Supporting employees with more complex mental health conditions

Richard FrostEmployment Specialist Team Lead

The Mental Health Continuum

Minimal mental wellbeing

Maximum mental wellbeing

Minimal mental illness/

disorder

Severemental illness/

disorder

A person with a high level of mental wellbeing despite

being diagnosed as mentally ill

A person with no diagnosable illness

but who has a low level of mental wellbeing

A person with a high level of mental wellbeing and no

mental illness

A person with a mental illness and a low level of

mental wellbeing

• No absolutes

(Adapted from “Mental Health Promotion: Paradigms and Practice” K Tudor 1996)

Complex Conditions

• Bi-polar Disorder

• Psychosis & Schizophrenia

Possible Causes

Biological

Genetic factors

Drugs/alcohol

Bio-chemical imbalance

Brain injury

Medical problems

Psychological

Childhood experiences – e.g. abuse/parenting style

Self esteem levels

Locus of control

Use of coping mechanisms/learned behaviour

Stress

Social

Poverty

Unemployment

Isolation

Poor housing

Crime

Source: Adapted from NHS Southwark

Influencing FactorsWhat damages our mental health?

Overuse of alcohol Exclusion

Misuse of drugs Racism and discrimination

Other extreme behaviours Prolonged uncertainty or anxiety

Avoidance Lack of a valued role or job

Isolation Abuse

Lack of activity or over-activity Poverty and social deprivation

Self harm Bullying & harassment

Repeated dismissive or

disrespectful treatment

Trauma

Source: Adapted from NHS Southwark

Signs of Mental Distress

Erratic or unpredictable behaviour Agitation or overt anxietyUninhibited behaviourSocial withdrawal / avoidance of social interaction or contactUnexplained or prolonged crying Change or disturbance in eating / sleeping patternsIncoherent speech Paranoia Physical ill-healthHearing voices / hallucinationsBehaviour inappropriate to the social context Any verbalised thoughts of suicide / harm

Source: University of Liverpool

Recovery

specialist services

through good help and support at work

psychological therapies

medication

Source: ACAS 2012

Influencing FactorsPositive coping mechanisms

Sharing the problem, expressing feelings

Good relationships

Seeking professional help Meaningful activity

Problem solving skills Leisure

Exercise and activity Coping skills

Rest Relaxation

Time management Good physical health and self-care

Healthy eating Feeling included and respected

Medication Talking therapies

Treating oneself Pets

Building self esteem 5 ways to wellbeing: connect, give, be active, take notice, keep learning

Source: Adapted from NHS Southwark

5 Ways to Wellbeing

The concept of ‘wellbeing’ is more complex than being ‘well off’ or ‘happy’ and is generally understood to include two main elements:

feeling good and functioning well.

Devon Partnership NHS Trust 2011

5 Ways to Wellbeing

• Connect – with the people around you

• Be Active – exercising makes you feel good

• Take Notice – be aware of the world around you

• Keep Learning – try something new

• Give to others - do something for someone else

www.fivewaystowellbeing.org

New Economics Foundation 2008

WRAP

• Daily Maintenance Plan - ‘What I’m like when I’m well’ and ‘Things to do daily to stay as well a possible’,

• Wellness Tools• Identifying Triggers and an Action Plan• Identifying early warning signs • Go back to things to do daily and Action Plan

Main features of WRAP

• Based on common sense and experience

• Easy to use

• Stresses how we all go through similar processes - but in very individual ways

• May be solely for our own use or can be shared with others

WRAP

Wellness Recovery Action Plan

www.mentalhealthrecovery.com

Feeling Stressed, Keeping Well

www.mindfulemployer.net/support/publications

Supporting Presence, Managing Absence

What happens in organisation to support staff who may have a mental health condition?

Application stage, Interview, Post-Interview checksSupporting presenceManaging Absence

What works?

What could be improved?

Mentally healthy, supportive work environment – informal and formal

Regular supervision, appraisal & feedback

Reasonable adjustments

Keeping in touch & phased returns

Mental health awareness training for line managers

Liaison with GPs and health professionals

Supporting Presence, Managing Absence

Signposts to further support – advice & information

ACAS – www.acas.org.uk Helpline Tel: 08457 474747

MIND – www.mind.org.uk

Rethink – www.rethink.org

MINDFUL EMPLOYER – www.mindfulemployer.net

MINDFUL EMPLOYER Line Managers’ Resource

Being Mindful – half-day workshop for managers

Being Aware – half-day workshop for staff

Keeping Well at Work – workshop & booklet

www.mindfulemployer.net

Thank You

Richard Frost01392 677050

www.workways.org.ukwww.mindfulemployer.net