Mental Health Awareness “ A Good Practice Guide for Managers ”

1. Mental Health Awareness“A Good Practice Guide for Managers” This project has been funded by Lancashire and Cumbria HIEC (Health Innovation and Education Cluster)

2. Mental Health • Case Studies • Take a look at the case studies (recognising mental illness and communication) and make a few notes on the page. • Do not share your thoughts or notes with anyone just yet! • However, we shall be sharing them later

3. What is “Mental Health”? • Just as we all have a state of “physical health”, we all have a state of “mental health”. • And just as we all have the potential to be physically ill, we all have the potential to be mentally ill at any point in our lifespan

4. Common Mental Conditions • Generally Anxiety based or Depression • Categorised as mild, moderate or severe • Consider mental ill health as a spectrum on which we ALL fall on • We all have good days but we all have bad days, it only takes some adverse circumstances and a run of bad days to move us along the spectrum of mental ill health

5. Anxiety Disorders • Generalised Anxiety Disorder is the most common affecting somewhere in the region of 1 in 50 people at some stage in their life. • Categorised as mild, moderate or severe • Another relatively common Anxiety Disorder is Specific Phobia affecting some 2.5 million people in the UK • Less common disorders include Post Traumatic Stress Disorder, Obsessive Compulsive Disorder and Social Anxiety • For more information on Anxiety Disorders please go to www.anxietyuk.org.uk

6. Depression • Depression affects between 1 in 5 and 1 in 10 people in the UK dependent on severity • Categorised as mild, moderate or severe • Depression is characterised by a cluster of symptoms including loss of interest in activities, too little or too much sleep, loss or increase of appetite, a slowing down of movement, hopelessness and thoughts of suicide • The severity of the depression is therefore measured by the number of symptoms present and how long they have been present • For more information on Depression go to www.mind.org.uk

7. Terminology - Stigma • Nutter • Lunatic • Psycho • Schizo • Bonkers • Loony • Wacko • Madman • Crazy • Barmy

8. Terminology • The act of Suicide has not been illegal since 1961 and therefore “Committed Suicide” is very much outdated, “death by suicide” or “died by suicide”, “completed suicide” or “took his/her own life” may be more appropriate term to use. • Try to avoid the terms “Depressives” or “Schizophrenics”. People are more than their mental illness

9. Some Facts Regarding Mental Health • Fewer than four in ten employers would consider employing someone with a history of mental health difficulties, compared to more than six in ten for candidates with physical disability • Only about 20% of people with severe mental health difficulties and around 50% of those with less serious difficulties are in paid employment, yet 80% want to work • 70% of people affected by mental illness say they have experienced discrimination at some time because of it • 25% of all G.P. consultations are due to mental health conditions shift.org.uk

10. Stress Vulnerability Stress and Vulnerability

11. Stress Vulnerability Model STRESS Mental illness Can be a source of stress in itself! “Breaking point” VULNERABILITY Large amount of stress before experiencing mental health difficulties Only a small amount of stress needed to experience mental health difficulties

12. Stress Vulnerability Model STRESS Reduce stress Mental illness Can be a source of stress in itself! “Breaking point” VULNERABILITY Reduce vulnerability Zubin & Spring, 1977

13. Common Mental Health Conditions • 1 in 4 people will experience a diagnosable mental health disorder (either anxiety or depression) in any one year, whilst 1 in 6 will have a “significant” mental health disorder • Mixed Anxiety & Depression is the most common, with just under 9% of the population meeting the criteria for diagnosis • 1 in 10 women will have post-natal depression (PND) The Office of National Statistics 2001

14. Less Common Mental Health Conditions • Panic Disorder affects around 0.7% of the population (or at least have a formal diagnosis) • Obsessive Compulsive Disorder affects 0.5% of the population • About 1% people will have a diagnosis of bi-polar disorder (manic depression) • Schizophrenia affects just under 0.10%

15. Relationship breakdown History of depression PTSD Current substance misuse (incl. alcohol) Chronic physical pain Loss (relationship; work, etc) Employment difficulties New diagnosis of a psychosis type illness Sudden death of friend or family member (particularly in completed suicides) Diabetes Financial worries Tinnitus Suicide – (Some) Risk Factors sprc.org

16. How Does Having a Mental Illness Affect an Employee’s Productivity? • Affects sleep (can be too much or too little) • Fatigue • Lack of confidence • Social anxiety (difficulty being in crowded places, public speaking, eating in public) • Poor time management • Poor concentration (can be due to the symptoms and/or medication) • Behaviour can be affected (erratic behaviour in more severe and enduring illnesses) • Higher risk of absenteeism and diminished presenteeism

17. Benefits for the Employee of Staying in Employment • Can increase self-confidence and self-esteem • Gives structure and stability • Sense of achievement and satisfaction • Empowerment • Promotes socialisation, independence, and self-resilience

18. What Can ALL Staff Do to Help Employees? • Where you have minor concerns about the emotional or psychological wellbeing of a colleague, consider: • Supporting the staff member yourself • Suggest they speak to their line manager for a referral to Occupational Health • Suggest they speak to a member of staff in their Directorate HR team • Encourage them to speak to friends or family • Suggest the EAP Service

19. What Can Managers Do to Help Employees? • Where you have serious concerns about the emotional or psychological wellbeing of a member of your staff, consider: • Encouraging them to access your EAP service • Encourage them to seek support from their GP • If the employee is known to NHS Mental Health Services, encourage them to make contact with their Care Coordinator • AS their Manager, you might want to consider an Occupational Health referral

20. What can managers do to help employees in a crisis? • Where you have very serious concerns about the emotional or psychological wellbeing of a member of your staff, you should be aware that: • You can expect a crisis situation to take up the majority of your day! • It’s not a case of ringing up and the situation automatically being taken off your hands in seconds/minutes

21. What can Managers do to help Employees in a crisis? • The definition of a mental health crisis is: • The employee may be expressing suicidal thoughts or actions • Posing a serious risk to themselves or (very rarely) others • Expressing irrational and bizarre thoughts and behaviours that indicate that they have lost touch with reality

22. What can Managers do to help Employees in a crisis? • In an emergency situation such as those on the previous slide, you should: • Ring 999 if the threat to life is immediate • Or consider contacting NHS Direct 0845 4647 • Or contacting Occupational Health who may be able to assist

23. Do keep calm! Do try to support employees with the dignity they deserve Do make yourself aware of support services for employees and managers, within the CCC Do only pass on information on a “need to know” basis Don’t give out your personal contact details to employees Don’t forget your professional boundaries! Don’t offer medical advice Do not offer confidentiality (remember you have a Duty of Care)!!! Some Do’s and Don'ts

24. Last Word, Confidentiality • We can all offer a limited amount of confidentiality • Remember Fitness to Practice/Teach • Safeguarding issues • In the prevention and detection of “serious crime” • Anti-terrorism laws • Serious risk of harm to self or others (including neglect)

25. References and Further Reading • Dame Carol Black, 2008, “Working for a Healthier Tomorrow”, Dept for Work and Pensions • Cooper, C & Dewe, P, 2008, “Wellbeing – absenteeism, presenteeism, costs and challenges”, Occupational Medicine, 58: 522-524 • Government Office for Science, 2008, “The Foresight Report: Mental Capital and Wellbeing” • Huppert, F, 2009, “Psychological Wellbeing: Evidence Regarding its Causes and Consequences”, Applied Psychology: Health and Wellbeing, 1: (2) 137-164

26. References and Further Reading • Sainsbury Centre for Mental Health, 2007, “Mental Health at Work: Developing the Business Case”, Policy Paper 8, London • Sanderson, K & Andrews, G, 2006, “Common Mental Disorders in the Workforce: recent findings from descriptive and social epidemiology”, Canadian Journal of Psychiatry, 51: (2) 63-75 • Semour, L, 2010, “Common Mental Health Problems at Work”, Sainsbury Centre for Mental Health • Zubin, J & Spring, B, 1977, “Vulnerability – A New View of Schizophrenia”, Journal of Abnormal Psychology, 86 (2): 103-126