Hertfordshire Partnership
NHS Foundation Trust
Keeping Well at Work
Dr Jo Wood
Deputy Clinical Lead/Senior Psychologist
EPMHS
Hertfordshire Partnership
NHS Foundation Trust
Overview of Talk
• Common Mental Health Problems
• Supporting people
• Introduction to EPMHS/IAPT and other
resources
• Case Study
Hertfordshire Partnership
NHS Foundation Trust
Time to get moving…
Hertfordshire Partnership
NHS Foundation Trust
How many people experience
common mental health
problems in the course of a year?
a: 1 in 4
b: 1 in 10
c: 1 in 20
http://www.mentalhealth.org.uk/help-information/mental-health-statistics
Hertfordshire Partnership
NHS Foundation Trust
Common Mental Health Problems
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Major Depression/Low Mood
Panic
Worry/GAD
Phobias
OCD (Obsessive Compulsive Disorder)
Hertfordshire Partnership
NHS Foundation Trust
Major Depression/Low Mood
• What is it? Depressed mood most of the day – feeling sad
or empty, appearing tearful (DSM-IV,1994)
• Symptoms? Reduced activity, weight loss/gain,
insomnia/hyper-somnia, agitation/slowness, fatigue, feelings
of worthless/guilt, poor concentration, thoughts of death
(symptoms not due to drugs, bereavement etc).
• How might it present at work? Lateness and sickness,
tired all the time, appearing uninterested, bad tempered,
slow, may make lots of mistakes due to poor concentration.
Hertfordshire Partnership
NHS Foundation Trust
Panic disorder (Panic attacks)
• What is it? Recurrent unexplained Panic Attacks, worry
about having additional panic attacks, worry about “having a
heart attack”, “going crazy”, “going to die”, “losing control”.
• Symptoms? Panic attacks =discrete periods of intense
fear/ discomfort experiencing 4 or more of the following:
palpitations, sweating, shaking, shortness of breath, chest
pain, nausea, feeling of choking, dizziness, fear of losing
control/ going crazy, tingling, hot flushes
• How might it present at work? Avoiding/ escaping
situations, sensitivity to heat or being in confined situations,
excuses to avoid.
Hertfordshire Partnership
NHS Foundation Trust
Worry/GAD (Generalised Anxiety Disorder)
• What is it? – Excessive anxiety and worry, occurring
more days than not and for at least 6 months, about a
number of events of activities (DSM IV, 1994)
• Symptoms? – Restless, worry, feeling on edge, easily
fatigues, poor concentration, irritable, tense, sleep
disturbance (DSM IV, 1994)
• How might it present at work? – Poor attendance
or lateness, arguments, short attention span, easily
distracted, taking longer to get things done.
Hertfordshire Partnership
NHS Foundation Trust
Social Anxiety
• What is it? – A marked or persistent fear of social or
performance situations where the person is exposed to
unfamiliar people or the scrutiny of others and in which they
fear they will act in a way that will be embarrassing or
humiliating (DSM IV, 1994)
• Symptoms? – Palpitations, sweating, hot, dizzy,
shortness of breath, chest pain, nausea, depersonalization
• How might it present at work? – Unwilling or failing
to attend meetings / give presentation, struggling with
customer contact, asking to move departments, poor
attendance
Hertfordshire Partnership
NHS Foundation Trust
Phobias
• What is it? Marked and persistent fear that is excessive
or unreasonable, cued by the presence or anticipation of a
specific object or situation (e.g., flying, height, animals,
receiving an injection, seeing blood).
• Symptoms? Immediate anxiety response (as in panic)
• How might it present at work? Avoidance of the
specific object or situation
Hertfordshire Partnership
NHS Foundation Trust
OCD (Obsessive Compulsive Disorder)
• What is it? Obsessions (also known as compulsions) in
the form of recurrent and persistent thoughts, impulses or
images that are experienced as intrusive and inappropriate
and cause marked anxiety or distress
• Symptoms? Repetitive behaviours (also known as rituals)
such as hand washing, ordering, checking or mental acts
such as praying, counting etc – all performed in response
to the obsessions
• How might it present at work? Lateness at work,
slowness in work tasks, procrastination, rituals at work
Hertfordshire Partnership
NHS Foundation Trust
Substance Misuse/Addictions
• What is it? Maladaptive pattern of substance misuse
leading to impairment or distress. Alcohol, amphetamines,
cannabis, cocaine, etc
• Symptoms? Need for increased amounts of substance,
persistent desire or unsuccessful efforts to cut down or
control substance use. Giving up activities, low mood.
Withdrawal – insomnia, agitation, nausea etc
• How might it present at work? Lateness and sickness,
employees borrowing money/asking for an advances in pay,
agitation, belligerence, attention/memory problems
Hertfordshire Partnership
NHS Foundation Trust
Other mental health conditions
• Schizophrenia
• Bi-polar disorder
Hertfordshire Partnership
NHS Foundation Trust
Can you spot which of these
famous people suffered from
mental health problems?
Abraham Lincoln
Winston Churchill
Bill Oddie
Kirsten Dunst
William Blake
Agatha Christie
John Lennon
J.K. Rowling
Ernest Hemingway
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NHS Foundation Trust
QUIZ
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NHS Foundation Trust
1. If an employee was struggling to get to
work on time. What might their difficulty
be?
2. A manager calls in sick every-time they
are due to be in a meeting. What could
be wrong?
3. An employee complains of getting hot
and dizzy and asks to leave the office.
Why could this be?
Hertfordshire Partnership
NHS Foundation Trust
Supporting Workers
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Is there a problem? – asking questions
Listening
Practical Help
Signposting
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NHS Foundation Trust
1. How do I know if there is problem?
• ASKING QUESTIONS
– What, Where, How……(Keep them open)
– What seems to be the difficulty for you?
– How long has it been a problem?
– What support do you think you need at the
moment?
Hertfordshire Partnership
NHS Foundation Trust
2. Listen
• Active listening – using appropriate body
language, summarising, reflecting back
the concerns and emotions, showing
empathy
“… that sounds very difficult for you”
“… that couldn’t have been easy
“…..so that was really upsetting for you”
Hertfordshire Partnership
NHS Foundation Trust
3. Practical Help
• If employee off work
– Stay in regular contact
– Encourage regular contact within the working
environment
• If employee at work
– Break down tasks
– Task allocation (not isolating or avoidance)
– Expectations (may need to set more goals)
Hertfordshire Partnership
NHS Foundation Trust
4. Sign-posting (or telling people what help is available)
• GP
• Emergencies – A and E, Samaritans etc
• Therapy
– CBT (Cognitive Behaviour Therapy)
– Counselling
– Support Groups
– Local agencies
Hertfordshire Partnership
NHS Foundation Trust
IAPT (Improving Access To Psychological Therapies)
What is IAPT?
We provide short term interventions and therapy
to help people overcome emotional difficulties.
Who can access our service?
Self-referral or referral from health professionals
can be made by contacting:
0300 777 0707
http://www.hertspartsft.nhs.uk/our-services/communityservices/enhanced-prmary-mental-health-servcies/
Hertfordshire Partnership
NHS Foundation Trust
CBT (Cognitive Behavioural Therapy)
What is CBT?
A talking therapy based on the principle that emotions are
related to the interactions between thoughts, behaviours,
and physical sensations.
How does CBT work?
By teaching how to change thinking and behaviours, which
can help manage emotions.
CBT tools can be adapted
and used daily by everybody
Hertfordshire Partnership
NHS Foundation Trust
Other services and useful resources
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Bereavement Counselling (Cruse):
» 08444 779 400
Addictions (The Living Room):
» 01438 355 649
Debts (Consumer Credit
Counselling Service):
» 0800 138 1111
Relationship counselling (Relate):
» 0300 100 123
Drug and Alcohol Recovery
Services (CRI):
» 01727 847 277
General counselling:
www.babp.co.uk
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Mind:
www.mind.org.uk
Rethink:
www.rethink.org
Institute of Psychiatry:
www.kcl.ac.uk/iop
Mood Gym:
www.moodgym.anu.edu.au
Living Life To The Full:
www.llttf.com
Get self-help:
www.getselfhelp.co.uk
Hertfordshire Partnership
NHS Foundation Trust
Case Study
• Read the case study and consider how
you would manage the situation – what
would you do?
Hertfordshire Partnership
NHS Foundation Trust
Bob
• Bob is a 46 year old male. He is employed as a
manager and has been for the past 22 years. He is
struggling to keep up with the demands of work. He
spends all of his spare time worrying about work and
checking his emails to make sure that everything is
done. He is snapping at colleagues and feels tense all
the time. He is having trouble sleeping at night and
has started drinking a bottle of wine each evening to
help him get to sleep. He can’t see a way out of this
and is considering going off sick.
Hertfordshire Partnership
NHS Foundation Trust
Top Tips: to advise someone with common mental health
difficulties
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Get active – do things you’re avoiding
Time to talk
Avoid drugs or alcohol
Recognise unhelpful thinking
Be around other people
You’re not alone
Seek support
Call your GP
Take time for you – relax
Hertfordshire Partnership
NHS Foundation Trust
Five Ways to Wellbeing
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Be active
Connect
Keep Learning
Give
Take Notice
(Foresight, 2008)
Hertfordshire Partnership
NHS Foundation Trust
Questions?