In analyzing the evaluation data from a recent study, we were surprised to find that that teaching managers about mental health issues in the workplace did not have an appreciable effect on their attitudes toward individuals with mental health issues (i.e., stigma). The training did change both managers’ and employees’ reports of managerial behaviour but managers’ attitudes were unaffected. We were especially surprised by this finding because our previous research suggested that training managers was an effective means of reducing stigma.[1] When I compared the studies more closely, one striking finding was that managers in our most recent study expressed much more favorable attitudes toward individuals with mental health issues than they did in our original study. Indeed, managers’ attitudes were so favorable it would be hard to think of an intervention that could possibly result in even more favorable ratings.
It would be rash to conclude that, as a society, we have dispelled the stigma that often accompanies mental health issues. As in other areas we may have driven the stigma underground, with managers and employees learning that expressing negative attitudes toward mental health issues is not acceptable. At the same time, there is no doubt that we have made considerable progress in this area. The success of campaigns such as the Bell “Let’s Talk” campaign, the enactment of a national standard for psychological health and safety, and the growing trend toward mental health awareness training have all led to an increased recognition that [a] we are all affected by mental health issues and [b] it is not only “ok” but healthy to be able to discuss these issues and our struggles.
In my 2016 presidential address to the Canadian Psychological Association, I suggested that a comprehensive workplace mental health program would entail a focus on [a] prevention (i.e., the reduction of stressors and enhancements of supports in the workplace), [b] intervention (i.e., recognizing and providing support for people in crisis) and [c] accommodation (i.e., assisting people to return from disability leave or stay at work during and after their crisis). Our first studies in the area focused on intervention – training managers and, more recently, coworkers[2] about mental health issues. Our results suggest that training managers and coworkers enables individuals to access the resources they need in a timely manner. In our first study, Jennifer Dimoff, Matthew Burnstein and I documented a substantial reduction in the length of disability leave associated with such training. Researchers and organizations have also now begun to recognize the importance of return to/stay at work programs.[3] Although much more needs to be done in both of these areas, prevention activities stand out as the area where both research and practice are lacking.
As researchers we have been derelict. We have conducted innumerable studies showing the association of workplace conditions with well-being. We continue to expand the list of stressors and workplace conditions that are associated with impaired well-being. However, most of this research is based on the weakest possible research design (cross-sectional self-report surveys). When we have conducted intervention research it typically takes the form of “stress-management”, “resilience” or “mindfulness” training – with a corresponding focus on changing the victim of stress rather than the conditions that caused the stress. As I said in 2016 “there is a marked lack of strong interventions studies showing that (a) we can change characteristics of the workplace and (b) doing so will positively affect employee well-being”.[4]
As organizational leaders and decision-makers we have been disingenuous – willing to invest in any program to improve employee well-being with the exception of actually changing the conditions of employment. We will fund off-sites, workshops, and lunch-and-learns. We will conduct regular assessments of the workplace to identify stressors and potential problems. And, all too often, that is where it ends. The next step in the process – changing the way we work – is too difficult, requires a more detailed cost-benefit analysis, will take years to accomplish and any number of other convenient excuses. In occupational health and safety we have learned that working safely must be “built in” to work processes. Solutions and problems that are simply “bolted on” to existing work methods are rarely effective. In the same way, healthy working means changing the way we do things – not trying to change our employees so they can cope with unhealthy conditions.
It is great that the efforts of so many individuals and organizations have been focused on opening the dialogue on workplace mental health. By all means let’s keep that discussion going. But having changed the culture in this way, now it is time for the hard work to begin – the work of changing our policies, procedures and practices so as to minimize stress and maximize individual health. Unless we do that, the success of “let’s talk” can quickly turn to “just talk”.
[1] Dimoff, J.K., Kelloway, E.K., & Burnstein, M.D. (2016). Mental Health Awareness Training (MHAT): The Development and Evaluation of an Intervention for Workplace Leaders. International Journal of Stress Management, 23,167-189.
[2] Oakie, T. (2017). Validating the Coworker Mental Health Awareness Training. Unpublished M.Sc. Thesis, SMU.
[3] Nielsen,K., Yarker,J., Munir, F., & Bültmann U. (2018) IGLOO: An integrated framework for sustainable return to work in workers with common mental disorders, Work & Stress, DOI: 10.1080/02678373.2018.1438536
[4] Kelloway, E.K. (2017). Mental health in the workplace: Towards evidence-based practice. Canadian Psychology, 58, 1-6.