Mental Health Awareness Session: Supporting Wellbeing in the Workplace

1. Mental Health in the Workplace Presenter: David Clarke Durham Mental Health Services

2. Agenda • Mental Illness – impact, stigma, signs • Promoting mental wellbeing in the workplace • Defusing strong emotion – crisis response (active listening, validation) • DMHS Crisis Services – a doorway to the wider service sector

3. Mental illness: Impact, stigma, signs

4. Ingredients for Good Mental Health • The basics: food, shelter, money, security, healthy routines • Positive view of self • Connection to others • Hope for future • Sense of purpose, direction, control, accomplishment

5. Pat Capponi The King! Two quotes on good mental health What people need is “a job, a home, and a friend” “The key to happiness is someone to love, something to do, and something to look forward to.”

6. What do you feel when you hear the words “mental illness” or “mental health problems”? Fearful Uncomfortable On guard or hostile Uncertain

7. The Mental Health-Mental Illness Continuum Mental health problems Illness Health Well-being Emotional problems or concerns Mental illness Occasional stress to mild distress No impairment Mild to moderate distress Mild or temporary impairment Marked distress Moderate to disabling or chronic impairment Adapted from “Understanding U: What is Mental Health?” (http://www.hr.umich.edu/mhealthy/programs/mental_emotional/understandingu/learn/mental_health.html)

8. OHRC Definition of Mental Illness … [clinically significant] patterns of behaviour or emotions associated with some level of distress, suffering (i.e., pain, death), or impairment in one or more areas of functioning (school, work, social and family interactions). At the root of this impairment are symptoms of biological, psychological or behavioural dysfunction, or a combination of these.

9. Focusing on tasks/paying attention Attention-Deficit Disorder Responding emotionally to situations in helpful ways Giving us a tolerably accurate picture of ourselves Depression/Anxiety Eating Disorder

10. Mental Illness in Canada – CMHA • 20% of Canadians will personally experience a mental illness in their lifetime • Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem. • Healthcare costs in 1998 were estimated to be at least $7.9 billion (care, disability, early death) http://www.cmha.ca/media/fast-facts-about-mental-illness/

11. Canadian Attitudes towards Mental Illness • Almost half of Canadians (46%) think people use the term mental illness as an excuse for bad behaviour. • One in four Canadians are fearful of being around those who suffer from serious mental illness.

12. Physical health issues Mental health issues

13. The Business Case for Prevention and Intervention • Disability costs • Time off due to illness • Worker loyalty • Job satisfaction • Productivity and cohesion

14. Mental Health Benefits of Working • The basics: food, shelter, money, security, healthy routines • Positive view of self • Connection to others • Hope for future • Sense of purpose, direction, control, accomplishment

15. Possible Signs of a Mental Health Concern 1 • Uncharacteristic behavior (a catch-all) • Consistent late arrivals/early departures or frequent absences • Lack of cooperation, inability to work with colleagues • Decreased productivity • Increased accidents or safety problems • Displays of anger or blaming others How to tell if an employee has a mental illness, in J. B. Payne & N. Werhun, Accommodating Mental Illness in the Workplace: A Practical Guide (Nelligan/O’Brien/Payne, 2012), p. 3 (item 2.2.1)

16. Possible Signs of a Mental Health Concern 2 • Difficulty concentrating, making decisions or remembering things • Making excuses for missed deadlines or poor work • Decreased interest or involvement in one’s work • Working excessive overtime over a prolonged period of time • Expressions of strange or grandiose ideas How to tell if an employee has a mental illness, in J. B. Payne & N. Werhun, Accommodating Mental Illness in the Workplace: A Practical Guide (Nelligan/O’Brien/Payne, 2012), p. 3 (item 2.2.1)

17. PROMOTING HEALTH, preventing illness

18. Resilience Defined “the capacity to bounce back, to withstand hardship, and to repair yourself”

19. The Resiliency Attitude “What is right with us is more powerful than anything that is wrong with us.”

20. Individual Protective Factors • Positive View of Personal Future • Relationships • Flexibility • Humour • Independence • Inner Direction • Self-Worth • Perceptiveness • Love of Learning • Competence • Self-Motivation • Spirituality • Creativity • Perseverance

21. Environmental Protective Factors • High Warmth, Low Criticism Style of Interaction • Access to Resources • Clear Boundaries • Prosocial Values • Values and Encourages Education • Opportunities for Meaningful Participation • Service to Others • Supportive Relationships with Caring Others • Shared Responsibilities • Appreciates Unique Talents of Each Individual • High and Realistic Expectations

22. Nan Henderson’s Resiliency Wheel Provide Opportunities for Meaningful Participation Increase Prosocial Bonding Set and Communicate High Expectations Set Clear, Consistent Boundaries Building Resilience Mitigating Risk Provide Caring & Support Teach “Life Skills” Henderson, Resiliency in Schools, p. 12

23. Other Factors • Good job design: • Skill variety • Task significance • Autonomy • Feedback • Availability of professional, confidential support (EAP, HR support)

24. DEFUSING STRONG EMOTION – CRISIS RESPONSE

25. Anatomy of a Crisis – The Four P’s PRESS PUSH (to act) PAIN PERTUR-BATION

26. Pre-frontal cortex (wise mind) Amygdala (lizard brain)

27. We are part of the person’s environment

28. Nan Henderson’s Resiliency Wheel Provide Opportunities for Meaningful Participation Increase Prosocial Bonding Set and Communicate High Expectations Set Clear, Consistent Boundaries Building Resilience Mitigating Risk Provide Caring & Support Teach “Life Skills” Henderson, Resiliency in Schools, p. 12

29. VALIDATION is the key to healthy connections and safe outcomes.

31. Practicing Validation (Communicating that You Understand and Value the Wisdom in the Other Person’s Point-of-View) Daughter (crying): “You just don’t get it! Lizzie is my best friend, and she understands me better than anybody else.” Father (raised voice): “She’s no best friend as far as I’m concerned. I don’t think she’s a friend at all! What kind of friend supports you cutting yourself?” Daughter: “She doesn’t support my cutting. She just talks with me about my problems.”

32. Empathy vs. Detachment (Coaching Mentality)

33. Keep all 3 elements in balance S-E-T: A Communication Strategy Specifically for BPD Support (“I” statement) “I want to try to help.” “I am very concerned about how you are feeling.” “This is the situation ... These are the consequences ... This is what I can and can’t do ... What can you do to resolve it? “This must be very painful for you.” “You’re in a tough situation.” Empathy (“You” statement) Truth (calm, assuming competence) Jerold Kreisman, Sometimes I Act Crazy

34. Five Steps to Better Outcomes • Regulate your own emotion • Validate (do this at every step) • Ask/assess (don’t jump in the problem pool) • Brainstorm/troubleshoot • Get information on your role (if any) and plan follow-up

35. DMHS CRISIS SERVICES – A DOORWAY TO THE WIDER SERVICE SYSTEM

36. 905-666-0483 • Acute crisis support • Multidisciplinary team approach • System information, navigation and linkage • Mobile support and crisis bed services, in addition to telephone support DMHS C.A.L.L. Centre – Crisis Access Linkage Line

37. Encouraging the Person to Seek Help

38. Avoid communication pitfalls such as labelling – your message needs to be that you see her as a responsible, capable person – someone who, when she sees a problem, wants to fix it • Frame support as a way of learning new responses to old problems, of skill building – it’s not a judgment on her character or a punishment for some misdeed. • Avoid the topic when either of you are stressed. • Provide educational materials and contact information for available help.

39. Appeal to his values. Explore the activities and qualities that matter to him. Then ask how any current struggles might be interfering with his ability to pursue any of those activities or to live up to standards he values. • Focus on specific problem areas, such as communication skills, memory lapses, parenting, or anger or stress management – try to find common ground in identifying these as “problems” that extra support could helpfully address. • Frame “mental health” as being about living the life you want to live – about feeling your best, physically, mentally and emotionally. It doesn’t mean you’re “crazy” or damaged in some way. • If he values independence and being in control, explain that extra support can help him become even more self-reliant and have more control over his reactions.

40. Thank you for listening! Always remember ... What is right about you and your workplace is more powerful than anything that is wrong. Don’t hesitate to contact David Clarke at dclarke@dmhs.ca