Spotlight: Dr. Jay Spence on managing mental health in the workplace

In his previous career as a clinical psychologist, Dr. Jay Spence realised he was often treating patients for preventable mental health issues. Deciding prevention is always better than cure, Spence launched Uprise to make it easier for people to self-manage their mental health with app-based tools – with a particular focus on the workplace.

As if the role of social media manager or community moderator wasn’t already stressful enough, the COVID-19 pandemic has led to a pandemic of mental illness. I spoke to Spence about how companies are addressing the wellbeing of employees and what we can all do to improve our mental fitness.

JC: How much responsibility should businesses take for the mental wellbeing of employees, particularly in 2020?

JS: Previously, mental health was seen as personal and outside of the remit of the employer. But then pioneering companies that were invested in wellbeing started to recognise there are impacts on the way that we work.

Post COVID, mental health is showing up much more visibly in the workplace. Research from previous pandemics suggests that the mental health illness rate across a 12-month period is potentially one in three at the moment. That’s huge. It used to be one in five.

Think about what that means for a company. A third of your team is going to experience a diagnosable mental illness within the year. So, the way that companies consider mental health has gone from “That’s external” to “What are we going to do?”

Because the estimated rates of mental illness are so high – the question is less about whether companies should manage it. It’s how to manage it effectively now?

Research from UNSW concluded that work is a causal factor in the development and exacerbation of mental illness. What the research says about how to deal with the causal factors is that it’s not so much about saying “You need an employee assistance programme”, because I think most know that’s a band-aid on top. The savvy ones know you can’t just outsource it all to an EAP like ours and think everything’s going to work out fine. They know it’s about job design and job resourcing and managerial support and organisational justice.

We’re still early in the piece about understanding what is good job design and job control and resourcing – especially in a pandemic where everything has to be rewritten all over again.

Working from home might sound like it should have some mental health benefits. But the sudden requirement for everyone to work from home with the first lockdown meant a lot of disruption and less-than-ideal ways of working for many people. Six months on, have companies learned from the experience, or are employees still being bombarded with Zoom meetings and unrealistic expectations?

I’ve been incredibly impressed with how much effort and care from companies has gone into looking after their workforces. But I would say, universally, they feel as though they’re not doing enough – that they’re failing – and that they could or should do a lot more.

HR and the work health safety teams have been given this remit of saving the company, engulfed by a tsunami of mental health issues. Traditionally, they’ve been disempowered. They’ve been under-resourced or underfunded and thought of as a cost centre. And now they’ve got to steer this huge ship towards mental health and psychological safety.

I think that they’ve learned a lot. But they know they’re just seeing the tip of the iceberg – the group of people waving that they’re drowning. There’s a huge iceberg underneath of even more employees that they can’t see. They feel an enormous burden of responsibility to fix a problem that I haven’t seen anybody fix yet.

Does that mean employees aren’t speaking up when they’re struggling? Is there still a stigma attached to mental health in the workplace?

There is still a stigma. It shows up in surveys that ask how comfortable people are about disclosing mental health issues to a colleague or to a manager. There’s still a significant percentage of people that say they’re not comfortable, but that’s rapidly decreasing.

I think there’s two sides to stigma, though. One of them is being aware that you’ve got a mental health issue and feeling embarrassed about that because it’s seen as a weakness.

If anything, one in three people experiencing mental health issues suggests that mental illness is getting closer to normal; not something that we need to be ashamed of, but something we need to be proactive in managing.

On the other side, there’s a whole group of people that haven’t the mental health literacy to understand that the symptoms they’re going through are actually part of a mental illness. There are massive groups of people experiencing what they would describe as high stress or burnout or fatigue or something, whereas what they’re probably going through is the early stages of depression or an anxiety disorder. They just don’t know that’s what it is.

You just mentioned burnout. In my experience, people often talk about overwork and burnout like badges of honour. Do people trivialise the impact?

Historically, burnout was trivialised to some extent. But because of how visible mental health issues are becoming in the workplace, I think it’s better recognised now that burnout is a proxy for emerging mental health issues; sometimes serious mental health issues.

This is a period of trying to reduce the expectations we place on ourselves and on others. If we try to maintain our old workloads or we ask others to maintain their previous workloads, it’s disregarding how traumatic this period actually is. You can’t maintain that for long when you’re going through something this chronically stressful and uncertain.

I’ve gone through a period of burnout already at the start of March and I’m a psychologist. I’m not supposed to have that happen to me. But I had to take time off and go back to therapy and do all of the stuff that I imagine people think I’m supposed to be exempt from. But it was because I was trying to hold myself to the same expectations as before COVID, and I couldn’t maintain it.

Unfortunately, what tends to happen when we’re overstressed is our old coping strategies from childhood pop up as the ways to deal with things. These contribute to burnout and mental health issues over time, because we’ll avoid or get angry or get frustrated or drink or whatever it is.

What can people do to stay mindful of their and others mental health and stop issues creeping up on them?

You’ve got to know what works for you; what’s in your personal care plan. You have to be a bit sophisticated in having a mental fitness routine that’s sustainable and effective for you personally.

Maybe you like meditation, but you’ve got to invest in keeping your meditation skills up. You’ve got to invest in your friends, invest in your activities, invest in your exercise. If you’re into cognitive behavioural therapy (CBT) do that.

We know what to do to improve our physical fitness, but I don’t think many people know what to do to improve their mental fitness. When people are surveyed on this, they’ll say, “I do some exercise and I take breaks and I go for a walk at lunchtime”. These approaches are slightly evidence-based, but there are much stronger evidence-based approaches to look after your mental fitness; like CBT, like acceptance and commitment therapy, like regular mindfulness, things like that.

The other thing is I would love to see a time in my lifetime where it’s normal for us when we’re starting to struggle to get some help externally – to get out of our own heads. And there are free services for that. Once you get too stressed, you’re in an echo chamber of your own awesomeness or misery or whatever, and it’s really hard to get out of that. It’s so much faster to have somebody outside of you say, objectively, this is what I see and here’s how we can cocreate a plan to get you out of this. If you’re not too far down the stress spiral, that might be three phone calls. I personally think that’s a very good investment of time.

Finally, is the common thread here that we’re all working too much?

Overwork is a very large part of it. But there are a number of other factors that contribute to the development of mental health issues and their exacerbation over time – the quality of your relationships at work, at home, family, things like that.

It’s about your capacity to be able to meet the demands of work. You could just be incredibly under-resourced, or not have the skills.

The role of a manager in an organisation is a clear moderator around people’s mental health and the degree of support that they experience. A good manager can act as a buffer against mental health issues.

But yes, if you’re looking for a top predictor, overwork has got to be at or near the top.


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