How to have a mentally healthy conversation
Working or studying while ill is a real burden, whether you have the aches & pains associated with a cold or the ‘flu, the pain of a torn ligament or the challenge of a mental health condition. What you need when ill is to be able to disclose your illness and get the support you need.
In the realm of physical illness, this is generally achievable. For those who labour under a mental health challenge the outcome is far less positive. With mental health, over 50% of employees think their employer is actually pretty rubbish at supporting mental health. More students are dropping out of university in their first year, due to mental health, than ever before. The stigma is so severe and support so poor that around 60% of employees hide their mental health condition. And the same is true at many of our schools and universities.
Yet around a third of us will have a mental health challenge at work, or in school or university. More working days are lost to mental health than anything else. Employees and students suffer. And employers, teachers and tutors see lost productivity, absence, more grievance, more complaints and more litigation, and less engaged staff or students.
This is wrong on every level. And for everyone. And we need to put it right.
Let’s first look at why it goes wrong, then we can see what we can do about it.
There are two sides to this problem – the person with the mental health challenge, and the person they need support from – a boss, teacher, university tutor, friend or colleague.
When these people have a conversation about physical health the framework in place works well. Generally the discussion will focus on The Label (“I have . . . the flu, a broken leg, arthritis, cancer”), The Story (“I caught it from…”, “I fell down a step”, “My joints have got increasingly inflamed”, “I found a lump”) and then The Impact (“I’m so weak I can’t even get up”, “I can’t walk”, “It’s painful to use my hands”, “I need an operation”).
And the common approach is to use the same framework for mental health. Label. Story. Impact. But let’s look at this from the perspective of the listener. For mental health, Labels are numerous and complex – autism, anxiety, ocd, bereavement, chronic stress, adhd, dyslexia, dyspraxia, post traumatic stress disorder, bipolar disorder and many more conditions. Each having a range of severity with ‘high-functioning’ on the one hand (where the sufferer is able to function effectively, despite the condition) to totally debilitating or even needing constant care on the other.
The Story associated with the condition is often overwhelmingly negative and emotional. Mine involves the death of a child, which led to my PTSD. At the start of my talk (“Mentally Healthy Conversations”) I invite my audience to play the role of my boss, teacher, friend, colleague or tutor. And then I hit them with my Story. The draining emotion of my story conveys the point well – this is not a good way to get support for mental health.
The Impact is also both emotional and complex. My PTSD leads to flashbacks and flashforwards which raises the need for complex explanations about the neurological impact of trauma on the way we process bad experiences. And when it’s at its worst, I also have Depression; which then requires a complex explanation to distinguish Depression from what many people mistakenly think it is (extreme sadness).
“Disclosing the condition label and impact explanation often doesn’t work for mental health challenges. The puts your line manager full square into territory which challenges their sense of competence.”
Jonathan Phelan, speech – “The Mentally Healthy Conversation”
No wonder that this sort of conversation leads to stigma and lack of support, and poor outcomes for organisations.
How to have a mentally healthy conversation
So how do we turn this around?
As I discovered in my own journey through my mental health challenge, better outcomes are achieved by using a different framework to discuss mental health. One that puts the listener into a place where they can feel competent and able to help. And I use this framework in my coaching work with people who are looking to manage their mental health challenges. This framework produces better outcomes.
What most bosses, teachers, tutors, friends and colleagues need to know is this:
Discussing the Triggers
First, what triggers the condition? What makes it worse for you? This, of course, involves a degree of negativity – but it is negativity with a positive purpose. The better the listener’s understanding of the triggers, the more they can see how to help you avoid those triggers. This almost immediately moves the conversation into positive, solution-focused, territory.
When I need support, I don’t have to tell the Story of my son’s death. Or of the impact of this on me in the form of traumatic flashbacks to his death, and flashforwards to other tragedies. Instead I talk about what triggers my condition. In a nutshell, my triggers are that my condition is worse:
- when I have lots of things going on around me at the same time
- when I have to stay away from home
- when things are unclear or uncertain
Because of my PTSD, I have a hyper-vigilant mind, which is constantly on the look-out for further tragedies. So, when I have dozens of things going on at the same time (whether at work or at home), I get overloaded, burdened and stressed that something may go wrong. This constant monitoring of my surroundings is so draining. And when I stay away from my family, my mind is more prone to anticipating some form of disaster happening to them, while I am far away from them. And this is because I was away from home when our child bereavement happened. And, also because of my hyper-vigilant mind, I anticipate risk and tragedy if I am unclear about what people are thinking. Because this leads to the risk that something might unexpectedly go wrong.
Discussing the Resilient Conditions
Resilient Conditions are the things that make you feel better – quite often (but not always) the opposite of the triggers. Quite often the trigger, and the resolution to the trigger is actually quite insignificant to the employer – so, it wont take much by way of adjustment in terms of cost or disruption to help you.
For me my resilient conditions are:
- I need the autonomy to be able to arrange my day so I can do things calmly, one thing at a time, without unnecessary interruptions, diversions or chaos. Then my mind only monitors for risk in one thing at a time, and this is far less draining.
- I prefer to be able to commute to work (which for me is a significant and expensive commute) and not stay away from home as much as possible.
- I ask my colleagues to be honest and straight-talking with me as much as possible, so there are no-surprises. I prefer to be told if I’m doing something wrong, rather than people hiding it or playing their true thoughts down.
Providing support for these resilient conditions in the workplace or in education is often relatively straightforward. Unlike physical illness where quite often the employee is going to need complete time out to recover, sometimes over extended periods; with mental illness often there is a focus for the employee on wanting to work, wanting to perform well (the sense of achievement and success can actually be enormously therapeutic) just with some minor adjustments.
Minor adjustments (from the employer’s perspective) can actually make the world of difference for the employee. Through Evenhood I’ve worked with people where some relatively straightforward adjustments make the world of difference: a quieter working space, fewer interruptions, calmer lighting, getting in an hour later and leaving an hour later, avoiding back-to-back meetings, having regular breaks, getting regular feedback, having a clear role profile, having more frequent conversations about what is expected, having some time for therapy – all of this is eminently achievable in most working environments.
Talents and abilities
Much more often than not, this next point is completely forgotten or overlooked; but the truth of the matter is that people with mental wellness challenges often have certain enhanced talents and abilities. We often see:
- increased interpersonal empathy – which is useful for people management and leadership
- the ability to identify and mitigate risk (one of mine – a great by-product of PTSD!) – which is useful for risk management, health & safety, business continuity and compliance
- increased creativity – which is useful for design and the arts
- tenacity and the ability to identify flaws – which is useful for programming, software development, audit and compliance
- increased logical thinking – which is useful for programme or project management and process design.
The role of the listener
Surprisingly perhaps, all of this focuses on the role of the speaker. Which seems a little rough. It is the person who has the challenge, the one that most often suffers from stigma and lack of support, who I am suggesting frames the conversation differently.
But that’s not entirely the case. It is (or ought to be) the responsibility of organisations to train their listeners (bosses, teachers and tutors) to have conversations using this framework. And the listener’s opportunity to support the speaker depends on them taking the initiative to guide the discussion through this framework.
And there are two further changes the listener needs to make.
The first is to have a non-judgemental mind. As I say in my speech: “Mentally Healthy Conversations” –
“Because if you think I’m weak, an oddball, or just plain strange, you wont be able to help me, because you will have misjudged me and misunderstood me from the start. If you are going to help me, you need to be non-judgemental. Yes; I am different. I had a one in a million experience. I am bound to be different. If you are going to be truly non-judgemental, you need to be prepared to accept that just because someone’s behaviour is strange or inexplicable, that doesn’t mean to say that they’re not normal. We are shaped by our experiences. Our experiences make us who we are – wonderful human beings. We are all normal, we are all even. We all have, evenhood. So when you encounter someone with a different personality, let’s replace suspicion, allegations of weakness and malingering, accusations of bad moods and grumpiness, with compassion, and an acceptance that an infinite variety of personality is the result of an infinite variety of life experience.”
Jonathan Phelan, speech – “The Mentally Healthy Conversation”
The second role is to actually listen.
”Like most bosses, teachers, friends, colleagues and tutors people think that their supportive role is to speak, to have the answers, an insight, something that will help. People with mental health challenges don’t need these things. They need to be listened to, with humanity, compassion and understanding.”
Listening is the most powerful and least used of all conversational tools. Listening empowers the speaker, it makes them feel (quite obviously) listened to and understood. And it aids a proper understanding of the issue.
The Evenhood Framework for Mentally Healthy Conversations
Using this framework leads to far-improved outcomes. Through Evenhood I’ve seen that when this framework is used, the people who need support, receive support.
And that’s amazing and so satisfying to witness. And it’s great for the organisation too; because one of the biggest surprises is the organisational discovery that people with mental health conditions don’t need support because we are weak. We need support because we want to be strong. We want to perform and be effective. So it turns out that this is win-win. Because those who give support; get, productivity, loyalty, less grievance, less absence, less complaints, and more satisfied staff or students.
So, that’s the framework that Evenhood recommends for Mentally Healthy Conversations. It works. It delivers more positive outcomes, for both sides to the conversation
All the best on your journey and if I can help your situation in any way please drop me a line on email@example.com