Is Mental Health The Last Taboo In Business?

I published a blog post on my use of antidepressants a week ago. It elicited a substantial amount of comment from people in business. My inbox and direct messages have been full. The general theme is the issue of mental health in the workplace needs to be talked about more. It has bubbled up given the traumatic time we have faced given COVID-19. We need to make sure it doesn’t slip off the agenda.

I’m taking the opportunity to republish this blog post, originally made two years ago. It’s by some way the most read and shared post I’ve had. Which tells me people want to have a conversation. Here it is below, unedited.

The Challenge Executives Face In Dealing With The Subject Of Their Mental Health

The Cost Of Mental Health Issues In Sport

I read a searingly sad story by Juliet Macur of the New York Times recently. It told of the suicide of young American cyclist Kelly Catlin. With sickening regularity, we hear of the suicide of athletes. Stories of elite athletes struggling with mental health issues are common.

To succeed in elite sport, athletes seek to gain an edge in every aspect of their preparation. For example, Lance Armstrong weighed his food. This enabled him to walk the line between having enough fuel and the best power to weight ratio. A troubling number of elite athletes have borderline eating disorders. This from a very successful performance director. It’s easy to see the potential for attention to detail spilling over into a deeper problem.

Why do people prone to mental health issues find themselves competing in sport? The struggles of cyclists Graeme Obree and Victoria Pendleton shed some light. These world beaters have opened up about their challenges. The obsessive behaviours and overwhelming anxieties.

These types of personality seek intense competition. They believe perfection is the key to success. Whatever perfection means. The dark side of these behaviours can open a Pandora’s Box of obsessive behaviour. Overwhelming anxiety, the feeling failure is around every corner.

The Pressure On Business Executives

Turning to the business world, many of the same conditions exist. It takes a driven person to start a business and navigate through the challenges of the early years. The years where it is all consuming and puts stress on all aspects of the entrepreneur’s life. Not to mention the lack of sleep. The expectations of investors and the hopes of staff.

It happens in more established businesses too. Being at the top of a large corporation brings stress. The demands of shareholders for revenues to rise, for the dividend to march upwards each year. Don’t dare stumble, because the stock price will suffer.

Business is at its heart about the management of risk. Executives allocate resource to seek a certain economic outcome. They then manage probability and risk to achieve the outcome. That activity itself causes stress for people. Run of the mill activity for one executive can manifest stress for another person. “Stress can’t be calibrated” as one very wise executive told me. If a series of adverse events occur, even an experienced manager can feel the stress mount.

It’s of the moment to focus on executive pay in these businesses. Yet stress and associated mental health issues aren’t discussed as frequently.

Mental Health In Business Is Still Off Limits

It has taken the sports world a long time to find itself at a stage where mental health is on the agenda. Of course, there is a long way to go. This hasn’t happened in the business world yet. António Horta Osório, CEO of Lloyds Banking Group, had a leave of absence due to stress some years ago. While reporting was sympathetic, this has been an exception in the business world.

Stress-related issues, depression and other mental health issues are common in business management. Are they any more or any less prevalent than in society in general? It’s difficult to say. Because it’s not an area that’s discussed. The reasons I suspect are many.

I opened with reference to the unforgiving climate in sports. Business is not too different, the same relentless drive to become better and better. The selection pool for senior business people is wider. The participants are largely older and better prepared. But go further up the ladder into the executive offices and you start to see some very driven people. Very successful people I’ve met in business share some characteristics of elite sports people.

The Risk Of Speaking Out

I have suffered from depression. I’ve had a corporate career and an entrepreneurial career too. I’m in an organisation originally a startup that has morphed into a small to medium enterprise. Over one hundred staff, international, revenue in the tens of millions. My professional life hasn’t caused depression. Work has the opposite effect on me. It gives me an opportunity to be creative or exercise my intellect. To feel a sense of achievement or even self-actualisation.

Do my colleagues and team want to know I suffer from depression? How safe in my leadership would they feel if they knew? Would they trust me? Mental health issues are seen differently from other illnesses. If I said to my team “I’ve got a serious kidney problem, I’m taking two months off” then people would be supportive. If I said “I’m suffering from depression, I’m taking two months off” I expect the response would be different. My return to work would be different.

What would my other stakeholders think? You work to develop a reputation and it takes years and a lot of hard work. Allies are won along the way. You amass a certain number of detractors too, you can’t please everyone. This is while things are going well, in tough times you can find allies thin on the ground. What would one of your detractors say if they knew you were battling depression? The rational ones would see through it and act the right way, but some wouldn’t.

My Observation Of A Real Situation

Before people rush to protest that the above scenarios wouldn’t happen. I have experienced organisations where leaders have taken time off to recover. Their illness described as “stress”, “burnout” and “overdoing it a bit”. Sometimes in hushed tones and a lot of knowing looks. In these instances, the rumours and questions were rampant. The return to work in these cases was not smooth for any of the parties.

In one case, an executive returned to the organisation but left for good sometime later. The person in question was closely observed and every decision made was quietly questioned. When out of earshot, the person’s health was debated frequently. The executive in question lost the ability to be decisive, constantly seeking endorsement for small choices. Sometimes overcompensating the other way, with an inappropriately heavy hand.

Confidence on one side was never restored, neither self-confidence for the executive. The inability of parties to be open about the health issue meant there was no realistic chance of the executive succeeding. The manager was set up to fail because of the absence of a healthy forum and environment. To be clear, first-class medical care was provided for the person. But the process didn’t extend to issues such as looking at the cause, and perhaps a phased reintegration to the workplace.

So Don’t Show Any Weakness

The net result is obvious. Don’t show any weakness. Don’t show any vulnerability. Carry on performing at the same intense level and hope things get better. Possibly seek help from your doctor. Maybe end up using medication to manage your situation. The wheel continues turning, this year’s numbers had better beat last year’s. If you can’t get your numbers, we will get someone who can. The last sentence is verbatim from a high profile CEO to a senior member of his team, as an aside.

It’s a brave person who comes forward and says “I’m not well, I’m suffering from a mental health illness”. Once that type of sentence is out there, it can’t be retracted. And there is no way to predict what happens next, what others say and do, how you react. For the person suffering it can be a release, a catalyst to start the recovery process. It can also precipitate a wave of deeper anxiety and stress. A feeling of being a failure, scared of the consequences of what’s now been said.

Fight, Flight And Euphemism

Someone seeking time out to recover often has to cloak the absence in euphemism. Or fabrication. The price of truth is high in many business cultures. The organisation, the person suffering, the person’s colleagues are all ill-equipped. How should mental health issues in the workplace be addressed?

In a long career, I’ve seen people struggle to navigate this. As the stress leaks, behaviours such as irrational and public anger can occur. Or poor decision making. Or frozen in the headlights, unable to make a decision. One very capable executive started to invent reasons to travel on business. Anything to be away from the searing light of the day to day pressure to deliver.

Can One Seek Help?

Here’s my experience. In my long career, I’ve had four periods where I have found depression very challenging. Not because of what’s been happening in the commercial venture. But because of what’s been happening with my mental health. Depression and all the associated feelings and effects have been a part of my life. It’s part of the human condition. As I’ve aged, I’ve learned to deal with this. Through my own efforts, but with the support of people around me.

On some of the occasions where I felt my depression was starting to affect me, I have confided in people at work. Senior people, peers, members of my team. I felt they deserved to know. Symptoms of depression can start to leak, can start to affect the demeanour of the depressed person. In turn, the effect can be felt by colleagues, sometimes very subtly, sometimes more obviously. A couple of times I felt it was right my senior stakeholder should know my situation. This guided by a mixed feeling of guilt and a sense of professional duty. They should be able to make their judgement on whether I should be leading.

In all cases, I received nothing other than sympathy or empathy. On one occasion I received a “me too” response from a senior person. I received support and received advice. Told how capable I was, how people looked up to me. How they knew I could manage this. I received guidance on possible courses of treatment or support. My anxieties washed away on a tide of support.

My Biggest Fear

What’s my biggest fear? Being asked to leave the business because of my issues with depression. I have written about the support received from people in my networks. So the fear doesn’t make sense, right? After all, the business performs well, year after year. I receive an annual performance review and there has never been an issue, over decades. I’ve never been fired, disciplined, given any sort of performance management. Yet the fear is there.

It’s reasonable to say that it’s part of my own psyche, part of the energy that drives me on. Wanting to win, fear of failure. Yet my observations tell me it’s rational nervousness too. I don’t see organisations being open about mental health in the workplace. I heard a senior executive say it’s a delicate subject. Because organisations don’t want to invite commentary on the workplace. What if it’s a toxic environment and the cause of mental health issues? The potential for corporate liability is obvious in that case.

It’s Not Always The Workplace

The toxic workplace exists, it’s reported on with depressing regularity. Whether it be sweatbox Chinese component factories or regimented distribution centres. Or financial institutions where behaviour can be stuck in the 1980s. If an organisation is the cause of stress or mental illness, that’s very serious. It must be addressed by senior management, the Board or even external stakeholders.

But we must recognise that people can arrive in the workplace with mental health issues. Something in the workplace can trigger an onset or deterioration of health. It’s my view that the safety net isn’t there often enough. Often it’s just part of one’s human condition, the workplace is irrelevant. I’m one of these people. Once I came to terms with my challenges, I developed strategies to manage myself. Not all people can self manage, they may not even be conscious of the issue.

A More Public Discussion?

I saw this well-written piece by Moya Sarner in a recent edition of The Guardian. It touches on many of the issues I raised above and more. This quote stood out for me:

 “There has been a lot of campaigning, awareness-building, encouraging people to talk – but I think there is still this fear of not knowing what to do or say, even at the simplest of levels.” 

That applies to both sides, the manager and the staff member suffering. The manager simply isn’t equipped to deal with someone who wants to discuss their mental health. Most often through lack of any formal guidance on what to do. Sometimes because their own empathy is not sufficiently developed to understand the issue.

The word “fear” is used in this article too. The fear of the first words being spoken on the matter. They can’t be retracted and there’s no way of knowing what the response will be.

Public discussion such as the Moya Sarner piece allows for is to be welcomed. This blog post has gone live three days after Mental Health Awareness week and the morning after watching the final programme in an excellent mini-series by BBC Two. Alastair Campbell is an excellent spokesperson for mental health and “Depression And Me” was another example.

Will The Workplace Discussion Open Up?

I have also described my biggest fear. I’m someone with a great deal of influence in my organisation. Someone with a track record of delivering the goods on many fronts. I wonder how it might feel for someone in a less influential position? Perhaps someone earlier in their career, with less experience.

It’s great to see the subject of mental health discussed more openly. Sports people speak out about a range of social issues, from racism to mental health. Publicity campaigns encourage at-risk groups such as young men to ask for help. Educating people to look out for signs of mental health issues in friends or family members. It’s all progress.

My hope is that this level of openness will extend fully to the business community at some stage. I hope I’m taking a negative view of the situation. Yet my experience from decades of experience in business is that we have a long way to go. It’s the last taboo in business.

1 thought on “Is Mental Health The Last Taboo In Business?”

  1. You are totally correct Stephen. The fundamental problem in my view, is that mental illness can cause us to act irrationally, or unreasonably. I know this from vast experience. Because of the taboo, we cannot be honest about our illness, until it is too late.

    By then, the company or management can be in ‘damage limitation’ or defence mode, and the employee can be in despair, feeling guilty, misunderstood, and untrusted.

    The conventional workplace depends upon an assumption of strength – it is each persons responsibility to ‘pull their weight’ at all times. How can admitting weakness or vulnerability fit into this? Of course the reality is that we all have this potential “weakness”, and actually admitting to it, and dealing with it, can avoid problems, create a far better working environment, and contribute to productivity, and the bottom line.

    But the fear remains, the taboo, the feeling that it’s weakness, that if we admit to it, we break beyond the facade we present, and the walls will come tumbling down.

    Ultimately, being honest and open, is probably the greatest sign of true strength and confidence in an organisation. The ability for people to really be themselves, and to truly be honest about themselves. After all, if you cannot be honest about who you really are with your employer, what sort of relationship are you establishing?

    Why can we not be honest? Because of the fear created by this taboo, there is a paranoia that if we are found to be suffering from mental illness, we will be viewed as a liability, and ‘managed out’ of the business. This leads to people just burying the problems, which get worse, or ‘self medicating’ with drink or drugs, which can go on for years, or even decades.

    But you’re right Stephen, it really is the last taboo, and surely it’s about time that we break this down. When can we start to be honest about who we truly are, admit to our vulnerabilities and humanity? If not now, then when?


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