Mental Health Awareness Week: How I supported a staff member experiencing mental illness
Hello my name is Nathan North, I am a Chief Biomedical Scientist and a line manager, working in Microbiology.
Although the staff member had been off work for over a month, I was not exactly sure of the diagnosis even though we had spoken a couple of times on the telephone.
In our return to work meeting planning a structured phased return was straight forward. This could be done in line with how I would manage a physical injury.
I was aware that this was a mental health issue because I knew that there had been some time spent in a mental health Unit, but what that really meant was difficult for me to understand.
I can relate to physical injuries and do not struggle with relating to unseen physical injuries such as infections, cancers or auto-immune conditions. I have also managed staff with various mental health conditions, but they have arrived with them ready diagnosed and they came with guidance on how to manage them. I have close family friends with severe physical disabilities and family members with dyslexia – we all get on very well and whilst there can be occasional difficulties we do understand each other and all get on very well.
I have managed staff through bereavement so why was mental health intimidating me?
My initial plan was therefore to deal with the issue as a mental injury and then work through a standard phased return. I also gave out the cards on my desk from CiC (Employment Advice) and The Guardian Service.
At our second meeting (We were having weekly meetings) it became clear that whilst I had managed to ‘wing it’ for a week I was missing something crucial. I just didn’t know what that thing was.
Physical injuries usually have a clear event causing them, or a regular repetitive task which exacerbates them. They also tend to have a clear treatment programme where the person’s body heals and then they can carry on with their life. In the terms of managing, you have a clear end point and a set of things that have to happen to get there.
I decided that as a manager I would ring Confidence in Care, and inform them that I was managing a member of staff who has a problem with their mental health.
Their advice was brilliant. As with all things that we learn it is useful if we can attach new concepts to an old tried-and-trusted theory which we are used to working with. For me this was health and safety and incident investigation.
I needed to perform a root cause analysis and ensure that the workplace was not contributing to the problem. Also I felt that I did need to enquire about their private life. What support structures did they have around them and what pressures outside of work were exacerbating any problems. Only with that knowledge could I properly help a return to full-time work.
I am not a comfortable small-talker and tend to speak when a conversation is necessary, not just for a chat. We needed to allocate a large period of time and just let the information flow out. Sometimes it had to be coaxed, sometimes it was quite personal. Whilst I am a socially aware, polite and confident person in a mixed race marriage, I am also a white male with my own set of preconceived ideas, values and stereotypes. I was attempting to create a safe and secure environment for a Muslim female with her own set of preconceived ideas, values and stereotypes about me. Trust was paramount.
There were issues related to: work breaks, start times, avoiding drinking, frequently working weekends, use of annual leave, school times, husband issues, child issues, extended family responsibilities, physical tasks at work, being the solver of everyone’s problems, the list went on… She was supposed to be part-time, but due to the number of weekends worked she was practically working full-time, but trying to have the work-life-balance of a part-time person.
She was (and is) a wonderful member of the department for all the things that managers like. She is hardworking, can do everything, likes teaching, works efficiently, solves problems, takes short breaks, hadn’t been sick for two years, doesn’t mind being moved to a different area of the lab at short notice, plans her annual leave in advance and doesn’t use excessive carer’s leave. When a colleague is struggling to work at the weekend, she will do it and keep the service going. She is a Band 3 with the full respect and admiration of the Bands 2-8c with whom she works.
I needed her to change and fortunately she knew that she needed to change. It was decided that there would be a full period of phased return. At the same time it was more important that she acquired as much knowledge as possible that she could self-manage her own mental health, rather than try to get her back working at full capacity in 4 weeks. We got her enrolled on the Mindfulness course. A series of after work sessions which teach you various techniques that enable you to manage your stress levels and overall mental health. We talked about the other support within the department. We have Mental Health First Aiders, and there were other confidants to whom she could speak.
I was able to overtly manage her at-work time.
I took away the flexibility of when to go for a break.
I instructed her when to go for her breaks.
She was instructed to drink at every break.
We decided to split up the work day into smaller chunks with more breaks – this had to be sold to her because she felt bad that she would be having more breaks and that her colleagues would talk negatively about her.
I could manage her colleagues, and I could ensure that the department supervisors at Band 7 know enough about her condition to make sure that she was taking her full breaks.
It was made clear to the supervisors that she was still working the hours that she was being paid for, that she was performing the tasks expected of her banding and that she was just taking 3 or 4 short breaks instead of 1 or 2 longer breaks.
I could prevent her from working extra weekend duties – this was not contested!
We also talked about family support. She used to walk her daughter to a secondary school local to RLH every day and then walk on to work. We discussed her daughter walking her to work, and then walking the last few minutes on her own to school. It is my understanding that this is still happening.
We met many times, sometimes formally as part of the sickness management process, but mainly informally. Every few days we would have a quick corridor chat, once a week we would have a meeting in my office. These could vary from 2 minutes to an hour. It was important to ensure that this time was available to us both.
Gradually my management has dropped away. She still has multiple short breaks – that is a permanent adjustment. We still have the occasional corridor chat but the situation has now moved to one of self-management. She does work occasional extra weekends. I’m sure that she still is the reliable and dependable mum, wife, daughter, colleague and friend. But she now has more skills. The department has everything that it had before, but with extras. We have another Mental health champion. We have someone who is willing to relate their situation to others so that they do not feel alone
Do you have any shared learning that you would like to share with other managers who may need to support a staff member experiencing a mental health illness?
I emotionally detach myself when I am at work. Therefore I only manage a situation as it presents itself in front of me. If someone is not at work I will manage them on their return. If they are at work I will also manage them. If they chose to do as I ask, that is their choice, if they chose not to do as I ask that is also their choice and I will then manage that. I do not take anything personally.
I set out to do all that I can to keep the members of the department in work and fully working to their contracts. That therefore has to include supporting them when they are ill.
I do my best to follow the trust policies – no matter how weak they seem to be when tested in the real world. I also have a professional work ethic and look to do my best at all times.
Accept that you cannot have the answer for everything – then you will be more willing to look for assistance.
Give the member of staff lots of time and attention. You have already invested in them.
Review your actions regularly by looking for beneficial results in the member of staff. If you cannot find any, you may need to change what you are doing.
Although you only manage their work time, you do need to discuss their personal life.
Only then can you look at how they are using their annual leave and determine if they are bringing stressors into work. It may also influence how you manage their flexibility to swap shifts, or to work extra shifts.
Discuss any newly acquired skills (such as mindfulness techniques) at your next meeting, and the next meeting, and the next meeting. As you work through the recovery with the member of staff they will have lots of new skills which they can use both in and out of work. This should be applauded and reiterated regularly.
What is the end point? Is there one? How do you start ‘unmanaging’ that member of staff. I don’t have that answer yet as we haven’t got there yet. I expect that it will be a situation that is managed / controlled forever and therefore should always be discussed – not necessarily directly.
Is it similar to an alcoholic that isn’t drinking? They are still an alcoholic, they have just managed the aspects of their life which had previously driven them to drink.
If I am to professionally manage someone with a mental illness to the best of my ability, I believe that I have to accept that it will be forever.
But, managing them to the best of my ability was my job before their mental illness became apparent – so what has changed?
Me. I had to learn new skills!