Mind what you think

By VIKKI BLAND


Clinical psychologist Ruth Allen wants to know why mental illness in the workplace isn't accepted as readily as physical conditions such as asthma, angina or migraines.

"People with mental illnesses should be treated the same way people with physical illnesses are. Sometimes they can work, sometimes they need time off," says Allen.

Mental illnesses include a range of conditions from mild anxiety to depression; bi-polar disorder and psychosis to schizophrenia. But with one in every five New Zealanders suffering some form of disability and more than one in 10 having suffered clinical depression, you'd think employers would be expert managers of mental illness - deflecting stereotypes and judgment and minimising the negative effects on career prospects and business productivity.

However, while some employers earn a "highly commended" for their understanding and commitment to working through the issues with valued employees, others deserve a "could do better".

Leanne Luxford, business manager for Working Well, a health division of the Mental Health Foundation, says some employers are proactive with communication policies that encourage staff to be open when they are having [mental health] difficulties.

"With others, I hear again and again that people fear disclosing their mental illness. And it's the supportive workplace employers who are retaining staff," says Luxford.

Luxford and Allen say there is still prejudice against mentally ill people in the workplace and a sense that mental illness is harder or scarier to deal with than other things.

"Terrible [media] images of axe murderers does employers a disservice because you could argue that people with mental illnesses make better employees because they know their limits and are skilled at managing their lives. They understand what it's like to be vulnerable and work at maintaining a balance," says Allen.

But surely some mental illnesses are dangerous? And what if they are destructive to business? One Auckland executive tells of flying key executives to visit an international prospect in the hope of securing significant business. During the customer visit, one executive, a sufferer of affective bi-polar disorder, "lost it". The visit had to be abandoned and the agitated executive escorted home to his doctor under the close supervision of his work colleagues and the airline.

Allen says for every horror story connected to mental illness there are hundreds more connected to life.

"What if [that man] had an asthma attack or a heart condition? What if he'd got drunk in front of the customer - or found out his child had died and had to jump on the next plane home? Would the end result have been any different?"

As for whether some mental illnesses pose a danger, Allen says statistics show most violent crimes such as rapes and murder are committed by a male known to the victim. She says some of these men can be mentally ill, as well.

"But while we have a huge number of people who have been diagnosed with some form of mental illness, murder is the smallest crime numbers-wise and many murders are not committed by the mentally ill."

She says distorted views of mental illness are driven by fear. "We are frightened because we can all go there."

Allen is unsure whether mental illness is on the rise or is simply better diagnosed today.

"The World Health Organisation believes by 2020 depression will become the second leading course of disability in the workplace after heart disease. Many people would say 21st-century living is the cause, [but] I think it's just that we are calling things different names. What we used to call melancholy we now call depression."

So what can employers do to create a working environment in which mental illness is accepted and treated like any other illness? How should a mentally ill employee be managed?

Luxford says it helps to remember that people aren't robots and nobody can be happy all the time.

"If employers can have the flexibility to tolerate people over-performing when they're happy and under-performing when [they're not] they will [reap] loyalty and staff longevity," she says.

Allen says work colleagues can help by allowing a person to be open about their mental illness, then not misusing that knowledge later.

"If someone who has had depression gets stressed over change management, then people who know about the depression tend to say 'oh you are becoming unwell again' instead of realising everyone is stressed by the change and the person with depression is behaving normally."

She says people who are concerned about the mental health of an employer or employee should discuss it with them.

"That is one of the biggest problems for people who have a mental illness - the stigma and the sense that it can't be spoken about."

Interestingly, she says employers should not make allowances for people with mental illnesses if their behaviour is not connected to their illness.

"We had one example of a male who was sexually harassing females at work. Because it was known he had an obsessive compulsive disorder, he was treated with kid gloves. But sexual harassment is not connected with [this] disorder."

Luxford says under the new Health and Safety Employment Act the employer has a duty of care to eliminate causes of stress, fatigue and mental harm in the workplace.

"Both employees and employers can try to misuse that process."

She says many employers are more than willing to embrace mental health education, but admits her organisation only tends to hear from those that do.

"There are some employers out there who think they are still a good employer because they have employee assistance programmes. But these are a bit like the ambulance at the bottom of the cliff."

What seems clear is that when the stigma surrounding mental illness dissipates, everyone will be better off. This includes the hundreds of thousands of us who at some point think we are 'losing it' - and the tens of thousands who do.


Working Well

Mental Health

How mentally ill are we?


* A total of 743,800 New Zealanders reported some level of disability in 2001, an increase of 41,800 over 1996-1997. However, the overall disability rate of 1 in 5 New Zealanders had not changed.

* The overall disability rate for males and females was the same.

* Physical disabilities remained the most common type of disability, but around a third of disabilities reported in 2001 were mental disabilities.

* One person out of every 100 will experience bipolar affective disorder. If a parent, brother or sister has the disorder, the risk increases to one or two in 10.

* Up to one in four women and one in 10 men will become clinically depressed at some point in their lives.


Recognising common, manageable mental illnesses


Bipolar disorder: rapidly changing emotions; elevated or "high" moods with times of depression; increased energy; sufferers easily distracted, conversation can jump rapidly between topics.

Brief psychotic disorder: sense of reality distorted for a finite period; conversations confused or disjointed; sufferers may believe voices are being placed in their heads, that they have special powers, or are being spied on. Hallucinations can occur. Brief psychotic disorder is rare and full psychosis is rarer.

Depression: persistent low mood, sadness or emotional numbness; irritability, anxiety, poor concentration; feeling guilty, crying for no apparent reason; feelings of hopelessness, thoughts of death. A number of these symptoms and others need to be present for longer than two weeks for diagnosis.

Schizophrenia: delusions, hallucinations, confused talk, things may appear to slow down or speed up; colours and sounds may intensify; uncontrollable feelings or a perceived lack of feelings; lack of personal care. Usually begins between the ages of 15 and 30. Symptoms need to be consistently observed over six months for diagnosis.

Source: NZ Mental Health Foundation