Mental health is team health

My last couple of weeks

On Monday this week I had dental surgery: something quite routine and I’m recovering just fine, but the surgery required me to be sedated — something I’d never done before.

Back in 2012 I was diagnosed with a mental health condition called phobia. This is nuanced and different for every patient, but in my case I experience both anxiety and physiological reactions whenever I find myself in a situation where I have reduced capacity to control the situation. (For example, if I’m on a train and the toilet is out of order, my condition will fire up.)

I had very good therapy (thank you NHS!¹) and for the most part my condition is under control: it rarely affects my day-to-day life. But most mental health conditions are chronic: they can’t be cured, only managed, and this became very apparent in the run-up to my surgery.

Sedation was a complete unknown to me. The way it’s described to patients is basically “you’ll feel fine because the drugs make you extremely relaxed and also you will experience amnesia so you won’t even remember the surgery” (or the taxi ride home, apparently, even though I sent perfectly coherent replies to text messages during that time!) This is meant to be reassuring and help with anxiety, but it was fodder for my phobia! A complete unknown situation that is specifically about not being able to control everything… nightmare scenario!

The consequence was that in the week or so before my surgery I had a lot of restless sleeps, preoccupation, and diminished capacity to do my job well. The techniques I learnt in therapy still held strong and in the end I didn’t need any time away from work, but it was bad enough that I did feel it was important to tell people - I told my direct client first, and then on the day when it was particularly bad, I told the entire team at that client.

Telling people that I am mentally unwell helped enormously for two reasons:

1. My colleagues were better prepared for anything unusual. They knew that my behaviour might be erratic or that I might need extra time or support, and they were able to use this additional information to plan better.
2. It helped alleviate my own guilt that being sick meant I wasn’t doing the job at 100% efficiency. Having a health condition is not shameful, and no one treated me like it was something to be guilty or embarrassed about. Having it out in the open made it easier to accept that truth.

Mental health is good for business

Just like how I argue fun is good for business, taking care of your team’s mental health is also good for business.

It might seem that things like giving people more time away from the office is impacting outcomes and deadlines — and maybe it is — but taking care of your team members ensures that they come to work at their best: meaning they also produce their best work. I always believe that good work is better than more work, when the outputs of your work are creative or intellectually complex.

If someone isn’t working in a caring environment, they’re much more likely to be looking for a job elsewhere, too.

Looking out for your team

Long-term mental health conditions take all sorts of forms, from depression through anxiety to post-traumatic stress disorder, addiction and many others. They affect at least one-third of the population so even if you don’t know it, chances are your team has members who are affected.

Mental health is different from neurodiversity (which is usually connected with disability) but the two often go hand-in-hand: for example, many autistic people like myself also experience anxiety. Mental and physical health conditions go together too - for example, generalised anxiety disorder often comes together with irritable bowel syndrome.

If you have team members who are open about their mental health conditions, take them seriously. Mental health conditions are chronic health conditions and should be treated exactly the same way as if you had a team member with chronic fatigue or cancer, for example. If people need time away from work, make sure they get it; without repercussion or judgement.

Commonly, you’ll find team members who are not open about their mental health conditions. This can sometimes be because they are afraid of consequences - of being judged or thought of as lesser than their colleagues, and sometimes it can be because they are judging themselves: silently denying themselves recovery because they don’t believe they deserve care from their colleagues.

If you have team members who appear to need help, be very sensitive in your approach to caring for them, especially if they’ve not directly opened up about it. In one-to-ones, ask people if they’re OK and offer to share any burden they currently have. Remind people that they can take time off without consequence, and encourage them to do it if they’re not feeling well. Sometimes you might need to offer help a few times before the team member is ready to recognise that the help is offered sincerely.

As well as ensuring people get time off, you can also help by understanding what they need to be comfortable doing their job. This might be a reassurance that the work they’re doing is valued, timely and of a high standard. Of course, only provide this reassurance if it’s actually true - if the team member is genuinely struggling, you will need to help rebalance their workload: find people for them to pair with or swap their work with someone else, or change the reported status of the project to one that indicates your project needs help from above. Always remind them that they are part of a team and none of their challenges need to be overcome alone.

Try not to talk about mental health itself in one-to-one settings with colleagues who have not opened up, because this can seem like a judgement, but remind them nevertheless that taking time off sick is always OK and continue to offer support and help with anything they might be struggling with at work.

One area to be especially sensitive with is triggers. If members of your team have PTSD, cPTSD or addiction, they might react in very unexpected ways to things you think are innocent or harmless. They might not be open about these things being triggers, so try not to prejudge your team members as being overly sensitive or assuming that because something is fun or positive for one person that this is automatically true for everyone.

Looking out for yourself

Don’t forget that as a leader your own mental health is just as important.

Sometimes it’s easy to forget that (as accountability moves up the leadership hierarchy) you take on more and more people’s successes and failures as your own, the more people you manage. That mental health concerns you found easy to manage earlier in your career might be harder to manage going forward.

Remember to talk to your own line manager about your challenges if you’re comfortable doing so, and take time off to heal when you need to.

If you feel able to, it can also be good to model this behaviour to your team. Showing them openly that you take care of yourself and take time off when you’re sick can help them to understand that this is allowed for them too. Talking openly about mental health can open doors for members of your team who are nervous about vocalising their challenges.

Of course, this very much depends on how much support you would get from your peers and managers. Not all workplaces are equal and there’s no shame in being quiet - being a “loud and proud” example is a brave action and not all workplaces are equally supportive of such actions.

Practical changes you can make

Some practical changes you can make now to your team whether you have any live challenges or not include:

• Training team members to be Mental Health First Aiders and/or Mental Health Champions. (There are many organisations offering these as training - I didn’t want to link to any one in particular.)
• If your company has an Employee Assistance Programme as a benefit, make sure your team members know it is available and encourage them to use it. When I worked at Citizens Advice, I used the EAP for a mental health issue I was having in the course of some “HR”-type work, and while it was definitely not top-tier therapy, it was great to have an independent voice to do some active listening to my challenges.
• And perhaps most important, include people’s individual mood in your regular checkins. Spotting when mood changes for a person can be the first sign that they could do with some support or extra help or time off. The best mood checkins are ones that aren’t numerical in nature, like the “Jelly Baby Tree” or “Which Nic Cage Are You Today?” (I can’t readily link to these but please consider searching these terms if you’re not familiar!)

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