Fit for Purpose
15/11/2007 - Submitted by: Tilia Bousios
One afternoon at work, during an otherwise normal working week, Jonathan Naess was very publicly sectioned under the Mental Health Act. It was a humiliating experience. Naess was a successful corporate financier with a long career in the City under his belt. "It was pretty lurid because I was actually taken to an institution dressed in my pinstripe suit," he recalls.
Naess was diagnosed with bipolar disorder, or manic depression, as it is more commonly known and placed in a locked ward in a psychiatric hospital. While hospitalised, two things happened that prompted him to "come out" as mentally ill to his employer - a risky decision in the competitive world of finance - and to carve out an unlikely role for himself as a mental health campaigner.
The first happened on a particularly bad day. "It was a very low moment, a sort of baying at the moon, feeling very sorry for myself," Naess explains. "I could see some very sick people who probably didn't have the same resources and friends and family as I did. I thought, 'I've got to have some solidarity with people who are perhaps not as lucky as me'."
The second, a session with a psychiatrist, sparked Naess' curiosity about why he had never encountered high flying professionals like himself who had a mental illness. "I was really encouraged when I saw a psychiatrist who said there are lots of lawyers and doctors and people like me who had this condition. I left the consulting room slightly curious as to what kind of lawyers these were. Whether or not they were hard-shooting City lawyers. So I was sceptical."
A few years later with the spell in hospital a distant memory, Naess had rebuilt his self-confidence and was happily ensconced in the routine of working life, proving his success at his job by "making hundreds of thousands of pounds" for his employer. He then took a year's sabbatical during which he set up an anti-stigma charity, Stand to Reason.
Coming out and decidingto campaign were difficult decisions but Naess says he felt compelled to do it. "It seems extraordinary that an issue so important, that has such a big effect on people's lives, is so far down the political agenda. The idea for Stand to Reason is to encourage people to - if they can - put their heads above the parapet. A bit like Stonewall did with gay people.
"I think there is a really deep-seated and gut reaction to the mental health issue that's been around for hundreds of years," says Naess. "It's socially unacceptable."
To combat stigma effectively he says people "from all walks of life" including those in senior positions need to be visible and to use the exposure to prove that people who experience mental ill-health are not "tarnished, broken, sub-species". For Naess, this means focusing on an arena where people who have a mental illness are more likely than any other group to be discriminated against: work.
Recent research shows the extent of the problem. Mental Health: The Last Workplace Taboo, published last year by the charity Shaw Trust, concluded that there was "widespread discrimination towards people with mental ill-health". In its survey of employers, one in three said they thought people with a mental health problem were less reliable than other employees.
The study found that most companies do not have an effective formal mental health policy and that 71% of employers estimated that only about 5% of their workforce may have a mental health problem - a severe underestimation when considering that three in 10 employees will experience mental health problems during a single year. One in four people are expected to have an incidence of mental health difficulty in their lifetime. Naess says the need to educate employers "cannot be underestimated".
With this in mind he has for the past 18 months been establishing a network of professionals to campaign alongside him and contribute professional expertise. The list includes directors, chief executives, managers from the private and public sectors, lawyers and communications experts, and each with personal experience of dealing with a mental illness while sustaining a successful career. Naess admits that he was concerned people would be reluctant to sign up, fearing negative ramifications at work. "I thought there might be just two or three of us and I wasn't sure if we'd only get retired people." All of the volunteers are of working age.
Naess says he wants to use the collective business experience of the volunteers to convince employers to come to terms with the fact that people who are mentally ill can make good employees, and encourage them to put in place mental health policies. "There is a widespread perception that retaining a person with a mental health problem creates a risk for a company. That's something we need to break down," he says.
He hopes Stand to Reason will help do that by making a business case for better treatment of employees with mental health problems. He points to the high costs of recruitment and retention when firms lose or let go of people with a mental illness. Such costs could be dramatically reduced, Naess says, if early signs of a mental health problem were identified by managers and acted on. For example, he points out, workplace stress can preempt a more serious mental health problem and employers should be encouraged to take account of this.
Through the Department of Health's latest anti-stigma initiative, Shift, the government issued "tips" for managers on how to deal more effectively and fairly with employees' mental health problems, including how to spot signs of problems early. Naess praises the initiative, and the work done by organisations such as the Chartered Institute of Personnel Development (CIPD) and the Employers' Forum on Disability encouraging employers to make improvements. He is also conscious of the work already being done by mental health charities to combat stigma - one of which is a new £18m fund managed by a coalition of mental health charities and the Institute of Psychiatry. The programme of advice for employees and back-to-work initiatives across the country run by the charity Rethink are also an important part of the bigger battle, he says.
Where possible, Naess hopes to work in partnership with other organisations, including the government, but he believes Stand to Reason has its own contribution to make. "We believe an organisation run by professionals who have suffered mental ill-health is uniquely placed to make the economic argument for a change in attitudes and to tackle discrimination."
With so much emphasis on mental health - including the admission of actor Stephen Fry to having mental health issues - Naess believes the UK may have reached a "tipping point" in the struggle to combat stigma. The problem, he says, is that despite so much effort across so many areas, more needs to be done to directly entice employers to the cause by making it as easy as possible for them to introduce workable strategies and policies focused on mental ill-health.
The plan for Stand to Reason, he says, is to be "unapologetic and to talk to the main board" to convince directors that they need to support human resources' departments to implement policies. This will mean providing employers with a "suite of interventions" they can use.
He expects these to develop over time with more research into what works best but suggests as an example, workshops and training around the Disability Discrimination Act (DDA).
The act defines mental illness as a disability and requires employers to make "reasonable adjustments" for employees with disability brought on by mental illness. According to leading mental health charities, however, awareness of the legal requirement remains low.
"People don't realise that mental health is a disability," says Sophie Corlett, Mind's policy director. "They don't realise that they are protected by legislation." Short of taking an employer to court under the act, Corlett says many employees feel powerless in the face of discrimination. She agrees that making the business case for employing people with a mental illness - and ensuring they are properly treated once they are on the staff - will change attitudes. This includes the government, she says, which, as the country's single largest employer, "should lead by example".
Will to Improve
But not all employers are impervious to the issues. Some, including larger corporations such as BT, are acting already. Corlett and Naess argue that this demonstrates that there is a will to improve and, crucially, that the positive results are there for all to see on the bottom line.
Naess is, for the moment, concentrating his efforts on addressing stigma in the private sector, pooling the expertise he has galvanised in the past 18 months, although he welcomes individuals from the public sector.
Paul Jenkins, chief executive of Rethink, says Stand to Reason could be a valuable asset to mental health campaigners. "I think it has a particular role to play in being able to directly bring to the public's attention the experiences of some very high-profile individuals who've done quite demanding jobs. There is the fear that [people with a mental illness] are not capable. Challenging that assumption that mental illness means incompetence is at the heart of changing the dynamics of [the stigma] debate."
Naess accepts that well-funded, high-profile anti-stigma campaigns have been tried before but have made little progress in dismantling entrenched attitudes in the workplace or in society as a whole. "The track record with anti-stigma is difficult. But to have even a moderate change in attitudes, big sums will need to be spent."
He is aware of and appreciates the gamble that he and other professionals are taking by admitting their mental health problems. But he is hopeful that Stand to Reason's message, and the other anti-stigma campaigns under way, will start to turn the tide. "The window of opportunity is here to change attitudes. The idea of equality for mental illness alongside physical illness will become common sense."
Related URL: standtoreason.org.uk