Disclosing Mental Health Issues in the Workplace

I have written previously about how we are making progress in the acceptance of mental health issues titled  Not all heroes wear capes. Many organisations staff and high-profile individuals have made their own personal mental health struggles public. It appears that at least on the surface that attitudes are changing. One of the areas that changes in attitudes towards mental health is becoming more prominent is the workplace. Most workplaces now offer several days each year for personal or compassionate leave. Many workplaces train managers on the importance of a good mental health environment and the walls of the building and break rooms are often covered in posters about accessing help for a mental health crisis. Most companies have Employee Assistance Programs so employees can have access to free counselling for personal or mental health issues.

This all sounds good and is a giant leap from where we were maybe even 10 years ago. So what is the reality of disclosing that you need a “mental health” day off ? . Given all the changes that have occurred you might be thinking it is not a problem. However, many people still lie about their reasons for taking the day off. I have personally lied at times about having mental health issues as I knew there would be consequences. I know of many people whose work environment has suffered because of open disclosure. Ironically, some of the workplaces were not for profit charities whose primary focus was on mental health. It almost seems like it is okay to not be okay just don’t do it at work and don’t tell us about it.

Sarah Billington wrote a great article for Huffpost in 2018 titled “I Took A Mental Health Day At Work And Lied About It. Here’s Why.” In which she described the stigma that still exists in the workplace around mental health issues compared to physical illness. One paragraph that really sums up what a common attitude in the workplace is states, “An inability to do your job because you have a cough and a sore throat are viewed as an inability to work effectively in the short term. No one will even remember in a month. But excusing yourself from work for a day because you’re spiraling with anxiety and need to step back and get on top of it can affect an employer’s more long-term view of your abilities, even if taking that day means that you can get healthy again and be better than before.” (Billington 2018). That one paragraph sums up the attitude that still seems to exist today in many workplaces and in society in general. The author then concludes with “The stigma is real and undeserved. Mental illness doesn’t define me, and I’m stronger than people give me credit for. But until managers and employers start to treat mental illness as just as manageable in their employees as physiological illness, and not a weakness, I’ll lie, and so will so many others.”(Billington 2018). The article is an excellent read and gives a great insight into the reality of disclosing mental health issues in the workplace.

Elraz (2018) suggests there is still a stigma around mental health issues and the workplace. The authors’ study confirms the benefits of speaking openly about mental health issues but notes how disclosure in the workplace can be problematic. Much of the discussion confirms the Huffpost article and suggests we still have a long way to go if we are to change the rhetoric around mental health into tangible and nonjudgmental action.

So where does that leave the individual who is suffering? I don’t wish to appear negative or to suggest that we don’t continue to make progress in how we view mental health issues in the workplace. It is always your decision on how to handle your mental health and your workplace. I just feel it is important to weigh up the pros and cons of disclosure. The goal is to get well and stay as well as possible, so figure out what will work best for you. Maybe you can see a counsellor privately and ring a helpline during lunch breaks to get through those really tough days. If you do choose to disclose your situation to your manager I hope you get all the support, you need. I just want you to go in with your eyes open. Not everyone at work is your friend and not everyone is going to understand.

Wishing you the best in your journey

Phil Miranda

Sources:
Billington, S. (2018) I Took A Mental Health Day At Work And Lied About It. Here’s Why. https://www.huffpost.com/entry/mental-health-day-work_n_5c023517e4b04fb21168335e
Elraz, H. (2018). Identity, mental health and work: How employees with mental health conditions recount stigma and the pejorative discourse of mental illness. Human Relations, 71(5), 722-741. doi: 10.1177/0018726717716752

Recovery from Childhood Sexual Abuse

I have written previously about how childhood abuse, particularly sexual abuse, can result in poor health outcomes HERE. The recent conviction and sentencing of Cardinal George Pell, as well as the Royal Commission into Institutional Responses to Child Sexual Abuse in Australia has brought this issue to the forefront of many people’s lives. While the effect of Childhood Sexual Abuse (CSA) is significant and its prevalence is disturbing there are also those who experience what is referred to as Post Traumatic Growth (PTG). This article briefly examines the effect of Childhood Sexual Abuse (CSA), its frequency as well as the potential for PTG. I appreciate that this topic evokes strong emotions, so I will endeavour to keep this article as factual as possible. This is not because I have no strong emotions about the subject, but as I have not personally experienced this type of abuse I don’t feel it is the appropriate place to express an opinion. Additionally, I prefer to focus on finding meaning and purpose in life  where possible, by living in the solution rather than the problem.

Prevalence of Childhood Sexual Abuse

Prevalence rates of CSA worldwide are often difficult to confirm, as individuals may be unwilling to disclose information or complete questionnaires related to their own experiences. Recent data suggests that 1 in 4 (25%) women and 1 in 6 (17%) men reported being sexually abused. The Centers for Disease Control and Prevention (CDC) also states 25% of women and 16% of men reported sexual abuse as children. Based on data from several western counties, between 64% and 86% of perpetrators were well known to the victim, which may also explain possible barriers to disclosure. Regardless of the exact percentage of individuals who have experienced CSA, the figures are concerning and the impact considerable.

Effects of Childhood Sexual Abuse

For many, childhood was a time for playing, laughing and learning. Parents and extended family provided them with a secure and safe place to learn, love, laugh and grow into physically and emotionally healthy adults. While many children may have experienced a happy childhood, there are those who suffered trauma through sexual abuse. Children who experienced CSA often experienced negative outcomes as result of this trauma. The impact of CSA on an individual’s well-being is significant. CSA is strongly associated with a greater risk for major depression, physical illness as well as increased anti-social and criminal activity. Female survivors are more likely to be involved in abusive relationships, risky sexual behaviour and self-harming. As parents, both genders place their offspring at greater risk of dysfunctional behaviours due to generational patterns of abuse they may inadvertently pass onto their children. The Royal Commission into Institutional Responses to Child Sexual Abuse suggests, CSA can have a ripple effect on families, communities and society in general due to the impact on mental health, relationships and social integration. It appears that CSA impacts not only the survivor but society as a whole.

Current Treatments

Interventions in the treatment of CSA survivors can take many forms. Cognitive behavioural therapy (CBT) can be effective for both behavioural problems, as well as psychological distress. Group therapy can be an effective intervention in the treatment of ongoing issues resulting from CSA. As well as mainstream services such as, general practitioners (GPs), psychologists and community health services, specialist sexual abuse services that address the mental, social, financial and legal issues that can affect CSA survivors can also be helpful. Body-based therapies such as massage, yoga and Eye Movement Desensitization and Reprocessing (EMDR) therapy are also showing promising results in the treatment of trauma in CSA survivors.

Post Traumatic Growth

Despite the trauma of CSA and its subsequent effects in later life, there is potential for positive adjustment, commonly referred to as Post Traumatic Growth . PTG can be defined as the positive psychological change in individuals following significant trauma. These positive changes can manifest in improved personal relationships, a more resilient sense of self, as well as a more positive attitude towards life in general. Research suggests that a positive change in self-perception, personal relationships and world view has occurred in many adults who were sexually abused as children. For some people PTG may be cherishing current relationships, being the best parent, you can be, or finding religious or spiritual growth. Sometimes appreciating the level of control, you now have as an adult that you did not have as a child can also be empowering. Some researchers argue that it is the perception of the traumatic event, rather than the event itself, which determines the level of PTG experienced. As the late Friedrich Nietzsche stated, “If you know the why, you can live any how.” Finding meaning despite the experience may hold the key to recovery. As one woman subjected to CSA stated “I am not a victim. I am a survivor!” My experiences with people from all walks of life have convinced me that finding strength and hope in spite of life’s difficulties is what humans are good at.

Wishing you all the best in your journey

Phil Miranda

 

NOTE: I appreciate this article may be triggering for some people. If you or anyone you know is at risk of self harm or suicide then please follow this link to the Australian Mental Health Helplines website. International readers can use this link Global Mental Health Resources for a list of helpline numbers. If there is imminent risk of harm then please call the emergency services in your region.

Sources:
Centers for Disease Control and Prevention (2010). Adverse child experiences study. Retrieved from http://www.cdc.gov/nccdphp/ace/prevalence.htm
McElheran, M., Briscoe-Smith, A., Khaylis, A., Westrup, D., Hayward, C., & Gore-Felton, C. (2012). A conceptual model of post-traumatic growth among children and adolescents in the aftermath of sexual abuse. Counselling Psychology Quarterly, 25(1), 73-82.
Newsom, K., & Myers-Bowman, K. (2017). “I am not a victim. I am a survivor”: Resilience as a journey for female survivors of child sexual abuse. Journal of child sexual abuse, 26(8), 927-947.