Mental Illness at Work

A manager's guide to identifying, managing and preventing psychological problems in the workplace

M. Race, A. Furnham

• Publisher: Palgrave Macmillan
• Year: 2014
• Print ISBN: 9781137272041
• eBook ISBN: 9781137272058
• Topic: Business
• Subtopic: Human Resource Management
• Index: Business

It is argued that the incidence of mental illness in the workplace is more common than many realize, ranging from stress to schizophrenia. In this book leading psychologists Adrian Furnham and Mary-Clare Race explore the psychiatric classification of illness and how symptoms can be identified to help develop mental health literate organizations.

chapter 1

Introduction

Would you recognize if a colleague at work was having a serious mental breakdown? You may be able to see signs of stress or depression, but can you detect schizophrenia or alcoholism? Are any of the top people in your organization psychopaths? And does anyone have full-blown obsessive-compulsive disorder? What should you do if you recognize symptoms of a major mental health problem? Is this essentially an HR issue?

Do some workplaces make you psychologically as well as physically sick? Are there pathological organizations which almost require you to be disturbed in order to work in them: the paranoid or psychopathic organization? Do certain workplaces cause mental illness? And are people with a particular propensity towards certain disorders attracted to certain jobs and organizations?

This book is about mental illness in the context of the modern workplace. It deconstructs the mythology and misconceptions surrounding mental illness and offers a useful taxonomy for understanding how the impact of mental illness in the workplace can be managed, mitigated and prevented. One aim is to help people recognize a range of psychological problems for what they are and offer appropriate help and advice before the problems become too serious.

People are frequently physically ill at work. Over the course of a working life, people are likely to experience a wide range of physical illnesses such as the common cold, broken limbs resulting from accidents and chronic conditions like hypertension. Many are also likely to experience a range of ‘psychological issues’ and sometimes these may result in mental illness. Whilst physical health and mental health are closely related, it is much more difficult to identify and deal with mental health problems in the workplace. One of the biggest challenges is the stigma that is still associated with mental health problems. People suffering from mental illness are among the most stigmatized and marginalized in society, and although a lot has been done in recent years to address this, there is still a long way to go before mental illness is regarded in the same light as physical illness. The stigma of mental illness is consequently one of the biggest barriers that people with mental illness face as the social distance and exclusion that they often experience as a result of other people’s prejudices can make it very difficult for them to integrate successfully with other people and maintain a normal life. Another negative side-effect can be that people suffering from mental illness are reluctant to accept professional help until a late stage because of the fear of being labelled if people find out they are receiving treatment.

One of the biggest challenges is the stigma that is still associated with mental health problems

In the workplace this often means that employees will withhold information from their line manager, HR professionals or other decision makers because of the perceived impact on their career progression. As a result, the very people who are in a position to help them manage and cope with their illness at work are often the last to know.

Depictions of mental illness in the media do not help, with a typically negative focus on the link between mental illness and violence, failure and unpredictable behaviour. The formation of these stereotypes is normal and to be expected in situations where we are basing our assumptions on often very limited personal contact with sufferers of mental illness. For example, a 2002 study of over 200 students in Malaysia highlighted the impact of stereotypes about mentally ill people, with the results showing that students with knowledge of, and contact with, mentally ill patients were less likely to have negative attitudes than students who had no prior exposure (Mas and Hatim, 2002). But what if we told you that most of us have more exposure to people with mental health than we think? Current estimates suggest that one in four people will experience some form of mental illness in any given year and yet awareness of, and attitudes towards, mental health would suggest otherwise. Proper education to dispel these myths and exposure to people with mental disorders is therefore an important step in overcoming these stereotypes, and later in this book we will explore this further.

1.1 Defining mental health

Mental health is a broad and complex topic and we will not seek to provide education on every disorder listed in DSM-V (the most recent psychiatric manual), but rather will focus on those conditions which can have the greatest impact on the business world.

To a large extent, psychologists have thought about mental health as an absence of mental illness. Most psychologists accept that we are bio-psycho-social animals. Our health and welfare is not determined exclusively by our biology, our psychology or our social lives and networks, but by all of these. Abnormal and clinical psychologists are most concerned with mental health. However, the comparatively new discipline of health psychology is more interested in mental health and how it affects physical health (Seligman, Walker and Rosenhan, 2001).

When a professional attempts to make an assessment of a person’s mental health, he or she tends to look at very specific features. Nevid, Rathus and Greene (1997) have listed 11 of these:

Appearance: appropriate and clean.

Behavioural characteristics: verbal and non-verbal.

Orientation: knowledge of correct places, space and time.

Memory: for recent and long-term past, people and events.

Use of senses: concentration and awareness.

Perceptual processes: sensing reality from unreality.

Mood and affect: having an appropriate emotional tone.

Intelligence: vocabulary knowledge.

Thought processes: logic and coherence.

Insight: self-awareness and psychological awareness of others.

Judgement: rationality and decision making.

It still seems rare for psychological textbooks to deal with mental health and wellness as not being anything more than an absence of signs of mental illness. On the other hand, there are lists of characteristics that epitomize mental health (Seligman, Walker and Rosenhan, 2001). These include the following: emotional stability and awareness; being able to initiate and sustain satisfying long-term relationships; being able to face, resolve and learn from day-to-day work, and personal and financial problems; being sufficiently self-confident and assertive; being socially aware, empathic and socio-centric; being able to enjoy solitude; having a sense of playfulness and fun; and showing signs of merriment, joy and laughter from time to time when appropriate.

Mental illnesses can be caused by environmental, cognitive, genetic or neurological factors. Clinicians are concerned with the assessment, diagnosis and management of psychological problems. They are both scientists and practitioners who often specialize in the treatment of various disorders like anxiety disorders (anxiety, panic, phobias, post-traumatic stress disorder (PTSD)), mood disorders (depression, bipolar), substance disorders (alcohol, stimulants, hallucinogens, etc.) or complex problems like schizophrenia.

Happiness is another widely discussed state that is essentially about mental wellness. However, it has been known for 50 years that happiness is not the opposite of unhappiness – the two feelings are unrelated (Bradburn, 1969). What this taught researchers was that absence of illness and unhappiness was not the key to understanding happiness, but that we need to know those factors that lead to stable happiness in an individual.

The relatively recent advent of studies on happiness, has led to a science of well-being (Huppert, Baylis and Keverne, 2005). All the early researchers in this field pointed out that psychologists had long neglected well-being, while preferring to look at its opposites: anxiety, despair and depression.

All the early writers in this area struggled with a definition. Eysenck (1990) noted telltale signs, both verbal and non-verbal. Argyle (2001) noted that different researchers had identified different components of happiness like life satisfaction, positive affect, self-acceptance, positive relations with others, autonomy and environmental mastery. Happiness also constitutes joy, satisfaction and other related positive emotions. Myers (1992) noted the stable and unstable characteristics of happy people, who tend to be creative, energetic, decisive, flexible and sociable. They also tend to be more forgiving, loving, trusting and responsible. They tolerate frustration better and are more willing to help those in need. In short, they feel good so do good. Diener (2000) has defined subjective well-being as how people cognitively and emotionally evaluate their lives. It has an evaluative (good-bad) as well as a hedonic (pleasant-unpleasant) dimension.

1.2 The incidence of mental illness

The understanding and awareness of mental illness in society has improved dramatically in the last 15–20 years and at the same time there appears to have been an upward trend in its prevalence rate (Deverill and King, 2009), with the most commonly quoted statistic estimating that one in four people in the UK will experience a mental health problem in any given year (http://mind.org.uk). It is not clear if the rate of mental illness has truly increased or if the increase in understanding of the topic has led to more accurate diagnosis and therefore a greater frequency of reporting symptoms.

Regardless, this increased prevalence of mental illness is quite alarming and particularly given the evidence that approximately three-quarters of adults with a common mental health problem are not in receipt of medication or counselling, including two-thirds of those who have been assessed as having sufficient a level of symptoms to warrant treatment (Deverill and King, 2009). The rate appears to be higher among women and in people in the 45–54 age bracket, and the prevalence rates are mirrored among working-age adults, with approximately one in six workers experiencing depression, anxiety or stress-related problems at any one time. This rate can increase to one in five when drug or alcohol dependence are included (Sainsbury Centre, 2007) and later in this book we dedicate a chapter to understanding the implications of drug and alcohol dependency.

1.3 Why we should care: the costs of mental illness to business

We have all experienced the negative impacts when a colleague is off sick: increased workload for the rest of the team, disruption to the operations of the business, a drop in sales revenue, etc. Mental illness falls into this category and is a silent epidemic impacting the business world at an alarming rate. In the UK, for example, it is estimated that around 80 million days are lost every year due to mental illnesses, costing employers £1–2 billion each year, and in the USA, according to recent collaborative research by Harvard University Medical School and the World Economic Forum (Bloom et al., 2011), it is estimated that untreated mental illnesses costs the country at least $105 billion in lost productivity annually. The very nature of mental illness also means that absences from work are rarely characterized by the odd day here and there; instead, sufferers are likely to experience prolonged periods when they are not able to work, and when they do return to work, they can take some time to get back to their previous level of performance.

Estimates for national spending in the USA on depression ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• List of Figures and Tables
• Preface
• 1 Introduction
• 2 The Basics: What is Mental Illness?
• 3 The Personality Disorders
• 4 Alcohol and Other Addictions
• 5 Workaholism
• 6 Sector-Specific Illnesses
• 7 Illness at the Top: The Paradox of Managerial Success
• 8 Spotting Illnesses
• 9 Cultural Nuances and the Globalization of Mental Illness
• 10 Coping with Illness: Responding to and Managing the Situation Effectively
• 11 Creating a Healthy Workplace Environment
• References
• Index