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Top 10 Ways to Nurture Mental Health

May is Mental Health Month! Across the world, many companies are highlighting mental wellness, mental health condition awareness and recovery. Over the past 25 years, I have been helping organizations create effective mental health campaigns, and here are 10 tips I’ve learned and resources I’ve discovered to help your mental health awareness campaigns be most successful.

1. Normalize struggle safely

One goal for many mental health campaigns is to let people know they are not alone. When mental illnesses and suicidal crises strike, people often suffer in silence. By letting people know that others have lived through similar challenges, campaigns can offer hope and community. Pain shared is pain lessened. The trap that some mental health campaigns fall into, however, is overemphasizing the prevalence of extreme behaviors as an “epidemic.” This type of messaging can make people feel hopeless about change. Worse, when it comes to suicide, this type of exaggeration might even create a cultural script that inadvertently influences people to engage in suicidal behavior, because it is the “norm” of what people do to cope with pain. Following the safe messaging guidelines helps ensure that the messages they are sending are promoting health and not creating additional risk.

2. Offer screening tools that lead to action

Screening is a great example of a low-cost, high-impact tool to highlight during mental health campaigns. As with other health issues, screening for mental health conditions increases the likelihood that we can identify emerging symptoms and alter their course with early intervention. Screening offers people a way to anonymously self-assess, which is often an attractive first step for those who are ambivalent about seeking help. A screening that just gives participant a label, however, will fall short. Effective screening tools give participants a call to action and link them to additional local and on-line resources. Many on-line and paper screening options exist (e.g., Screening for Mental Health), and nationally recognized days can make screening a part of a community’s regular health programming:

See also: New Approach to Mental Health  

3. Know your resources on a first-person basis

Effective mental health campaign leaders do their homework. If you want to be a trusted referral source, you need to walk your talk. Get to know your local mental health providers. Visit your local psychiatric hospital. Invite local counselors to a “meet and greet” event. Call your local crisis line, text the Crisis Text Line or contact your EAP (employee assistance program) to get a better sense of how it works. Ask the questions you need to have answered so you can refer people confidently. Your referral will be so much stronger if you can say, “Oh, I know Dr. So-n-so, she’s really approachable and competent. I’ll take you there to meet her if you’d like.”

  • Need more information about EAPs? Here is a buyer’s guide:

4. Share stories of hope and recovery

A main goal of many mental health campaigns is to reduce the stigma of mental illness; however, paradoxically, the more we talk about stigma, the more we actually reinforce it. Instead, we can fight stigma by sharing stories of hope and recovery. When we can demonstrate how others transform their wounds into sources of power, we create hope. When respected people come forward and say, “I suffered, and I got better,” others feel they can get better, too, and the issues become less marginalized. When campaigns highlight the experience of living with a mental health condition, focus on the turning points, the coping and resilience and the interventions that worked. One powerful storytelling resource that models best practices in safe and effective testimonies is the photojournalism of Dese’Rae Stage. Her project “Live through This” is an anthology of portraits and interviews of people who have lived through their own suicide attempt. Dese’Rae’s story and project are highlighted in a new documentary just released in April 2017 called “The S Word.”

5. Make messaging attractive, compelling — and even fun

What attracts us to advertising? Messages that make us laugh, catch us off guard or inspire us. It’s human nature to turn away from things that are scary, confusing and depressing. The challenge for mental health campaigns is to make messaging uplifting, engaging and compelling without becoming so superficial they miss the point. Here are some examples of messages on the mark and one example of what not to do:

6. Tell people what you want them to remember

Sometimes, in our attempt to get attention to our cause, we play up tragic outcomes and overlook important calls to action and messages of hope. We need to tell people what we want them to remember: Treatment works, prevention is possible and people recover. Let people know what to do if they are struggling or if they are worried about a friend or loved one. Tell people exactly how to get involved in suicide prevention in their communities.

  • More tips on creating an action-oriented, positive narrative

7. Engage leadership

Often, mental health campaigns gain momentum at the grassroots level – passionate families, students or faith community members come together and apply their collective energy to make changes. “Grass-top” approaches should also be considered to augment this strategy. People in positions of influence can often move things along more quickly and usually just need to know that people care about an issue. So, engage your leaders to start the conversation. Ask them to speak publicly on why mental health matters to them, why it’s an important health and safety topic for your workplace and how mental health challenges have shown up in their own lives. If they have experienced a mental health condition including depression, addiction or overwhelming stress themselves and have received any form of support that was helpful, their “lived experience” is often the most important driving force in changing culture within a company. By sharing their vulnerability and positioning their story as overcoming hardship by reaching out, they model for the rest that “we are all touched by this, and we can get through it together. I’ve got your back and will persist with you to get you the help you deserve.”

See also: Language and Mental Health (Part 3)  

8. Provide opportunities for deep learning

Many mental health promotion efforts seek to promote awareness, but education alone will not move the needle. We call it the “State Trooper Effect.” We pay attention to educational or awareness raising efforts when they are done well and right in front of us, but once they are in our rear view mirror we tend to go back to what we were doing before. Deep learning goes beyond passive input of knowledge. Deep learning engages people in a knowing-being-doing process. Yes, education is part of that equation – a necessary, but not sufficient piece. We also need to get people “doing” – physically, emotionally and even spiritually involved in the work, and, to really make it stick, personal reflection on the experience is key.
One example of “learning, being, doing” is Project Helping – a corporate, positive psychology engagement program that gets people engaged in actions that create a caring culture at work.

9. Create a symbol of solidarity

We’ve seen how the color pink has symbolized breast cancer awareness. Symbols of solidarity work, but they need to be unique. When these symbols work well, people can see at a glance the community that is being built. Symbols used to promote suicide prevention can let people who are struggling know who might be a safe person to approach with questions. When the symbol of solidarity starts to spread to large groups of people it is a powerful testament to a person secretly in despair. Some examples of symbols of solidarity include:

Photo by Joits

  • “Honor bead” necklaces worn at the American Foundation for Suicide Prevention’s Out of Darkness Walk. Participants choose to wear different colors to symbolize their experience – one color represents “I have lost a loved one to suicide,” another color might mean “I have struggled myself,” while another says that “I support the cause of suicide prevention.”

10. Promote belonging and purpose

Thomas Joiner’s model of suicide risk tells us that a thwarted feeling of belonging and a perception of being a burden are two critical factors that increase a desire for suicide; the opposites of these states are belonging and purpose. When we create meaningful communities and let people know they are needed, we are doing suicide prevention.

How can your mental health campaign help people connect to one another and find a new or renewed sense of purpose? How can people “pay kindness forward” and develop trusting relationships with one another?

Conclusion

Mental health awareness campaigns need to go beyond “awareness raising.” They need to do more than just share statistics and the local resources’ contact information. Promising campaigns model hope, inspire creatively, practice safe messaging and call us to action. The campaigns that are most effective go well beyond any awareness day, week or month and are “baked in” to a company’s health and safety culture. The ones that are truly culture-changing are “by, about and for” the people within the company; real employees telling real stories of hope and recovery. When we realize we have a secret we all share, the walls come down and we heal together.

New Approach to Mental Health

In recent years, thought leaders in business, government and risk management have developed a sophisticated understanding of the bottom-line impacts of untreated mental illness in the workplace. For example, mental health and brain science dominated the agenda at the Davos World Economic Forum in 2015. And the National Business Group on Health held its first CEO Mental Health Summit in October 2015. Among the costs highlighted in these forums: worker productivity loss, high healthcare utilization rates, skyrocketing disability outlays and employment litigation.

To further advance mental wellness in the workplace, it’s essential for legal and human resources to be part of this collective effort. Here, we explore this disparity in approaches, and discuss why it is so harmful to the interests of all – employers, insurers, employees and their families.

See also: Language and Mental Health

What most thought leaders know about workplace mental health, in a nutshell, is this:

  1. Mental illness is common and treatable, with a 25% incidence rate and an 80% recovery rate, akin to chronic physical illnesses;
  2. Early detection and treatment are the most effective and inexpensive means of helping employees get well and return to full productivity quickly; and
  3. If an employee takes a leave of absence, the longer the absence, the less likely the employee is to return to work.

Thus, the organizational strategic imperative is to create workplace conditions designed to enhance early detection and treatment, restoring the status quo as efficiently as possible.

In stark contrast to this organizational imperative, legal and human resources professionals often advise supervisors, managers and EAP professionals to treat potential emotional and mental health issues exclusively as a performance matter. This advice is usually driven by a desire to “avoid an ADA claim.” However, this approach usually postpones the inevitable and makes a claim under the Americans with Disabilities Act more, not less, likely.

The result is often this pattern: a continuing decline in the employee’s condition and work performance, a severing of trust between employee and supervisor and isolation from others at work. Once a disciplinary action or performance improvement plan is imposed, both parties cut ties, and the result is a toxic cycle of leave of absence, disability claim, a request for accommodation, a failed interactive process, separation of employment and either litigation or a pay package. This is an expensive, disruptive and painful process that can often be avoided.

Employers would do well to consider this as an alternative approach:

Design a mental health policy that will unify executive leadership, legal counsel and human resources around the organization’s strategic approach to overall wellness.

  • This policy defines the vision, and the business case, for improving the mental health of the workforce and using the ADA interactive process as an effective means of achieving early detection and treatment of these impairments.
  • Training for supervisors, managers, legal counsel, HR, EAP staff and healthcare providers will highlight: A timely and collaborative exchange of information and interactive process maximizes success; the ADA does not require a fundamental alteration of any job; work teams and supervisors need to partner with HR on making accommodations work.
  • The policy will establish a confidential process for employees to obtain affordable, accessible treatment (either through existing vendors or through curated referrals).
  • Developing and implementing the mental health policy can stimulate and engage your organization in a discussion of the high incidence of emotional and mental health impairments and how these common, treatable conditions can be accommodated.
  • Mental Health 101 Training should be integrated into total wellness programs, including how to mitigate and address stressors in the workplace, how to respond to a colleague or supervisee who may be struggling and how to seek help confidentially.
  • Mental health champions should be designated, trained and made available as confidential resources to anyone at any point in the chain of command dealing with a mental health issue.

When executive leadership, legal counsel and human resources unify behind a strategic, business-savvy approach grounded in total wellness and ADA compliance, everybody wins.

See also: Why Mental Health Matters in Work Comp  

Insurance Thought Leadership’s continuing series of articles focused on suicide prevention is written by the Workplace Task Force of the National Action Alliance for Suicide Prevention, the public-private partnership championing suicide prevention as a national priority.

How to Handle the Winter Blues

For some, winter is a time of celebration – the holidays, winter sports, beautiful snowy landscapes and a reason to drink hot chocolate. For others, the shortened days bring on something called Seasonal Affective Disorder (SAD). For people who experience SAD, otherwise known as the “Winter Blues,” they find their symptoms of mild depression start in the fall and end as the sun shines for more hours in the spring. People who live farther from the equator are more likely to feel the effects of shorter days. According to the American Family Physician, about 6% experience severe SAD and as many as 20% may experience a milder form of the disorder.

Common symptoms include:

  • Lack of energy that is not fixed by increased sleep
  • Upset mood: irritability, sadness, mood swings, anxiety
  • Less interest in your usual activities
  • Weight gain from increased carbohydrate craving
  • Distraction and decreased ability to cope with stress.

What causes SAD? How can it be treated?

Sunlight affects our biological rhythms and our sleeping and hunger schedules. When we lose our ability to access sunlight, our “biological clock” is disrupted. Furthermore, sunlight affects one of our main mood chemicals, serotonin, the brain chemical that affects sexual desire, feelings of well-being, sleep, memory and even the way we interact with one another.

Thus, treatment for SAD can involve light therapy, counseling and medications. Dealing with SAD also means making a conscious effort to get outdoors when there is sunlight.

Here the Mayo Clinic offers more information on treatment and home remedies.

What is the relationship between SAD and suicide?

See also: Blueprint for Suicide Prevention  

There is a myth that the winter holidays and “winter blues” increase the risk for suicide. Many inadvertently may increase risk by perpetuating this myth and interfering with prevention efforts through this misinformation. According to the CDC, the suicide rate is, in fact, the lowest in December and the winter months around the world; the rate peaks in the spring and the fall. Several theories exist as to why this might be so. One is that during the holidays, more family tend to be around, which might increase a sense of connection or decrease opportunity for suicide. Another reason might be that people hold on for hope of positive changes in the new year, and when these changes don’t happen, their hopelessness increases. One final reason related to SAD is that, when the sun returns and the weather warms, some may find an “energized despair,” when before their energy was too low to act on their suicidal thoughts.

See also: What Is the Business of Workers’ Comp?  

In summary, Seasonal Affective Disorder is real and can be very disruptive to health, productivity and relationships. Like all other health conditions, early detection and treatment can significantly improve quality of life.

When Workplace Safety Is Core…

In a true Culture of Safety, safety always wins. It is the first among equals; it is the card that beats all others. In short, Safety is a Core Value of the organization.

Safety and other Core Values are:

  • Continuously communicated.
  • Lived by leaders in their words and behaviors.
  • Formally and informally reinforced, recognized and rewarded
  • Integrated throughout all operations.
  • Used as a compass to guide decisions.
  • Measured and monitored against goals.
  • Committed to, not simply complied with.

The Importance of Mindsets

It’s my firm belief that for an individual to be successful at anything, he or she has to have the right Mindset, Skill set and Tool set. And of these, the most important is Mindset. Why? Because Mindsets drive Behaviors.

Mindsets are created by a wide variety of factors: upbringing, social circles, religion, education, etc. But when it comes to the workplace, mindsets are created and reinforced by the organization’s Culture.

People behave safely when they have a Safety Mindset, a belief that safety in the workplace is their responsibility, both for themselves and others. That belief leads to decision-making based on the potential hazards and risks of any behavior.

Safety and Mental Health

The Core Value of Safety is not just about the right safety gear or procedures. It creates an environment where the mental well-being of the people is just as important as their physical safety.

Did you know 1 in 5 Americans in the workplace live with a diagnosable mental health condition? While many are able to use medication, treatment, wellness practices and peer support to manage these health conditions, too many go unidentified and untreated, And like most neglected health conditions, their status often worsens unnecessarily.

Unaddressed mental health conditions and addictions can negatively affects productivity, attention to detail, quality of work and the safety of the individual as well as co-workers, but with treatment, support and wellness, people living with mental health conditions can be some of your most gifted employees. Most employers simply aren’t aware that often people with the strongest work ethic, creativity, charisma, detail-orientation, and interpersonal skills as also sometimes vulnerable to depression, bipolar condition, obsessive-compulsive disorder and anxiety.

When left unchecked mental health conditions and addiction can be life-threatening. Tragically, the suicide rate in the United States has been steadily increasing since 1999, especially among working age men. According to the Centers for Disease Control and Prevention, suicide was the fourth leading cause of death for males ages 25 to 54 in 2014.

See also: Language and Mental Health  

When Safety is a Core Value, it goes beyond preventing physical illness and injury. It also includes supporting the emotional well-being of employees. Beyond being the right thing to do, it is in the organization’s economic best interest to ensure that its employees are mentally resilient, healthy, and productive. There is a significant return on investment by promoting employee mental health, positively impacting everything from disability and workman’s compensation to productivity and employee retention.

Does your Culture reflect the value of Mental Health?

It can be difficult to determine the true nature of an organization’s culture when you’re inside it. As the noted media theorist Marshall McLuhan put it, “We don’t know who discovered water, but we know it wasn’t the fish.”

But that doesn’t mean you shouldn’t continually evaluate your Safety Culture, especially in terms of mental health. These questions can help you determine if mental health is part of your Core Value of Safety:

  • What does your company’s culture say about how you value mental health as a part of overall wellness?
  • What does the work environment tell people about how they should best deal with stress? Conflict? Depression? Addiction?
  • Does your company’s leadership model mentally healthy behavior? Is emotional intelligence and mental health self-care supported?
  • Is anyone at the top level of leadership “out” and talking about their recovery journey from addiction or mental health challenges?
  • Is mental health promotion and suicide prevention part of your Health and Safety Programs? (e.g., training on early identification and intervention, mental health resources like Employee Assistance Programs, suicide prevention hotlines, peer support resources, etc.)
  • Do employees recognize unidentified and untreated addiction and serious mental health conditions as a potential safety hazard just as they would someone with a head injury, heart condition or broken leg?

Culture is Everyone’s Responsibility

Cultures aren’t something “out there”. They are created and maintained by individuals, not organizations. They are the sum total of the shared values of everyone in the organization, how each individual shows up and creates an environment for others to show up.

Anyone can — and does — have influence over the culture. Of course, Leaders have significant influence, but Culture is not simply their responsibility. To a larger or lesser degree, every employee influences the Culture every day.

If you want to have a true Safety Culture, everyone in the organization must have:

  • A Mindset of Safety, viewing every situation and decision through the lens of safety.
  • Safe Behaviors that ensure a safe workplace.
  • A recognition that mental health is as vital as physical health.
  • An understanding of resources available to stay physically and mentally healthy.

Cultures are created, reinforced, or even changed one person at a time, having the right Mindset to lead to the desired behaviors. That’s how you move Safety beyond a program or set of rules to “the way things are done around here.”

See also: Why Mental Health Matters in Work Comp  

Promoting mental health, suicide prevention as well as physical health and safety is how an organization truly lives its Core Value of Safety.

Blueprint for Suicide Prevention

On Sept. 3, 2015, a press release was issued by the Carson J Spencer Foundation; RK, a construction company in Denver; and the National Action Alliance for Suicide Prevention. This press release was timed to coincide with Suicide Prevention Month in September and World Suicide Prevention Day on Sept. 10 . This press release announced the distribution of A Blueprint for the Construction Industry: Suicide Prevention in the Workplace (aka The Blueprint). One year later, we believe  that this document was a catalyst in developing a national movement in suicide prevention in construction. This articles tracks the milestones of this movement and future directions.

In 2010, the National Action Alliance for Suicide Prevention and its Workplace Task Force were launched in conjunction with World Suicide Prevention Day. The co-authors served as inaugural members of the Workplace Force. The Blueprint was intended to create awareness, generate advocacy and spur action in the construction industry around suicide prevention. In addition, The Blueprint provided a toolkit for how to discuss mental health and suicide prevention in the construction industry.

Equipped with The Blueprint, the co-authors began an initiative to break the silence and create a culture of caring. The co-authors sought to gain the attention of the construction industry through a media saturation campaign. The intent was to build a reproducible model within the construction industry that could subsequently be used as a reproducible model by other industries. In short, the coauthors sought to integrate mental health and suicide prevention in safety, health, wellness and employee benefit programs by framing the topics as the “next frontier in safety.”

The Centers for Disease Control and Prevention (CDC) published a report that placed the construction and extraction industry as second-highest in the nation for suicide rates.

But, a year later, The Blueprint has exceeded expectations. It spawned an outpouring of targeted action that is rippling throughout the construction industry. The impact has been felt in: publications, presentations, projects and partnerships.

Publications

The publishing of The Blueprint created demand for articles by major independent construction industry publications and those published by trade associations. There have been at least 28 unique articles published since the first one was posted online by the Construction Financial Management Association (CFMA) on Nov. 1, 2015.

See also: Union Pacific Leads on Suicide Prevention

These articles have included both in-print and online versions. The articles have begun to cross over from construction into architecture and engineering, to make this an issue that is being discussed in the integrated AEC industry. The articles have penetrated major industry brands, including Engineering News-Record (ENR); the Associated General Contractors of America’s Constructor; CFMA’s Building Profits; Associated Builders and Contractor’s Construction Executive; Construction Business Owner; and the National Association of Women in Construction’s Image.

Presentations

Once articles were appearing in industry publications, it was easier to solicit presentations. The first presentation that Cal Beyer gave regarding suicide prevention was the September 2015 CFMA Southwest Regional Conference, where he included suicide prevention as part of his company’s commitment to Safety 24/7: safety at work, home and play. The second presentation he delivered was to the South Sound Chapter of the National Association of Women in Construction in November 2015 near Seattle. These two early successes made it easier to “sell” the concept of presentations.

Sally Spencer-Thomas presented at the January 2016 Men’s Health Conversation at the White House in January 2016, while Beyer presented at the pre-meeting at the Department of Health and Human Services. The next two presentations were led by Spencer-Thomas in February 2016 at an executive roundtable sponsored by Lendlease in Chicago and to the Associated General Contractors of Washington. More than 100 attendees heard Beyer’s presentation at the Pacific Northwest Forum of the National Association of Women in Construction in April 2016. Two sessions were facilitated at the CFMA Annual Conference in June 2016. Similar sessions were offered in Portland, OR, in June to the AGC of Oregon and in Boise, ID, in July for the Idaho Chapter of CFMA .

The marquee event was held in Phoenix on April 7, 2016, when more than 100 attendees participated in the CFMA’s Regional Suicide Prevention Summit. Similar summits are scheduled by CFMA chapters for Charlotte on Nov. 9, 2016, in Portland, on Nov. 16 and Chicago on Feb. 17, 2017. A series of summits have been proposed by numerous CFMA chapters in 2017, including: Denver; Washington, DC.; Indianapolis; Houston; and Las Vegas.

Projects and Partnerships

The first partnership was established with CFMA through publications — including the first article as well as two custom PDF publications highlighting both the “why” and “how” to address suicide prevention in construction companies. Moreover, CFMA launched the aforementioned Construction Industry Alliance for Suicide Prevention and created an executive committee task force.

Clare Miller, the Executive Director of the Partnership for Workplace Mental Health, has been distributing periodic updates on the construction industry to her organization’s members. A partnership was formed with the JP Griffin Group, an employee benefits consultancy in Scottsdale, AZ. The Griffin Group created artwork for four custom poster templates that has been provided to the construction industry at no charge. Hoop 5 Networks, an IT system consulting company from San Diego, provided web development services for the Construction Working Minds website maintained by the Carson J Spencer Foundation.

Union Pacific invited Spencer-Thomas and Beyer to present in Omaha at the Railroad Suicide Prevention Summit on Aug. 24, 2016, so that rail industry leaders could transfer the lessons learned from construction to their own industry. Likewise, the U.S. Department of Veterans Affairs requested the construction industry be represented at its roundtable on suicide prevention on Aug. 30, 2016. While Beyer was not able to attend, he invited representatives from the CFMA and ABC associations to attend.

See also: A Manager’s Response to Workplace Suicide  

Finally, the best example of the growing partnership is the creation of a construction subcommittee on the workplace task force of the National Action Alliance for Suicide Prevention. There are now nine members on this subcommittee, and it is the largest subcommittee of the workplace task force. These subcommittee members represent a broad cross-section of the construction industry. The nine subcommittee members are:

  1. Cal Beyer; Risk Management Director; Lakeside Industries, Inc. (Issaquah, WA)
  2. Dr. Morgan Hembree; Leadership Consultant; Integrated Leadership System (Columbus, OH)
  3. David James; CFO; FNF, Inc. (Tempe, AZ)
  4. Tricia Kagerer; Risk Management Executive; American Contractors Insurance Group (ACIG); Dallas.
  5. Joe Patti; Vice President & CFO; Welsbach Electric Corporation (College Point, NY)
  6. Christian Moreno; Vice President; Health Risk Solutions; Lockton Dunning (Dallas)
  7. Bob Swanson; Retired President; Swanson & Youngdale, Inc. (Minneapolis)
  8. Sally Spencer-Thomas, CEO, Carson J Spencer Foundation (Denver)
  9. Bob VandePol; Executive Director, Employee Assistance program; Pine Rest Christian Mental Health Services (Grand Rapids, MI)
  10. Michelle Walker; Vice President Finance & Administration; Spec ialized Services Company (Phoenix)

Conclusion

Thus, in less than one year, the construction industry has moved from not thinking about suicide prevention to being a leading industry in the effort. In fact, in May 2015, Forbes published an article called, “What Construction Workers Could Teach Other Industries About Mental Health Awareness.” This demonstrated how broadly this awakening and action has been felt.

This first phase of garnering awareness and political will is critical in starting this national movement. The next phase is to institutionalize these efforts by bringing best practices in suicide prevention to companies, researching outcomes to better understand what works and developing policy and procedures that support mentally healthy, resilient and psychologically safe workplaces.