Mental Wealth

A Managers Guide to Workplace Mental Health and Wellbeing

Emi Golding, Peter Diaz

• Publisher: Morgan James Publishing
• Year: 2019
• Print ISBN: 9781683500742
• eBook ISBN: 9781642793673
• Topic: Business
• Subtopic: Human Resource Management
• Index: Business

• Psychological Safety at work is now considered a key element of Workplace Health & Safety and Risk Management, particularly in Australia
• Employers in all industries are legally required to handle workplace mental health effectively
• The things corporations have done so far aren't working and executives are looking for answers that Mental Wealth can provide
• Managers learn how to have a conversation about mental health with a staff member that makes the issue better, not worse
• Leaders discover the 7 Pillars of a Mentally Wealthy Workplace
• Shares an approach to workplace mental health and wellbeing that is proven to actually get results

PART ONE

THE PROBLEM WITH WORKPLACE MENTAL HEALTH

1

What is a Mental Illness?

One of the questions we like to open our workshops with is: ‘How would you define a mental illness?’ We’re always surprised by the diversity of answers and the perspectives taken. Some people describe it from the perspective of the person with the condition; others describe it from an observer’s viewpoint; still others from the person on the ‘receiving end’.

These are some of the more popular themes:

• •Behaviour that is irrational or risky
• •An unstable emotional state
• •Negative thoughts
• •A chemical imbalance in the brain
• •A genetic condition
• •Dysfunctional relationships
• •An illness or a disease
• •Something that impacts on work and life
• •Feeling sad, anxious, lost, overwhelmed or misunderstood
• •Causes disability
• •Disconnection from anything that matters
• •A condition that requires a diagnosis from a professional, such as a GP or a psychologist

The first thing that stands out to us about these ideas is just how many of them fail to actually define something. They are saying it is ‘something that’ affects mood, ‘something that’ affects behaviours’, ‘something that’ causes disability. Yet we really struggle to determine what the ‘something’ is.

Looking at these themes, the last definition, ‘a condition that requires diagnosis from a professional’, is usually offered by an educated and thoughtful audience member. It’s my favourite, though, because it comes with one h*** of a kicker:

There is actually no consensus among experts on what mental disorder is.

A number of very clever people have published a bunch of very impressive papers, but at the end of the day, there is no actual consensus amongst professionals. There is one giant publication, The Diagnostic & Statistical Manual of Mental Disorders (DSM), which was put together by the American Psychiatric Association and presents a list of every diagnosis that one could be given. However, not everyone agrees with what is written in it. One of the biggest bones of contention is the fact that we are up to version five of this manual. Now, reviews and revisions are not a bad thing, generally, but in this case, there are some very telling problems.

What’s wrong with the DSM?

Firstly, if we look to previous versions of this manual, in the original 1952 version, there were 106 different mental health diagnoses that one could be given. In the latest version, we have 297. Is it really possible that society has suddenly developed so many more types of mental health problems, which previously never existed, or is one of the following options more likely?

• •That our current society has a tendency to over-medicalise what once used to be considered normal emotions and experiences.
• •That the creators of this manual have a personal interest in the creation of more problems (as they can offer solutions). It’s noteworthy that, at the last count, over sixty nine per cent of the panellists for the DSM 5 acknowledged taking large bonuses from various pharmaceutical companies.

There’s more. Not only has the number of potential diagnoses grown, but the criteria for diagnosis has also changed substantially in relation to severity, duration and symptoms experienced. For example, one of the hotly debated areas in the current version is grief. Previous versions directed that if a person had experienced bereavement, they could not be diagnosed with depression for at least two months. (Interestingly, other forms of loss like loss of job, marriage, finances, etc., were not granted the same exemption.) However, the exemption for bereavement has now been removed, meaning that if a person grieves for more than two weeks, they can be diagnosed with depression. It follows that medication can then be prescribed. However, many would disagree with feelings of grief being defined as depression so quickly. There are some technical details about this that I won’t go into here, but the fact remains that these criteria are not based on scientific test or study, but on the consensus of the current group of psychiatrists involved in the publication.

Furthermore, the fact that certain diagnoses have been added and removed makes the underlying scientific basis for their inclusion highly questionable. For example, in early versions of the manual, it was considered a mental disorder if someone believed in God. This was removed in later versions of the manual. Similarly, homosexuality was considered a mental disorder for many years, and many people were subjected to painful and humiliating ‘shock treatment’ in an attempt to cure them of the mental disorder. This was removed from the DSM as an official disorder in 1974, yet replaced with ‘sexual orientation disturbance’ which has a more vague definition. It makes one wonder what diagnoses in the current version will later be discredited as society becomes more accepting and tolerant of difference and emotional experience.

It is telling that when the current version of the DSM was being written, a number of petitions and critical responses were submitted from bodies such as the American Psychological Association, the British Psychological Association and the American Counselling Association, in an attempt to address a plethora of problematic diagnoses and criteria. However, it was to little effect.

If you want even more supporting evidence, then look at the book itself. It is called The Diagnostic and Statistical Manual of Mental Disorders. Not Mental Illness. Even the most medical of medical professions stops short of actually calling such issues illness.

The DSM itself notes that: ‘No definition adequately specifies precise boundaries for the concept of ‘mental disorder’… different situations call for different definition.’ It further states: ‘There is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no mental disorder.’

If our most recognised source of mental health information is actually a book of unproven theories, which keeps changing with the flavour of the day, we really are stuck between a rock and a hard place.

And if we don’t really know what a ‘mental illness’ is, then why is the term ‘mental illness’ so prevalent? For this, we need to look to history.

Why is the term ‘mental illness’ so common?

Think back to the old movies you’ve seen, from around, say, the 19^th century. When you take a look at the street scenes of commoners going about their daily work, there is inevitably some poor crazy man or woman, dirty from the street, cast out and rejected by society. To be considered crazy was to be disowned, and people in mental or emotional distress were discarded to fend for themselves. It wasn’t that long ago that this treatment was usual. Unfortunately, in some situations, it is still in evidence.

Enter the medical profession in the early 1900s. Remember, doctors were previously referred to as ‘quacks’, but they now started to gain status. They were good people who cared for those suffering with mental health problems, or maybe just wanted to get them off the streets. Either way, they decided to set up big institutions—the early psychiatric hospitals. These provided mentally unwell people with food, shelter and relative safety. The view was that these problems were permanent, so it was expected that people would live the rest of their life there, being ‘treated’ by doctors (though with no expectation of recovery).

Along with these developments came a shift in the way we thought about mental health. In order to reduce the stigma surrounding such issues, the medical establishment started to refer to mental distress as mental ‘illness’. It helped the general population to compare it to physical problems, and shift the blame away from the person themselves and onto the ‘illness’.

This kind of thinking still exists today. And, no doubt, for some, it is very helpful to think of mental distress as an ‘illness’. It does reduce stigma, and it does mean that some people who would otherwise be less likely to get help are more willing to seek it. However, there has not, to date, been proof of any underlying disease or biological illness, so to speak. There is a feeling of being unwell, or ill, but no proven physical condition—that would be impossible, given that it is a ‘mental’ illness, hence, of the mind, not the physical body. Given this, the term mental illness is actually an oxymoron.

To learn more, check out The Myth of Mental Illness, “written by eminent psychiatrist Dr Thomas Szasz.

The theory of chemical imbalance

A popular medical explanation blames mental distress on chemical imbalance. But, again, this is actually yet to be proven—it is still a theory (albeit one widely promoted by the pharmaceutical industry).

Now, before you dismiss us as whacko conspiracy theorists, listen to the facts and make your own judgements. When someone begins to feel unwell, mentally or emotionally, their first stop is usually their GP. For physical conditions, there is often some test which can be done to confirm a diagnosis—whether it is a blood test, a biopsy, an x-ray or some other scan. And that’s a good idea—you want to get a thorough physical check. But if physical causes are ruled out and symptoms persist, people are likely to be told that their condition is down to a chemical imbalance in the brain. There’s no test that confirms this—no analysis, nothing. Regardless, on this basis, people are prescribed medications to address the purported imbalance.

For argument’s sake, let’s suppose the cause of mental distress is a chemical imbalance in the brain.

Consider this: We know that the brain creates and regulates our thoughts and emotions. It follows that every emotion we experience could be considered a chemical imbalance in the brain—whether positive or negative, mild or strong. When you are happy, or excited, you are having a chemical imbalance in the brain. When you are worried or sad, there is a chemical imbalance in the brain. We all experience emotions, and chemical imbalances, all the time. So on the basis of someone experiencing certain emotions, to say they have a chemical imbalance in the brain is really stating the obvious.

What’s difficult to ascertain is whether the chemical imbalance causes the emotion, or whether something, either in the external world or in our inner world of thought and emotion, has led to the chemical response. Chicken or egg? For example, we recently came across a course participant who shared during the break that they had recently separated from their spouse. This had meant selling the family home, splitting their assets, and beginning a whole new life at the age of sixty. They were experiencing the signs and symptoms of depression. Now, would you expect the cause of such depression to be ‘a chemical imbalance in the brain’? Or perhaps a natural human reaction to the current situation?

Of course, the pain, suffering and distress still exist. We don’t want to minimise that. But the course of treatment will depend on what you perceive to be the cause of the problems.

If it is something ‘external’, then the best approach to treating mental distress would be to consider the cause of the emotions rather than the subsequent chemical response. You would likely prescribe that the person seek some counselling or psychotherapy, support from friends and other services, and do things that will help them get through this difficult time.

Meanwhile, if you believe that chemical imbalance leads to the subsequent emotions, do you really think we should be adding more chemicals to the mix? Many people, including some from practicing...

Table of contents

• Cover
• Title
• Copyright
• Table of Contents
• Preface
• Foreword
• Introduction
• PART ONE: THE PROBLEM WITH WORKPLACE MENTAL HEALTH
• PART TWO: THE 7 PILLARS OF A MENTALLY WEALTHY WORKPLACE
• Conclusion
• About the Authors And the Workplace Mental Health Institute