How investing in mental health is good for business

Michelle:
Hello, and welcome to the CPA Australia podcast, your source for business, leadership, and public practise accounting information.

Hello everyone, and welcome to another episode of CPA Australia podcasts. I'm Michelle Web, and I'm part of the team which manages public practise content here at CPA Australia. In today's episode, Clare Mann, managing director of Communicate 31, discusses how investing in mental health is good for business, with Adrian Craig, a member of CPA Australia's public practise engagement team. They will take us through the role of business owners in mitigating mental health risks in the workplace, and the characteristics of a workplace that is mentally healthy.

Clare is a renowned psychologist, bestselling author, and existential coast. Her expertise in leadership, communications, and psychology has led her to be one of the most sought-after psychologists in Australia. She has published three books, and contributed to six others, one of which is the prescribed university reading for professionals in human resource management. Her inclusion in "50 Unsung Business Heroes" positions her as a thought leader and facilitator of change.

Clare's latest book, "Communicate: How to say what needs to be said, when it needs to be said, in the way it needs to be said," has received international acclaim, with the foreword being written by US presidential advisor and bestselling author, Doug Weed. She was awarded fellowship of the British Psychological Society, and Australian Human Resources Institute, for her contribution in thought leadership to these professions. Clare's unique style of communication enables her to make complex issues simple and immediately applicable to everyday problems.

Clare, thank you for joining us today. Adrian, I will hand over to you to get us started.

Adrian:
Welcome, Clare. Thank you for your time this afternoon.

Clare:
Thank you. Good to be here.

Adrian:
Great. First question, Clare. How would you describe the relationship between mental health and physical wellbeing?

Clare:
Yes, mental health and physical wellbeing are inextricably linked. You almost can't have one without the other. They each affect each other. Our mental health affects our physical health; our physical health affects our mental health. And when we look at health, of course, health is more than the absence of disease. When you and I think about health, for instance, it's to do with vibrancy, and energy, and certainly free from pain, but some sort of level of ease and wellbeing in the body, and also in our thoughts and mind.

I think one of the useful ways, Adrian, is to use the analogy of a car. If we want to get from A to B, if the car breaks down, it's obviously frustrating and it's limiting, we can only go so far. And if we see the body, only one way of looking at it, but if we see it as a bit of a vehicle, if it breaks down and doesn't perform, or it's too slow, again, we're angry, frustrated. That, in turn, affects our psychological [inaudible 00:03:09]. We become depressed, angry, and resentful.

And I think ... I say both of these are inextricably linked, but think about the car for a moment. If we put in the wrong fuel, we run it into the ground, we're doing no checks, and we don't replace the oil, it's going to break down. And likewise, if we eat badly, we live on junk food, we have too much coffee or alcohol, we don't invest in the maintenance, we're going to get sick. And also with our mental health, we have too much stress, we have bad relationships, and we have no time to take time to smell the roses, we're really going to be in trouble.

Adrian:
How much does mental illness cost the Australian economy each year?

Clare:
There are many ways to try to establish, what is the cost to the Australian economy of mental health per year. Firstly, let's just, to start, define what mental illness is, per se. It's the serious mental illness that's really diagnosed, things like depression, anxiety, related behaviours like substance abuse, obsessive compulsive disorders, in a way that's really interfering with the everyday functioning of a person's life. Enormous costs.

Let's just think of it on the back of an envelope for a moment, before I give any figures. You look at the medicare costs to the economy, but also business as a whole. Work cover, there's time off work. There's the cost to the business in having to cover those resources. Lowered performance, of course, and reduced creativity. And also, the morale on other people. If people are constantly absent, or there's turnover.

There was recently a story, actually, in the Australian press, that estimated the mental health care bill to be $12 billion a year, which is pretty excessive. And it's estimated that between 20 and 30 percent of anyone in a workforce, at some stage, will suffer from a serious mental illness some time in their career, the depression, the anxiety, and the obsessive compulsive disorders. That's pretty high, isn't it, Adrian?

There are lots of other costs, of course. Some are personal. Some are interpersonal, social, and also at a societal level. Suicide is the very high end of this level of depression and anxiety, when people see there's no other way out. Approximately 3000 people a year are doing that, and 20 percent of suicides, we believe, are linked to workplace. So, this is something we really need to take very seriously.

There's a lot of self-medication that goes on, through alcohol, of course, and people trying to take away the pain themselves. But the effect on the family, in effect of the extra resources and care needed for children, breakups, divorces ... We're obviously painting quite a dire picture here, but when we start to add up all those sort of costs, and the deteriorating performance impact on others, it really is quite a costly picture.

Adrian:
Clare, what are the characteristics of poor mental health?

Clare:
What I normally see is a bit of a continuum, really. We've got the softer end, so to speak, where there's the beginnings, the underpinnings, the start, for people not to be functioning as well, psychologically and emotionally, as they could. At that level, we've got, obviously, levels of stress, but perhaps the person's managing them, but it's getting a little bit too much, haven't got many resources in the tank, sort of thing.

But there starts to be indifference, cynicism. Not so much commitment to what they're doing. Then it start to move up that layer, where we're liking at burnout, which can result in very much a physiological result, which is adrenal burnout, when the poor adrenals have been pumping out adrenaline, trying to survive, affecting sugar levels in the body. The person's not eating well, living on caffeine, as we move to a state of burnout. Burnout is also when there's a level of disinterest, and really, people don't care anymore.

If we go right to the other end, where people are coping there, sometimes for a very long time, and they look around society, or they look around, particularly in a corporate environment, where it's almost acceptable, that sort of corporate warrior. People sort of think this is normal, even though they're suffering. They perhaps see it as a weakness. When people are running their own business, there's, of course, huge numbers of pressure. There's working on the business, as well as in the business, and the constant demands throughout the year, and different times of one's life.

The serious mental illness, and again, I've mentioned it, but we're looking at things like chronic depression, when someone is really not able to shake that sense of lowered mood. Anxiety. People can have panic attacks. People then often self-medicate, because they feel that's a weakness. They will have routines, like obsessive-compulsive behaviours. They will constantly check things, or they will become a perfectionist, a workaholic. There's conscientiousness, and there's people investing in working hard and getting somewhere. The other bit is where they feel a huge amount of anxiety if they're not in control.

Really, swinging from, certainly, mood swings, and moodiness. Poor communication. Snappiness, sarcasm, cynicism. A lot of unpredictability. If someone's a manager, and they're managing a team, they're actually unpredictable, in terms of what they promise. They forget they promised things, they forget to do things. They're very reactive. Increasing that medication, of course, but that very much don't care.

Wrapped up in all of this, of course, is this sense of, there's a stigma attached to this. There's a sense of shame. People don't want to talk about it. And certainly me, as a psychologist, I'm encouraging this, because behind closed doors, from the CEO to the cleaner, people are suffering in a world, as we become more intensified, really, and not take enough time to smell the roses, as I say.

Adrian:
As you mentioned, people who run their own businesses face a wide variety of workload and time pressure points. What are three ways to improve mental wellbeing?

Clare:
Absolutely. Now, because these are inextricably linked together, what we do mentally and emotionally is also what we're doing physically. All that has to come together. Let's look at the first one. I think it was Steve Covey, in "The Seven Habits of Highly Effective People," who said, "First things first, we have to but credit back in the bank. We cannot run our tank down really low, or else we're really going to be in for problems."

We've got to look at our health. We've got to look at our diet. We are so confused in many ways. What do we eat? We've got so many businesses vying for our attention, there's so many professionals telling us. I was recently involved with a number of health care professionals in the tour for the National Symposium for Health and Nutrition in Healthcare, and I worked with someone called Dr. Michael Klaper, who was over from the US.

I wholeheartedly suggest people watch the documentary on Netflix called "What the Health," because what we eat obviously is what we become, and when we're under stress, we often eat a lot of foods that are really not serving us, and what we think is a healthy diet is not allowing us to maintain or get the energy from our foods. Diet, regular diet. Don't allow our sugar levels to be going up and down, which is very much related to stress, and the hormones of cortisol and adrenaline affect that, of course.

Take exercise, of course. But people use phrases in business sometimes, "I'm at the pump all day." A terrible term. And they then actually go on the treadmill, but they don't really like the gym. Do an exercise that you enjoy. If it's walking the dog, or walking by the water, or yoga, or swimming, or golf, take that as the option. Don't do something because you think, "Well, that's another tick in the box. I'm exercising." The body knows the difference. Our hormonal balance is affected by our sense of enjoyment, whether there's another thing I ought to do on my to-do list.

This affects sleep, of course. A lot of people, when they're under a lot of stress and mental challenges, they can't sleep, because their brains are in a high active state. I may talk about this a little more when I look at neuroscience, and what we can learn from that, a little bit later. But they're pumping out a lot of adrenaline, their brain is in a very active beater state, as we say. Cortisol and adrenaline are just keeping them going, and there's a bit of a buzz about it, but if it keeps going, it becomes dangerous.

And it's the cortisol that wakes the person up. They may have fallen asleep right away because they're tired. At 3 in the morning, they wake up. It's in a fight-or-flight reaction. Now, when we attune our adrenals to that, we will be in a pattern, and people find they cannot sleep. They go to sleep in exhaustion, but they're not having quality sleep.

Exquisite self-care is one of these. Have some fun. And be careful on the alcohol and coffee, okay? Because that is dehydrating the body, and it's also, it feels good at the time, but if we keep doing that as a prop up, that's not going to work. The first one is exquisite self-care.

The second one is about the quality of our communication. Longitudinal studies done on happiness around the world found that invariably, there were two things that influenced happiness, wellbeing, sense of success, regardless of whether people were married or single, had children, working or not working, professional or not, and those things were to do with a sense of belonging to something bigger than themselves. It could be their family, or their community, or professional body. They had an identity. But it was the quality of communication with themselves, but also with other people.

Improving how we communicate, having the conversations that matter, is working through our problems, feeling hurt. Don't wait for things to build up. Be understood, and understood other people. Quality of communication.

And then last of all, stress and mental health issues are a big thing to do with people feeling out of control. It is, increase your sense of autonomy. Don't feel you're at ... Reassess your life's purpose. What are you doing? What's your vision? Where do you want to be in five years? What is this really all about? Don't feel you're at the whim of your current circumstances. Real freedom starts in our mind, of course. And maintain more control over your time and situation.

Adrian:
Clare, what are the characteristics of a workplace that is mentally healthy?

Clare:
There's a number of characteristics that can be used to identify whether a workplace is healthy or not, and I'd like to go through these. They're kind of important, and I'll try and expand on each of them.

Overwhelmingly, it's something about autonomy. It's, if individuals, whether they're senior or junior, don't feel they have control over their time, the order in which they do the tasks, they don't have any flexibility, there's an enormous amount of stress involved in that. Even if they're enjoying the job, if they're up against deadlines all the time, and there's no wiggle room, that can actually cause people a lot of disquiet. Really, thinking about that is, how in our job design, for instance, can we put those things in place that enable the people to have a level of autonomy?

It's also about clearly-defined work roles. Now, this is not to do with job enrichment, or the richness or variation of the job, but do people know what they're doing? Is there confusion? Do they know where their jobs begin and end? And in many organisations, they actually don't, and so there's a lot of scapegoating, or things aren't covered, or people overstep mark, and then they feel pushback for something they got involved in that they're not going to be credited for.

Defining work roles. Be very clear about that. It's not just on paper. It's having those conversations with members of staff, so they understand it too, and you're both on the same page.

Job security is a big one, of course. If someone is constantly worried about whether they're going to lose their job, they're attending to lower-order needs, and not able to give their all to the workplace, and there's a lot of stress associated with that.

It's also how demanding the job is. If you've got a job that is constantly demanding, and there's no let up, no variation in task, that's stressful, but also being underdemanding. If people don't feel that their skills are being properly utilised, and they feel the job's not quite asking from them what they're able to provide, that can be stressful at the same time.

There was a piece of research, came out a while ago in the British Psychological Society, actually, which looked at the reasons people left work, and this relates to something that's really important in terms of a mentally healthy workplace. It's about the relationship with colleagues and bosses. People often think people leave primarily because there's more money, or a spouse has to move away, or something. Overwhelmingly, the reasons for leaving are conflict with peers and with a boss, which cannot be resolved.

And so, our relationships in the workplace, looking at the relationships you have with each other, of course, but also if you are responsible for staff, what are you doing to put in place a mechanism to have those conversations, resolve those issues? Or else we're going to have either people leaving, or if they're unable to leave, there's that increased sense of anxiety, depression, about what they're actually doing. That whole relationship with the boss is very important. Openness, being fairly treated.

It's really almost the basics that we know about. We know how we want to be managed, so we need to put this out at the same time. It's also about how change is managed, Adrian. Is it communicated well to people? People commit to what they create, and so if we just constantly keep telling people things are changing, this is what's happening, get on with it, you're not going to have the emotional buy-in and commitment, than if you actually involve people in the process, and you give them time to assimilate it.

Resistance to change is normal and predictable, and often is good, because we don't want to throw the baby out with the bathwater. Looking at how changed is managed, outside stress, of course. If there's problems at home, if there are financial difficulties, children difficulties, these come into the workplace. Having a culture that enables people to at least be validated for that, as opposed to, "Well, that's work and that's play; I'm sorry, we don't want to hear about it," which links to culture, what sort of culture we're developing. Non-bullying culture is a big one, and how traumatic your work day is.

These are lots of characteristics, I know, but there are indeed those, and I hope people are getting some tips from this, is that if people are constantly feeling that they're around stressful people, there's aggression in the clients they deal with ... Let's think of small businesses at the moment. They're dealing with customers that are very demanding, "I want it now." There's individuals who are putting pressure on them. That is very demoralising over time.

Again, it comes back to autonomy, but also people become addicted to levels of cortisol and adrenaline in their body. They're getting excited by it, they feel they're energised by it, but there's slowly a tipping point, and if you constantly, there's what we call a traumatic day, over time, the credit at the bank gets constantly taken, and we get overdrawn with all the associated problems.

Adrian:
Clare, for business owners with employees to manage, what are the common signs that an employee is struggling, and also, what steps can they take to help that employee?

Clare:
All these sort of ... If somebody is struggling, whether it may be some of our listeners here, or they've got employees that are struggling, there's things that immediately come to mind. People start turning up late. There's a sort of sloppiness around what they do. Absenteeism is a big thing, of course, where people feel they can't get out of bed. But it's going on too long.

But people try to hide these things for a long time, firstly to hold on to their job, of course, but also they don't want to feel stigmatised. They also feel, "I can shrug this off." People want to come to work. They want to be proud of where they work. They don't want to feel they're struggling, particularly when everyone else seems to be doing so well. There's this wonderful myth that everyone out there has got the ideal life, and is doing brilliantly, and of course it's not true. We're human beings and we have ups and downs. So, absenteeism, lateness.

There's a lack of engagement with other people. They're not interacting with colleagues in the same way. There's a terseness, possibly, when they're given instructions or asked to do things, an impatience. And they tend to have lack of engagement with clients, of course, which leads into all sorts of problems, the clients you're actually dealing with.

Often we find out through people's appearance. There's a sort of shabby appearance. People don't look after themselves as well. Even when they come into a professional environment, they haven't shaved. Small things like this. The clothes aren't pressed. The attention to detail which prepares people for professional life, that tends to deteriorate.

And there's often weight gain or weight loss. People, they change behaviour that we might observe. They're keen to go and get a drink after work, and it starts off with a bit of fun, but it's sort of happening every day, and it's a little bit too much.

These are the sort of signs, Adrian, that someone is struggling, so look at it in yourself if you're listening. Look at it in the people you're working with.

And so what can we do to help people? Help ourselves, of course, and help other people? We need to have healthy workplaces. Emotionally healthy, but physically healthy, as well. Is there natural light? That may not be possible for many, but creating those environments, which they're not aggressive for bullying.

Resolving issues, resolving conflicts. Don't push them under the carpet, because they will bubble away, and they cause what we call a toxic workplace, where there are secrets held, and that doesn't work very well. That's often the avoidance of conflict that results in that, not a deliberate intention for that to happen.

We've got to have the conversations that matter, so we've got to have exquisite communication skills to dare to question people, to raise these concerns which are very delicate issues. And people are often self-conscious. We're self-conscious. We often don't want to be intrusive, but we do have a responsibility, not only to employees, but also to our colleagues, but to each other as human beings, if we're going to work alongside each other.

Create a context. Get training for your staff. Get training for your managers, so that they can have those difficult conversations easily, and not shy away from them and have problems in the future. This is all about creating a culture that health is important, really. But the boss has to walk the talk. Our managers, our supervisors, our team leaders, they've got to walk the talk. Words are cheap; people want to see action, and the best thing we can do is lead by example.

And to somebody who's unsure of vulnerability, we're going to raise this with people, that we're concerned about them, that they're not coping as well. Their work performance is going down. You say to people, look, this happens to us all. We're in demanding roles. There's, particularly in professions, a lot of legal issues that need to be covered, so there's a lot of pressure in auditing, and all sorts of things. And actually saying, "This happens to us all." And we really champion people that put their hand up and say, "Let's sort out the problem before it becomes a really big problem."

And of course, policies need to match that. Put in place policies that support these sort of initiatives, from training, development, taking time out, giving people the opportunity to engage and talk. And for larger organisations, but also small ones, things like employee assistance schemes can be valuable, so that people can go offsite and have a level of counselling or support, but we mustn't delegate that to someone else. It's our responsibility, leaders, managers, and peers, to take a responsibility for our own mental and physical wellbeing, but also to be concerned about others, and raise it.

Ultimately, there's a lot of things we can actually do to pinpoint this, to help people on their way, and the one I said at the beginning is, people commit to what they create. Don't impose things on people. Get people involved. People are far more able than we realise, way beyond their job descriptions, and when they're asked to engage, usually are only too happy and enjoy the work opportunity to enrich their job in this way.

Adrian:
Clare, my final question, and I think it leads beautifully from everything you've just said, how would you say that investing in mental health is good for business, and what is the cost to a business of not investing in employee wellness?

Clare:
Absolutely. We've raised a number of issues already, that we can immediately see where the costs are involved. If you've got increased absenteeism, lateness, poor performance, we're going to have problems. Turnover of staff, you've got people on a learning curve, not performing as they should be. All of these are incredibly costly. People's attitudes towards work. How they're dealing with clients.

You can lose clients. I've worked in organisations where just that attitude, or dropping the ball, is very important to that relationship between that customer and that provider, and then suddenly the ball's been dropped, even though you have high performance still, and that really effects the brand of that provider. These are really important things.

There's also a cost in attracting talent, of course. Do people want to work in an environment that they see is overly stressed, or doesn't take physical and mental health seriously? These are all direct costs, but also indirect costs. But enormously impactful on any organisation of any size, but particularly the SME.

There's also issues to do with lowered levels of creativity and innovation, and there's really interesting work around the area of neuroscience that's saying that what happens in the brain, and where our blood flow goes, and what we call "firing and wiring," new habits are learned, and ones are unlearned.

One sure thing is that when we are constantly busy and under stress, our brains are in a very active state, which is what we call a beta state, and if we were to wire people up, we'd see on a graph that there's very active brain activity. And that's what happens when we're under a lot of stress. I mean, we are talking together at the moment, we're in kind of medium-beta. We're attending, we're not under stress, we're feeling comfortable, but we're very alert.

During the day, we will all go into daydreaming. Even if we don't think we do it, and in fact we don't do it under extreme stress, it often blocks that ability to do it, and it's very important. So, people could be in the middle of a task, and they find they're looking out the window, and something else comes into their head. What has happened is that the brain activity has gone from beta to alpha, and it's slowed down, and it's in those moments, in the alpha or the theta stage, that moments of inspiration, entrepreneurial ideas, great new insights, come.

Now, this is really interesting, because when we work in large organisations that are trying to push people and say, we're going to put all our effort into creativity and innovation, if they're keeping people in a state of high beta activity, those moments of inspiration are not going to come. All business leaders know, to be creative, they sit there and they often look out the window for a while, and then the inspiration comes. Or it comes when they're on holiday, or playing golf, or having a glass of red. This is really important.

The cost of investing in good mental health is you've got good opportunities for people to have rest. Say to people, "You need to get away from the desk at lunch time. You need to rest and rejuvenate. Your performance will be better." Neuroscience is catching up a bit with common sense, and that's really important, but also, I recommend people look at writers and leaders like Ricardo Semler, who ran Semco in Brazil.

He wrote a wonderful book called "Maverick," where he created what was called the most unusual workplace. He always did the opposite of what we are supposed to do these days, of he didn't have any job descriptions, didn't have any work specifications. He got people involved, even when they moved offices. He got people trying to vote on what was happening, and even though the managers didn't really agree with the ultimate decision, they went along because it was the norm. These are very out there sort of practises, but it didn't just make people feel good. It made positive improvements in the bottom line. So, have a look at the work of Ricardo Semler in "Maverick." There's TED videos on him.

We obviously have to fit it into our own culture, but what can we take from that? When we involve people, when we give people opportunities to be creative, have rest, downtime, we are investing in mental health. That's go to be good for business, and that will be reflected in our own bottom line. Because the cost, really, of lost investing, as we've seen, is very powerful, both direct and indirect costs.

Also, we have to ask ourselves, how we manage is how we would have it to be, and how we lead is how we would have it to be. We're creating the organisations of tomorrow, so really be the change you want to see in the world. Do we say to ourselves, would we want our children to be working in these environments? If it doesn't pass that test, then we've got to change it. We don't want our kids to be stressed, burnt out, why are we doing it to ourselves and other people?

A useful resource, Adrian, might be a free digital, downloadable magazine called "Ethical Futures." "Ethical Futures" is a magazine that champions businesses that are creative and profitable and successful, but without abusing people, the environment, or animals, and there's a great bit of dialogue there on how we can improve, certainly, our workplace practises.

Adrian:
Sounds great, Clare. Thank you very much, and thank you very much for your time today. It's been a wonderful discussion, and I think we're going to help a lot of members in what you've said, so thank you very much.

Clare:
Thank you. I've really enjoyed it, and keep up the good work.

Michelle:
Thank you, Clare, for your insights, and thank you, Adrian, for taking us through today's session. We will look forward to catching up with you both on optimising organisational change, and the business of physical health in 2018. To find out more about Clare, you can visit www.linkedin.com/in/ClareMann.

Thanks for listening to the CPA Australia podcast. To download the transcript and find more information on today's episode, visit www.CPAAustralia.com/podcast/