While the tide is out: human resources for mental health #HR4MH

This is a transcript of a talk given at the human resources for mental health event held on 05/02/2013. To find out more, go to Twitter #HR4MH

Let me start by telling you a little bit about me.

On paper, I’m a high achiever with lots to offer an employer. I was the only person from my state school to be offered a place at Oxbridge. I hold two first class degrees. I have over a decade of continuous experience in the health and social care field, working in public and third sector organisations, and in voluntary, practitioner and managerial roles. I am professionally trained in clinical audit, and I’m a qualified antenatal teacher and a qualified probation officer.  Within six months of qualifying as a probation officer, I was lecturing to students on a Criminal Justice degree programme; within a year, I was working in a specialist team; within two years, I was in management. I am focused and ambitious, and crave new challenges.

I also have a severe and enduring mental health condition, called bipolar disorder. I first became aware of its symptoms when I was about 12 years old, so I’ve been trying to live with it for over a quarter of a century now. People with bipolar have a pattern of switching between abnormal mood states. Sometimes they experience severe clinical depression; at other time they experience high levels of energy, agitation and sleeplessness. When this is fairly mild, it’s referred to as hypomania; when it’s severe, it is called mania – which is why the condition is still sometimes called “manic depression”. Most people think of the term mania as meaning extremely, madly happy. In my case, I have the energy levels and the sleeplessness, but rather than feeling euphoric, I get panicky, desperate and obsessed with taking my own life. Psychiatrists refer to this as “dysphoric”, meaning unhappy, mania. In the middle of a dysphoric mania in 2001, I tried to commit suicide by taking an overdose, and had to have significant medical treatment to prevent permanent organ damage.

As you can imagine, bipolar, like other severe and enduring mental health conditions, can cause profound disablement to sufferers. Conditions like this cannot be satisfactorily addressed by visiting a GP or by undertaking lifestyle changes. Treatment will need to be by a psychiatrist, and usually involves heavy duty medication whose side effects can in themselves be disabling. There is no set definition of what constitutes a “severe and enduring mental illness” but the phrase is usually understood to mean serious conditions such as schizophrenia, bipolar, and personality disorders. Some also include eating disorders and severe depression, but the specific diagnosis is less important than the degree of impairment the condition causes.

One area of serious disablement is in an individual’s ability to gain and sustain employment. The Office of National Statistics believes that on average, 74% of adults of working age are in employment. For adults with any form of disability, this drops to 47%. For those with any long-term mental illness, it is 21%. And for those with schizophrenia – perhaps the most stigmatized of all diagnoses – it’s just 8%.

These severe and enduring illnesses tend to be what doctors call remitting/relapsing conditions, meaning that although they are lifelong and, sadly, incurable, sufferers can recover from individual episodes and have periods where they are completely asymptomatic. For me, it’s a little bit like living on a beach which gets periodically swamped by a tidal wave. When the tide is out, the beach is clear and I can build all kinds of structures – a career, a relationship, hobbies. My last period of remission was amazingly long; I had 8 years almost symptom free which is really unusual in bipolar sufferers. In that time, I built a new life. I started a new relationship, I moved London, and progressed rapidly in the National Probation Service. I continued to take medication but barely needed to see my GP, let alone a psychiatrist. But I always knew I was living on borrowed time, and in summer 2010 I began to relapse. By the end of March 2011, things had completely broken down and I realised I was unfit for work. In September 2012 I lost my cherished job.

Of course I grieved for my lost career. But I feel that the process was made much easier by the fact that I had declared myself as disabled under the terms of the Equality Act 2010, and its predecessor the Disability Discrimination Act, right from the day that I applied to work for the service. For all those years that the tide was out, it was just something that sat in the files held by HR and my manager. I was doing very well, and I didn’t require any specific support or adjustments. When I moved into management, I foresaw that it would be stressful, so I updated my Reasonable Adjustment Action Plan with my new line manager. She arranged for me to have a work laptop with a secure connection so I could work from home if necessary, and completely understood that I might sometimes need some flexibility in start times or to take a brief period of sickness absence to manage my stress levels.

Sadly, it wasn’t enough to stop me becoming ill; after so long in remission, I think maybe it was just time. And this time around, it’s like the tide is trying to make up for having been out so long. This is the longest episode I have ever had – even my psychiatrist keeps saying that, at two and a half years, it has been “a long old haul”. Work were very patient with me for month after month, and Occupational Health was always supportive, but it gradually became obvious that no-one could say if or when I would be fit to return to my job. No matter how much the organisation valued me it just couldn’t keep my job open forever. But because I’d been open and honest since day one, there was no question of me being put through any kind of hearing under the sickness or disciplinary policies. Instead, by mutual assent, a Compromise Agreement was drawn up. I received a payment in lieu of notice, and an agreed reference will state that I performed my duties to the Service’s complete satisfaction. There will be no mention of my sickness absence.

As I hope I’ve made clear, whilst I may be very ill for months or even years at the time, in my periods of remission I am perfectly well and have a lot to offer, as do many other people with serious mental illnesses. Most of us want to work. We all know that the benefits to an individual of being in work are not just economic. Work improves self-esteem and social bonds, and can in fact be a protective factor that stops some people from becoming ill again. But we need employers who are willing and able to see who we are, not just our illnesses. My remissions are precious to me. I want to make the most of every moment that I am able to dance on the sand, and this includes participating in meaningful, satisfying employment. While I’m waiting, sometimes not very patiently, for the tide to be fully out, I’m doing what I can to make good use of my experiences. I don’t have a choice about having bipolar, but I can make the best of my situation. I write an mental health award-winning blog. I work with Mind’s training and fundraising departments as an Expert by Experience in mental health, sharing my story on training courses or in pitches to potential donors. My hope is that writing and public speaking will be useful skills that I can build on, on that day when I am finally ready to take up full time employment again. When that day comes, I stand my best chance of success in the workplace if employers educate themselves about mental health conditions and use the Equality Act as creatively as they can. With the changing work patterns brought about by new technologies, the scope for devising flexible and responsive Reasonable Adjustment Action Plans for employees with mental health conditions has never been greater. We just need to you be alert to what we can do, rather than what we can’t.

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