Mental Health in the 21st Century Workplace
Hazards & Defences
Dr Adrian Massey
Islington Headteachers’ Network
Summer Conference 2014
Overview
Concepts
• Disease, illness, sickness
• Neurosis, psychosis, personality
• The medicalization of life
Practicalities
• Workplace risks to mental health
• Healthy work
Health Warning
“Psychology – The study of people who do
not need to be studied, by people who do.”
Variously attributed
Disease, Illness & Sickness
• Disease
• Illness
• Sickness
Disorder of structure or function
Experience of symptoms
Social recognition and support
Disease, Illness & Sickness
• Disease
• Illness
• Sickness
Disorder of structure or function
Experience of symptoms
Social recognition and support
The medical model is not a very satisfactory
explanation for human behaviour, particularly for
mental health problems!
Disease, Illness & Sickness
“It is more important to know what sort of a
patient has a disease than what sort of a
disease a patient has.”
Sir William Osler
Neurosis, psychosis, personality
• Neurosis
• Psychosis
• Personality
Disorder of feeling
Disorder of thought/perception
Individual, distinctive characteristics
Neurosis, psychosis, personality
• Neurosis
• Psychosis
• Personality
Disorder of feeling
Disorder of thought/perception
Individual, distinctive characteristics
Are neurosis and psychosis predominantly accidents
of nature and personality disorders predominantly
accidents of nurture?
The medicalization of life
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Expectation of material, social and sexual success
Aspects of normal life reframed as pathological
Grief, disappointment, frustration, inability to cope
‘Stress’ is the epitome
The medicalization of life
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Expectation of material, social and sexual success
Aspects of normal life reframed as pathological
Grief, disappointment, frustration, inability to cope
‘Stress’ is the epitome
Within many organisational and legal processes
perverse incentives exist for employees, managers
and clinicians to medicalize non-medical problems
Costs – Individual
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Clinicians can make things worse!
Distress protracted for the employee
Risk of more serious ill-health
Serious mental health problems are demeaned
Costs – Organisational
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Wasted medical and managerial time and resource
Organisational inefficiency/injustice
Disempowerment of managers and employers
Compassion fatigue
Costs – Organisational
Costs – Organisational
Workplace risks to mental health in the 21st Century
Obvious –
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Recessionary job insecurity
Rapid change facilitated by IT
Aging workforce
Greater scope for job mismatch and strain
Workplace risks to mental health in the 21st Century
Insidious –
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Stifled communication esp. with ‘sick’ employees
Ambiguity re. role of employer, job options
Loss of autonomy
Unrealistic expectations of employment
Perceived injustice by stoic employees (fairness)
Compassion fatigue of managers to genuinely ill
Healthy work
Healthy work
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Recognition that policies can incentivise acopia
Clarity re. management role/employment options
Managerial ownership of management problems
Timely resolution of employment issues
Human (cf. medical) care and compassion
Access to medical advice when needed
Then…
Now!
“One of the first duties of the physician is to
educate the masses not to take medicine.”
Sir William Osler