Recognition of the Signs of Mental Illness and How to Intervene

In the previous post, I discussed being mindful of mental health in the workplace.  This involves not only awareness and being present to staff and colleagues, but also being able to recognise the early warning signs of mental illness and having the courage and competence to intervene.

The early warning signs of mental illness in the workplace

Recognition of the early warning signs of mental illness enables early intervention to prevent deterioration in a person’s mental health.  Without such an intervention, issues can build up for the individual, making it more difficult for them to manage their stress and/or stressors.

The Mentally Healthy Workplaces Toolkit introduced in the earlier post provides a list of possible early warning signs of mental illness and lists them under five categories:

  1. Physical – such as constant tiredness, continuous ill health, major changes in appearance and/or weight, complaints about ongoing health concerns
  2. Emotional – such as irritability, loss of a sense of humour or of confidence, increased cynicism, nervousness, overly sensitive to perceived or real criticism
  3. Cognitive – overall performance decline through lots of mistakes, lack of concentration and/or inability to make decisions (constant procrastinating)
  4. Behavioural – behaving out of character by becoming more introverted or extroverted, withdrawing from group activities, lateness to work, not taking scheduled breaks (such as lunches) but taking unofficial time off
  5. In the business – inability to meet deadlines, declining motivation, frequent absences, working long hours unproductively.

There may be multiple causes for one or more of these early signs to occur.  So, it becomes important to check in with the person involved as to how they are going and whether you can be of assistance.

Checking in – having the conversation

Often managers and colleagues are reluctant to say anything to the person showing early sings of mental illness and the person involved is often unwilling to raise the issue for fear of being seen as “not coping” or “being weak”.  Part of the problem is that they really need support and care and genuine concern for their welfare.  They can be experiencing a strong sense of isolation, lack of support and associated depression.  Extending a helping hand can often work wonders.   But how do you start the conversation?

People in the workplace are very ready to ask someone about a physical injury such as a broken wrist but when it comes to a mental illness they are often fearful or uncertain – yet the person with the early signs really needs someone to show care and concern.  So, we can have a situation where the two parties – the manager/colleague and the person experiencing mental illness – are compounding the problem by not engaging in the conversation- a form of mutual withdrawal.

The recognised format for the initial conversation where someone is displaying the early signs of mental illness is called AYOK – “Are you okay?” The Mentally Healthy Workplaces Toolkit offers four steps for starting the conversation:

  1. Ask R U OK?
  2. Listen without judgment
  3. Encourage action
  4. Check in

It is useful to preface this conversation with the observation, “I have noticed that…and I am concerned for your welfare.”  In other words, communicate what you have observed (shows you are interested in the person) and express care and concern.

The person involved may be unwilling to talk initially but it is important to undertake the occasional check-in.  An experienced practitioner at the 19th International Mental Health Conference mentioned that on one occasion he had the initial AYOK conversation and the person involved said they were okay…and yet, some months later they came up to the practitioner and said, “I’m not okay, my daughter committed suicide three months ago – can you help me?”  Having had the initial conversation opened the way for the subsequent voluntary disclosure.  To avoid the conversation compounds the sense of isolation of the individual involved – they feel that they can’t help themselves and that no one else is willing to help them.

It is important to prepare for the conversation beforehand – know what you are going to say, allow time for the interaction and choose an appropriate time and place.  You need to ensure that you are prepared to listen and be mindful during the conversation.

You can provide support by suggesting they use the Employee Assistance Program, visit their doctor (who can initiate a formal Mental Health Care Plan) or discuss options for making reasonable adjustments to their work situation.  The important thing is that you take compassionate action, not letting the situation deteriorate.

It is vitally important to maintain confidentiality about any information disclosed to protect the privacy of the person involved.  You will need the explicit consent of the individual to disclose the information to co-workers, for example.  The information conveyed to you can only be used for the purpose intended by the disclosure – e.g. to enable a reasonable adjustment to their workload or pattern of work.

The exception would be where the person discloses that they are experiencing suicidal thoughts or feelings.  In this case, you will need to seek professional support.  Beyond Blue has some very sound and detailed guidelines for the conversation in these situations, including what language to use.  ConNetica, in their blog post Chats for life APP, also provides an App (with practical conversation tips) which has been designed by young people for young people experiencing mental health problems, and possibly suicidal thoughts and feelings.

As we grow in mindfulness through meditation and reflection, we can become more aware of the early signs of mental illness, have the courage and confidence to have the AYOK conversation and a willingness to take compassionate action.

 

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of geralt on Pixabay

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Mental Illness in the Workplace

There are two compounding trends that, in concert, are beginning to increase the issues associated with mental illness in the workplace.  They are the incidence of narcissistic managers and the growth in the number of people in the workforce who have a mental illness.  I will deal with each of these trends in turn and link the issues to the offsetting influence of mindfulness.

The Incidence of Narcissistic Managers

Many significant publications such as Psychology Today, Harvard Business Review, Inc.com, Health.com and Time.com, have recently discussed the incidence of narcissistic bosses and ways to self-manage in the workplace to protect yourself from psychological damage caused by these bosses.  It is suggested that most people will encounter at least one narcissistic manager in their working life – I have experienced three that I can recall.

What are the characteristics of narcissistic managers that contribute to mental illness in the workplace?  Well the characteristics of these managers have been summarised by the underlying philosophy of “me, myself, I” – that is  I “first and foremost”.

Characteristics of Narcissistic Managers

There are many characteristics of narcissistic managers described in the articles and in research. Some of the more common traits described (and confirmed by my own experience) are:

  • Self-aggrandisement – believe they are more capable, competent or efficient than they actually are (believe they create high performance teams when the reverse is true)
  • Obsession with self advancement – their careers come before anything or anybody else
  • Over-concern with visibility and being seen in a good light
  • Blame others when mistakes occur (to deflect blame from themselves) – always looking for a “scapegoat”
  • Will lie to save their projected image
  • Take credit for other’s work if it advances their own positive visibility
  • Insensitive to the needs of others, especially their own staff
  • Will constantly change priorities depending on what advantages them, without regard for the impact of such constant change on others
  • Will have an in-group, but any member can become part of the out-group at anytime if they cause embarrassment
  • Create unrealistic time pressures for staff to try to show that their area is highly productive
  • Will publically criticise their own managers in front of the manager’s own staff
  •  Will micromanage to try to ensure that mistakes do not occur and that what they want to occur will actually happen.

The Impact of Narcissistic Managers on Mental Health

The reality is that these managers do not achieve control. In fact, their situation becomes progressively out of control  and they experience high levels of stress as a result, on top of their self-induced stress caused by self-obsession.  They may gain compliance through fear, but lose commitment because people physically or psychologically withdraw to protect themselves – no longer caring about the work, unwilling to offer suggestions for improvement, avoiding contact with the manager or engaging in covert sabotage (to get back at the narcissistic manager). They also lose confidence and begin to question their own competence.

The narcissistic manager, then, not only creates an environment conducive to the development of mental illness in staff, they also potentially aggravate  the condition of staff who already have a mental illness before joining the narcissistic manager’s workgroup.  The compounding issue is that the narcissistic manager lacks the insight to see how they contribute to the conditions creating, or aggravating, mental illness; nor are they overly concerned about the individuals negatively impacted by the highly stressful workplaces they create.

People in the Workplace with a Mental Illness

Beyond Blue, an organisation dedicated to improving the mental health of all Australians, estimates that there are 3 million people in Australia suffering from anxiety or depression and eight people die each day from suicide.  This suggests that anxiety and depression are an issue in the workplace.  Beyond Blue funds an extensive research program covering anxiety and suicide for all categories, including young people, women, men, aged people and the LGBT community.

The Black  Dog Institute also supports the development of mental health in the community.   They draw extensively on research to support their role.  From this research, they are able to maintain that:

Mental illness is very common. One in five (20%) Australians age 16-65 experience a mental illness in any year.  The most common mental illnesses are depressive, anxiety and substance  use disorders.

What is particularly concerning is that they report that suicide “is the leading cause of death for Australians aged 25-44 and second leading cause of death for young people aged 15-24”.

This means that suicide is potentially prevalent among people who are in early-career or mid-career as well as those entering or about to enter the workforce.

The role of Mindfulness 

The narcissistic manager exhibits the characteristics that are the opposite of the mindful manager.  They particularly lack self-awareness and hence self-management. They are by nature lacking in empathy and compassion and are unable to communicate with insight as they are blinded by their own emotions and selfish-obsession.  Their only motivation is to advance themselves – they have no source of motivation beyond themselves and  are thus unable to engage committed individuals.

As we mentioned in recent posts, emotional intelligence skills can be learned through mindfulness.  The challenge is finding ways to engage narcissistic managers in mindfulness training when they have a “keep busy” mindset.  Offering mindfulness training as a means of stress reduction may provide the motivation for them to be involved – because it focuses on “where they are hurting”.

Hence, mindfulness has the potential to help narcissistic managers to manage their stress levels, change their management style and assist other individuals experiencing mental illness.

Jon Kabat-Zinn has demonstrated over more than 30 years that his Mindfulness Based Stress Reduction (MBSR) training has very substantial benefits for people suffering different levels of stress and forms of mental illness.  His findings through his practice have been confirmed by neuroscience research.

As individuals in either group grow in mindfulness, they will experience the benefits, and contribute to the development of a more humane workplace.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of Maialisa on Pixabay