The rise in workplace depression and anxiety is causing job culture to change

by Nicky Pellegrino / 25 September, 2017
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Illustration/Getty Images/Listener

If you are struggling in the workplace, you’re not alone. A growing number of experts say it’s time we started talking with colleagues and bosses about our emotional health.

I used to leave the office, get in my car and drive down to a spot overlooking the Auckland harbour, where I’d park up, then sob for 10 minutes or so before completing the journey home. I was going through a serious bout of depression, but I never told my manager or the people who reported to me at work, because I didn’t want to seem weak and unfit to do my job. Looking back, surely someone must have guessed what was going on. Perhaps they just didn’t like to say anything.

Kara Smith is among a growing number of people doing their best to change workplace culture so that emotional health becomes an acceptable thing to discuss among colleagues. A general manager at IT recruitment company Talent International, she lost an older brother, Allon, to suicide in 2010, when he was 37. He had been working in Australia, and although the family knew something wasn’t right, no one realised he had been severely depressed. “He must have felt incredibly isolated,” Smith says. “I don’t think he thought it was okay to open up about it.”

That loss has made Smith more aware that people around her might be struggling in the way Allon was. She believes we have a responsibility to look out for each other’s mental well-being in the workplace as much as in our home lives.

“We spend at least a third of our time at work, and it’s often a second home,” she says. “We sit around in an office together for eight or nine hours a day, so an employee might be the first one to notice that something is not quite right and have an opportunity to help. What I’m trying to do is to create an environment where people are more open with each other.”

Bombardment stress

If many of us are struggling to cope, it’s hardly surprising, says Auckland clinical psychologist Natalie Flynn. She has been practising for 22 years, and in the past five years, she has started seeing a new trigger causing problems for her patients, which she calls “bombardment stress”. “A lot of people who come to me are stressed not just because of increased workload and lack of me-time but by the complexity there is to our lives now and the amount of information we are getting,” she says.

In this digitally driven world, we are assailed by a mass of contradictory opinions and advice, whether we’re working as lawyers or farmers or raising children. It’s all too easy to become overwhelmed and paralysed by self-doubt.

Flynn has found many people are reluctant to admit they’ve reached a crisis point. “Sometimes, I have to do a lot of work to get them to accept a diagnosis of depression. They want to think they’re stronger; that they should be able to handle that 10-hour working day.”

Kara Smith says we have a responsibility to look out for each other’s well-being in the workplace. Photo/Rebekah Robinson

Tough business

Recruitment can be a tough business with high staff turnover, Smith says, and Talent has an employee-assistance programme offering workers free counselling. Smith has been looking at other tactics for breaking down barriers, such as joining her team in weekly physical-training sessions, hammering a punching bag and getting sweaty together.

“People often think the boss has to be this staunch person who never shows any emotion,” she says. “But I don’t believe that’s right at all. By showing you’re human, it makes you more empathetic. Colleagues are more likely to come to you for help, or to ask if you need some.”

The pay-off is better worker retention and productivity, says Smith, who is communicating her message to Talent’s corporate clients. This has included getting mental health campaigner Mike King along to speak at a business breakfast.

King uses his skills as a former stand-up comedian to disarm his audience. As he talks about his self-esteem issues as a child and his adult experience with depression and addiction, he is honest and funny. Then he starts asking questions. Who here has suffered depression? Who has needed counselling? Who has had suicidal thoughts? A forest of hands goes up. While it’s fewer for that last question, it’s still a shock to see the number of successful people in management positions who have at some point contemplated ending their lives.

King is used to it. He’s made similar speeches all around the country and seen the same reaction. Recently, he asked a roomful of hundreds of men in Taranaki who among them had never had a suicidal thought. Only six stood up. “I allow people to recognise themselves in my story, but the most important part of all my talks is the questions,” King says. “What I’ve noticed is people want permission to admit we’re all struggling. Everyone wants to take their mask off.”

His preference is to speak to schoolkids, which he does for free. But in the interests of putting food on the table, he started booking paid corporate sessions. “And my diary is full. I can’t meet the demand.”

There is a trickle-down effect, of course. It can only help our youth – who, according to Unicef, have the highest suicide rate in the developed world – if parents lose the “harden up, mate” attitude and learn that it’s okay to express their feelings.

But he worries that putting the label “mental illness” on normal emotions such as anxiety and depression isn’t helpful, because it increases people’s fear of being judged if they talk about how they feel. “Having a suicidal thought makes you human, not mentally ill. No one wants that label.”

Mental health campaigner Mike King.

“Okay to be vulnerable “

King is campaigning full-time to change attitudes through his Key To Life Charitable Trust. Its latest programme, I Am Hope, involves distributing wristbands to kids and adults that signal to anyone in need that the wearer will help them, without judging. He has been blown away by the response.

“I’ve just spoken to 300-odd construction workers in North Otago and afterwards they asked for 200 more of the bands to wear to show their kids it’s okay to be vulnerable.”

King says the message is starting to get through. “There’s a real shift; a real sense of change happening,” he says. “I’ve been in this for four years and never seen anything like this year. When I started out, I’d get six people turning up to my free public talks. Now I’m getting 600. That’s a real attitude change. A lot of people are looking for positive solutions.”

Shaun Robinson, chief executive of the Mental Health Foundation, is seeing the same thing. Recently he had a record number of people along to a talk he gave at an Employers’ Association meeting in Canterbury. Hundreds of thousands more people have accessed material on the organisation’s website and its Farmstrong well-being programme, aimed at the farming community, is growing rapidly.

Farmstrong was seed-funded by the Movember Foundation but is now backed by ACC because it has seen a link with a reduction in farm accidents. It’s all about getting rural workers, who are often isolated and traditionally meant to be stoic, to open up to one another. There’s a dedicated website, farmstrong.co.nz, and Healthy Thinking workshops have been run throughout the country.

“We’ve just finished our second year, and the recognition of Farmstrong in the rural community is at 50%,” says Robinson. “People who have participated are showing about a 15% improvement, compared to the baseline of farmers, in terms of their own perception of how they are coping day-to-day.”

Marlborough farmer and depression sufferer Doug Avery is also an advocate for farmers battling stress. He is in demand as a speaker on the emotional issues rural workers face each day and has won awards and honours for his contribution to mental health in the country.

Mental Health Foundation chief executive Shaun Robinson: “Mental distress is usually invisible, but it’s still very real.” Photo/Rebekah Robinson

Hesitate to confide

Although a host of public figures have spoken out about their experience of depression – former All Black Sir John Kirwan and fashion designer Denise L’Estrange-Corbet among those in this country; everyone from Prince Harry to author Marian Keyes internationally – there is still a stigma associated with it. Many people would hesitate to confide in their boss or co-workers. Robinson cites research from the Scottish mental-health programme See Me Scotland that found 50% of workers wouldn’t tell their manager they were experiencing emotional distress.

Preliminary analysis from the 2016 Health and Lifestyles Survey suggests that figure is higher here. Only a fifth of workers said they would tell their employer if they were diagnosed with a mental illness and just a tenth indicated they would tell their colleagues.

Many workplaces are trying to change this, partly because they have to, with stress and mental fatigue becoming health and safety issues. Since a fifth of us are experiencing some sort of emotional distress at any one time, most workplaces are dealing with these issues daily.

“We don’t stop being human when we walk through the door at work,” says Robinson. “Whatever is happening in the rest of our lives doesn’t go away. Mental distress is usually invisible, but it’s still very real.”

Not only is it real, but it’s costing us money. In a 2016 study of eight countries, including the US, Mexico and Japan, Sara Evans-Lacko of the London School of Economics examined the effect of depression on the workplace and the costs associated with both absenteeism and presenteeism (when you are at work but not functioning at your normal level). She found it was a considerable issue for all the countries, regardless of their economic development, and collectively it was costing $246 billion a year.

The costs associated with presenteeism tended to be five to 10 times higher than for absenteeism. And managers were those most resistant to taking time off, so they were responsible for more of those presenteeism losses.

Increasingly, big companies are coming to the understanding there can be a return on investment when they introduce screening and treatment programmes for employees. Big corporates, such as Unilever, are leading the charge in trying to find effective ways to reduce depression in the workplace. The food-to-cosmetics company was involved with a 2014 report that found 55% of employees diagnosed with depression needed to take time off work because of the illness.

Unilever’s former global vice-president of human resources, Geoff McDonald, has spoken about his experiences, telling the UK’s Telegraph, “I woke with a panic attack that was so severe I thought I was having a heart attack and was going to die. I went to the doctor the next day, who diagnosed me with anxiety-fuelled depression.”

McDonald stepped down from his Unilever job in 2014 to focus on Minds@Work, a UK-based organisation dedicated to making workplaces mentally healthier. In New Zealand, the Mental Health Foundation has been putting energy into the same sort of thing. Among resources offered is a booklet, Working Well: A Workplace Guide to Mental Health, downloadable free from mentalhealth.org.nz.

“We’re now seeing businesses coming back with programmes they’re implementing that draw very heavily on the material,” says Robinson. “It’s starting to really gather some pace – from big organisations like The Warehouse, ACC and Coca-Cola, to smaller businesses. People are recognising that positive well-being creates engaged, productive staff, reduces presenteeism, increases turnover and contributes considerably to the bottom line.”

Investing in employees as an asset involves more than subsidising gym memberships and putting out a free fruit bowl. If staff are constantly overworked and under pressure, the warm fuzzies don’t cut it.

Work/life balance falling

We are working hard as a nation. According to 2013 Census data from Statistics New Zealand, more than 40% of full-time managers put in over 50 hours a week. The OECD Better Life Index has us falling at 28th out of 38 countries for work-life balance (the Netherlands comes out best and the US and Australia are trailing behind us at 30th and 31st respectively).

“Working people harder and harder can be counterproductive,” argues Paul Dalziel, a professor of economics at Lincoln University. “Particularly when a certain amount of observation and creativity is required in staff.”

In a book he co-authored, Well-being Economics (Bridget Williams Books), Dalziel offers the case study of a Southland dairy farm that invested in extra workers and moved to a more socially friendly five days on/two days off working model so staff could do things such as play football on a Saturday or go to church on a Sunday. As a result, workers were less tired and burnt out, and that affected the bottom line. “While there was a rise in salaries, the staff were picking up on things like animal health, so that was paid for by reduced loss of stock,” Dalziel says.

He is aware that small-business owners, most likely stressed themselves, may look at caring for staff as yet another demand they have to meet. “But sometimes, a very small change can make a big impact on both the well-being and the productivity of the workforce. It can be a win-win for the employer and the employee.”

Success stories

Much the same conclusion was reached by a Like Minds, Like Mine research project, called What Works, done on behalf of the Mental Health Foundation. Dr Sarah Gordon, of the University of Otago’s department of psychological medicine, looked at success stories, interviewing a number of people with experience of mental illness and their employers to get some idea of what was needed to create a healthy workplace.

“One of the most interesting things was when we asked the employees if there were accommodations being made to support them, they would say yes,” says Gordon. “But when we asked the employers if they provided special accommodations for these people, they would say no. The main ones were increased flexibility of working hours, sick leave arrangements and location – and employers didn’t see them as out of the ordinary.”

All workers, not just the depressed ones, need some flexibility and support, says Gordon. They all have things in their lives that need to be accommodated, from sick kids to aged parents. The What Works research also examined difficulties around disclosure. When do you tell an employer you’ve had a mental-health issue – at the outset when you’re being interviewed for the position or down the track when you’ve proved you can handle the role?

There are no straightforward answers, although Gordon spoke to some employers who admitted they were glad they hadn’t been aware of a mental-health problem at the interview stage because they might have excluded a person who then turned out to be a valuable member of the team.

Simpson Grierson’s Jo Copeland.

Wake-up call for lawyers

The legal profession has been among those hardest hit by depression and anxiety – lawyers are 3.6 times more likely to suffer. The suicide of top barrister Greg King in 2012 was a wake-up call for the sector, and mental health is now a huge focus. For Jo Copeland, head of HR at Simpson Grierson, that means intervening early. As part of their induction, new graduates joining the company are told it’s okay to admit if they’re struggling.

“Afterwards, without fail, I’ll always have one or two come up and say they suffer from depression and anxiety,” Copeland says.

For her, a tipping point was discovering a young lawyer employed by the firm was crying himself to sleep every night and feeling suicidal because he believed he had to hide the fact he was gay in order to survive his profession. “It’s hard enough to manage in this perfectionist, high-achieving environment without feeling that,” she says.

Simpson Grierson now has the Rainbow Tick to show they embrace diversity and a comprehensive mental health plan. Its approach is compassion first, and partners have had training to help them spot signs of a colleague in trouble. If necessary, the company will hold jobs open for 18 months. It also allows staff to buy extra annual leave and is involved in an Outward Bound scholarship, Take 21, for young lawyers who might be at risk.

Other initiatives to build resilience include an internal website – called OK? – focused on mental wellness and they are developing staff workshops. “This is the most rewarding work you can do,” says Copeland. “We know we’ve prevented suicides.”

The World Health Organisation says depression is the leading cause of disability worldwide and a major contributor to the global burden of disease. There is a link between psychological health and heart health, for example, and a recent study from the University of Munich suggested depression should be considered alongside cholesterol levels and obesity as a risk factor for stroke and heart attack.

A US study suggested elevated stress hormones, such as cortisol, could lead to problems with blood-sugar metabolism, increasing the risk of diabetes. And stress and depressive episodes have also been linked to a rise of inflammation in the body.

Afraid of derision

As part of her treatments, Auckland clinical psychologist Natalie Flynn brainstorms and role-plays with clients. “Some have very reasonable requests/information to give to their employers, but are simply afraid of being met with derision or being looked over,” she says.

“I’m talking about issues such as approaching employers about physical pain or a mental-health diagnosis. Even in mental-health services, a place that promotes empathy and kindness, I often see sensible, resilient workers being driven to distress because of lack of support as they burn out to meet management goals.”

I was one of the lucky percentage that responds to medication (there is evidence that they are ineffective for 30-40% of people who use them as a sole treatment). A year on fluoxetine levelled my mood and cleared my mind enough for me to understand what had triggered the problem in the first place. I had become overwhelmed trying to do a demanding job and write a novel to a deadline.

That was more than a decade ago, and since then, I’ve been careful not to make the same mistake again. I work hard, yes, but never too hard, because I remember how it felt when all the joy drained from my life. And I don’t want to go back there.

Where to get help

  • Lifeline: 0800 543 354 (available 24/7)
  • Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
  • Youth services: (06) 3555 906
  • Youthline: 0800 376 633
  • Kidsline: 0800 543 754 (available 24/7)
  • Whatsup children’s helpline: 0800 942 8787 (1pm to 10pm; 3pm-10pm weekends)
  • Depression helpline: 0800 111 757 (available 24/7)
  • Rainbow Youth: (09) 376 4155

For more information, try the Mental Health Foundation’s free resource and information service on (09) 623 4812.

This article was first published in the September 9, 2017 issue of the New Zealand Listener.

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