Making it Personal and Meaningful – The importance of creating a much more ‘human’ approach to mental health for people in your organisation

I write this on the back of the very sad news about TV presenter Caroline Flack who took her own life yesterday, and also after having listened to a brief but motivational talk recently from Jamie Tworkowski who is the founder of TWLOHA (To Write Love on Her Arm), a not for profit movement dedicated to presenting hope and finding help for people struggling with depression, self-harm, addiction and suicide. I felt an urge to promote the work and the concept of being ‘human’ as an employer.

I really loved their openness of approach and words of vision, which speak to the individual directly (& which can be found on- line alongside the wider information about what they do as an organisation - https://twloha.com/learn/vision/).

Honest and to the point, I felt that this was something to be signposted to as ‘what good looks like’ for organisations who are creating strategies for employee Health and Wellbeing. Wearing hearts on sleeves and showing that we are all human.

Their very personal vision for them goes like this:

The vision is that we actually believe these things: You were created to love and be loved.

You were meant to live life in relationship with other people, to know and be known.

You need to know your story is important, and you're part of a bigger story.

You need to know your life matters.

We live in a difficult world, a broken world. We believe everyone can relate to pain, all of us live with questions, and all of us get stuck in moments. You need to know you're not alone in the places you feel stuck.

We all wake to the human condition. 

We wake to mystery and beauty, but also to tragedy and loss. 

Millions of people live with problems of pain. 

Millions of homes are filled with questions—moments, and seasons, and cycles that come as thieves and aim to stay. We know pain is very real. It is our privilege to suggest that hope is real and help is real.

I thought they phrased it so beautifully and spoke with deliberate intention to show that they care. Creating a plan to improve the support we give to our employees must start with an understanding of who they are, and what they need. Creating solutions of transforming the quality of occupational process, writing policy and signposting to solutions or information, although helpful are not ‘silver bullets’. I have worked in organisations who have forgotten this.

Our Mental Health is influenced by our relationships, our ability to self-actualise, our psychological safety and recognition we receive. How we feel emotionally in turn influences our attraction, commitment and motivation at work. Getting the wider ‘people strategy’ right is essential…..but getting the emotional and psychological support right is paramount, and should be part of a synchronised approach to creating an environment in which our people can ‘thrive’ through empowerment and belonging. 

TWLOHA focus specifically on encouraging, informing and inspiring around a specific area. It is one that I recognise and is of National importance for any employer. Perhaps as an indicator of its level of importance, Jackie Doyle-Price was appointed the Minister for Suicide in 2018, and the recommendations from some of the most influential national reports on Health and Wellbeing and Mental Health, (Farmer & Stevenson / HEE learners etc) are explicit in making recommednations for employers in the area. And yet it seems to take another high-profile death for us to react, act or indeed express any interest in the area, despite an increasing social media and news presence around Mental Health work in general. 

Sadly, there has been a rise in death by suicide in the UK in recent years, with 20,906 suicides in men and women aged between 20 and 64 years between 2011 and 2018.  

Thinking about my current area of work (Healthcare), data from the Office of National Statistics indicates that 682 health professionals have taken their lives by suicide over the last seven years, which is a rise by 44.8 % from 2017 to 2018.  

This is concerning as it doesn’t map to general suicide rate reporting which reports a decrease in national levels in the last two years. 

Who is at Risk?

The following high-risk groups were identified in the 2012 HM Government National Strategy and remain so: 

? Young and middle-aged men; 

? People in the care of mental health services, including inpatients; 

? People in contact with the criminal justice system;  

? Specific occupational groups, such as doctors, nurses, veterinary workers, farmers and agricultural workers.

For females, the risk of suicide among health professionals was 24% higher than the female national average, this is largely explained by high suicide risk among female nurses. Male and female carers also had a risk of suicide that was almost twice the national average.  Death by suicide is for female health professional staff is higher than for males, accounting for 389 of the 682 deaths, with nurses having the highest rates of suicide amongst health professionals, peaking at 53.7% in 2016.  

Why? Understanding suicide behaviours are complex and arguable there is no single explanation of why people choose to end their lives. We know that social, psychological, and cultural factors can all interact to lead a person to suicidal thoughts or behaviour. 

For many people, an attempt may occur after a long period of suicidal thoughts or feelings, while in other cases, it may be more impulsive and as a result of recent trauma or conflict. 

Several risk factors commonly act together to increase vulnerability to suicidal behaviour. The World Health Organisation has classified these into the different groups below:  

Societal

• difficulties accessing or receiving care
• access to means of suicide
• inappropriate media reporting
• stigma associated with mental health, substance abuse or suicidal behaviour which prevents people from seeking help 

Community

• poverty
• experiences of trauma or abuse
• experiences of disaster, war, or conflict
• experiences of discrimination

Relationships

• isolation and lack of social support
• relationship breakdown
• loss or conflict 

Individual

• previous suicide attempts
• self-harm behaviours
• mental ill-health
• drug and alcohol misuse
• financial loss
• chronic pain
• family history of suicide 

So, what can we do, or at least do better as employers?

We must ensure that we protect our People. For some organisations this may be a shift from focusing on finance and operations, but Mental health, whatever sector we work within, has an enormous influence on our business, the quality of our work, the quality of our services and our reputation in the market and as an employer. In turn then, our ability to attract and retain our people and to enable them to be motivated and efficient is at risk if we do not address the emotional and psychological needs of our workforce. For too long People have taken a back seat behind performance metrics which champion finance efficiencies and operational efficiency targets. We must change and up our game.

How do we make protecting our people part of Organisational Strategy?

Protective factors are those that can help to reduce vulnerability to suicidal behaviour. The consideration of how best to support and enhance people’s access to protective factors is an important part of preventing suicide. 

Some examples of protective factors for employers to therefore consider include:

• The ability to easily access effective mental health support and treatment when needed.
• Ensuring that supportive line manager relationships exist
• Ensuring that capability to understand and manage people who have MH issues in the workplace exists.
• inclusion of problem-solving skills and coping skills that help people to manage in difficult circumstances as part of an organisations Learning and Development offer.
• Creating effective protocols, policies and procedures and ensuring  line managers are adequately trained to implement policies in compassionate and supportive ways.
• Ensuring we are conscious of how working patterns, shifts and a laxk of flexibility make result in feelings of ‘Burnout’ which negatively impact mental health.
• Promoting a workplace culture that has no tolerance for bullying and that the culture is one of compassion and kindness.
• Promotion of a culture where we truly listen and respond and where we look to forecast changes which may result in stress.

Organisational strategies for workplaces should also reflect National Strategies

The National Suicide Prevention Strategy for England has identified several areas for action for suicide prevention. These include: 

1. Reducing risk of suicide in high-risk groups (such as young men, people with a history of self-harm, people in contact with the criminal justice system) 
2. Improving mental health for all and using tailored approaches to mental health support to help reach specific groups (such as children and young people, minority ethnic groups, the LGBT+ community and people with chronic health conditions)  
3. Reducing access to means of suicide 
4. Providing better information and support for those bereaved or affected by suicide 
5. Supporting the media in delivering sensitive approaches to suicide and suicidal behaviour  
6. Supporting more research, data collection and monitoring

How we show that we care, how we show our commitment to support and how open we are on discussing mental health is paramount. We need to make it visible and walk the walk.

Well Done to TWLOHA for their efforts and shame on those who do not make explicit or adequate the support required for improving Mental Health in their workplaces.

Shame also on those who could and yet neglect to chasten our media and worse still tolerate the relentless bullying and harassment that exists in our media society.