of structure or function • Illness Experience of symptoms • Sickness Social recognition and support

6. Disease, Illness & Sickness • Disease Disorder of structure or function • Illness Experience of symptoms • Sickness Social recognition and support • The medical model is not a very satisfactory explanation for human behaviour, particularly for mental health problems!

9. Disease, Illness & Sickness • Disease, Illness & Sickness • “It is more important to know what sort of a patient has a disease than what sort of a disease a patient has.” • Sir William Osler

10. Neurosis, psychosis, personality • Neurosis Disorder of feeling • Psychosis Disorder of thought/perception • Personality Individual, distinctive characteristics

11. Neurosis, psychosis, personality • Neurosis Disorder of feeling • Psychosis Disorder of thought/perception • Personality Individual, distinctive characteristics • Are neurosis and psychosis predominantly accidents of nature and personality disorders predominantly accidents of nurture?

12. The medicalization of life • Expectation of material, social and sexual success • Aspects of normal life reframed as pathological • Grief, disappointment, frustration, inability to cope • ‘Stress’ is the epitome

16. The medicalization of life • Expectation of material, social and sexual success • Aspects of normal life reframed as pathological • Grief, disappointment, frustration, inability to cope • ‘Stress’ is the epitome • Within many organisational and legal processes perverse incentives exist for employees, managers and clinicians to medicalize non-medical problems

21. Costs – Individual • Clinicians can make things worse! • Distress protracted for the employee • Risk of more serious ill-health • Serious mental health problems are demeaned

24. Costs – Organisational • Wasted medical and managerial time and resource • Organisational inefficiency/injustice • Disempowerment of managers and employers • Compassion fatigue

25. Costs – Organisational

26. Costs – Organisational

27. Workplace risks to mental health in the 21st Century • Obvious – • Recessionary job insecurity • Rapid change facilitated by IT • Aging workforce • Greater scope for job mismatch and strain

28. Workplace risks to mental health in the 21st Century • Insidious – • Stifled communication esp. with ‘sick’ employees • Ambiguity re. role of employer, job options • Loss of autonomy • Unrealistic expectations of employment • Perceived injustice by stoic employees (fairness) • Compassion fatigue of managers togenuinely ill

29. Healthy work

30. Healthy work • Recognition that policies can incentivise acopia • Clarity re. management role/employment options • Managerial ownership of management problems • Timely resolution of employment issues • Human (cf. medical) care and compassion • Access to medical advice when needed

31. Then… Now!

32. “One of the first duties of the physician is to educate the masses not to take medicine.” Sir William Osler