Turning workplace worries into maladies

New guidelines suggesting bosses watch out for mental-health problems end up medicalising normal emotions.

In December, the Chartered Institute of Personnel Development (CIPD) and the leading mental-health charity MIND released some guidelines for employers to understand how to manage and deal with mental illness at work. The guidelines were brought out on the back of a survey that interviewed 2,000 people in employment in the UK. More than a quarter of respondents said that they had experienced some form of mental illness and that very few employers encouraged their employees to talk about mental illness.

I was intrigued. I have been in personnel management for more than 20 years and I can honestly say that I have very rarely come across anyone who was mentally ill. Coming from a nursing background, I would expect to be able to detect any signs of mental illness among my staff.  So what is going on?

On reading the guidelines, one thing became clear to me:  the definition of mental illness is very broad. It is so broad, in fact, that I am not sure why we are not all deemed to be mentally ill. Whether it is constantly feeling anxious about meeting a deadline, being depressed that you are finding it difficult to achieve your objectives at work, feeling lonely because you have no friends at work, or stressing out because everyone is relying on you to clinch that sale – these feelings could all, given this broad definition, be classified as mental illness.

The expanding definition of mental illness is well expressed in the increasing girth of the mental-health professional’s ‘bible’: in 1952, 64 behaviours were listed as mental disorders in the Diagnostic and Statistical Manual of Mental Disorders; today, there are more than 250 such behaviours listed.

No wonder I have not been able to identify any sign of mental illness at work. It is not that I have failed to notice employees feeling stressed out, or having a workload that is a little heavy, or even a shy employee unable to make friends quickly. I simply had not labelled any of these experiences as ‘mentally ill’. Silly me. But for me, these experiences are what all of us have to deal with in our everyday life - either at work or at home. These are entirely normal responses to the inevitable challenges that each of us may have to face. And the truth is that most of us do succeed in dealing with them.

I remember my first day as a student nurse (back in the Seventies) at a hospital ward in Brighton. I was scared, fearful of answering the hospital phone in case I misheard the person at the other end and all the time worrying if I was going to kill someone. After all, just two months before, I had flown into London on a winter night from my home in the Far East. During those two months, I had to acclimatise to the cold (as I had only known hot weather before), learn how to eat hospital food, use knives and forks (in my homeland, the norm was to eat with one’s fingers), not to mention having to mix with people who often spoke with accents that I struggled to understand. I was also terribly homesick. But I persevered. I made friends and, before I knew it, I moved on to face other new experiences. Each of those new experiences brought its own fears and anxieties that needed to be addressed and overcome.

Unfortunately, classifying responses to everyday work experiences as a form of ‘mental illness’ undermines the idea that employees can deal with these fears and anxieties, either by themselves or through talking them over with their friends and colleagues. Instead, this approach encourages and seems to justify medical intervention arranged by the employer or a ‘caring professional’ who will undertake some form of therapeutic activity with you. Once this happens, you lose control of making decisions yourself, you become less of an adult and more of a child that needs help. This is not to suggest that mental illnesses like schizophrenia or severe depression are not serious problems that need to be treated. But there is a clear distinction between these serious illnesses and normal reactions to challenging experiences at work.

What has been missed is the good news from the CIPD survey: while 25 per cent of respondents were relatively gloomy about their current mental health (four per cent said it was ‘poor’ and 21 per cent said it was ‘moderate’), 41 per cent described their mental health as ‘good’ and 33 per cent said it is ‘very good’. So, three quarters of respondents regarded their mental health as at least good. Surely this is a cause for celebration?

Of course, many of these upbeat respondents will have felt stressed or anxious about their work from time to time. The difference is that they simply did not see this as a sign of being mentally ill. They must have gotten over these challenges by personal achievement, by relying on their colleagues at work. Or by talking through their worries with their loved ones, or perhaps even with their managers. 

The world of work has never been easy. Even when the UK economy was booming, work would have had its ‘highs and lows’. We are now experiencing an economic climate where unemployment is high and rising for some groups, where public-sector cuts are in progress, and where it is very much a ‘dog eats dog’ atmosphere in some workplaces. The forecast is that this will continue to get worse in 2012. In such challenging circumstances, I would argue that the last thing we need is to channel employees into the navel-gazing activity of interpreting everyday work emotions as mental illness.

As someone who is in the business of people management, I would want my staff to raise any anxiety or fears they have about work with me. Some do this, while others prefer to confide in their friends. I would not assume their issues were signs of mental illness, but I would hear them out, suggest ways of coping and keep an eye on them. Often the remedies are common sense as often employees with problems are actually yearning for a listening ear. A problem explained is often a problem solved. But by medicalising these issues, we turn what is often a passing set of circumstances into a problem intrinsic to the person themselves - and that really is mad.

Para Mullan is a fellow of the Chartered Institute of Personnel and Development.

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