John Binns: An increasing difficulty in making decisions, an increasing tendency to become anxious about things you wouldn’t normally be anxious about, an increasing difficulty to focus and stay in the moment, alongside some of the things most of us think about around depression is not really being able to see the whole picture around things, of tending to see the downside of situations.
Philippa Lamb: The catastrophic thinking and negativity.
JB: Yes as opposed to a rounded picture.
PL: So how did you feel, where did you get to?
JB: I didn’t really have the self-awareness to recognise that those things were creeping up on me, I just kind of essentially kept ploughing on every day thinking, ‘Maybe tomorrow I’ll feel better.’ That absence of getting help, absence of recognising that I needed help really led me to come to a kind of cliff edge point where there was a particular day where I just absolutely couldn’t go into the office the next day.
PL: And what happened then?
JB: Well what actually happened was from that point I was off and out of the business, I was a partner in the business, that senior guy in the business, for three months. I went into a psychiatric hospital for three weeks as an in-patient, which was not a great experience as you might expect. The way I was functioning at that point was at such a low level and so unlike me and my perception of me that I could not see how I would ever get back to doing what I had done before.
PL: What John Binns experienced as a senior partner at Deloitte isn’t unusual. More than 40% of organisations report they’ve seen a rise in mental health problems in the last year alone.
Emma Mamo: I think one in six workers right now are experiencing stress, anxiety or depression, so quite a large prevalence.
PL: Emma Mamo is Head of Workplace Wellbeing at the mental health charity Mind. Her job is to help employers recognise and respond to mental health problems amongst their people.
EM: I would say that even two people diagnosed with the same condition would absolutely experience that condition differently and I think that's why it’s always important to have that holistic conversation about what it looks like for them.
I think it’s always difficult to talk about how you might spot the signs or indicators that someone might be experiencing because sometimes there can be no outward sign and people can be hiding something like this or not really understanding what’s going on for them because they might just be withdrawing but obviously if you are a people manager or just indeed if you’re a colleague you should know the people around you, the people you work with quite well so you might be able to notice differences in them. So for example someone might be staying later or getting in earlier which is different so that might be an indicator that they’re struggling or if they're quite a happy, chatty person, I'm quite a chatty person, if I'm feeling the pressure or stress I absolutely withdraw, I get quite clipped. If people are talking to me I won't have any nonsense, let’s just say what we need to say and get moving. And that's an indicator for my manager, if she sees that, to think, ‘Well maybe Emma’s struggling.’
So I think it’s just really looking at people’s mood, maybe their physical appearance, maybe if they’re reflecting to you that they’re not sleeping, these can be indicators that their mental health is being affected but again I would like to caveat that with there may be no outward sign and that's why it’s really good for employers to be proactive and make conversations about mental health quite normal.
PL: When it came to the crunch for John Binns he found help and his employer supported him wholeheartedly. Looking back at that time though he says he learnt something he does now take into his work advising companies on how to approach mental health.
JB : Now actually my personal experience of what happened was I suppose, to use a football analogy, a game of two halves, as people use it. In other words my perception that the organisation and other partners would essentially take a view that if this has happened to this guy he can't possibly function the way he did before, didn’t happen.
PL: So you expected they'd probably try and push you out?
JB: I absolutely expected that. Now that didn’t happen. So the very positive element of what happened with me was the conversation which was absolutely not the one that I was expecting to have, and I always remember the words because they meant such a lot to me at the time was, “What we are looking for is John Binns up and running as you have been 18 months before and we don't quite understand what’s happened with you but just tell us and let’s talk about what we need to do to help you get back on your feet, and it doesn’t have to be tomorrow, and it could be six months or a year but let’s just…” That messaging was hugely empowering for me.
PL: At the point of crisis he was supported but that's not the whole picture.
JB: Actually at that point there was more support than I ever expected to be available. What wasn't so good and a lot of the work that I went on to then do back at Deloitte and also with many other organisations now, was the period leading up to that.
Actually now I see, and it’s a pattern I see time and time again, but there was that 18 month at least lead in where incrementally week by week I was beginning to suffer with some of those symptoms I described earlier. There was no culture within the organisation at that time, and indeed most organisations, particularly city organisations, but generally talking about mental health as if it would ever be an issue that individuals ought to think about for themselves or for others, so I didn’t get any help, my colleagues didn’t recognise them, of if they did they would feel extremely uncomfortable with asking him and it was that that I set out to try and change within Deloitte to get a greater understanding that this is actually very common. Actually help works and if you get it early and you spot this stuff early you don't need to get into the position that I did.
PL : Norman Lamb is a Liberal Democrat MP and under the last government he was Minister of State for Care and Support. He's dedicated to getting a fairer deal for people with mental health problems generally and he sees work and the workplace as a major part of that.
Normal Lamb: In terms of my work on mental health in the workplace I signed up for the Department of Health to become an exemplar employer under Time to Change early on in my time as minister and I made a commitment to get every government department signed up. We achieved that - it took quite a long time but they eventually all signed up. But I felt that until we did that it would be impossible to go out and make the case for others to do it. We had to demonstrate that we were getting our act together. And the fact that it took a couple of years rather demonstrates the resistance still in terms of people understanding the importance of this. So there is a long way to go.
PL: Norman went on the challenge FTSE 100 companies to do the same.
NL: Quite a few responded positively, either to say they’re doing their own thing or that they will sign up. But lots didn’t - lots didn’t even respond. So we’ve got a long way to go yet.
PL: Were you surprised by that?
NL: It’s depressing but it’s what happens with mental health, there is institutional bias against mental health still, in society, within the NHS. It’s a historic injustice that has to be overcome and the economic and the moral case for this is overwhelming. It costs the economy something approaching £100bn a year and so it’s an absolute nonsense for us to ignore this - we ignore it at our peril.
PL: Nearly 40% of employees have considered quitting their job due to stress at work. It’s a big number but two thirds of senior managers just don't think stress is a good enough reason even to take a day off, so clearly there's often still a really marked mismatch between attitudes at the higher levels of organisations and the experiences of the workforce further down the ladder.
Having said that there's been a lot of attention focused on the support that employers should offer when one of their people runs into a mental health problem. Now though the onus is shifting more to what employers should be doing to support good mental health and one of the big stumbling blocks getting in the way of that is stigma. Here’s Emma Mamo.
EM : I've been working at Mind for about eight, nine years, and I've seen attitudes to mental health really improve. We’ve had celebrities, we’ve had sports figures, we’ve had politicians, talk about their mental health. In the business world, in employment, that's where we’ve not seen as much improvement. When does pressure become stress, when does stress become something more or exacerbate an existing condition? And it is the idea of who can take the strain and who can't and also once you say something you can't unsay it in the workplace so will you always be seen through that lens? And if you’re put forward to promotion well you couldn’t handle this how could you move up? And yeah if your organisation is making redundancies potentially you might feel well ‘I’ll be first in line for the chopping block if I'm saying I'm struggling’.
But that's why at Mind we've been trying to make the case to employers that all of your staff have mental health and actually peak performance from your staff, employee engagement, that motivation, all of that's underpinned by them having good mental health.
PL: In fact far from being a sign of weakness the behavioural characteristics of people at risk of mental health problems often mirror those of high achievers.
JB: If you start to think about some of the traits associated with those people that we often regard as high fliers, or the people that everybody wants in their team; people who care about the outcome of things; people who are ambitious; people who listen to feedback and don't just blunder on.
JB : Who are self-critical; people who volunteer for things, etc. etc. and if you put brackets, ‘too much’, after each of those you actually start to see that certainly in work environments a lot of what we’re talking about are the risks associated with high flying, ambitious individuals.
PL : For Emma Mamo responding to the signs doesn’t go far enough, she argues that employers should start tackling root causes and that way they can reduce the likelihood of mental health issues taking root in the first place.
EM: At an organisational level, I think that an employer if they want to address mental health well they have to be doing three things. One of them is about promoting wellbeing for all of your staff because we all have mental health and what that looks like is around promoting work/life balance, that idea about people working sensible hours and not always working over and above. And then around promoting positive working relationships, senior management being good role models about wellbeing. And then also looking at learning and development, this isn’t always about putting people on a training course but using mentors or buddies within an organisation to upskill people. And also ensuring that employees feel that they have a voice, that they have a say in how they do their job and how the organisation is run. So that's the first part of doing this well.
Then the second part is around tackling the work-related causes of mental health problems. So at an organisational level a lot of organisations do staff surveys and so on. So it’s that idea of taking a temperature check of your organisation. But I think what’s really key to this then is around your people managers: they’re the people that should be monitoring the wellbeing of staff, checking in with them regularly, a culture of one to ones.
And then the final part of it is around just having the right policies and practices in place to support people if they are experiencing a problem and be that workplace stress, a period of emotional stress, or if they are living with a mental health problem that sometimes symptoms flare up and they have to manage their condition while being in the role.
PL: So it’s a layered strategy.
EM: You can't do the promoting wellbeing if you’re not really going to address it and you can't support people if you’re not trying to do the preventative. It is absolutely, it has to be all three otherwise you’re going to undermine and/or it will look tokenistic if you’re just promoting wellbeing.
PL: More employers are now training their people to spot and deal with mental health issues and nearly a third of organisations do train their line managers but given the key role that those line managers play are they doing enough? Here’s John Binns.
JB : I absolutely believe that one of the key preventative mechanisms that business can put in place is for line managers to have had some training and to be more aware of some of those early signs and some of the preventative things that one can do generally that this is important, that there are things you can do to prevent it and what might be some of the early signs.
The key problem will be that if line managers are not used to having, in my view, conversations with people in their teams which are rounded and which are not just about, “How are your sales going? What’s your utilisation like? What’s your pipeline,” blah, blah, blah.
PL: Why aren’t you performing like you were last year?
JB: What’s your billing?
JB: If that is the nature of every interaction that one has, whether it’s in a weekly team meeting, then it will be extraordinarily difficult if you are worried about someone then who appears to be changing their behaviour in some way.
So the key lesson I think for line managers is to recognise that good management means that you ask much wider questions and you’re generally talking about how are things going, how people are feeling, as a normal conversation.
PL: So if you need to you can open it up.
JB: So at that point it’s not a big issue.
PL: Messaging is key. Because of the sensitivities around mental health the success of a policy or a campaign can simply turn on how it’s pitched.
JB: We put on something and described there was going to be a session around mindfulness and talked about it explaining something about its origins, which its origins are around Eastern meditation, and advertised it and I think about five people turned up.
PL: They all ran for the hills.
JB: We put exactly the same thing on with exactly the same people doing exactly the same talk and called it, High Performance something or other, I can't quite remember.
JB: And it was full.
PL: Simple as that.
JB: The key is thinking about the culture in your particular organisation, thinking about what working and what description would work and it would be different for different organisations, and then playing it back in that way.
PL: So if you’re starting to look at this here’s a word of advice.
JB: The way I look at it is it’s always best to divide it up a little bit and think what you might do at particular layers. So there might be three or four layers, there's the senior leadership culture change bit, what’s one or two things you can do at the top level of that triangle which is around helping to get the message out there that we are going to take this seriously it’s okay to talk about this kind of stuff.
There's then what are we going to do perhaps in the middle level which is preventative? What training might we put in place for line managers? What kind of interventions to help people to recognise signs to be aware of? What questions might we ask in surveys around work practices that might be changed?
And then at the bottom of the triangle there's a kind of what things might we do to enable there to be better support if someone gets into a position where there's either a crisis or they really need some help?
PL: Norman Lamb has personal experience of the impact that mental ill health can have. His son was diagnosed with OCD when he was 15. He's grown up and working now but he's struggled with it ever since.
NL: It means that I have insight into what other families go through, the impact that mental ill health has on the whole family, the strain it puts on people and the price that you pay for not getting it right and for not treating it seriously enough.
PL : So what do you think employers should be doing?
NL : Well employers are a critical partner in this and I want to engage closely with employers and employer organisations to get across this sort of point or the case for enlightened self-interest that it’s in your direct interest to take this seriously. Ignore it at your peril. And I think if we can improve the training so that managers understand that the way in which they behave and treat people in the workforce will have a direct impact on that person’s wellbeing but also on the company’s bottom line.
PL: If you have thoughts on this tweet us @CIPD with the usual #CIPDpodcast. And if you’d like to know more Mind is the place to go. That's Mind.org.uk.
Next month transformational change management and the role HR can play in making it happen. Join me then.