Mental Health at Work: It’s not rocket science

1. Mental Health at Work: It’s not rocket science Rachel Perkins, BA, MPhil (Clinical Psychology), PhD, OBE

2. Introducing myself • Mental health expertise: • 30 years working in NHS mental health services from clinical psychologist to director. • Expertise of lived experience: • 25 years working with a long term mental health condition. • 25 years setting up programmes to help people with mental health problems to retain/gain employment. • 15 years employing people with mental health problems. • Trying to influence national policy: • Led an independent review to Government ‘Realising Ambitions. Better Employment Support for People with a Mental Health Condition’ (with Paul Farmer, CEO, Mind, and Paul Litchfield, Group Medical Director, BT). • Chair of Equality 2025 - cross Government strategic advisory group on disability issues.

3. You don’t have to be an expert – it’s not rocket science! (Much as mental health professionals like me would like to believe it is... it’s not true!) • Mental health conditions come in all shapes and sizes ... and have all sorts of peculiar names invented by all sorts of (equally peculiar) mental health professionals ... but you don’t have to worry about them. • You can’t tell a book by its cover and everyone is different – knowing a person’s diagnosis tells you very little about what challenges they may face at work or what might help them to work successfully. • Some mental health problems are caused by bad things that happen to us ... some are caused by difficulties at home ... or at work ... some just happen out of the blue!

4. Notice when things are not right You don’t have to go around trying to spot peculiar symptoms ... just notice changes in usual behaviour ... the person behaving ‘out of character’. For example: • withdrawing from others when usually sociable. • quiet when usually talkative. • arriving late when usually on time … or staying late when they usually leave on time. • having difficulty doing things they normally take in their stride. • irritable, tearful... But if someone has a mental health problem don’t assume that every little thing indicates they are ’going off’!

5. Don’t ignore it (hope it will just go away): talk about it • Be positive and supportive – exploring the issues and what might help. • Keep it ordinary – it is very difficult to talk about mental health / emotional problems. • Open questions that allow the person to talk about what is wrong or their concerns: • “How are you doing?” “What can I do to help?” • If you have particular causes for concern, don’t ignore things until they become a major performance issue. Talk about them at an early stage in an exploratory, non-judgemental way: • “I’ve noticed that you have been arriving late recently – I wondered if there are any problems?”

6. Discuss what might help • Make it clear that you value the person and that you want to help. • Discuss how work might affect their condition. • Are there particular things that the person is worried about? • Are there particular parts of the job that the person finds difficult? • What will colleagues think? • Will this mean I am always passed over for promotion? • Discuss what adjustments/support they think might help – short term and longer term. • Work with the person to find practical ways of helping ... often little things can make a big difference.

7. Make practical plans to help ... and write them down so everyone knows what has been agreed. For example: • More regular feedback (even just saying ‘thank you’) • Time off to see a doctor/therapist • Help with prioritising work • A bit of flexibility in start and finish times • Working from home for a day a week • The opportunity to call a friend or supporter • A quieter place to work But there are no formulas... Assume the person is the expert and ask them.

8. Don’t make assumptions • Don’t assume the person has mental health problems ... maybe they are having personal difficulties, or just having a bad day. Make adjustments if someone is not coping – regardless of whether they are identified as having mental health problems • Don’t assume work is the problem (or even a problem)... • Don’t assume the person can’t cope with stress (running the second world war was probably pretty stressful)... • Don’t assume that everyone finds the same things stressful... • Don’t assume that taking time off or doing less is the answer... • Don’t assume that the person will always need these adjustments / support...

9. Many mental health problems fluctuate • Most of the time we are fine. Some adjustments may help to keep us fine, but some we need only occasionally when things are bad. • Sometimes it can be helpful for someone else to help think about what support / adjustments would help (e.g. friend, family member, professional...) • Agreeing plans in advance can help (it can be difficult to negotiate when you are in a bad way). • Providing fluctuating adjustments/support can stop a person having to take time off sick.

10. And if the person does have to take some time off… • Keep in touch (a card, a friendly call... If the person doesn’t feel up to talking, what about an email, a relative, a friend?) • Remember: it is very difficult going back to work after having mental health problems. • Making plans for returning: • A meeting before you go back (with manager, with colleagues). • Particular things the person is worried about and how to address these. • A return to work plan... including what you will do in the first week. • What to say to colleagues. • Maybe a graded return...

11. But again, don’t make assumptions: that the person will need a graded return about what that graded return might look like • Starting back part time and building up hours. • Working from home. • Specific time to catch up on what you have missed before launching into new tasks and projects. • Starting back with more limited duties/responsibilities for a while and gradually increasing them. • A period of different duties/responsibilities. • Having extra support to do parts of the job you find particularly challenging. • More frequent supervision and support for a while. • Working particular shifts to start off with. • Working alongside someone (a buddy/mentor) to start off with. • Not working additional hours. Specific plans, time scales and review processes help to reduce anxiety.

12. So to conclude… • Talk about it – openly, honestly, without embarrassment! • Mental health problems are common – some people have diabetes, some people have depression – so what? The challenge is to create an environment where people feel they can talk about challenges they are facing. • Take practical steps to help the person prosper at work. • This is not about ‘letting people off’, or ‘letting people get away with things’: it is about ensuring that everyone in the workforce contributes and prospers. • Don’t assume: • That you have to be an expert – talk to the person about what might help and work it out together. • That people with mental health problems are unable to cope with stress, unreliable, etc. • Do assume: • That mental health problems are ordinary. • That people with mental health problems can be valued and productive employees. It really isn’t rocket science!