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Mental health and work

The workplace and mental health are closely intertwined – work can be the cause of problems, and issues can express themselves in the workplace.


Organisations that don’t improve their culture are at risk of failing their people, while those that do change have a chance to attract the best people for longer.

We hear from Alastair Campbell, former communications adviser to UK prime minister Tony Blair, and We hear from Alastair Campbell, former communications adviser to UK prime minister Tony Blair, and Sean Elson of Pinsent Masons about operating under pressure while dealing with depression; and from Philip Aiken of Barclays and Kate Dodd of Pinsent Masons about practical measures companies can take, and about creating a ten point charter to help them do better. 


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Matthew Magee:

Hello and welcome to Brain Food For General Counsel, a monthly look at the biggest issues your organisation faces with help and advice from experts – legal and otherwise – on how you can help your organisation do better. My name is Matthew Magee, and I'm a journalist here at Pinsent Masons.

No organisation can thrive if its people are routinely not healthy. But not all health problems are visible or obvious – you can work with someone for years without knowing that they have poor mental health. So we will investigate today what organisations can do to become better employers of people with mental health issues, and we'll look at just how essential that is for the organisation itself and for the wellbeing of its people.

There is a business case for better mental health awareness and processes, but the overwhelming argument for improving how this is treated in the workplace is a human one – it's the rare person who never suffers any mental or emotional health problems, and the workplace that understands that is going to be a better place to work as well as a more productive and profitable one.

If anyone had any doubts that people with depression and anxiety can be productive and effective under pressure then Alastair Campbell will dispel them. Right hand man and communications advisor to ex-UK prime minister Tony Blair, Alastair was at the heart of opposition then government for more than 10 years, in the room through crises such as foot and mouth, fuel shortages, the attacks of September 11th 2001 and the Iraq war. He did it while dealing with depression and anxiety that he has laid bare in an unflinching account, Living Better, published last month. We'll hear from Alastair about what it's like to operate at that level when dealing with depression, and about his tactics for coping.

It's a story that will be familiar to Pinsent Masons partner Sean Elson, who'll talk us through his own experiences of mental health and work.

Philip Aiken of Barclays and Kate Dodd of Pinsent Masons will help us understand what practical action organisations can take, and what differences that can make to an organisation's culture and, ultimately, its future direction and viability.

But first to Alastair Campbell, whose book opens with the words 'On a dark Sunday night last winter, I almost killed myself' and continues with unusual candour to detail his long experience with depression, which first came to a head in the 1980s. Even back then he chose not to hide it, which was rare for anyone, never mind someone even slightly in the public eye as he was, a news editor of one national paper, then political editor of another.

He told us about how his condition has affected him, but first I wanted to know if his open-ness itself undercut the shame that was, and is, all too common when dealing with mental health – did it de-fang what others still considered an insult?

Alastair Campbell:

I think I have benefited from being open, even though I got a lot of flack from a lot of people politically and media wise, they were all pretty good in the main about me saying sometimes I got really badly depressed once, had a complete crack up and had a drink problem and so forth. I never really felt any blow-back at all. That as I say is for me in a fairly fortunate position, I had employers who understood, I had friends and family who understood. I think it's harder maybe for people in organisation where it's less understood. And I meet people all the time, some of whom who end up in court where they feel that because of the openness about mental health that it is held against them and it is held against them in terms of promotion prospects. It is held against them in terms of bullying and so forth. So you have got all of this today, but I have always felt that being open has helped me as an individual and it has also helped how I feel about the world around me.

I think that in my early days when I was a journalist I dealt with my mood swings through alcohol in part, a form of self medication. And also denial. And then I think when I stopped drinking in 1986 I had a breakdown I think I then developed a different form of denial through work. I think I became a workaholic, I probably always was a workaholic, I quote Tony Blair in the book as he once said to Vladimir Putin when Putin noticed that I wasn't drinking all the vodkas that were being lined up at these toasts and it was just this queue of undrunk vodka was gathering by my plate and Putin was sort of looking at this little spectacle across from him and Tony spotted him looking and said "Oh, don't worry about him he's a thingaholic" and it's a very good description. So I think I drowned it in drink and then I buried it in work and it was only really after I left number 10 in 2005 I was I would actually call it a form of self harm, I was physically hitting myself and I thought this has gone on too long.


Alastair writes about the tactics he's developed to cope with his illness, one of which is a scale of one to ten where he gives a score to how he's feeling each day. He says the best one is where he thinks of himself as a jam jar, as recommended by one expert.


So the jam jar was a thing that I came across in Canada with a woman who I actually went to see, she's a genetics expert, it was to talk to her about whether there was a genetic element and she basically said that you look at your life as a jam jar, at the bottom of the jar is the sediment and that's your genes nothing you can do about that, then your life fills up with experiences that are good or bad and they mix in and most of it goes in and it goes out because we don't remember everything and some things aren't important. But then what happens is as you go through life, if your jam jar becomes unmanageable and there's too much going on in there and you're not managing properly it explodes. And she says, and that's illness. That can be any sort of psychological illness but that is how to think of it. And she said instead of spending all our lives as we do sort of ruminating about what is already in the jam jar, stuff that we can't undo, she said try to think of it as what can we do to grow and extend the jam jar so that we can pour more life into it.

And when she was talking to me I sort of half got what she was on about but it was a few days later, I woke up in the middle of the night and I drew my own jam jar. So mine started with FFF, which is Fiona, family, friends - if you get those key relationships right and then I've always as I say been a bit of a workaholic so I've put work into two bits. I called it meaningful activity paid and meaningful activity unpaid. And then I was into my fundamentals that was sleep, diet and exercise. And then you're into the things that really really matter to you, the things that are very very personal. So for me Burnley Football Club, bagpipes, scenery, speaking French and German, reading in French and German, the music that I like to listen to, the books that I like to read. And then I think I'm into the whole curiosity, creativity thing, you know the idea that trying to learn something every day that you didn't learn the day before. And what was interesting about it, when I was doing it, I was off the page before I even got to medication, which I still take and it is still part of my jam jar. But if you had said to me the day before I met the woman, how do you stay okay with your depression, I would have said oh, well I take medication every day.


Mental health is still pretty poorly understood by those without direct experience of it. Many societies have got past the stage where it can be openly mocked without consequence, but not quite to the stage where we routinely change the way we work and operate to accommodate it.

This is why personal testimonies are so important, to help people understand the situation and to reinforce the message that this is something to be discussed, not hidden away. We know we can't send someone with a broken leg out to deliver the post, but we are usually much less clear what we can and can't ask someone to do if they have depression or anxiety. Talking about it helps us all.

Sean Elson of Pinsent Masons told me about his experiences.

Sean Elson:

People who haven't maybe had much experience with mental health issues might look at somebody who outwardly is wealthy, successful with a family and lots of material possessions. And so what on earth could they possibly have to be depressed with? And then somebody who is in near terrible circumstances might be one of the most happy go lucky people you could possibly meet.

It tends to manifest itself in a number of ways, very low mood, irritability etc so the kind of things that you can have just frankly through being alive. We all experience these low periods and times of difficulty, the problem that is occurred for me on a couple of occasions has been the fact that it's quite insidious. So you start to feel lower and lower and eventually it becomes that's how you feel, that's how you are, it's you. Rather than recognising that actually this is not how it should be and this shouldn’t be a permanent state of affairs.


The reaction of most people when they learn about Alastair Campbell's experiences – from the book, or his many radio and television programmes about his depression, or his campaigning on mental health issues – is probably incredulity that he could more or less help to run a country while dealing with sometimes-severe episodes of mental ill health.

But he says that having such an all-consuming job actually made it easier to deal with in some ways, and that the problems became more acute when work at that level of intensity stopped.


I coped because I had a desire to do what I was doing, I had even with lower energy I still had quite a lot of energy and then what would happen, and I'm afraid that's where families take the brunt of it, I'd come home I'd be completely exhausted and I'd just sort of crash. So I think work was actually part of the management of it in a funny sort of way. I think people who are in very busy, high pressure, high stress jobs I think it's that feeling of where you're meant to enjoy something. It's why for example I think that, from my experience a lot of people find Christmas and New Year really really stressful. If your mind and your body is still kind of trapped in a very very high pressure work zone and then suddenly you're mentally chilling out in a rented home or on the beach or, on a bike ride or something but your mind is still elsewhere. Added to it certainly in my case when I was you know really really busy, was that the phone never stopped anyway and there was always stuff to do it would just add to that sense of 'I'm not in the right place'. Not feeling that you're in the right place, that's when I feel my depression is starting to kind of take a really bad hold of me and often that does start when I'm taking myself out of the mode, the zone that I'm most used to and into a different one.



Alastair Campbell has dealt with pressure the like of which few of us can imagine, yet he has said in the past that in all his time at the heart of the UK government only five events truly counted as a crisis. How did he cope in those moments?


If I remember rightly what I would have said the five crises were, that would have been Kosovo, foot and mouth, fuel protests, 9/11 and Iraq I would say. I would say for them the only one that did impinge really directly on my mental health was Iraq and that was because of the particular circumstances I found myself in with real difficulties at home because Fiona had had enough of the job and was also against the policy. And I just had particular difficulties and added to which I tried to get out, then subsequently became the focus of so much of the - talk about a target on your back, that was when I really, I did have a target on my back in terms of the media and politics and so forth - so apart from that … no, in fact.

This is something I think you've got be a bit careful of in any big organisation where there is a potential to have a crisis is that they can be kind of a bit addictive, once you getting used to doing a job like that, where it is quite high level and it is quite stressful and there is a lot of travel and a lot of time and a lot of difficult challenges and problems, which others might see as crisis but providing you handle them properly they're not, and that can become a bit kind of dull and a bit mundane and then there's a danger that actually what you live for is the 'oh my God this is meltdown' because then that plays to the idea that we can sort this, we can fix this. But I think in relation to my mental health, no I think apart from those very personal circumstances in Iraq I didn't feel that the crisis itself was adding to many additional problems.



Sean Elson wonders if there is a more intricate relationship at work here, whether all-consuming work such as being a lawyer actually attracts people who are more at risk from mental health conditions.


In certain types of professions there may be a certain type of people that are attracted to those professions, high achieving, high functioning but maybe with elements of needing to feel a sense of control or always wanting to be better or a perfectionism. Those things I think are very relevant factors for people in professional services. One area is also this sense of competition as well. The extent to which it may or may not be healthy to be in a constant state of feeling that you're in competition with your peers. Whether it's for bonus or promotion or the next big project and the extent to which that is particularly healthy may contribute to people's issues. So are very much a component of wanting to work in a collegiate environment where we're all working towards the same goals rather than a kind of devil take the hindmost type scenario and where people are constantly striving for fear of what the consequences are if you're seen as 'under performing'


So while Alastair Campbell could work effectively the cost was, in the end, enormous. And while neither Alastair nor Sean would go so far as to say that one thing caused the other, it is uncontroversial to say that work and its stresses and pressures is a factor in mental health for all of us.

Philip Aiken recognised this. He is a managing director in the legal function at Barclays Bank and he has helped put together the Mindful Business Charter to try and address some of the working conditions that can lead to ill-health. It came out of a conversation with Pinsent Masons senior partner Richard Foley and a shared recognition that some of the stresses of work were productive and some were most definitely not.

Philip Aiken:

We were talking about the fact that the day job, the actual job, the lawyering that we do, is in most cases reasonably straightforward. But what makes the job harder are the pressures that we put on each other, the demands that we put on each other within our own organisation but also the demands that we put on each other in terms of client and service provider. So in my example, there is the bank and law firm or in-house function and law firm, and how it seems that an element of humanity has come out of that relationship.

As we each sit behind our computer screens it's too easy to casually set a deadline and unintentionally and perhaps inadvertently cancel someone's weekend plans or their plans to see family or their plans to care for their children or perhaps some elderly relative, and that we needed to think of a way to put the humanity back into those relationships, particularly at a time when many in-house functions are seeing their law firms as an extension of their function, as colleagues.

And it was in that conversation we said yes isn't it just a case of putting together just 10 basic principles, this is how we're going to interact with one another, where we respect each other and also we recognise that each of us have lives outside of the workplace. And one of my biggest frustrations about the workplace is that everyone is so busy pretending they have no other commitments that work is the most important thing. And whilst work is always important, it is not always the most urgent thing in our lives. And actually it's time that we talked about that more, the fact that there is a need to balance commitment outside of the workplace with those important commitments inside the workplace and that if we all work together we can make that happen much more effectively than we have done before.

I am seeing instances where law firms are saying in response to a deadline, 'we can get you that document on Monday morning but that will involve two of my associates working at the weekend. That's absolutely fine if this matter is at the stage that it requires that level of urgency, alternatively we can get it to you by close of business on Tuesday'. Inevitably the response from our side as a client has been, no there's no need for anyone to work the weekend on this, close of business on Tuesday is absolutely fine. Much of the work that we do, if not all of it, is important but a minority of it is urgent and I think before the mindful business charter people were failing to distinguish the urgent from the important. And I think is critical.


Whichever way you look at it – legally, ethically, commercially, on the basis just of humanity - employers have a duty to treat their workers in a way that doesn't damage their health. Work still needs to be done to ensure that this is applied to mental as well as physical health.


So if you assume that one of your main assets are your people how do you make sure that that asset is performing and functioning as well it possibly can. To my mind mental wellbeing of those people is critical and core to that. The work place has had for over 100 years now a very robust set of health and safety regulations which was predicated on the physical wellbeing of colleagues in a work environment and that had its genesis in a period of time - the industrial revolution - when people were being physically injured in the workplace. And I think if we now look at the digital revolution that we're going through people are, I think, being injured in the workplace, but in a way that we can't see, in a mental capacity.

People have the ability to work 24/7, they have the ability to send emails at whatever time of the day, it is easy for people never to switch off. And I think employers should start asking themselves to what extent are they exposing their people, the main asset of that organisation, to the risk of injury in the workplace as a result. If you're saying there is a reasonable risk of that injury then what is it that organisations are doing in order to mitigate the risk of harm to their colleagues when they step into the workplace, whether that is virtually or physically?


So that is the question: what can companies do about this? It's an area where many managers feel uncomfortable, not having direct experience of the issue or the consequences of a team member having mental ill-health.

Diversity and inclusion consultant Kate Dodd of Pinsent Masons says that identifying problems is crucial, but that to do that you need to create a culture where mental health is talked about.

Kate Dodd:

This has always been a problem for employers is that mental health is often something that hasn't been spoken about and often the first time an employer finds out about somebody having a mental health condition is when there is some sort of issue or a breakdown or an absence from work. And then it becomes a question of should the employer have known? You know would a reasonable employer have known that that person was susceptible or was suffering?

From a kind of a organisational level the types of things that a GC should be thinking about are: do we talk about mental health, do I feel comfortable about putting the words mental health into an email, or do I think oh I'd better call it wellbeing rather than mental health? Because those are the kind of flags that often demonstrate that it's a real taboo subject within a business. And another really good flag is do senior people talk about their own lived experiences of mental health in my organisation? And for a GC that's a very good question to ask themselves. Because if the answer is no, then it's likely that those conversations, if they're happening, will be happening behind closed doors and of course what we know is that the more stigma that exists within an organisation the less likely there are to be having these conversations day to day and to be able to spot, to help to assist and of course to create that kind of much more human working environment.

The legal obligations that an employer has are around duty of care etc. disability, discrimination. The far more important aspect in some ways is how an employee is being treated, whether they feel they're being treated fairly or unfairly because that's what will make an employee stay with the business and its also what will make an employer's brand either be a positive brand or it will be quite a toxic brand that people do not want to work for.


There is a commercial as well as a human imperative here, says Philip - you will be a better business if you take this seriously.


I don't think an organisation can perform as well as it can unless people are healthy, are working in a sustainable way and are not being subject to pressures which are unreasonable in the workplace. But an employer has to look at what its assets are and one of its most important assets are its people and the health and wellbeing of those people are going to directly impact how well that organisation is going to perform. Attacting, training, developing people is expensive and it is hard work to find the best people. If you're unable to persuade talent that your organisation is the one where someone will thrive in a sustainable way, then it is my belief that it will become harder to attract talent to your organisation. Let's assume for the moment that you do manage to attract that talent to you organisation but the ecosystem within which that talent is required to work is such that they can only bear it for a small number of years before burnout. Then that person is going to leave and then you need to attract and recruit someone to replace that person. I see that the old ways of working are fundamentally inefficient and therefore I see the commercial imperative of getting that right as being key to an organisation's success.


Kate has described this as a culture change, and that frightens people because culture is so notoriously impervious to change. She says: don't believe the hype. It will take time – years probably – but it is possible. We just need, as in many other aspects of this, not to treat mental health as different to other parts of working life.


Just look at it like any other type of change. I think businesses sometimes get very caught up with this idea about culture change, saying 'well it's impossible to change a culture' and of course it isn't. And if culture change is approached with the same type of organisation and framework as any other type of change within a business then that is a really good place to start. And we have looked at this in exactly the same way as we would look at any other type of change, we've got together a group of people who are responsible for dealing with it, we have made sure that we have got the right people in the right places, that it is somebody's day job. I think sometimes the problem with culture change is people think it's quite a difficult thing to measure and therefore people should be doing it off the side of their desks. They might see it as not being core to strategy for example. An important aspect of culture change is making sure that it is not dismissed as being something that will take too long. Because culture change does take years, so I think it's a case of making sure that there is can acknowledgement that this is going to take time. That maybe there is a three to five year plan. That people approach it with that aspect in mind so that over the course of three years or five years or however long it takes they can see that they are moving in the right direction.



Thanks for joining us for the latest Brain Food for General Counsel podcast. Remember you can keep up to date with hour by hour coverage of business law news by the Outlaw reporting team at pinsentmasons.com. Do not forget to subscribe to us wherever you get your podcast until next time, goodbye.

Brain Food for General Counsel was produced and presented by Matthew Magee for Pinsent Masons, the international professional services firm with law at its core.


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