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Understanding Mental Health

Monday 17 February, 2020

The term mental health is used to describe how we think, feel and our ability to deal with both good and bad experiences.

Everyone lives with mental health, when we have good mental health we enjoy a sense of purpose, direction, energy and the ability to deal with any challenges that happen in our lives.

A persons mental health doesn’t always stay the same, it can fluctuate as circumstances change and as they move through different stages in their life.

We all have times when we feel down, stressed or frightened. Most of the time those feelings pass, but sometimes they develop into a mental health problem like anxiety or depression, which can impact on our daily lives. For some people, mental health problems become complex, and require support and treatment for life.

Mental health problems affect around one in four people in any given year. They range from common problems, such as depression and anxiety, to rarer problems such as schizophrenia and bipolar disorder.

How to recognise mental health problems

Mental health problems can have a lot of different symptoms and signs. As a rule, people should seek help from a GP if they have difficult feelings that are:

  • stopping them from getting on with life
  • having a big impact on the people they live or work with
  • affecting their mood over several weeks
  • causing thoughts of suicide.

People who are struggling might be more tired than usual, may make uncharacteristic mistakes, find it hard to be motivated, develop poor timekeeping or be short tempered. They might isolate themselves, avoid friends/family/colleagues or appear distracted.

It can be difficult to identify these early warning signs in ourselves, and it can help to have family, friends or colleagues who can help us connect this to our mental health.

If you do recognise that you need help, the first point of contact in the health service is your GP. They may suggest ways that you or your family can help you manage, prescribe medication and refer you to a counsellor or a specialist / other part of the health service. 

Why are conversations about mental health so difficult?

Awareness of mental health is increasing, but we still face a world where people with mental health problems encounter discrimination and can face challenges getting the help they need. Many people who experience distress try to keep their feelings hidden because they are afraid of other people’s responses.

Looking after your own mental health

We can all take steps to improve our own mental health and build our ability to cope with adversity. Taking care of yourself is a skill that needs to be practised, it isn’t always easy, especially if we feel anxious, depressed or low in self-esteem.

There are 10 evidence-based ways to improve your mental health:

  1. Talk about your feelings - talking about your feelings can help you maintain your mental health and deal with times when you feel troubled.
  2. Keep active - regular exercise can boost your self-esteem and can help you concentrate, sleep, and look and feel better.
  3. Eat well - what we eat can affect how we feel both immediately and in the longer term. A diet that is good for your physical health is also good for your mental health.
  4. Drink sensibly - we often drink alcohol to change our mood, some people drink to deal with fear or loneliness, but the effect is only temporary.
  5. Keep in touch - try and make sure you maintain your friendships and family relationships even when you are struggling or busy, a work–life balance is important.
  6. Ask for help - none of us are superhuman, at times we all get tired or overwhelmed by how we feel or when things don’t go to plan.
  7. Take a break – a change of scene or a change of pace is good for your mental health. A few minutes can be enough to de-stress you, so give yourself some 'me time'.
  8. Do something your good at and enjoy - doing an activity you enjoy probably means you’re good at it, and achieving something boosts your self-esteem. 
  9. Accept who you are – we are all different, it is much healthier to accept that you're unique than to wish you were more like someone else. So be proud of who you are, recognise and accept the things you may not be good at, but also focus on what you can do well.
  10. Care for others - helping can make us feel needed and valued, and that boosts our self-esteem.

Supporting others

Talking about mental health can seem daunting, but we’ve all had conversations with people about bereavements, breakups and other life events – they are difficult but they do mean a lot to the person having a tough time. When you ask someone how they are doing be genuine and warm, help them see that you are being sincere and that you care.

If someone does need a supportive conversation here are a few tips to make it the best you can offer:

  • Time and place - choose the right time and place for the conversation so that you can devote your full attention in a place that is comfortable for them. Make sure that you minimise disruptions such as switching phones to silent.
  • Active listening - active listening is a term for a range of techniques that keep us present and engaged in a conversation. Be yourself, use friendly/open body language, acknowledge what's being said with appropriate nods and gestures, repeat what they've said to check you got it right and ask appropriate questions (but do not probe!).
  • Manage your own feelings - it can be hard to hear difficult or upsetting things, but to reassure and encourage the person you should refrain from showing signs of surprise or judgement. You want the person to be comfortable to be speaking to you and understand that you will treat what they say with respect. They may welcome your suggested solutions, but ask first, they may just need to vent.

Thoughts of suicide

If anyone says they are feeling suicidal or can't go on, or if you suspect they are thinking of taking their own life, it is important to encourage them to get help. Encourage them to contact Samaritans straight away (call 116 123, this is a free call and is available 24 hours a day, 7 days a week). You could also help them to call their doctor or a close family member or friend. If you are concerned for someone's immediate safety, or they tell you that they plan to end their life imminently, you can call 999 and ask for the police or take them to a hospital A&E Department.

Ongoing mental health problems

For some people, an episode of mental ill-health is a one-off, for others mental health problems can be longer term or occur in episodes throughout their lifetime. With mental health, recovery isn’t the same thing as cure, often people just learn to manage/live with their mental health problem.

Supporting someone who has a mental health problem is about helping them to find ways to recover and helping them to stay well. Remember that the best expert on a person’s needs is themselves – if there is one golden rule for supporting someone, it is never to assume and always ask.

Mental health in the work place

Fear of discrimination and feelings of shame are among the top reasons people give for not telling employers or work colleagues about their mental health problems.

By creating workplace cultures where people can be themselves, it will become easier for them to speak about mental health concerns without fear, and it could encourage them to reach out for help when they need it. Even so, the decision to disclose at work is not one people take lightly.

There are a wide range of legal rights that protect mental health at work. These range from basic human rights such as the right to freedom of expression and freedom of association, to the health and safety legislation that keep people safe from hazards, including psychological hazards.

The Equality Act (2010) in England, Scotland and Wales and the Disability Discrimination Act (1995, as amended) in Northern Ireland - most people with ongoing mental health problems meet the definition of disability in the Equality Act (2010) and the Disability Discrimination Act (1995, as amended). This means that people with mental health problems are protected from discrimination and harassment and are entitled to reasonable adjustments to adapt their job or work.

To provide adequate support it is vital to ensure that the work environment is a safe and pleasant place to be, free from discrimination.

Some employers engage an external Employee Assistance Programme, these services are confidential and can be accessed free and without the need to disclose use to your employer. There may also be access to occupational health support through your employers HR department.

A line manager plays a crucial role in supporting staff that experience distress and/or mental health problems. They are the first official contact between the employer and the individual and will be responsible for setting the tone. If a person is off work due to mental health it is important to stay in touch to let them know that as their manager you care for their well-being. Returning to work after a mental health episode can be awkward and cause further stress, line managers can help to manage this by:

  • asking the person who is off work what they would like their colleagues to be told;
  • including them with any invites when staff are spending leisure time together – they may decline but will appreciate being asked;
  • maintaining contact in the same way as if they had any physical health problem;
  • asking if there is anything that can be done to help on their first day back and offer help to get them back into work routines.

Line managers also need to be understanding of; managing absence and the return to work policy, dealing with performance management and appraisals, and the impact of change in the workplace on their team.

Tips from the Mental Health Foundation for Employers to create mentally healthy workplaces

Value mental health and wellbeing as core assets of your organisation:

  • Commit to developing an approach to mental health at work that protects and improves mental health for everyone, whilst supporting those people who experience distress. Designate board champions, and ensure senior leaders and middle managers are responsible for implementing mental health programmes.
  • Commit to reviewing the way you do business to ensure your everyday working culture is as mentally healthy as possible. Make evidence based mental health promotion tools like mindfulness and exercise available to all staff.
  • Regular staff surveys and other research to build data about staff mental health, using findings to plan and deliver action and inform workplace policies. Recognise and celebrate the impact of existing employee benefits and corporate social responsibility activities on the mental health and wellbeing of staff.

Support the development of compassionate and effective line management relationships:

  • Provide opportunities for managers to attend relevant training to support staff living with mental health problems and the wellbeing of all staff more widely.
  • Provide proactive support for staff line-managing people with mental health problems, including access to HR and, where necessary, occupational health services.
  • Recognise that line managers who have personal lived experience of mental health problems are a unique asset to a company.

Address discrimination:

  • Ensure that discrimination on the grounds of mental health status is seen to be as unacceptable as discrimination in relation to other protected characteristics such as race, gender or sexual orientation.
  • Encourage staff to report any discrimination or harassment they face and to blow the whistle on discrimination they witness.
  • Support national and local anti-stigma initiatives such as Time to Change and Mental Health Awareness Week.

Value the diversity and transferable skills that experience of mental health problems bring and support disclosure:

  • Include mental health in diversity and inclusion strategies, and recognise the mental health component of wider equality initiatives. Ensure your business creates opportunities to link with employability providers to enable people with mental health problems to join your workforce.
  • Give people positive reasons to disclose by establishing a culture that values authenticity and openness – this should be led from the top of the organisation.
  • Explore setting up peer support and mentoring programmes for staff with lived experience of mental health problems

Further information

This article has been written using research from several mental health related organisations/charities. There are lots of places that provide information, advice and guidance on mental health problems including; Mental Health Foundation, Mind, NHS, Mental Health UK and Samaritans.