Early in 2020 a DEN member who had, at my instigation, told her story of Clinical Depression in a Department of Communities and Justice (DCJ) staff newsletter over a year previously observed that nothing had changed. She was right.
In 2018 I had been approached as DEN Chair to ‘do something’ about mental health. But I held off, knowing it would be a challenging proposition. The DEN was re-establishing itself and it wasn’t the right time – until early 2020. This was before COVID became such a dominant force in our lives. In a way the timing could not have been better.
I set up an initiative I called Change the Conversation. The big issue with ‘mental illness’ was the stigma associated with it – and this was down to language. In particular, the use of the word ‘mental’. I had long had an aversion to the use of the language of psychiatry to describe normal human conditions that had become magnified and persistent. I had worked in psychiatric hospital in the early 1970s, so I had a sense of profound levels of psychological dysfunction compared to the less intense and extreme disorders experienced by the employees I encountered.
The majority of ‘mental illnesses’ experienced by Australians are depression and anxiety. These are, I believe, better described as emotional rather than mental disorders. We have debased emotions in our reverence for intellect and mind. But, in fact, they are more powerful and influential than our cultural discourse allows for. An emotional trauma cannot be simply eased by mental or intellectual effort. But it can be repressed.
Mental illness is a term that should be left to disordered mental functioning. The stigma associated with the implication of mental or cognitive malfunctioning must be eliminated from descriptions of psychological states which do not impair mental functioning at all. For this reason, I wanted to shift the conversation away from ‘mental’ and the language of psychiatry toward emotional health and psychological injury.
Why the Stigma?
Generally speaking, we are not only ignorant about mental illness, we are conditioned by stories – as news and as fiction – to fear people diagnosed as mentally ill. The language is harsh – mad, or insane. As a consequence, everything lumped under that label becomes tainted by the same prejudice. Disordered thought will lead to disordered behaviour.
As well as working in psychiatric hospitals I spent quite a few years involved with what were commonly called Licensed Boarding Houses in NSW. The residents of these facilities initially came from psychiatric hospitals emptied inconsequence of the 1983 Richmond Report. For the most part they were people with intellectual disabilities or mental illness whose conduct was stable enough that they could live with support in the community.
There were times in a psychiatric hospital when I had to deal with conduct that was confronting and threatening, but I did not work on the locked wards where the most dangerous inmates were housed. I worked with Licensed Boarding Houses to resolve issues that arose when a resident’s conduct deteriorated, and they could no longer safely access their community; or stay living in the facility.
There are times when a person diagnosed with a mental illness justly merits concern and caution. But not always. Knowing the difference is important. It is rare that a staff member in a public sector agency will exhibit behaviour of such concern.
That said, manifestations of poorly managed emotional distress may be more common – and exacerbated by mishandling by colleagues and, more particularly, mangers. If such incidents are seen to be a manifestation of ‘mental illness’ a combination of prejudice and ignorance will trigger the stigma.
Staff who have been diagnosed with depression and/or anxiety have told me that they are less likely to ‘admit’ their diagnosis because they are concerned that rather than being treated with compassion and empathy, they will be identified as being mentally ill. Most have stories about regretting trusting a manager who behaved in an insensitive and discriminatory manner in response.
The stigma is founded on ignorance and prejudice. Managers are crucially placed to ensure their teams are neither ignorant nor unkind, and that the work environment they oversee is safe for staff who have a psychological injury.
The Importance of Language
I believe there are compelling reasons for making a clear distinction between ‘mental’ and ‘emotional’ states of health. I am also aware that this is contested by some, and I am not going to debate that matter here.
I want to focus on the impact of language and propose a pathway out of the discrimination, prejudice and insensitivity that comes from our cultural use of ‘mental illness’.
I prefer the term psychological injury or disability. An injury can be temporary, or it can be triggered and return briefly. Disability is permanent, but not always ‘disabling’.
In physical terms we can understand that a disability may be the result of a feature of the physical environment. For example: a person in a wheelchair can’t get into a building because there are only stairs and no ramp. Making a ramp is about accessibility.
What is the psychological equivalent? What makes a psychological environment accessible or inaccessible? Here we shift to talking about inclusion or exclusion.
The answer lies in individual and collective behaviour – friendship, empathy, compassion, openness, caring, supportive – you get the picture. Let’s add knowledge and understanding as well.
In a person-focused environment (culture) in which the needs of staff members are addressed with flexibility and empathy a person experiencing an adverse emotional state is less likely to need to ‘disclose’ a formal diagnosis.
Several things must happen before this kind of environment can be routinely expected. There must be informed, and responsive, leadership and we must become comfortably adept in talking about our inner states without resorting to the language of psychiatry or psychology.
Informed and Responsive Leadership
Staff with a psychological injury or disability are most concerned about talking to their managers about the need for a workplace adjustment or a short-term accommodation.
Unfortunately, we do not select for, or teach, emotional intelligence or self-awareness. It is true that psychometric testing these days can filter out candidates with significant psychological problems, so fewer narcissists or sociopaths are likely to be employed. However current managers and executives are not scrutinized to any effective degree. As a result, the concerns of this essay remain as a daily issue for many.
The two interlinked attributes – emotional intelligence and self-awareness – cannot be taught through the normal learning and development methods. At best they can highlight the need for them, provide introductory material and point people in the right direction. After that it is very much a case of personal development driven by a motivated individual. It can be hard work, and confronting.
It is defined as: the ability to understand, use, and manage your own emotions in positive ways to relieve stress, communicate effectively, empathize with others, overcome challenges and defuse conflict. (Helpguide.org) There is an abundance of information online.
Virtually all management training these days places an emphasis upon having a working understanding of psychology and developing a fair degree of self-awareness.
Emotional Intelligence is acknowledged as an essential attribute for effective leadership. But developing it requires self-awareness.
Being self-aware is a mark of being psychologically mature. However, it is not something that can be taught as a purely intellectual exercise or covered in a series of courses.
The ideal of life-long learning has been dropped from many learning and development discourses for want of interest. Enhancing both emotional intelligence and self-awareness is a long journey that requires steady effort and commitment. The rewards make the journey worthwhile.
Recovering Sovereignty Over Our Own Inner States
As I was researching for Change the Conversation, I came across The Global Leadership Foundation, an Australian business dedicated to the goal of developing emotionally healthy leaders and emotionally healthy organisations. That, in a nutshell, was what I wanted.
Emotionally healthy leaders would not perpetuate the stigma, and an emotionally healthy organization would embrace the reality that we all will experience emotional trauma – whether brief or sustained – at some time in our lives. There should be no need to ‘disclose’ a clinical diagnosis. There should be no need to struggle to get what is critical to personal wellbeing.
What The Global Leadership Foundation instantly helped me to see was that there was a way of talking about our inner states that used no clinical language – we didn’t need to psychologize, just humanize.
I had the good fortune to work with Malcolm Lazenby from the Foundation to develop a series of pilot workshops I called Getting Above the Line (and in typical bureaucratic fashion it was shortened to GATL). There were 3 series of workshops (GATL 1,2 & 3). Each series ran around 90 minutes once a week for a month (or longer). The object was to stimulate awareness of our emotional states and learn how to stay ‘above the line’ (where there was awareness and control).
The workshop pilots were held over MS Teams with a small group of DEN volunteers. They proved useful in our work context and in our private lives. I did get a proposal from Malcolm to run a program based on the pilots at a very good price, but the COVID induced budget brake put that idea on hold. Get in touch with me if you want details of the workshops.
What became very clear, after the workshops, was just how well we could talk about our inner states using clear but simple language. We were able and willing to share feelings we normally kept protected.
The good news is that the Foundation’s content has been incorporated into DCJ’s learning and development programs for managers. It is a great first step.
The Reality About Our Psychological Wellbeing in the Workplace and Elsewhere
The risk of psychological injury – especially depression and anxiety – seems to be growing. There are indications that work-related psychological injury is increasing. Certainly, in NSW this appears to be the case in the public sector. This may be a result of the do more with less philosophy as workforces shrink and work demand does not.
COVID 19 has added a range of stressors – lockdowns and restrictions on human interactions; working from home and juggling work and parenting demands; the maelstrom of misinformation on social media. Depending on one’s outlook there may be a storehouse of woes awaiting delivery. These are not easy times.
Addressing the needs of staff with clinically diagnosed conditions is vital. They must be able to seek assistance or accommodation without being subjected to insensitive and unempathic responses from leaders. And addressing this will also solve a lot more problems.
The stigma associated with the mental illness label is the tip of an iceberg of devalued emotions. We have neither the language nor the habits of mind and heart to be as openly caring as is our healthy nature will allow; and does desire.
There are good signs, however. In my former department, over 2020 and well into 2021 the themes of emotional wellbeing and psychological health were talked about more often and more openly.
Making a personal effort to develop emotional intelligence and self-awareness might to be unattractive to many, but it is inescapably true that this is vital work we must do for ourselves, and for those for whom we have responsibility. It is the way of the future, and has been so for the past few decades.
The least we can do is leave the language of psychiatry and psychology to psychiatrists and psychologists and rediscover the language of natural empathy and concern.
The Global Leadership Foundation has a useful (and brief) publication that can be bought as an ebook (and as hardcopy). You can find it at: https://globalleadershipfoundation.com/product/book-the-emotionally-healthy-leader/
It would be a good thing if personal journey could start with this one small step.