Stigma and mental health in the workplace

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October 9th, 2019

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“Crazy”, “stupid”, “dangerous” are some of the words that Singaporean teenagers thought of when asked about mental illness (report here), showing there is much to do with stigma and mental health.

In the same report, 46.2% of respondents, who were aged between 14 and 18, also said they would be “very embarrassed” if they were diagnosed with a mental illness, while nearly a quarter (22.7 per cent) said they would not want others to know if their relative were mentally ill. (Read more here).

These responses are not a least bit surprising. If one has ever lived in Singapore, you would recognise the complete lack of understanding and awareness of mental health issues amongst the population. A psychologist we interviewed describes,

“Knowledge about mental health is very poor in the general public, with most relating mental illnesses to schizophrenia, dissociative identity disorder for instance, which have much lower prevalence rates than common illnesses such as depression and anxiety. The public’s perception is that the mentally ill person is one who is violent, unreliable and unstable, etc. As you can imagine, this discourages patients to speak up about their condition, which then perpetuates the public’s poor knowledge about mental health”.

It is this lack of understanding that perpetuates stigma and discrimination against individuals who are suffering from mental ill-health.

What exactly is stigma? According to Erving Goffman, it is “an attribute, behaviour, or reputation which is socially discrediting in a particular way causes an individual to be classified by others in an undesirable, rejected stereotype rather than an accepted, normal one”. Discrimination is usually related to disadvantageous treatment and has very negative effects on the individual. Some who have experienced discrimination may start to accept the discrediting prejudices aimed at them and lose their self-esteem and self-identity. This leads to feelings of shame, a sense of alienation and subsequent social withdrawal leading to feelings of shame, a sense of alienation and social withdrawal.

Stigma, prejudice and discrimination towards people with mental health is commonplace in Asian societies. A mental health worker we spoke to talked about her experience:

“Having worked in mental health in both Asian and Western cultures, I’ve noticed that the stigma around mental health is much stronger in Asian societies. Western cultures in comparison have more in the way of educating the public about such issues and have better public health policies in place. In some Asian organisations, it is not uncommon for prospective employees to be asked about their mental health history”.

To further illustrate my point, a recent study by the National Council of Social Service (NCSS) in Singapore found that:

  • 70% of people polled believe that people with mental health conditions experience stigma and discrimination in their lives and workplaces.
  • Six in  10  believe  that  mental  health  conditions  are  caused  by  a  lack  of  self-discipline and willpower
  • More than five in 10 are not willing to live, live nearby or work with a person with mental health condition
  • 5 in 10 believe that persons with mental health conditions should not be given any responsibility

This has prompted NCSS to launch a “Beyond the Label” campaign in September 2018. The aim is to “address stigma faced by persons with mental health conditions in society”, through raising awareness, educate, facilitate conversations, encourage more balanced portrayal of people with mental ill-health in the media and celebrating the resilience and stories of people in recovery.

However, is a national campaign enough in addressing the mental health stigma so prevalent in Singapore society?

Workplace mental health in Singapore

The mental health picture in Singapore is not a rosy one.

Findings from our recent Working in Asia Pacific report 2019, Singapore performed the worst in workplace mental health issues, compared to Australia and even other Asian cultures like Hong Kong China and Mainland China.

Firstly, many people do not feel equipped enough to support a colleague facing a mental health issue at work:

The data also shows that Singaporean respondents in particular did not feel comfortable discussing mental health conditions with colleagues or their managers. Only two-fifths of respondents agreed that their work culture is open about mental health conversations – the lowest out of all four countries polled.

Interviewees we have spoken to touched on issues where there was a lack of support because people lacked time and I quote:

“We “don’t have time” to deal with people who need time out for mental health (or physical) issues…too much to get done.”

This is again not really a surprise due to the workload, long hours and work-related stress prevalent in Singapore organisations. People are more focused on the day-to-day operations and their work, so mental health is shoved to a wayside.

Much work needs to be done in organisations towards building a culture that values mental health. As a senior manager we spoke to explained:

“Only one of our subsidiary companies provides their staff with access to an Employee Assistance Program.  I am currently working to obtain funding approval to offer that to all employees across our business.  Without having access to resources such as EAP, our employees and our managers are less able to deal with crises when they occur.”

What we can do

Start treating physical and mental illness as equals

Our minds are part of us – our heads are connected to our bodies. So why is mental health treated like an abnormality whereas physical health is treated like a normal ailment? The irony is that in most occupations, we use our minds much more than our bodies!

Many people with mental ill-health are able to function and work just like you and me. It is not unlike someone with a common cold or a chronic physical condition such as diabetes or hypertension. Some people with the cold are able to continue working as long as their symptoms are not too serious or contagious. Mental ill-health is very much the same.

Start paying attention to the language we use to describe mental health issues

There is a lot of derogatory language embedded in Singapore’s culture when describing individuals with mental health. “Crazy” is a common term in all language groups, so is calling people “mental” when they behave in a certain way.

If we are to make any progress in erasing stigma, we need to stop with these labels.

Another related issue is the misusing of mental disorders. Mental disorders are not adjectives, however it is not uncommon to hear people say “You are so OCD”, “I’m feeling a little bipolar lately”, “she seems a little schizo”. These labels and the context they are being used in are inaccurate, demeaning and perpetuate stigma. They make light of mental disorders and people who experience these disorders.

HR and leaders to work together in creating an open culture at work

HR departments are the gatekeepers to employment and together with senior leadership, would be able to drive a more open culture towards mental health at work. This might include setting up simple initiatives like lunch time talks on mental health and well-being issues to open up dialogue and address myths that people have about mental illness. It may also involve setting up Employee Assistance Programs (EAP) if there aren’t any, or sprucing it up to offer more holistic assistance to employees.

Having open, compassionate, learning conversations about mental health

Instead of reacting with discomfort or shunning a person who talks about their mental health, it would help to have open, learning conversations where a safe space is created for the person to share their experience. For instance, when a colleague or subordinate shares about the stress and anxiety they are feeling, simple questions like “could you tell me what happened? “, “what were your thoughts?”, “how did you feel”. These creates opportunity for dialogue and emotional support. Showing compassion towards someone who is struggle with their mental well-being can go a long way.

Singapore has a long way to go with regards to mental health and acknowledging its existence is just the beginning. But if we start taking steps towards normalising mental health, then it is a step in the right direction. As they say, better late than never.

 

References:

https://www.ncss.gov.sg/Press-Room/National-Council-of-Social-Service/Press-Releases/Detail-Page?id=NCSS-Launches-First-Nation-Wide-Campaign-to-Fight

https://www.todayonline.com/singapore/crazy-weird-scary-survey-unveils-negative-labels-youths-associate-mental-illness

https://www.straitstimes.com/singapore/many-still-steer-clear-of-people-with-mental-illness-poll