By Emma Haslett Thursday, 30 September 2010

Mental health: The last taboo

Mental health remains a very sensitive issue, but employers who show understanding will benefit from having more engaged staff who need less time off sick.

Few things are shocking to employers these days. Subjects that were once considered forbidden territory, like sexuality, are now out in the open - having a colleague leave on a Friday as Paul and return as Pauline on a Monday warrants nothing more than a company email and understanding comments. With mental health problems, though, things aren't quite so open.

That's partly because mental health is such a difficult one to pin down. The number of traits branded a 'disorder' seems to have increased consistently since psychology and psychiatry entered the mainstream, and it sometimes feels as if, these days, traits that might once have been described as mere eccentricities are labelled and treated with an appropriate form of therapy. Anything from mild anxiety to full-blown schizophrenia can come under the umbrella of 'mental health disorder'. In fact, in some industry sectors - think advertising or the media in general - traits that could be put down to certain mental health conditions are revered. So when you're confronted with studies like one by charity Rethink, which found that each year a quarter of us will experience a mental health problem, it's easy to question what is going on. And yet former HBOS chairman Dennis Stevenson, CNN founder Ted Turner and Alistair Campbell have all confessed to suffering from mental illness.

But when it comes to disclosing their condition to employers, that cynicism still worries those with mental health disorders. In fact, another Rethink study found that, of 3,000 mental health service users, more than half hid their condition from their boss for fear of losing their job.

Taking on employees with a serious mental health disorder can be risky for both parties. They may need time off, which would put a burden on colleagues, or you may need to take special measures to help them. Then again, given that one-in-four figure, there's more than a chance that most workplaces already employ someone with a mental health disorder. Paddy Cooney, a programme leader at the National Mental Health Development Centre and also the line manager of bipolar sufferer Robert Westhead (see p.46), says showing that you are willing to be supportive will ease the pressure on employees who are struggling with problems. 'When people feel they can talk about it, they are more engaged and, actually, their sickness rate - and turnover rate - are both very low.'

The Mindful Employer Initiative was created to help employers open up those channels of discussion. The idea is that to demonstrate their commitment to supporting those with mental health disorders, businesses sign up to its charter and receive information and support not just for the employee, but also for his or her colleagues, line manager and anyone else involved. Because, as the organisation puts it: 'It's not only about the person with a mental health issue.' More than 700 organisations, including the Nationwide Building Society and HMRC, are already involved.

Disclosure to colleagues is more of a challenge. Hugh Look, a media consultant, who suffers from attention deficit hyperactivity disorder, admits he only tells the colleagues, managers and clients he knows his disorder will affect. He has yet to experience an adverse reaction, partly because of the way he explains it. 'I tend to normalise it,' he elaborates. 'I say, imagine you were a perfectly healthy but a small and slightly built person. There are jobs you're just not going to be able to do. There's nothing wrong with you, but you've got to accept that as a limitation.'

One fact is becoming increasingly clear: the number of people diagnosed with mental health disorders entering the workforce is rising. Dr Neil MacFarlane, a consultant in adult developmental psychiatry, says: 'Employers are going to have to get used to it, because there are hundreds of thousands of people now at school who have been diagnosed with a mental health disorder.' UK diagnosis levels are at their highest ever and people are becoming less worried about discussing their disorders. As a result, the next generation of workers will be more familiar with the terminology and more relaxed about discussing it - and whether employers are comfortable hiring them or not will become increasingly irrelevant.

Robert Westhead
Programme leader for the Shift campaign at the Department of Health.
Diagnosis: bipolar disorder

It is difficult to imagine Robert Westhead during a manic phase. A neat, softly spoken Clark Kent-type with glasses, he calmly explains how it feels when it happens. 'You don't need sleep, because you're just so full of energy. You talk 10 to the dozen. You totally lose touch with reality and behave in ways that are very bizarre to other people.

Westhead was first diagnosed with bipolar disorder at 19, after a gap year in India turned out to be more of a voyage of self-discovery than he had expected. On a houseboat somewhere in Kashmir, Westhead suddenly became the life and soul of the party. The following week, his mood crashed.

For some sufferers, the manic periods of bipolar disorder can lead to increased confidence and creativity, which is why so many sufferers end up in the creative industries. For Westhead, though, it was different. After the initial period of increased energy, things became more serious. 'I would quickly become ill to the point where I was having delusions.'

Medication was the obvious course of action, but lithium, the first medication he was prescribed, left Westhead depressed and anxious, which went on for several years. When, in the early 2000s, he started a high-pressure job as a government press officer, one senior manager made his life particularly difficult. 'She told me I wasn't being productive, and that she didn't like me. She was a bully.' Not a nice experience, but it at least gave him the gumption to discuss his condition with his line manager, whom he trusted. Once that senior manager knew, the heat was off. 'They were all very careful to stop the bullying behaviour, because they thought they might be exposing themselves to a risk if I made some kind of a complaint.'

Westhead says the mood in his office then changed for the better. His line manager offered to make changes (including seating him away from the bullying director) and Westhead gained the confidence to talk to his colleagues about it. 'They were fine about it. It was a huge relief to get it all off my chest. It's a terrible secret to hide all the time.'

Despite all this, Shift, the Government initiative to tackle stigma surrounding mental health issues which he heads, is coming to an end, and Westhead says he's still concerned about applying for new jobs. On a job application, he agonised over whether to tick the 'disability' box, and whether to disclose his disorder to employers at all. He didn't tick the box.

- For more information, see MDF The BiPolar Organisation 

David Farrell-Shaw
General manager, Specialisterne Scotland

The office of Specialisterne Scotland, a new software testing company with a twist, is a vast, empty space in a trendy building in the centre of Glasgow. Its 5,200sq ft is ready for the company's workforce to take up residence - 75% of whom will have autistic spectrum disorder (ASD).

Heading the organisation is David Farrell-Shaw. Farrell-Shaw, whose seven-year-old son is autistic, says he got involved after he saw a piece about Specialisterne's original project in Denmark and its founder, Thorkil Sonne. Sonne had realised that despite his son's autism, his interests in IT gave him solid earning potential. 'I knew I had to be a part of it - even if it was just answering the phones or making the tea,' says Farrell-Shaw. 'It is creating a future for people who would once have been cast aside' - or reduced to menial labour.

Software testing requires a penchant for repetitive tasks, an obsessive level of attention to detail and an almost superhuman need to order and classify: characteristics that can often be found in people with ASD. Take Farrell-Shaw's son, James, for example: 'He can type faster than I can, and he never uses Google to search for things - he memorises and types out the URL. You have to see it to believe it, because sometimes it's not just a word, it's dozens of different characters.' How many seven-year-olds can do that?

Because people with autism often experience high anxiety levels, the Specialisterne team has done everything possible to cut down on its causes. One of those often takes the form of a heightened sensory awareness, so instead of an open-plan office, employees will work in small rooms, cutting down on noise levels and distractions. And if anxieties do lead to bad behaviour, the team will understand why and handle it accordingly. Or, as Farrell-Shaw has it: 'If they throw a wobbler, it won't become an HR issue.'

Collaboration is one area which can present autistic individuals with problems, so the office includes a range of facilities designed to teach its employees how to share. From the Lego Mindstorm robots they'll have to programme during their interview - 'they'll only work properly if the interviewees share their knowledge with others', explains Farrell-Shaw - to the games consoles in the break-out room, which will only be equipped with collaborative games.

Farrell-Shaw has high hopes for the company: set up with more than £1.1m of funding, it is currently recruiting its first 12 trainees, who will each start on £20,000 a year. The plan is to expand the team to 61 (50 of whom will be autistic) by 2015. That might sound ambitious, but given that after just six years, the Danish business is turning over £15m, it's not unreasonable at all.

Hugh Look
Media consultant, Rightscom
Diagnosis: attention deficit hyperactivity disorder (ADHD)

Hugh Look was late for work on the morning that MT met him. He had lost his mobile phone. To most people, that would be just an irritating part of daily life. To Look, it's more than just frustrating: it represents the failure of one of his critical coping strategies. Because of his ADHD, he loses things at an unusually high rate for a 55-year-old.

Look's anti-loss measure takes the form of a box, into which he empties his pockets when he gets home. His mobile - a necessary tool to which he will inevitably refer several times an evening - stays with him all the time. 'It goes from room to room with me. I never let go of it,' he grins. It all sounds like terribly hard work, but for Look, who wasn't diagnosed until his early fifties, it is a relief. While he says he's very much an ideas man, one of the more serious manifestations of Look's condition is procrastination, which makes deadlines difficult to meet. He says it has led to him being fired - or narrowly escaping the sack by resigning - from various jobs. Look says ADHD contributed to the breakdown of his marriage - but before the diagnosis, he had merely put everything down to his own inadequacies.

But despite the diagnosis and the treatment that followed, procrastination is still a problem. As a media consultant who is tasked with everything from producing reports to helping clients analyse their publishing strategies, his job involves frequent deadlines. But having a short attention span is difficult. 'Things my colleagues could achieve in an eight-hour day would take me 14, 15, 16 hours to do,' he says.

There are plus points, though. Look says ADHD sufferers tend to be more independent than their peers. He describes a previous job that involved a lot of cold calling. 'We would phone people and usually they would request a brochure and say they would get back to me. One day, on impulse, I said I'll come and see you instead. And it worked. In fact, it was amazingly successful.'

When Look told his boss about what had happened, he was met with disbelief as sending out brochures was entrenched in the firm's values. But, in the end, the entire company took up the strategy. Now, slumped halfway down his chair after an hour's interview during which he has talked non-stop, Look shrugs happily. 'ADHD people are just quite good about running with that counter-intuitive thing,' he says. Has it ever been a problem for his employers? 'I haven't always been great with authority, but you learn where to draw the line.'

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