Mental Health Awareness Week: Prevention and Mental Health

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There is mounting evidence that the growing cost to society of mental illness is not sustainable. The sad reality is that poor mental health is often a ‘silent killer,’ only really raising its ugly head with sporadic and shocking media interest into celebrity suicides or accounts of extreme suffering through adversity. It naturally reinforces a Government funding focus on tackling the ‘end result’ as opposed to taking serious preventative action in the first place.

This year’s ‘Mental Health Awareness Week’ together with the global emphasis on the social and psychological effects of COVID-19, offer a stark reminder of why we should be investing more in providing people with the mental, emotional and social scaffolding necessary to navigate the effects of isolation and social distancing in a healthy way.

Hoffman’s (2020) Psychology Today article, suggests the recent COVID-19 social distancing measures are problematic because interpersonal connections are central to human resilience. He argues that in times of crisis, we experience a heightened reliance on social relationships that enable us to adapt. Hawryluck et al.’s (2004) work on the effects of social distancing during the SARS outbreak, raises concerns over the increased propensity for depression and anxiety as a result of limiting social interactions that are central to managing mental health.

Mental health forms an essential part of who we are and how we feel.

Increased mental wellbeing helps us form secure and trusting relationships with the people around us and increases our ability to thrive in our work and studies. Mental health is the fundamental linchpin that supports our ability to learn, grow and adapt through life’s uncertainties.

Before COVID-19, levels of stress and anxiety were rising incrementally across the global population.

A report published by the King’s Fund (2008) ‘Paying the Price: The cost of mental health care in England to 2026’ suggests that the number of people in England who experience a mental health problem is projected to increase to 9.88M by 2026. In particular, lower-level indicators of poor mental health such as anxiety, are expected to equate to approximately 2.6M people in England alone.

Economic and societal pressures feed a 24/7 ‘always switched on’ culture where sadly, performance is commonly more valued than mental health.

Deloitte’s (2007) ‘At the tipping point? Workplace mental health and wellbeing’ report emphasises the critical role of employers in promoting mental health and wellbeing. It highlights the impact poor mental health has on overall health, the ability to work productively, people’s relationships with others and the wider societal costs associated with unemployment, organisational performance and health and social care.

Ensuring that people enjoy good mental health over their lifetime depends on maintaining a balance between performance and wellbeing by prioritising preventative measures against poor mental health that will pave the way for better outcomes from childhood through to older age.

Risks to mental health begin at birth and then develop at key transition points.

Key life moments such as transitioning from school to work, promotions at work, becoming a parent or retirement, all represent times of change and potential uncertainty. Public Health authorities accept the existence of these risks, yet very little investment is made to support people to make these transitions from a mental health perspective.

The King’s Fund report estimated that 51% of people suffering from anxiety remain undiagnosed and untreated. That figure, together with the impact of COVID-19, makes a compelling case for taking a more uniformed approach to the ‘mainstreaming’ of preventative skills to build positive mental health across the workplace and school communities.

A preventative focus would start to reduce the costs associated with chronic and acute mental health treatments and increase levels of employment and tax revenues. In a nutshell, investing in prevention has the potential to ultimately reduce service costs so that scarce resources can be directed to best effect.

An economic case for prioritising prevention.

The Australian Government have put forward the economic case for prioritising mental health prevention that has projected a cost-saving of $18.8M alone for 11-17-year olds, $8.3M for parental support and a $45.8M for workplace interventions. These big numbers highlight the fundamental connection between improved mental health and their impact on the economy. Prevention makes good economic sense and illustrates that with the right targeted investments, we can strengthen our own nation’s mental health, economic productivity and wellbeing.

However, preventative programmes need clear outcomes and financial rates of return.

Linked to the World Mental Health Organisation, (WHO) The ‘Mental Health Atlas’ report (2017) emphasises the importance of strengthening effective leadership and Governance for mental health and implementing strategies for prevention. On a global stage, their findings showed only 20% of Member States reported the availability of measurable indicators to monitor the effectiveness of services and programmes. Given the economic pressures faced by COVID-19, it is now more important than ever to ensure mental health initiatives have a clear set of outcomes and provide a clear return in investment.

Deloitte’s (2007) report highlights several challenges for employers in successfully implementing workplace preventative mental health programmes. These include a failure to see employee mental health as a priority against other operational demands or implementing a reactive approach to mental wellbeing policies, rather than focusing on prevention and cultural transformation. Other concerns were highlighted around the lack of understanding on how the company currently performs in this space, a weak evidence base to measure the return on investment of any programmes, and a lack of best practice examples to promote improvements. The report highlights the importance of raising workplace priorities around promoting a culture that supports the proactive management of mental health and wellbeing and encourages employers to comprehensively research, measure and monitor employee mental health initiatives for their effectiveness.

The challenge.

You may have noticed that the research and reports referred to in this article are largely over a decade old. The advice around measuring programme effectiveness, together with the challenges faced by COVID-19 mean assessing the effectiveness of mental health programmes needs to be taken much more seriously. It’s going to be far too easy for decision-makers to fall back on existing mental health and wellbeing interventions that offer very little effective outcomes. We are now living in extraordinary times in which old ways of doing things won’t be enough.

Two important challenges will require focus both during and after COVID-19:

  1. Effective and measurable mental, emotional and social support for the workforce, clients and the people in their care
  2. Ensuring people have the skills to maintain relationships, accurate decision-making and self-leadership.

Analyse the current reality: As a leader, manager or HR Professional take the time to reflect on:

  • How confident are you that your people are engaged and mentally healthy?
  • How confident are you that your people have the skills to manage their mental health and resilience?
  • Do they know how to grow and adapt during times of change?
  • Do they know how to avoid burnout?
  • What are the costs of not having the skills?
  • What could a more resilient culture create or mean to your organisation?

Make it count.

I am tired of meeting new clients who have previously invested in ‘tick box’ exercises with little evidence of outcomes or return on investment. ‘Quick fixes’ such as wellbeing App’s, typically work on the basis of employing ‘a positive mental attitude,’ that simply do not address the complex factors associated with workplace absence or attrition. 


I’ve spoken to well-meaning employers who have commissioned mindfulness workshops focusing on techniques for distraction to managing stress, who then come to us with their workplace problems still unresolved. Neither examples focus on creating a solid framework and steady platform necessary for people to proactively make sustainable and long-term changes to their thinking, daily habits or behaviours together.

 

Maintaining positive mental health should be a collective approach rather than an individual problem that puts the onus on the individual in isolation. Ad-hoc learning seminars, ½ day courses and ‘wellbeing days’ only serve to pave over the cracks of employee burnout or poor mental health. 

 

The big questions are; how do you analyse ‘the current reality’ or measure and monitor mental health initiatives for their effectiveness? How do preventative measures against poor mental health feature within your business, your community or do you just focus on reacting to the consequences of mental ill-health?

References

Deloitte Centre for Health Solutions (2007) ‘At the tipping point? Workplace mental health and wellbeing,’ pp. 1-36. Available at: https://www2.deloitte.com/content/dam/Deloitte/uk/Documents/public-sector/deloitte-uk-workplace-mental-health-n-wellbeing.pdf

Hawryluck, L., Gold, W.L., Robinson, S., Pogorski, S., Galea, S and Styta, R. (2004) ‘SARS control and psychological effects of quarantine’ Emerging Infectious Diseases Journal, vol. 10, no. 7, pp. 1206- 1212.

Hoffman, L. (2020) ‘COVID-19 Pandemic, Social Distancing, And Adolescence: Youngsters’ difficulty complying with severe limits to in-person socialization,’ Psychology Today, Available at: https://www.psychologytoday.com/intl/blog/beyond-freud/202003/covid-19-pandemic-social-distancing-and-adolescence

King’s Fund: ‘Paying the Price: The cost of mental health care in England to 2026’ (2008) pp.1-135. Available at: https://www.kingsfund.org.uk/sites/default/files/Paying-the-Price-the-cost-of-mental-health-care-England-2026-McCrone-Dhanasiri-Patel-Knapp-Lawton-Smith-Kings-Fund-May-2008_0.pdf

World Mental Health Organisation: The Mental Health Atlas report (2017) pp. 1-60. Available at: https://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf?ua=1

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