Putting a face on mental illness

I recently attended a mental health conference where Margaret Trudeau was the featured speaker. Margaret spoke eloquently and passionately about her own struggles with mental illness. She is an incredibly courageous person to bare her soul—to open up completely—in the interest of putting a human face on mental illness.

Her speech, together with the rest of the speakers, confirmed for me something that I already knew: there is a lot about this issue that I don’t know. It also caused me to reflect on my own experience with a very good friend who has a mental illness—one that I never really understood until now.

Blue (not their real name) is a wonderful, kind and generous person. Blue is a very driven person with a passion and desire to succeed that is the envy of many. But what many people do not know about Blue is that Blue has a secret struggle with inner demons that manifest themselves in a number of different ways. Blue has been under the care of a mental health professional in the past; however, denial is a powerful drug. The desire to be normal and/or the belief that inner demons can be held in check by sheer willpower has led Blue to believe that, “I have it under control.”  Unfortunately, Blue does not, making daily living difficult. Life is constant chaos—most of it self-initiated. And in fact, this is where Blue seems to be most comfortable.

I failed Blue as a friend because I was ignorant about what to do. I had no instincts to guide me in how to deal with Blue. I saw white, Blue saw black. What was obvious to me was anything but to Blue. I expect my reaction was similar to that of most people when faced with such a situation. Most do one of the following:

• chalk it up to a passing fad, thinking it will go away on its own;
• trust that the individual (in the case of adults) will seek the appropriate treatment on their own; or
• shower the person with kindness in hopes that kindness and support will be enough to see the person through.

I tried all three approaches and each one failed. I did not stop to understand the nature of Blue’s mental illness. I could never understand how Blue could not grasp the significance of their behaviour. I fell into the trap of thinking “this too shall pass” and I naively believed that I could help carry some of Blue’s emotional baggage, to lighten their load. Instead, I became increasingly frustrated with Blue and even began to question myself. It was not that I didn’t care; I just didn’t know what to do.

With one in five Canadians suffering from a mental health issue in their lifetime, I am sure that many others have had similar experiences. Mental illness not only impacts the individual, but also their friends, families and co-workers. Increasingly, employers will be called upon to provide a psychologically safe work environment for employees—free from stigma—and with sufficient support mechanisms in place targeted to not only those suffering from a mental health illness, but also to their friends and families.

In creating this psychologically safe work environment, my advice to employers is as follows:

• Education is important. If I had known then what I know now, I would have treated Blue differently. It is impossible (and impractical) for line managers to know all the complexities of dealing with someone with a mental illness, but they should know the basics. They should understand how a mental illness might manifest itself, how to react when they suspect someone might be struggling and, most importantly, where to refer someone for help.

• Develop a plan of action. The Mental Health Commission of Canada (MHCC) has done some tremendous work in identifying 24 employer actions that can be implemented to protect and enhance psychological health and safety. They have created an action guide for employers.  The MHCC, together with others, are also working on the development of a standard for psychological health and safety in the workplace, which is expected to be released in the fall of 2012. There are resources available for employers who wish to deal with this issue head-on.

• Access to professional help is vital. An employer can’t make someone seek treatment. All they can do is ensure that professional assistance is available. It is absolutely critical that someone dealing with a mental health issue seek professional treatment. Telling them to “snap out of it” doesn’t work.  Mental illness is a serious condition that deserves the same amount of attention as someone suffering from a serious physical disease such as cancer.

• Create a culture of caring. Although the workplace may be the cause of stress that could further complicate a mental illness, attachment to the workplace can also be critical to an individual suffering from a mental illness. In the case of Blue, it provided focus to keep the inner demons at bay. However, there may be periods of time when someone with a mental illness is simply unable to perform as you would expect. A psychologically safe work environment is prepared to work with an individual to accommodate their disability/illness in anticipation of the “bad days” (e.g., allowing them to work from home). Managers and supervisors are also wired to care. A simple “How are you, is there anything I can do to help?” goes a long way.

• Partner with vendors that understand. Helping an individual with a mental illness return to active employment is different than rehabilitating someone with a physical injury. Up until fairly recently, many insurers did not acknowledge the difference. Ask your insurer to describe the process they follow to manage the absence of someone with a mental illness, and make sure you hear the words, “We get that it’s different from a physical disability.”

The most severe cases of mental illness that make headline news are rare. The real face of mental illness is not scary.  It is people like you and me—productive members of Canadian society with so much to give. The stigma associated with mental illness forces these people to suffer in silence, which is wrong on so many levels. People with mental illness do not chose to be unwell and, yet, our collective ignorance pushes many into the world of denial. Access to treatment could make their worlds so much more fulfilling.

The brain is no different than a heart or lung. Sometimes it works perfectly, sometimes it does not. And when it does not, we need to embrace the individual and throw all available resources at the illness—not push it under the carpet. People like my good friend Blue deserve better.