For all the talking we’re doing, for all the well-meaning campaigns, I still believe we are woefully under-trained (or untrained for that matter) in how to effectively and comfortably talk to someone about their mental health, particularly in the workplace.

This was the focus of a workshop I facilitated at the recent, successful Working Stronger conference hosted by the Canadian Mental Health Association – Alberta provincial branch.

The heart of this annual event is to bring together leaders and staff from various sectors and companies to acquire skills and engage in dialogue to increase the psychological health of their workplaces.

I performed my “Funny, You Don’t Look Crazy” about my lived experience with mental illness and my eventual return to work. Then I led an enthusiastic group of individuals in an interactive breakout entitled: “Ready, Set, Recognize: Detecting Mental Illness and How to Help”.

To be quite frank, I was nervous. I had several years employed in the not-for-profit health sector. But my corporate experience has consisted of a two-year stint in a small company (really small – 6 people including me!). 20 years ago.

I was hired as a marketing-assistant-slash-receptionist. Heavy emphasis on the receptionist part. Well, actually, heavy emphasis on the slash part. It was my first job since getting my “sea legs” back after being in the psych ward several times over the previous 5 years. Handling conversations, let alone their phone system, was going to take courage.

I held jobs both when I was struggling and in denial of my mental illnesses and also after when I was learning to manage them. It wasn’t easy for me. I know it wasn’t easy for my bosses or co-workers either.

4 simple steps to make the conversation easy and effective.

Working with well-meaning but misguided managers, and exceptionally talented ones, I’ve learned some strategies about what works and what doesn’t when it comes to addressing mental illness in the workplace.

The result is the framework I created called: O.A.R.S. (Observe, Ask + Actively Listen, Refer and Support). A simple protocol to support an employee or co-worker who may be facing a mental health issue.

The steps of O.A.R.S. are simple, but not necessarily easy. We aren’t used to having these conversations. The only way we’ll get confident is by practice.

One solution for companies is to offer safe learning opportunities and ‘rehearsal’ time for these dialogues in low-stake/no-stake situations.  We can be as awkward and unsure as we need to be and gain experiences of success that we can take into real-world scenarios.

I call the framework the Wizard of O.A.R.S. because, well, who doesn’t like a nice play on words? (Actually, I do know several people who don’t. But that’s beside the point.) And because oars bring balance, stability and direction to a boat. Just like oars, people can give support and guidance to those around them who may be facing mental health issues.

This is not a quick fix. The steps don’t work instantaneously. They can in rare cases. But they will gradually, over time, make a difference.

Observe – Changes in behaviour, length present + document

Ask + Actively Listen – Discuss concerns in terms of behaviour, its impact + needs

 Ask open-ended questions

 Mirror + validate

 Be patient + wait

 Be curious

 Discuss impact of behavior

 Focus on collaborative problem solving + actions

Refer – To resources in the workplace and/or community

Visit my resource page to download a Mental Health Resource Guide for additional tools.

Support – Continue to communicate and encourage; find agreement + set healthy objectives

Click here to download the detailed step by step O.A.R.S. e-guide with links to a fun video of Everyone Loves Raymond using active listening!

Observe, Ask & Actively Listen, Refer and Support: the Do’s & Don’ts

Before you have a conversation with someone at work about their mental health, here are some do’s and don’ts to keep in mind.

DO…

  • Set the conversation up for success
  • Check in with yourself: is it a good day for YOU to speak to them?
  • Check in: is it a good day for THEM?
  • Play it out: where, why now, how, what will you say, what might they say, how will you respond?
  • Have the facts: make sure the facts you have are correct
  • Determine your objective
  • Focus on building trust, rapport, safety + open dialogue so they feel free to talk
  • Speak to them as early as possible
  • Document behavior changes + note impact
  • Be clear about what you need from them
  • Prepare for own internal emotional reactivity
  • Plan + prepare for resistance
  • Listen without judgement
  • Use an icebreaker

DON’T…

  • Avoid talking about impact of behavior
  • Make assumptions about the behavior or jump to conclusions
  • Interrupt
  • Minimize or dismiss feelings
  • Try to fix or offer advice
  • Enable

Please note: The O.A.R.S. framework is for non-urgent situations. If you feel the individual is at risk of harming themselves or others, immediate care should be sought at the nearest emergency ward. If the individual refuses help and is actively suicidal or at risk for harming others, the police should be called to assist. Please consult your company policies and guidelines.

Do you want to make a positive impact? Have that conversation NOW.

Effectively talking to someone who you think may be struggling with a mental health condition at work can be fiddly and unclear. As a result, managers and supervisors postpone or avoid these conversations, especially if we think the person is going to respond with resistance. Maybe we hope the issue will resolve itself. It almost invariably doesn’t though.

Sometimes individuals dealing with mental health issues aren’t ready to admit it to others or themselves. I certainly wasn’t. It’s not an easy thing to accept. The stigma of mental illness, especially in the workplace, has decreased but it still exists. This can lead people to refuse assistance or refuse to acknowledge the problems directly.

Unfortunately, if left unaddressed, behavior resulting from mental illness may cause difficulties at work and result in discipline, termination or other negative workplace consequences.

As a manager, co-worker or ally you can be proactive and discuss the behavior with the person before it escalates into discipline or termination. The earlier you speak with someone, however uneasy this may be, the higher the chance for optimal outcomes. Early conversations also offer the best opportunity to prevent a condition (if present) from escalating or becoming chronic.

Letting a person who you’re concerned about know you’re willing to listen without judgement, support them and problem solve can open the door for discussion.

This is what Liz, my boss at the marketing company did when I went to her for help. Even before that, she prepped the ground for positive interactions. From the start of my time there, she focused on building a personal rapport with me. One based on trust, respect and active listening. She was frank, firm, fair, kind and honest. When I had difficulties, I knew she was the person I could go to and receive wise counsel and fair treatment.

My experience with Liz gave me confidence that has influenced me to this day. THAT is the kind of impact you can make.

 

 

© Victoria Maxwell

Could your workplace benefit from learning how to comfortably address mental health issues? Contact Victoria to discuss the Workplace Mental Health Awareness package: a performance of ‘Funny, You Don’t Look Crazy’ followed by the ‘Ready, Set, Recognize’ workshop. You’ll learn the simple O.A.R.S. protocol to make those awkward conversations easy and effective. Contact me.

While I sipped coffee and munched on a croissant, a supervisor approached me. I had just finished performing ‘Funny You Don’t Look Crazy’ (my story of mental illness and return to work) for a quiet but wonderfully engaged group of managers at a breakfast training event.

He confessed one of the biggest barriers he, the managers and staff face is being comfortable talking about mental health at the company. “We know how to discuss physical illnesses, but mental health issues? Not really.” It’s one of the most common remarks I hear. We don’t have an accepted vernacular and we’re not practiced at it.

Silence kills

This discomfort can lead people to say nothing, ranging from not intervening when they see someone in distress or not speaking up when they need help for themselves. Enter the deadly (literally) silence.

Results from a University of Oxford study found leaving serious mental illness untreated can shorten an individual’s life by as many as 10 to 20 years, similar to the mortality risk of tobacco smokers. 1

I started performing my one person shows about my experience with bipolar disorder and recovery back in 2001. At that time, other than Margot Kidder and Kay Redfield Jamison, there were few people divulging the personal secret of psychiatric disorder.  

Over the last 15 years though, we’ve made good strides in addressing mental health and making it more common place to discuss. We have the “Bell Let’s Talk” campaign, Mental Illness Awareness Week in October and Mental Health Week in May, to name just three.

However, even with these awareness initiatives, the discomfort of discussing mental illness in the office remains, and silence ensues. Silence breeds fear, drives myths and lets stereotypes remain unchallenged. These then reinforce reasons (though unfounded) for individuals who are struggling to refrain from getting help.

Using data collected from close to 500 university staff and students, a 2014 Australian study found the “silence surrounding mental health problems permeates … environment(s) and impacts on help seeking behaviours… (and the) recovery and well-being of affected individuals.” 2

According to another study out of Toronto, silence has negative implications for relationships and productivity in the workplace as well. 3

Programs that raise awareness and aim to reduce stigma are important. But if people’s discomfort of discussing mental illness is never addressed, these campaigns will be of little long term benefit.

4 steps to create comfortable conversations about mental health

Whatever role you hold in your company, the following are 4 strategies to increase your comfort and effectiveness when discussing mental health.

1. Find Company Mental Health Champions. Share Stories. Get Real.

Safe, inclusive and supportive environments will stop the silence on mental health.

Elio Luongo, Chief Executive Officer and senior partner, KPMG in Canada in a Special to The Globe and Mail agrees. How they went about that was a first in corporate Canada.

In 2017, they created the role of Chief Mental Health Officer (CMHO). They enlisted, Denis Trottier, an audit partner who has “lived through clinical depression while maintaining a successful career”. 4

Having an individual willing to disclose their own experience with mental illness and recovery can open up dialogue, change perceptions and create comfort faster than any other kind of educational program. Patrick Corrigan, one of the foremost experts in stigma research, found in study after study, the most effective method to change attitudes about mental health is what’s called contact-based behavioural health anti-stigma interventions. That is, “people with lived experience of mental illness or substance use disorders interact with the public describing their challenges and stories of success.” In fact, this kind of approach is twice as effective as an educational program alone. 5, 6

At Coast Capital Savings, then CEO Lloyd Craig, shared his devastating story of losing his son to suicide. Craig was a pioneer in workplace wellness initiatives and the Credit Union became a model for workplace mental wellness. In a short time, measures they took, which included Craig sharing his story, produced noticeable results. 7

Discomfort around mental health will only dissolve when people see it’s safe to share stories and ask for help. As Luongo puts it, it’s essential “we walk the talk, right from the C-suite level so that our people can be comfortable sharing their stories and talking openly about mental health at the firm.”

2. Be prepared for and accept the uncomfortable feelings.

Like difficult conversations that are…well…difficult. Uncomfortable topics are… well…uncomfortable. Paradoxically, knowing and accepting that something will be uncomfortable can make the experience easier to bear. Two studies out of Denver found accepting (versus avoiding) negative emotions was shown to be associated with reduced levels of anxiety and stress.8 Prior to talking about mental health, assume unpleasant emotions and sensations will rise within you. Your job is only to tolerate them, be mindful of those awkward feelings and continue the discussion. Preparing for them will make the conversation easier.

3. Practice talking about mental health.

Practice brings experience. Experience brings mastery and mastery brings confidence. 9, 10  Be intentional. Start with low risk situations. Take strategic opportunities to discuss mental health in casual conversation in positive terms. The more you do, the easier it will become. For example: decide that for each day over the next week, you will learn something about mental health and share it with others at work or on social media. Or choose to disclose something personal about how you stay mentally healthy. Let people know what you are doing and encourage them to join. Ask people what do they do to stay mentally well.

4. Make it fun and be curious.

This sounds counter intuitive, even improbable, maybe even insensitive. Make mental health fun? Yes. Even though mental illness can be a heavy subject that doesn’t mean learning about it, or creating a supportive environment, has to be. I consider myself to be an mental health icebreaker of sorts. I use a lot of humour as I share my personal experience with anxiety, depression and psychosis. Yes, I’ve managed to find something pretty funny about running down the street naked while in a psychosis – I think flirting with the ambulance guys has something to do with it.

Self-deprecating humour goes a long way to help people feel like they don’t have to walk on eggshells. A lighthearted and respectful approach opens dialogue up as well as people’s hearts and minds. The more serious we are about a subject, the more cautious we are asking questions and the more difficult it is to discuss.

Start simply. Hold short lunch n’ learns that explore well-being, host interactive workshops that offer strategies for mental wellness and self-care. Focusing on mental wellness first, can prime the pump for mental illness topics.

Silence is not golden. Speak up.

Michael Landsberg, former sports host of TSN’s Off the Record , lives with generalized anxiety disorder and depression and is a staunch mental health activist. He says: “When we talk openly, frankly and honestly about mental health, we’re one step closer to healing.” 11

The silence around mental health will only be broken if we take the risk to speak up. Every time we make a decision to talk about it, and not remain quiet, the more healing is possible. This means healthier companies, stronger communities and more vibrant families.  

How do you speak up about mental health at your work? Comment below and let me know.

For more Mental Health resources, tips & tools, sign up for my newsletter.

© Victoria Maxwell

References

1. University of Oxford. “Many mental illnesses reduce life expectancy more than heavy smoking.” ScienceDaily. ScienceDaily, 23 May 2014.

2. Curtin University. “The silence of mental health issues within university environments: a quantitative study.”: Archives of pychiatric nursing, Vol: 28, Issue: 5, Page: 339-44 Publication Year: 2014

3. University of Toronto. “Mental Health Issues and Work: Institutional Practices of Silence in a Mental Healthcare Organization” by Sandra Moll; Doctoral Thesis, 2010 

4. “Corporate Canada needs to help break the silence on mental health”  by Elio Luongo; Special to The Globe and Mail; January 31, 2018

5. Corrigan, P.W. (2012). Where is the evidence supporting public service announcements to eliminate mental illness stigma? Psychiatric Services, 63(1), 79-82.

6. National Academies of Sciences, Engineering, and Medicine. 2016. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington, DC: The National Academies Press. 

7. “Employers Who Are Walking the Walk” by Donna Panitow; Reprinted from “Workplaces” issue of Visions Journal, 2009, 5 (3), p. 29-30

8. Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Shallcross AJ, Troy AS, Boland M, Mauss IB. Behav Res Ther. 2010 Sep;48(9):921-9. doi: 10.1016/j.brat.2010.05.025. Epub 2010 Jun 1.

9.  Conger KJ, Williams ST, Little WM, Masyn KE, Family Research Group B. Development of Mastery during Adolescence: The Role of Family Problem Solving. Journal of health and social behavior. 2009;50(1):99-114.

10. Why a Sense of Mastery is the Key to a Better Confidence?  by Evelyn Marinoff

11.  Michael Landsberg, quote: https://www.thelavinagency.com/speakers/michael-landsberg

Warning: possible triggering content. This post deals with suicide.

We lost two high profile individuals by suicide in the last couple weeks. But there are thousands of people who will die by suicide today who we won’t hear about on TV. Those people mattered too. There are millions more who are suffering from the pain of mental illness in silence.

I was struck by something a colleague said to me, “we’re talking publicly about mental illness now, but we still don’t know how to help”. It’s true. We are talking about mental illness more; suicide even. But many of us, including me, are still sometimes unsure about how best to help a person in distress, or a person in pain who doesn’t want help. I don’t want to offer trite advice to them. I sometimes don’t want to say “it’ll get better” – that seems so vapid and ineffectual.

When I was suicidal, I could barely hear what people were saying to me. Literally, it’s like my brain couldn’t untangle the meaning of their words. And I was SO uncomfortable in my own skin. But frankly, most times it did help when someone told me it would get better or at least it would pass.  Just having someone present, and willing to sit with me made a difference. Because eventually it did get better. Eventually it did pass.

Before I go further, I want to add many people, particularly families, do everything they can to help their loved one. Parents, siblings, relatives and friends reach out in every possible way. Sometimes it’s enough. Sometimes, tragically, it’s not. That’s the reality. And the result is tragedy for everyone involved. If you’ve experienced that, I don’t have the words to adequately express my feelings. ‘I’m so sorry’ seems empty, but it’s all I have. This post is not meant as a panacea or about saying you should have done more. Not. At. All.

It’s meant to offer some resources and perhaps some guidance for those unsure what to do or for those in pain.

If you are suffering:

Know this: YOU matter. If you feel like no one cares, NOT true. I care. I don’t care what your mind is telling you. Please reach out. Please talk to someone.

If you don’t have people to speak to or you don’t want to call people you know, call a distress line. That’s what I did. There were times when I couldn’t stomach the idea of admitting how I felt to someone who knew me. So I called our local crisis line where I could remain anonymous. It helped. It did.  Click here for crisis line numbers.

If you can’t bear the thought of talking with a person please look at http://unsuicide.wikispaces.com for online suicide prevention help. ‬

If you are suicidal:

Read this first.

If you think someone you know might be suffering:

Please reach out to them – even if you don’t know what to say or how to say it. When I was in pain it was so difficult to share how desperate I was feeling. You might save a life. Ask. Tell them you care. Talk to them. Call them.

My fellow Psychology Today blogger Deb Serani offers excellent suggestions in this Psych Central blog interview on Psych Central about how to be there for someone in emotional pain.

Please also visit my website for a downloadable Mental Health Resource e-guide.

This post from Dr. Sandra Hamilton offers further tips.

When I was struggling, my friend Kerry would have me over for a bowl of borscht soup with fat dollops of sour cream. We’d just sit there, slurping soup. We munched on these heavenly white doughy buns and had deceptively uneventful conversations. But having him there, willing to be with me while I felt like I was in a dark hole gave me reason to hang on until the shadows passed.

His presence helped me feel connected to Life and to be honest, to Love. That was more important than anything he said or did. Don’t underestimate the power of your presence.

Please forward or share.

© Victoria Maxwell

As an HR manager you already know mental health issues are taking a toll in your workplace. But you may be at odds as to how to effectively and comfortably address them. How do you get comfortable talking about mental health issues in the workplace? You need concrete tools to help staff feel comfortable reaching out for help and skills to offer co-workers so they’re equipped to support a colleague.

The good news is you can do this with relatively little financial investment.

It’s a process, takes commitment and consistency, but creating exceptionally healthy workplaces always do. And I bet, as an HR expert, you’re already passionate about creating positive changes for the people and organisation you support.

People do and can recover from mental illnesses with timely and appropriate treatment. People, like myself, return to living rich, full lives and have satisfying and productive careers. I was diagnosed with bipolar disorder and generalised anxiety disorder. I was extremely depressed and even suicidal for a time. But, with the right support, and that meant the right support at work, I returned to be a productive employee and eventually opened my own thriving business.  

You are part of the solution.

Below are three resources that will help. Begin to implement some of the following and your workplace ecology will positively shift. You’ll see staff flourish, along with the bottom line.   

1. The Wizards of O.A.R.S. (Observe, Approach, Refer, Support) free e-guide.

I created this e-guide to help individuals become comfortable when wanting to support an employee or co-worker. It’s a step-by-step framework of what to do when a colleague may be dealing with a mental health issue. Read it and see if it brings more confidence to your conversations about mental health issues in your workplace.

Oars bring balance, stability and direction to a boat. So too can people give support and guidance to those around them who may be facing mental health issues. The following is for non-urgent situations. If you feel the individual is at risk of harming themselves or others, immediate care should be sought at the nearest emergency ward. Download the guide for a detailed description of each step and more tips.

Observe – changes in behavior, length present

Approach + Listen– discuss concerns in terms of behaviour. Focus on actions

  • I’ve observed that or I see that… (ie: you’re not joining us for lunch any more or you’ve been missing meetings or you’ve had more accidents lately)
  • I’m concerned… (ie: you don’t seem like yourself or you seem to have less energy than usual…)
  • How can we support you at work to help improve things for you or What can we do to improve things at work for you?
  • Then…LISTEN (Active listening skills are needed – Here’s a short video that gives tips on this particular kind of listening)

Refer – to resources in the workplace and/or community  (i.e. EAP, counselling, support groups, etc.) Also please visit the resource page to download a Mental Health Resource Guide for additional tools.

Support – as best as you can. Use active listening skills (see above).

2. Proactively supports employees’ mental health by implementing some of the evidence-based guidelines of a psychologically healthy and safe workplace.

The Mental Health Commission of Canada has endorsed these standards as a way of working towards and positively affecting the mental health of your most valued investment: your workers.

Standard for Psychological Health and Safety in the Workplace materials can be found here.

3. Check out Mental Health First Aid programs, hereLike physical first aid courses, they teach how to confidently help someone dealing with a mental health issue or crisis until the appropriate support arrives.

As a human resource manager, you juggle many responsibilities. You have the power to influence the work environment and the health and productivity of the staff. Use your power for good and create a legacy that includes creating a mentally flourishing workforce.

If you’d like a customized interactive workshop based around it, please contact me at victoria@victoriamaxwell.com

© Victoria Maxwell

I get heartbreaking messages every week. Parents email me because they desperately want to help their adult child who has a mental illness, but refuses help. A teacher who’s struggling with bipolar disorder but doesn’t know where to turn. A manager sees one of his employees grappling with anxiety and depression and wants to know how to best handle the situation.

This is all excellent. I don’t mean it’s good people are suffering. But it’s good people are reaching out for help more. The shame and stigma of mental illness is still present to be sure, but it is diminishing, if only because the pain people are no longer willing to endure.

I’m not a therapist or doctor, but I am an expert by experience. Over the course of the past 20 odd years (and trust me, some years were really odd), I’ve learned to manage the symptoms of bipolar disorder, anxiety, psychosis and recovered from disordered eating.

There are thousands of mental health websites and resources available. The ones I’ve put in this downloadable mental health resource and tips e-guide are the ones I trust most. They have been a crucial part of my wellness journey. It’s important to me that you have the same tools to lean on and have some next steps to follow to help you on YOUR way. You will also find it available on my resource page.

Some are region specific, many are not. Not all will be applicable to your particular situation, but many will be. Some are for loved ones searching for effective ways to support their family members. Others are for individuals living with a mental health issue who want to find guidance to build a better life. I encourage you to explore and then reach out to the organizations or people listed below that fit your needs.

In addition, you may want to read my post Psychology Today post “How to Find Help When the Person You Love has Mental Illness” to learn concrete strategies to navigate the confusing mental health system.

Things may feel heartbreaking, but it’s never hopeless. I know. I’ve been there.

How do you help your child without hurting yourself?

One of the most painful experiences can be watching your adult child reject the help you know they need. What can you do when your son or daughter refuses to accept they have a mental illness or need medication? I asked my dad about it because I was one of those adult children.

It was a spring afternoon and my dad and I were listening to one of his favourite classical CDs. I asked him what advice he would give to other parents of adult children who have mental illness. He prefaced his thoughts with this: it probably isn’t what parents want to hear, but it’s what we went through and what helped.

1. It’s going to be a long difficult journey, so hang on. If you’re prepared for an arduous lengthy process it helps to manage unrealistic expectations. Paradoxically it will be a little easier to endure the trek. Don’t be discouraged. Just because it’s taking a long time, doesn’t mean recovery won’t happen.

2. Stay in contact with your adult child no matter what, even if they don’t want to be in contact with you. My parents tried to stay in contact with me by phone. When I wouldn’t return their calls (which was usually the case), they would drive by my house to see if a light was on. When they didn’t know where I was living (because couch surfing was common for me), they attempted to keep in touch through my friends. This might seem extreme, even invasive. But my behavior had been so erratic and perilous it was crucial to have some communication, to have some way to intervene if a crisis occurred.

Reflections on what my father said and what my parents did:

3. The more my parents offered help, the more I pushed them away. But having them stay in touch with me, no matter how intrusive it felt, kept me safe (or as safe as possible at the time). Even when our encounters were filled with yelling, swearing, the slamming of car doors, it didn’t matter. What was pivotal was that they had contact with me.

4. Although I fought the support my parents extended to me for over 5 years, their unconditional love always reached me, even when we were arguing. When the time came and I finally realized I needed help, the unwavering acceptance they had shown allowed me to reach out to them for that help. I knew they were my safe place to fall even though I had pushed and pushed and pushed them away so many times.

5. My parents were clear: they were open and accepting of my diagnosis. They didn’t have any judgement about mental illness. So if I chose to reach out for help, they would be there with open arms. This approach provided fertile ground for my own acceptance.

The timetable for recovery is different for everyone. And the definition of recovery needs to be flexible and fluid. If you, as a parent, are feeling overwhelmed, exhausted and frightened, this is natural. This IS an overwhelming, scary and tiring experience.

Get support from other family members going through the same ordeal. Contact your local mental health group* for family support groups. Knowing that you are not alone in this journey can be life saving. And you may find you are more on track that you realize.

What are suggestions you would tell to families trying to support a loved one with a mental illness?

© Victoria Maxwell