I am thinking of the people I am most in touch with outside any sense of obligation. Ten is enough. I need a cut off number and that’s a good one for my purpose. There’s a mix. Siblings and other relatives, friends, and former colleagues with whom I have an ongoing interaction. These are people I like and care about.
Three are not people I’d assess as having any significant emotional health concerns – but 2 have experienced traumatic events that have caused a disruption in their professional performance at least once.
Of the remaining 7, 3 have had some kind of clinical intervention, including medication for a diagnosed psychological condition. The remaining 4 have struggled with mood and motivation for sustained periods.
My original list was 15, but I eliminated 5 former colleagues I have come to know because of my involvement in disability inclusion. Of them two have clinical diagnoses for a psychological condition, and the other 3 experienced trauma or stress that has led to struggles with mood and motivation. Three of these people have a disability that is not psychological in nature.
Of the first 10, half are very creative, and half are on the very high end of the intelligence spectrum – a few are in both groups. This group of 10 I know at a pretty reasonable level of authenticity.
I have been reading in psychology for many years, though I haven’t studied it formally. Since early December 2018 I have been keeping a list of audiobooks (my disability makes hard copy really difficult to handle). As well as 5 books on psychology or psychotherapy, I listed 27 books under professional development – 10 on some aspect of organizational psychology, and 17 personal or individual psychology.
Way back I spent quite a bit of time encountering severe cognitive and behavioural disorders when I worked in psychiatric hospitals and with licensed boarding houses.
I am laying all this out because I want to talk about a theme that is contentious – the difference between mental and emotional ill health – and, in particular, whether talking about mental illness is a useful idea. I don’t think it is.
What I Am Not Doing
I am not contesting whether there is such a thing as mental illness. Personally, I don’t like the term – but that is on philosophical grounds. I accept the term is in common usage. There are psychological conditions that render an individual dysfunctional and a danger to themselves and others – and for whom strong interventions such as medication or confinement for treatment or control are indicated. But people with such conditions are very rare in workplaces.
The most common diagnoses in our workplaces are affective (mood – like depression) disorders, anxiety and substance abuse disorders, and these I want to focus on. I am not excluding anything else for any reason other than I don’t want to be constantly making exceptions. Most of the people I know have been formally diagnosed, or acknowledge they have, one or more of these conditions. There tends to be 3 options for managing these conditions – medication, some form of psychotherapy, or self-management.
Nothing I say below should be construed to be any more than my non-clinical opinion offered to stimulate conversation.
The Needless Stigma of the Mental Illness Label
Back in 2018 I gave a presentation, as DEN Chair, to a meeting of Young Professionals. Afterwards I was quickly accosted by 3 guys who wanted to know what the DEN would be doing about mental illness. Were they asking on their own account, or on behalf of colleagues? I didn’t ask. I had to confess that I was rebuilding the membership, and this was a complex area I didn’t have the resources to tackle, at the moment.
Things got moving the following year when one of my now former colleagues with a diagnosed condition of clinical depression joined the DEN and went public with their personal story in the department’s electronic newsletter. At the beginning of 2020 she observed that nothing had changed. The stigma still hung over her and others.
The trouble with the term, mental illness, is that it used by people who have had no exposure any information on the subject. As a consequence, they rely on stereotypes drawn from popular culture.
The term suggests an illness of the mind – a mental disorder. This can be interpreted as irrational and impaired thought, and disordered conduct. These are not attributes that are desirable in a team member.
Mental illness is depicted as disturbing and dangerous in popular culture. And this is true of some instances. But here we run afoul of a bad habit we all have – seeing the worst of a general category as representative of the whole. Mind you, we can also do the same thing with the best.
Most people will not, on their own account, research something like mental illness to arrive at an informed and balanced point of view. They will be receptive to information; and may be prepared to shift their personal perspective. But a lot of folk will also think they know enough, and resist changing their opinions.
So, a person who lives with anxiety or depression, who exhibits neither disordered thought nor conduct, is taking a risk if they decided to ‘disclose’ their condition to a manager or colleague. Sometimes they see a need to ask for an accommodation at a time when their anxiety or depression is particularly active. But the risk of being treated badly may be assessed as too great.
A colleague told me of their bruising encounter with a manager. External circumstances had triggered a need to ask for an extension of time to a deadline. Their condition had ramped up and they were struggling to focus. They needed time out.
The manager’s response was blunt – if you can’t handle the heat, get out of the kitchen. My colleague had been delivering high quality work consistently for several years in this team, and never asked for any accommodation. They were shocked; and hurt. Worse, now their ‘secret’ was out, their manager’s attitude toward them changed. Their judgement was no longer trusted, and their work was suddenly subjected to hyper-critical assessment.
What happened here was an instance of bullying by a manager who saw a staff member who was vulnerable – and struck. This is not a usual thing. It does appear that 80% of managers would not behave this way. But the few who do can do great harm.
Living with a disability can be hard enough as it is. Anxiety and depression are diagnosable conditions precisely because they can be periodically debilitating, and some kind of intervention to bring relief is sought. But they do not usually lead to disordered thought or conduct. They don’t impair performance – as is demonstrated by the number of people who don’t disclose, and who achieve at high levels – and in senior management roles.
Don’t get me wrong. Sometimes the price of that high achievement is paid through ongoing personal struggle and pain. We all experience periods of anxiety and depression – and then they pass. Relationship breakdowns, hoping for and then not getting that job, the death of someone close – these can bring us low, and then we rebound. But for others the ‘rebound switch’ does not work as well.
So why stigmatise a person whose switch does not work well? This is not only an emotionally cruel thing to do; it adds an additional burden to one already present.
The Needless Burden of Disability
Like all things, disability is on a scale. Being blind or deaf, for example, maybe normal for the individual, but there is a cognitive cost that must be paid just to participate in life with any sense of equity. Discrimination, by accident or intentionally imposed, adds a burden that does not have to be there.
My ankles do not work. Every move I make while upright has to be conscious – if I don’t want to fall over. I can no longer walk with the careless ease that is the hallmark attribute of being human. Now every step must be intentional. My goal has been to get through a year without falling. I haven’t achieved it yet.
When I sit, I am safe, but then my hand disabilities come into play. My grip is impaired by digits that do not work as designed. I could just sit and do nothing of course – but my ears and eyes are just fine.
For me an inaccessible physical world adds a burden of stress and effort – from floors that are slippery to containers I cannot open without tools and effort. Its not fun. Sometimes its frustrating. Despair isn’t an option. This is my reality. I benefit from the social model of disability which is progressively removing barriers with better design and more sensitive conduct from others.
But even with barriers removed things are not easy. Last weekend I took 4 hours (working virtually non-stop for the last 3) to deliver a curry with spicey rice and 3 side dishes – even with help finishing off the side dishes. That was in my own kitchen, which is fairly well set up. In earlier days that would have been a relaxed 90 mins at the most.
It’s worth being reminded what the social model is:
The social model sees ‘disability’ is the result of the interaction between people living with impairments and an environment filled with physical, attitudinal, communication and social barriers. It therefore carries the implication that the physical, attitudinal, communication and social environment must change to enable people living with impairments to participate in society on an equal basis with others. (pwd.org.au)
People with psychological disabilities are not so lucky at times. Their burdens from disability are usually not visible. But they are no less heavy. They can be exhausting emotionally in the same way a physical disability can be physically draining.
There are 4 barriers in the social model: physical, attitudinal, communication and social.Having to encounter and adapt to attitudinal barriers born of ignorance, fear and prejudice is an added burden of emotional stress that is not often recognised, because the disability is not visible – often protectively so. It is only among ‘safe’ people can the guard be let down and the real level of emotional pain revealed.
Who wants to be thought unpredictable, unreliable or incompetent because of something that has nothing to do with work performance? There are times when we are all sub-par because of a physical injury, an illness or an allergy – and we need an accommodation. Our reputations are not injured by it. But if the cause is psychical, rather than physical it can be a very different story.
How Do We Remove Attitudinal Barriers?
While it’s good that we have a social model of disability, its not much use unless we work at dismantling all the barriers. We are doing pretty across all 4 in some areas – but we are nowhere near close to complete removal. However, one area where we are doing very badly is attitudes toward what we call mental illness.
We can see how badly we do this when we stumble over awkward euphemisms like “mental health issues”. Sometimes this is truncated to just “mental health” – as in “He’s got mental health.” This is real. I have heard it half a dozen times.
My inclination is to get well away from ‘mental health’. I favour emotional health or psychological injury. I know there are philosophical arguments that can masquerade as scientific ones here. I am happy to have that argument, but not here.
There are two solutions I see as viable:
- Deliver training on what mental illness is really about to break through the stereotypes, the fear, the prejudice.
- Develop a program on building emotional awareness and health outside the clinical framework of psychology and psychiatry. If we are more capable of talking about our inner states, without using clinical or scientific language, we may become less fearful of, and less disposed to misunderstand, people who say they need us to back off on demands for a little.
The difference between a ‘normal’ person and person with a diagnosis of depression or anxiety may only be that their ‘normal’ is other people’s bad day. Rather than freaking out about the fact they have a diagnosed psychological condition, we should be impressed that somebody whose life is like our bad days non-stop seems no different to us most of the time. They need time out? Hell yeah!
I use the term ‘burden’ here intentionally. The emotional pressure of being as ‘normal’ as possible can be challenging, and now and then a person gets close to breaking point. This applies to working parents with young children, those who care for ageing parents or a child with disability – as well as others. A friend is looking after his ageing parents and doing a PhD as well as working fulltime. There are times he exhausted – physically and emotionally. Oh, and he’s been renovating his house as well.
It just happens that with some people, their background burden is a busted switch. If we owned who we are as humans – with inner lives that can turn to **** for a short time, a longer time or a long time, we might be kinder, and more gentle, when responding to an expressed need for accommodation.
By and large staff tend to be pretty good with their workmates. Its managers who cause much more grief. An unempathic manager might be just one person, but they impact a whole team, or a whole business area.
The Global Leadership Foundation has a vision of helping to build emotionally healthy organisations with emotionally healthy leaders. I love that idea. They are not the only people with that objective, just the one that helped me see it as a simple articulation of a vitally important goal.
It has been abundantly evident that, over the past few years, the emotional wellbeing of staff has become a major concern for employers. Various strategies have been put in place to encourage self-care; and identify early signs of potential crisis. These are welcome, because a diverse array of responses is needed for a diverse workforce.
However, I have seen no mental health ‘myth-busting’ sessions for managers and leaders. The stigma of ‘mental illness’ remains. There’s a reason that leaders are called leaders. Encouraging staff to participate in the available programs and strategies is not leadership. Leaders must model empathy, and if that does not come naturally, they must put the effort in to address that lack. Contemporary leadership requires competence in empathy, as well as operating beyond fear and ignorance.
On the wider frame we must come to understand that the difference between the ups and downs that colour all our lives and those whose lives are mostly ups or downs is a faulty switch that may be caused by trauma or a cerebral malfunction. If we are to be truly inclusive, we must accept that such is just part of the spectrum of being human. It’s not a flaw of character or mentality. It’s just a heavier burden than others carry.
We do not make being a parent or a carer the subject of stigma. Though once we did. There was a time, not so long ago, when a woman was not considered suitable for promotion because of the risk of motherhood. Neither was a woman considered as intelligent, or as rational, as a man. Being a woman was a disability. It carried a stigma.
We have sorted out that ignorance and fear, well, almost. Now we must do the same for people with psychological injuries – and with the same determination, passion, and compassion. That means effective leadership and action at all levels.
Stigma: a mark of disgrace associated with a particular circumstance, quality, or person. (Oxford Dictionary)
There are some things that are rightly a subject of disgrace. A psychological injury is not one. Neither is a mental illness. We are better than that.