Supporting employees with more complex mental health conditions Richard Frost Employment Specialist Team Lead

The Mental Health Continuum Minimal mental wellbeing Maximum mental wellbeing Minimal mental illness/ disorder Severe mental 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 Factors What damages our mental health? Overuse of alcoholExclusion Misuse of drugsRacism and discrimination Other extreme behavioursProlonged uncertainty or anxiety AvoidanceLack of a valued role or job IsolationAbuse Lack of activity or over-activityPoverty and social deprivation Self harmBullying & harassment Repeated dismissive or disrespectful treatment Trauma Source: Adapted from NHS Southwark

Signs of Mental Distress Erratic or unpredictable behaviour Agitation or overt anxiety Uninhibited behaviour Social withdrawal / avoidance of social interaction or contact Unexplained or prolonged crying Change or disturbance in eating / sleeping patterns Incoherent speech Paranoia Physical ill-health Hearing voices / hallucinations Behaviour 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 Factors Positive coping mechanisms Sharing the problem, expressing feelings Good relationships Seeking professional helpMeaningful activity Problem solving skillsLeisure Exercise and activityCoping skills RestRelaxation Time managementGood physical health and self-care Healthy eatingFeeling included and respected MedicationTalking therapies Treating oneselfPets Building self esteem5 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 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 Feeling Stressed, Keeping Well

Supporting Presence, Managing Absence What happens in organisation to support staff who may have a mental health condition? Application stage, Interview, Post-Interview checks Supporting presence Managing 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 – Helpline Tel: MIND – Rethink – MINDFUL EMPLOYER –

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

Thank You Richard Frost