Mental illness should be a concern to employers not only because of the suffering experienced by individual employees but because of its impact on the workplace. Productivity is negatively affected not only by absenteeism but also by “presenteeism” — that is when employees are at work but unable to function well because of problems such as concentration, accuracy or memory that are associated with mental health difficulties.

Given the human and financial costs associated with mental health, it is important that we find ways to create positive and supportive work environments and intervene early and effectively when problems arise. We usually become aware that an employee is troubled when changes in their behaviour raise concerns about their health or safety or that of others around them, or about their work performance or their ability to do their job. These behaviours may range from minor changes that create irritants in the workplace to changes that present immediate concerns regarding health and safety.

Because minor problems can develop into major problems, you are encouraged to recognise and address all problematic or troubling behaviours at their earliest occurrence. It is therefore important to know your staff well and to be alert to changes in their behaviour and performance.

Effects on workplace environment

The presence of mental health problems can affect the work environment in many ways:

• Negative impact on teamwork and co-operation

• Heavier workloads for co-workers

• Distraction of co-workers

• Problems with morale

• Increase in workplace errors, accidents and injuries

• Illegal activities at work including drinking and selling illicit drugs compromising other employees

It is also imperative to note that not all signs of possible mental health challenges can be overt and so, your response as an employer or HR manager need not be hostile and/or punitive in the first instance.

Be alert to changes in general behaviour, physical health, appearance and work performance.

Changes in behaviour while at work may include:

• Decrease in personal hygiene

• Difficulty concentrating, making decisions or remembering

• Flushed appearance; sweating

• Frequent complaints of fatigue or unexplained pains

• Confused or distracted appearance

• Expressions of strange or grandiose ideas

• Hyperactivity; excessive talkativeness

• Displays of anger or blaming others

• Reported changes in patterns of eating or sleeping

• Avoidance of social interactions or public presentations

• Apparent daydreaming; blank stare

• Unsteady gait

• Slurred speech

• Red, watery eyes; pupils larger or smaller than usual

• Smell of substance on breath, body or clothes

• Nausea, vomiting or excessive sweating

• Tremors or shaking of hands, feet or head

Changes in work performance may include:

• Frequent late arrivals

• Excess use of sick or personal time

• Patterns in the days of absence or ineffectual job performance (eg, on Mondays or Fridays)

• Decreased productivity

• Disorganisation; untidy workspace

• Increased accidents or safety problems

• Problems in work relationships

• Increased errors and missed deadlines

• Decreased interest or involvement in work

• Decline in dependability

You cannot assume that you know the cause of the behavioural changes you observe. Altered or problematic behaviour may be related to a mental health or substance misuse problem, but can also result from personal problems, poor judgment, personality characteristics or other health problems.

Stigma itself is a fear

If someone acts differently because they have a “mental illness”, it is because they are afraid or being judgmental when need not be. It is time to demystify mental health and realise that were are all struggling to adapt here on this crazy planet. Some people struggle more than others, but that is usually because they have had a horrible experience that was not their fault.

Shame causes worse mental health than anything else. If we get rid of the shame of having a mental illness, we get rid of more than half of what ails. Instead of making people feel more separate, we need to pull them closer into our arms and tell them they are OK. We start by telling each other that we are OK. Please know that whatever you feel is OK.

Breaking down stigma and viewing mental health as a public health crisis is critical for reframing our approach and creating a system that prioritises prevention. Despite these critical concerns, advancements in the mental health field around prevention and treatment lag far behind.

Progress is slow because the issue is difficult. We are not able to measure progress the way we can with other disciplines because we cannot physically observe these illnesses, and we largely operate in a crisis-based system, reacting rather than preventing. This according to Jaimie Gradus, associate professor of epidemiology and the mental and behavioural health strategic direction lead at the Boston University School of Public Health.

She adds: “In all of our decades of studying mental illness, we’ve gotten no better at prevention. Breaking down stigma and viewing mental health as public health is critical for reframing our approach and creating a system that prioritises prevention.”

Thus this critical conversation “Resetting the Dial: Demystifying Mental Health in the Workplace” is timely as we move to change the way we see and interact with mental health.

• Hanif Benjamin is a clinical therapist and clinical traumatologist who works out of the Centre for Human Development Ltd in Trinidad & Tobago