How to support managers to reduce the stigma of workplace mental ill-health

Nuffield Health’s latest whitepaper ‘MORE THAN WORDS’ shines a light on the importance of language to normalise everyday mental health ill-health

Poor mental health costs UK employers between £33 billion and £42 billion a year. This is made up of the cost of absenteeism, turnover costs and presenteeism. There is likely to be a significant increase in those experiencing mental ill-health due to the pandemic.

Nuffield Health research shows 80% of people have experienced a decline in mental health while working from home during this time, and it’s predicted we will see a ‘mental health echo’ of the pandemic. The Centre for Mental Health estimates up to 10 million people in England may need support for their mental health due to the pandemic. That’s 20% of the adult population.

Currently, and alarmingly, it is reported 300,000 people with long-term mental ill-health lose their jobs every year. One factor leading to this is the reluctance to discuss mental ill-health in the workplace, resulting in employers being unaware of these individuals’ needs and how best to support and retain them.

No more than ever, we must encourage a dialogue about mental health in the workplace. Open discussion enables mental ill-health prevention and ensures employees view mental fitness as important as physical fitness. However, studies reveal employees feel unable to talk to their employer when they’re beginning to experience distress or mental ill-health, with only 16% feeling able to disclose an issue to a manager.

Language plays an important role in assisting staff to talk about and manage their emotional wellbeing. It is also an essential tool for managers to create an open workplace culture, where conversations about mental health are welcomed and expected.

What challenges do workplaces face?

Nine out of ten people experiencing mental ill-health say they have been subject to discrimination. We see these worries reflected in today’s workplaces, as many employees are still unwilling to share their mental health experiences for fear they will be treated differently. Conversations are often avoided, or when they do happen, tend to focus on a very medicalised idea of mental health, which can make open discussions more difficult.

This medical dialogue strongly focuses on illness, diagnosis, and conditions. However, with the emphasis on ‘what is wrong with you’, people don’t see mental health as something that exists on a continuum, that can be improved upon.

Phrases like ‘disorder’ or, for example, referring to a colleague as a ‘depressive’ exacerbate the stigma. Individuals avoid asking for support – especially at work – with some fearing that connotations of weakness mean they’ll be overlooked for promotions or won’t advance in their careers.

To accelerate earlier intervention, we must change how we view and talk about mental health in the workplace. Employers have a responsibility to lead this positive change by helping to de-medicalise and detoxify language.

Re-thinking words

Medical terms regarding mental ill-health are not typically used in everyday language. And as such, we often don’t have a shared understanding of terminology. The meaning of ‘anxiety disorder’ to a manager maybe very different from the personal experience of anxiety for an employee. As such, meaningful conversations can be difficult when we rely on a medical way of discussing mental health.

Also, using medical terminology regarding mental ill-health runs the risk of defining a person in terms of a diagnosis (“Ahmed is depressive…Gillian is OCD), leading to unhelpful and alienating language in the workplace.

Managers and HR can guide teams in avoiding purely diagnostic terms like ‘anxiety disorder’ and ‘depression’ and encourage more general discussions around human distress.

Everyone has mental health which can change at any time, just like physical health which can change rapidly depending on what is going on in our lives. Supportive employers should help employees identify where they are currently and how to access the support to help them move towards their maximum desired mental fitness.

This needs to be reflected in the language we use in the workplace; how we speak to one another face-to-face, and how we communicate via email and other channels, as many of us continue to work remotely.

Take, for example, the well-referenced statistic that ‘1 in 4 people will experience a problem with their mental health each year’. This statistic, whilst illustrating how common mental distress can be, can be ‘othering’. Individuals see mental ill-health as something that happens to others; they see themselves as part of the ‘3 in 4’. There is no responsibility to have a conversation about mental health, so employees don’t speak up.

Employers should encourage teams to reframe language to make it fully inclusive, the ‘4 in 4’. Creating internal messaging, which adopts a concept of mental health across a continuum, that supports every step of someone’s potential journey; from enhancement (“I am mentally fit but want to be fitter”); to prevention (“I am experiencing stress and want to prevent it getting worse”); and treatment (“I am experiencing mental ill-health”).

This also means those not currently experiencing difficulties aren’t left out of the conversation, as the focus shifts to mental health being more than simply the absence of mental ill-health.

Reframing conversations

In the same way, colleagues may chat about their weekends over the water cooler. Managers should introduce informal chats where mental health is observed openly.

Asking casual questions like ‘how are you feeling?’ and ‘is there anything we can do to support you?’ could make it easier for an individual to share how they are really feeling, when away from the stigmatised setting of formal meetings.

Detoxify language by focusing on ‘wellness’, rather than ‘illnesses. Questions like ‘what’s wrong with you?’ should shift to a more holistic discussion, and view of mental health, that considers what is happening in an individual’s life. This emphasises events and experiences, so the individual feels no sense of blame.

These conversations require language free from judgement and ‘loaded terms’ which usually accompany them. For example, words like ‘psycho’, ‘nutter’, ‘crazy’ are emotive and damaging – even if used by an employee in playful banter with a close colleague. They may not realise that speaking in this way implies something to be embarrassed about for those experiencing mental ill-health.

Not in recent years has the nation collectively experienced the challenges to mental wellbeing brought about by the current pandemic. If we act now and act together, we can use this shared experience of distress to bring about change. Together we can help encourage empowering conversations around mental health and help more people access the support they need, earlier.

By Brendan Street, Professional Head of Emotional Wellbeing, Nuffield Health
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