While talking about mental health and admitting the problem is beneficial, above all people need encouragement to accept evidence-based treatment and to normalise their lives as soon as they are able once treatment has been felt to be working and benefiting the individual.
A concern is the reticence of people to inform their employer of the nature of the illness lest they be penalised. If employers were more receptive to mental health problems in a manner analogous to their appreciation of physical illness, and especially when the cause is work-related, then their path to treatment seeking and wellness would be significantly enhanced. Investing in the training of managers so that they assist rather than stigmatise those with such problems would be a worthy exercise.
Information on one such initiative was published in Lancet Psychiatry earlier this month. The project leader and author was Dr. Josie Saville-Milligan of the University of New South Wales in Australia.
The investigators recruited managers at the level of commanders from the fire service. The 128 managers were divided into two groups. One group were given a four hour training programme in respect of mental health, and the second group were offered it at a later stage. It consisted of information on the symptoms of depression, anxiety and other common mental disorders.
It also advised on helpful responses to make to somebody with one of these conditions and provided them with the language to do so. An unhelpful response to somebody with depression would be “but everybody gets depressed at some time” while a helpful one would be “I’m sure this is a very difficult time for you”. Assistance on implementing these positive communications was then provided.
Managers were advised to meet with the employee, early in the course of their identified illness, to make practical suggestions, to encourage treatment seeking, to discuss return to work options and to reassure that the door was “always open”. They were specifically advised to avoid psychotherapeutic comments, as this was beyond their expertise. The study aim was to investigate whether exposure to such a programme would change sickness absences over the subsequent six months among those supervised by these managers.
The results showed that for those who received this training, the absenteeism among their employees did reduce significantly. This is an important finding since firefighters have high absenteeism rates due to mental health problems and being first responders are exposed to high levels of stress and trauma.
The public health implications of this study are significant if they are bolstered by other similar studies conducted in other high-risk groups such as hospital employees, soldiers, police officers and so on. The intervention for the managers was brief and practical. They were advised against any efforts to be amateur therapists, a temptation that many succumb to in an effort to be supportive. And, as a result of the training, they felt comfortable broaching mental health issues with those they were in charge of.
One of the concerns that psychiatrists have about anti-stigma campaigns is that while they encourage discussion of mental health issues, there is little further on offer that can have a concrete impact on those experiencing these problems. This study represents a down-to-earth approach that managers can adopt and it to be welcomed. Of course, the impact of the training may not last and it may be that refreshers, perhaps annually, are required. This is an area for further study. If the findings of this can be translated into other areas of employment then absenteeism rates and productivity could potentially improve significantly and this will be of benefit to society as a whole.