Taking Mental Health Training Online – A Timely Intervention?

Trisha Forbes and John Moriarty describe their collaborative project with AWARE-NI and Queen’s and Ulster Universities to develop an online training platform aimed at improving workplace wellbeing via improved ‘Mental Health literacy’

AWARE is the depression charity for Northern Ireland, with a stated mission of achieving “A future where people can talk about their mental health openly, access services appropriate to their needs and have the skills and knowledge to maintain positive mental health.” Through the delivery of its Mood Matters programme in diverse workplaces across Northern Ireland, AWARE has recognised the importance of the world of work to one day declaring that mission accomplished.

iAmAWARE is an online stress reduction programme which introduces participants to signs and symptoms of depression and anxiety and offers suggestions for potential coping strategies and stress reduction techniques based on the principals of self-help strategies and cognitive behavioural therapy. Our team of organisational and mental health researchers from across Queen’s University Belfast and Ulster University were privileged when AWARE approached us with their vision for iAmAWARE and a proposal to partner and use our research skills to complement their existing wealth of expertise.

Why target workplaces?

People’s jobs are often where they access key information, like which fire extinguisher to use for electrical equipment versus a kitchen fire, or their statutory entitlements to different types of leave and welfare support. Some of that occurs through formal organisational policy and provision, though the togetherness of work also generates informal information networks. So a poster in the tea room can be doubly effective in directing someone to information about mental health, while also starting a conversation among colleagues.

(This civic role of employers has been underscored during the pandemic, where government has effectively relied on employers to administer welfare as well as administer public health advice and enforce guidelines.)

Additionally, work itself can be a key part of the story of why someone experiences good or poor mental health. Work can be a source of identity, pride, friendship and purpose. It can also be stressful and energy sapping if the work conditions are poor and support is low. Furthermore, stressors from across different areas of life can come to a head in the workplace. Someone who successfully puts on a brave face for family members or tries to act the happy warrior for friends could be pushed to their limit by a work scenario. Therefore the idea of mental health literacy is to help people recognise signs of strain both in themselves and in others.

From in the room to on the screen

Mood Matters was AWARE’s original face-to-face intervention delivered through interactive group sessions, usually within or near people’s place of work. Even prior to the pandemic, there were always hard-to-reach employers and employee groups, such as those working outside normal office hours, or travelling a lot as part of a work routine, pointing to a need for iAmAWARE. Through a grant from the Wellcome Trust, we have been able to engage design experts to adapt that material to an online platform incorporating infographics, video, reading, opportunities for reflection and signposting to support.

The real-life examples AWARE provide are drawn from years of experience of talking to workers about the challenges they face. In a short video clip, Training Officer Marina McCully introduces participants to a scheme for recognising ways to break down a common workplace sensation of being overwhelmed, by taking a step back and observing our thoughts, feelings, physical sensations and behaviours.

This can then lead us to see how these different experiences interact and form our coping response to stressful events, sometimes creating a vicious cycle where one negative area spills into the next and so on. Recognising this pattern in ourselves or our colleagues can be crucial to moving towards a more ‘virtuous circle’.

The role of the researchers has been to amplify the voices of the people who will be the end users of the programme. This has involved in-depth conversations with volunteers from two organisations, PwC and the McAvoy Group. We held focus group discussions with three groups of employees (“frontline” or client facing staff, human resources and senior management) to understand participants’ views on mental health generally, as well as challenges faced by participants regarding their mental well-being in the workplace. This gave us a breadth of perspectives on what is already being done by employers to address these challenges, and what might be done in the future.

Participants were then given access to the iAmAWARE online platform for verbal feedback, which has significantly guided subsequent re-design and refinement. At present, a wider group of employees are being given the chance to take the latest version of the training and in-built surveys are capturing further feedback as well as information about those employees’ well-being at work, knowledge of, and attitudes towards, mental health and ill-health.

The pandemic has presented a challenge for the research and for the interpretation of the data and one which we continue to confront. However, it has also been an event which has underscored and strengthened the need for high-quality accessible training which (a) is not dependent on being at a certain place and time and (b) enables workers to reflect on the implications for their wellbeing of curtailed schedules, work from home and work-life balance in this changed work landscape. We have been able to capture some of these early reflections through our survey and it is clear the delivery of the programme will have to evolve and be adaptable to a range of possible scenarios over the coming years.

Research Team

Queen’s University Belfast: Dr Trisha Forbes, Dr John Moriarty, Dr Karen Galway, Dr Paul Best and Dr Heike Schroder

Ulster University: Dr Paula McFadden, Dr Patricia Gillen and Prof Mark Tully

The design work on iAmAWARE programme is thanks to Creative Three Media (@wecreativ3). 2020 has been an unbelievably tough year for small businesses, so please support yours!

The Aftermath: Reflecting on Mental Health Awareness Week and a Unique Arts Festival

There’s a day for pretty much everything now. World Suicide Prevention Day, Non-Smoking Day, National Bring Your Dog to Work Day (26th June in 2020 by the way…not sure how that will work in lockdown). So I think it’s fair to say that Mental Health Awareness Week has a fair bit of competition. From both a personal and professional perspective though, in recent years it’s been a highly relevant and important week to me, so I wanted to share some thoughts and reflections on this.

According to the Mental Health Foundation’s website, the purpose of the UK’s national Mental Health Awareness Week is, “to raise awareness of mental health and mental health problems and inspire action to promote the message of good mental health for all.” The 2020 campaign was of particularly importance to many given the significant impact of the COVID-19 situation on the UK’s mental health.

As my work over the last number of years has mainly involved researching suicide and mental health, and most recently mental health and well-being in the workplace, Mental Health Awareness Week has tended to be a fairly busy time. The 2019 week involved a flurry of activity; indeed there were so many places to be, events to attend and present at, as a research team we found ourselves fanning out across Belfast and Northern Ireland, following a ‘divide and conquer’-type approach. It’s a distinctly pre-pandemic memory.

I was aware that the Northern Ireland Mental Health Arts Festival (NIMHAF) was running throughout Mental Health Awareness Week in 2019, but was generally too busy with my own commitments to fully engage with it. The programme of events looked really enticing, and right up my street, but sometimes, as I have on occasion learnt the hard way, you have to check yourself before you wreck yourself. Subsequently however, my Queen’s University colleague Dr Anne Campbell invited me to come along to a meeting of the NIMHAF Organising Committee. A few months later I found myself agreeing to be the Chair of the Festival’s Board, having never actually been a Board member of anything else before. It felt like kind of a big deal, and to say I felt out of my depth and still very much do, is a complete understatement. But anyway. It’s happening.

I was diagnosed with bipolar disorder when I was 19 years-old. Now at the age of 40, I’m pleased to be able to look back and say that I have mostly been well since given my diagnosis. On the contrary, there have obviously been times when I haven’t been at all well. I’ve had at least three significant manic or hypomanic episodes, which have been incredibly difficult times for those around me, more so than for myself. And I definitely know all too well what it is to be depressed. I try to regard being a mental health researcher with lived experience of mental ill health to be a privilege. A have an insight into what it’s like to be a ‘service user’ as well as a researcher.

We really tried with NIMHAF this year to ensure that all participating artists had lived experience of mental health challenges. We take a strong ‘Nothing About Us Without Us’ approach. Due to lockdown restrictions, the seventh NIMHAF had to move at short notice to an online format, adopting a variety of platforms (e.g. Instagram takeovers, Facebook, Zoom) in order to best facilitate the delivery of each event. Much of the programme continues to be available on the Festival’s website: https://www.nimhaf.org/what-s-on

Some of the images from Identity, an online exhibition of photography.
Clockwise from top-right: Title?-Brendan Jamison; One Thing-Neil R. Finlay; On the Orbit of Identity-Honorata Art; A Crisis of Leporid Identity-Ryan Mur; A Song in the Blood-Siobhán Barbour; Dual Realities 2020-Ciaran Magill; To Flourish and to Flutter-Nuala Ei; (centre) T, A Drink with Jam & Bread-Rachel B.
Copyright is that of the artists

Some stand-out highlights of the Festival included-

It was a really diverse programme of events, very well supported and feedback received was overwhelmingly positive. Special recognition must go to Dawn Richardson, the newly appointed Artistic Director of the Festival, who was able to pull together an alternative, successful, COVID-friendly programme, with only a few weeks’ notice. The Mental Health Foundation funded this year’s Festival, and without their contribution, NIMHAF 2020 would simply not have happened. Plans are now afoot for 2021’s Festival, and we will be releasing a publication to precede the May NIMHAF, which we are all really excited about.

From a personal, honest perspective, the major imposter syndrome still remains around Chairing the NIMHAF Board. It is only through the work of the incredibly dedicated members of the Organising Committee, and the endless guidance and support of the previous Chair, Professor Gavin Davidson, that the Festival continues to happen. It is an honour to be involved with these hard-working, passionate individuals. I feel so lucky on many levels to be working in a field that I care about and can relate to very deeply, and relieved that personal stories of lived experience of mental ill health are now less likely to be seen as shocking or taboo. I don’t delude myself into thinking that the knowledge that I have bipolar disorder will not alter someone’s perspective of me; but am comfortable with who I am and with being open about my mental health journey. I hope that in some tiny way it might contribute to the destigmatisation of mental health challenges more broadly.

Work in the Time of COVID

Challenges and opportunities of working from home through an historic period

Working from home sounds ideal if you love both. But let’s be real. Only a very lucky few out there find no fault with either their home or their job. Even though a lot of employers have tolerated or even encouraged remote working in recent years, only a small minority of people take that up. As a workforce, the act of going somewhere specific to do the particular things our jobs require of us is still our apparent preference. 

But suddenly the COVID19 pandemic brings us to somewhere new and unfamiliar as a society and, as individuals, leaves us somewhere utterly familiar, namely at home. For those whose home has always been a sanctuary safely distant from work, the advice to now distance from our work colleagues tears down that boundary. Of course we want to keep pursuing our goals as professionals and organisations, but nobody can pretend this is business as usual. Any time we experience a dramatic change like this, there are risks to our mental health. Allied to this, each individual and family is challenged by COVID in a unique way, be that through childcare or other caring demands, or through the stress of isolation from others. So we need to look after ourselves and our colleagues during this period and ensure our systems and approaches for this phase are empathetic and supportive.

To that end, here are some thoughts I’ve assembled from articles, conversations and reflection over the past week.

Starting the day

Routine is important for most of us, so maintaining your usual alarm time and, yes, actually getting dressed, all keep us connected to normality. Okay, you can leave the tie on the rack and maybe save on some of the Maybelline, but I think aiming for at least weekend wear will help move you mentally into a state of preparedness. Plus a lot of companies are meeting remotely and at short notice as they navigate the challenges to business, so better to be ready to take that video call as it comes in than be scrambling around for a shirt. 

Configuring home for work and fashioning a new routine

It’s good to create a space which can at least temporarily pass as an office space. Ideally this would be somewhere that’s well lit and quiet, but headphones and a decent lamp will do for most of us. Ideally work somewhere you need to ‘go to’, so not the place you’d usually be. We’ll talk about news consumption in the current climate, but proximity to the TV probably isn’t optimal, even if it’s just one of the sports channels playing Happy Gilmore on repeat. Just as important as having a space which is for work, is stopping work sprawling into every corner of your home and maintaining spaces which are for the rest of life outside of work. 

The same boundary idea can be applied to time as well as to space. I’m an advocate and sometime practitioner of the Pomodoro Technique, where each hour is divided into two 25-minute blocks of task-oriented work with five-minute breaks. I’ve had this approach recommended unprompted by both work coaches and physiotherapists, who find it a good way to combat and prevent issues with posture back pain. If you’re aware of bad work habits which you have, like staying too long at your screen without stretch breaks, maybe COVID is an opportunity to create some good new habits (along with the extra running you may be doing for lack of alternative diversions).

On the flipside of this though, don’t let perfect become the enemy. You could lose a lot of time trying to get your spare room just like your office space in work, but it’s important to be flexible at times of upheaval. Normally I prefer not to do email first thing when starting work and to get one focused task done first, but this week I had to acknowledge that these aren’t normal times. The University I work for is rapidly trying to adapt so students can continue to progress and research is still delivered to the usual standards. So getting an early look at email helped me get a sense of what to expect during the day. Similarly, I’ve found myself checking email on my phone at odd times when I usually wouldn’t, but this is because I’m balancing work with childcare for a lot of the day, so my daughter’s bedtime presents a window to get organised for the next day. We need to be ready to navigate changes as they arise. There’s a fine balance to be found between flexibility and having no boundaries around work: we’ll all develop an initial set of boundaries but it’s best not to become wedded to those and keep adapting.

The big bad world out there

I’m neither a social media sceptic nor an avid user, but wherever you fall on the spectrum I think now is a good moment to examine the time spent online and what we want to achieve by it. Coronavirus seems like a fast-moving story, but a lot of the developments are incremental updates of the same central story and by enlarge government advice isn’t changing more than once per day. But with a lot of people who would usually be otherwise occupied now at home, it can feel like there’s an online discussion going on about COVID, and one which feels viscerally important if anyone in our lives is at risk.

Again, this is all about balance. We don’t want to miss important information, but we also can’t spend our days on screens deciphering whose analysis and information to believe and share, which of our most recent thoughts deserve a global audience and which arguments are worth picking and with whom.

Then there’s smaller-scale communication, including messaging services which many are using to maintain connection to relatives and reduce isolation, including some for the first time. But this too can be overwhelming and I personally advocate ringfencing particular periods of the day for both online engagement and for news.

Personally, the best decision I made all week was to schedule two news intakes per day at 6pm (radio while I cook or tidy) and 9pm. Where there are specific social media accounts or pages which I find particularly important, I’ve bookmarked those as URLs I can access directly, rather than going in the ‘main gates’ of social media.

Oh but to hear your voice

I’ve also started calling people as a first resort before typing a message. The digital era has taken us away from phonecalls while simultaneously improving the experience of calling people. Maybe this is the point when the call returns to being the first attempt at contact. For the first couple of days of last week I was reaching out to a lot of people by text but then found I was typing almost constantly. On services which show if a person is typing, I’ve started just hitting the call button and saving them the effort, in the knowledge that they can reject the call if it doesn’t suit. A call also is something I can involve my daughter in to an extent, whereas a written message means multi-tasking and having one eye on her and the other on the device.

It’s been good to see colleagues organising online meetings and maintaining direct contact rather than always reverting to endless email threads. This is one example of where there might be a positive legacy from this period, whereby some of the virtual groups and meeting spaces might remain and become the preferred alternative to the laborious written exchanges.

Ask

If you aren’t already, now is a good time to become acquainted with the provisions your employer has in place to support your mental wellbeing, be those policies around work patterns, codes of practice, employee assistance programmes or information resources. It’s worth paying close attention to communication from leadership about any accommodations the organisation is making and following up with line managers and teams so people know what one another’s needs are. Reciprocally, it’s good to be proactive and check in with colleagues to ensure everyone’s clear on the agreed direction and on what supports are available.

Ask why

As individuals and as organisations, being knocked off schedule does afford us an opportunity to reassess what’s important in what we do, where we add value to society and the economy and what fires our passions. Much of this is being done at speed and almost through connecting to an unconscious set of priorities as companies scramble to maintain ‘core’ functions and work, leaving some of the ‘usual stuff’ to one side for now. Maybe when things settle, there will be some conversations examining how much of that usual stuff is really of value to anyone and how much of it is work generated by what we perceive that others may value.

My sense is a lot of organisations are still in emergency mode and workers are being swept along by that. And we’ll be carried some way along by adrenaline and this near-term sense of pulling together. But we don’t know how long this will last and it’s likely to be a marathon and not even Eliud Kipchoge can survive 26 miles on adrenaline. What will sustain us through the longer run is connecting to purpose and value. What is it that you value about the work you do? How can you use this period of flux to make your daily experience of work more connected to those values?

As always, I’d love to hear your thoughts.

Wellbeing, Meaning and Purpose: Too Much to Ask from Your 9-to-5?

We all know that there’s a relationship between our work and our wellbeing. But what kind of relationship? In social media parlance, it’s complicated. We’re all different: we do different jobs and even those of us in similar jobs will be attracted by different aspects of that work. We know work can stress us out but we also know people for whom work is a passion, a pillar of personal identity and a source of support and human interaction.

I recently participated in an on-campus event during Mental Health Awareness Week, aimed at promoting mental health research from across the university and opening a dialogue between its students, staff and members of the wider local community. As well as research posters and interactive exhibits, a number of professionals and volunteers who work to support people’s mental health were present to give information and advice. Those organisations included Aware NI, Parenting NI, Inspire and the Occupational Health Division of Queen’s University. During a relatively quiet period, I asked a few of the folks exhibiting(a) what it means to them to be well at work and (b) what employers can do to ensure employees are as well as possible(1). This is the first of a series of blogs in which I explore some of the themes which emerged their responses.

Marion from Inspire, who offer phone and in-person counselling to employees across a range of organisations, said that for her, being well at work means “to enjoy my job, to look. forward to going to work on a daily basis, and to know what I am doing has meaning for me and others”. This was directly echoed by a member of QUB Occupational Health who highlighted the importance of having “meaningful work”. I would see ‘meaning’ as akin to having a sense of purpose: the good days at work for me are the ones where I leave with a sense of having moved closer to the purpose I had in mind when first taking the job.

An occupation is more than being occupied. The keyboard-wielding comedian David O’Doherty does a joke about how he recently ‘finished the internet’, at which point he was asked to enter his initials beside a picture of Bill Gates. He also observes how easy it is to feel busy in the modern world and to be thoroughly diverted by the latest distraction the internet has to offer. This bi-product of hyperconnectivity clearly impacts the working day. Innovations like email and laterally Slack are in theory here to reduce the time it takes to communicate and to bring us into a more frictionless and efficient space wherein we can harness one another’s talents and seamlessly collaborate like cells in a giant socially-formed brain. And yet paradoxically, it’s conceivable that we could all spend all our working days thoroughly processing and actioning all of our emails and yet for not one of us to feel as if they’ve moved any closer to our particular goals, or even gotten done what we set out to do first thing this morning. This phenomenon of being occupied but without a sense of purpose or progress seems directly antithetical to the pursuit of meaning in work which my contributors highlighted as a key facet of workplace wellbeing.

So how do we connect to our sense of purpose and harness that pursuit of meaning as a force to drive our work forward? As individuals, we can introduce practices such as having a personal mission statement which we regularly review and update, planning our time over a long enough period that we can protect certain hours in the day, week or month to ensure that our core direction of travel is towards further those higher values and goals which we see in our work. I would argue that time and space for regular reflection is key to noticing how even small tasks which might seem like time thieves can form a piece of a much bigger jigsaw and be more aligned to one’s purpose than it might initially appear.

Of course, this is more than just a challenge for individual employees at an organisation. Employers also have it within their power to help the people working for them to have purpose and have ownership over some part of the organisation’s mission. This can come through reward and recognition, but can also be infused into training for team leaders and into processes such as supervision and appraisal. Now, consider two different processes through which this infusion of purpose could be achieved. One is the bottom-up emergence of a culture where the values of individual staff are pooled to shape a declared mission organisation. At the other end of the spectrum is the setting by leadership of values and purpose without broad-based input, followed by a top-down process of aligning how staff see their purpose with the declared purpose of the organisation. Is either of these likely to succeed, or has either a better chance that the other? I would suggest that if these represent two extreme points on a spectrum, the balancing point probably lies closer to the bottom-up point.

Zooming out one degree further, I think there’s a duty on society as a whole to examine and question the connection between work and purpose. I’ve been involved in some work with colleagues on ageing, retirement and the agenda to ‘extend working lives’. One theme which comes up when people talk about retirement is the idea of becoming purposeless. While our families, friends and passions beyond work can all give us purpose and drive, few things organise and marshall our actions and efforts in a goal-directed manner in the way that the formal setting of our employment does. But must that be the case? Are there ways we can organise our society such that meaning in life isn’t so firmly bound into our culture of work? Are there objectives we are striving for as a society which could be shared among people in a way that creates both individual and shared purpose? Perhaps this is happening already?

One final note: I haven’t mentioned passion. I’ve written before about the emerging discourse of passion, particularly in recruitment. It’s a theme I want to explore again soon, particularly having read some divergent and challenging perspectives on this soon. While not unrelated to purpose and meaning, I suspect that passion is also somewhat distinct and I hope to explain why.

As mentioned, I’ll be returning to the responses to my questions about the meaning of workplace wellbeing for inspiration and further themes. Should you with to submit your own perspectives, the link to the questions is:  https://forms.gle/iNVnsQBi4AYrnvzD7 . Please note this is not formal or ethically approved research, just a way to garner feedback and ideas and ensure I’m basing my thoughts on more than introspection! I’m hoping for this to be an evolving resource and I welcome your feedback via the comments or though personal contact if you have any thoughts on any of the questions I throw out, any criticism or if there’s anything you’d like to see covered here in more detail.

  1. Responses were typed into a Google Form; each person was told that the purpose was for a blog post.

Welcome to a Blog about Work!

This is a blog about work, where work fits into our world and where each of our jobs and roles fit into the story of who each of us is. Our culture encourages us to find meaning and intrinsic motivation in work. Addressing Amazon employees in Tennessee in 2013, then US President Barack Obama said that:

“Jobs are about more than just paying the bills.  Jobs are about more than just statistics. We’ve never just defined having a job as having a paycheck here in America.  A job is a source of pride, is a source of dignity. It’s the way you look after your family. It’s proof that you’re doing the right things and meeting your responsibilities and contributing to the fabric of your community and helping to build the country.  That’s what a job is all about. It’s not just about a paycheck. It’s not just about paying the bills. It’s also about knowing that what you’re doing is important, that it counts.”

The right thing. When politicians connect work to personal values, such as dignity and purpose, or reinforce work as a moral pillar, we can be forgiven for questioning their motives. Governments need tax receipts and as few people receiving unemployment support as possible. At the same time, the financial rewards for working have ceased to increase in the way they did for successive generations and two incomes are now required to sustain the quality of life that one used provide. If you’re unwilling to augment the extrinsic monetary rewards for work, then working on people’s intrinsic motivations seems like a good bet.

Now how many people’s sense of self-worth is altered by Obama’s voice in their head is debatable. But through whatever process, it’s clear that many people do place a value on work over and above the number of dollars, pounds, Euro or Yen that it gets them. An obvious example is the prominence of work in casual conversation. How many questions do you usually exchange with a stranger before one or other asks “what do you do yourself”? Unacceptable answers include “I listen to music”, or “I walk my dog”, whereas “I’m a music critic” or “I have a dog-walking business” are fine. Even without mention of work, the meaning is understood, as is the ritual of getting some contextual handle on this unfamiliar person.

Even income itself has gained moralistic weight: the idea of being a ‘breadwinner’ who ‘provides’. In the final episode of Eddie Izzard’s “Marathon Man”, the comic takes a detour from one of his forty-three consecutive marathons around the UK, to visit a project supporting men with Alzheimer’s Disease. He speaks to another Eddie, who describes the classic early-onset Alzheimer’s symptoms: being unable to read a clock; and not being able to write. But worst of it all for Eddie was giving up his job:

“It’s boredom that gets you. You’re used to working, you can’t get a job. I thought my world had ended. Can you imagine it? Never work again? I’ve worked all my life.”

But work is changing. Ageing populations, family structure, the growing prominence of urban centres and the fight against climate change all have profound implications for how much work and what kinds of work our society will need from people. During her bid to succeed President Obama, Hillary Clinton got into hot water for saying she planned to “put a lot of coal miners and coal companies out of business”, in the context of a plan to move the US onto a renewable energy base. In Ireland, businessman and Apprentice host Bill Cullen experienced a similar backlash for suggesting in 2010 during the height of the country’s recession that young people should be willing to “work for nothing” in order to gain experience and competitive edge in a shrinking job market. In both instances, the context is important, though the reaction is equally informative. Changes in what people expect from society by way of occupation and role will not be welcome news to many. The challenge is more than economic: it’s a challenge to all those values and sense of what is the right thing to be doing with one’s days and with one’s life.

In future posts, we’ll be exploring how work influences wellbeing, plus taking a look at some of the trends which are reshaping the world of work before our eyes: casualisation; platform work; the gig economy; flexible working; extended working lives for older people; remote workspaces; and emotional labour. We have some ongoing projects here at Queen’s University Belfast which we look forward to telling you about also.

We hope for this to be an open collaboration between those of us for whom workplaces are a central research focus, as well as people working on policies and practice to make adapt their organisations to the challenges of 2019 and the century ahead. If there’s something you’d like us to cover, or if you’d like to contribute to this blog, please use the comments below to reach out – we’d love to hear from you.

And we’ll try and finish each post with a work-related song- take it away LunchMoney Lewis!