A man is hit by a car. Passersby gather round. He’s not bleeding; they decide he’s fine. He’s not unconscious, but he’s not getting up. They decide he likes attention—or he’s lazy. They don’t have time for this. The man is left on the ground, abandoned.
This was the scenario in a brief black-and-white film clip shown by retired Canadian Forces Lt.-Col. Stéphane Grenier at the Vancouver Mental Health Summit on December 6. A parable for our times?
Grenier likens his return to his workplace after a tour of duty during the 1994 Rwanda genocide to showing up with a broken leg in a cast and having some co-workers and superiors welcome him by kicking him in the shin. In reality, he had undiagnosed post-traumatic stress and depression.
“We would never do that to an employee with a physical injury, but this is what we do to people with mental health problems,” said Grenier to the audience at the Fairmont Waterfront Hotel.
We have to stop looking at everything through the lens of physical injury, he admonished. We know what to do when someone sprains their ankle, but we don’t know what to do when someone “sprains their brain.”
Grenier presented a graduated model showing how many people develop mental health problems. He compared each of the mental health zones to physical injuries or illness along a continuum. The green healthy zone signifies that mind and body are healthy. That shifts into the yellow “sprained ankle” zone—or where there mild mental distress or impaired function. The next is the orange “broken leg” zone. Here symptoms and impairment of a mental condition are more persistent and severe. And finally the red zone, where the mental illness now requires clinical are—the equivalent to stepping on a land mine and losing a foot.
Early intervention
Grenier and presenters Paula Allen partner, consulting, and vice-president, health solutions, with Morneau Shepell and Sean Slater, vice-president, business development, with Solareh all stressed the need for early intervention.
People don’t get sick overnight. A manager or supervisor is well positioned to pick up clues that an employee may have moved into that yellow zone.
“Here on planet Earth, we’re uncomfortable with intervening from a place of caring,” said Slater in his manager’s tool kit talk.
Slater advocated for daily observation by mental health-literate managers. “I’m not talking about Big Brother, stalker kinds of things. I’m talking about taking an active role in the lives of our employees.”
Don’t look for symptoms, Slater said. Look for one or more changes in a person’s behaviour, attitudes or reactions. Watch for anything uncharacteristic that persists for more than two weeks, such as disorganized thinking, decreased concentration, aggression towards themselves or others, unusual patterns of absence, despair, stomach problems or insomnia.
We are all, Grenier said, subject to the “accumulative wear and tear of life,” and there are times we find ourselves in the “bucket of shit of life.”
He cited researchers Brewin et al. (2000), who showed that lack of social support is a far greater risk factor for mental health than trauma severity, psychiatric history and childhood abuse.
“So,” said Grenier, “perhaps the antidote is an infusion of social support.”