Ep.18 Caring for your mental health in a pandemic

Maria Rampa: Hello, I’m Maria Rampa and welcome to Engineering Reimagined. 45 per cent of Australians will experience a mental health condition during their lifetime. One in six New Zealanders have been diagnosed with a mental illness such as depression, anxiety or bipolar disorder at some point in their lives. In Singapore, it’s one in seven people. But as COVID-19 continues to disrupt the way we live and work, challenges caused by the pandemic are increasing stress and anxiety for many of us as we struggle with self-isolation, the loss of work and income and concern about loved ones’ health. Mental health organisations have reported a steep rise in calls and emails, while Beyond Blue’s online forum activity reached an all-time high in its "coping during the coronavirus outbreak" chatroom.

So how can we manage our mental health and wellbeing in these difficult times? Today’s technology allows us to virtually stay connected with our friends, family and colleagues, but is it enough?

In this episode Aurecon’s Scott Powell talks to Beyond Blue CEO Georgie Harman about how we can support our own and each other’s mental health and wellbeing in the coming months. Even as restrictions ease and we begin to return to work, it’s expected that weeks of self-isolation will have made its mark and the lasting effects could be felt for months or even years to come.

When things return to normal, what will we have learned about ourselves and others and will businesses and communities be better equipped to understand and support our mental health and wellbeing?

+++++

Scott Powell: Hi Georgie, thanks so much for agreeing to chat to me today about the issue of mental health and how the current COVID-19 crisis we're seeing is impacting society and workers.

So welcome.

Georgie Harman: Oh, thanks, Scott. It's great to get to chat to you in bizarre circumstances, but nonetheless great to have a chat.

Scott Powell: Maintaining good mental health in the workplace is a real passion of mine. I've seen firsthand the impacts of severe mental illness when my cousin's husband took his life and left behind two young children. And when I see the statistics for mental illness in society in Australia, I’m really compelled to keep the conversation going about how we can continue to combat mental illness and indeed, consider the role that businesses can play in continuing the conversation and the struggle with people who might be faced with mental illness. What is it that inspired you to work in this field?

Georgie Harman: Scott, can I just say, I was with you I think the first time that you talked about your family's experience and it was such a powerful moment for you as a leader to be talking very openly about the fact that mental ill-health and suicide has touched your family. And I remember looking around the room and seeing the reaction on your colleagues' faces, and it was incredibly powerful. And the more we have people like you who actually open up and show their vulnerability and show their passion for good mental health, you know, that's so incredibly important. As organisations like mine, Beyond Blue continue to do their work.

I ended up working in mental health completely by accident. My career has been an interesting one where it doesn't really make much sense. I've worked in private industry; I've worked in the nonprofit sector, for a long time working in HIV AIDS, I have worked in state government, I've worked with the federal government. And now I have what I always describe as the best job in Australia.

And it was a baptism of fire for me. And I started, in particular, to meet with people who have lived experiences of mental health challenges. The amount of work we still have to do, the amount of social injustice, the amount of the system that still fails to provide the opportunities for people to be their best selves is the thing that really keeps me going and keeps the fire in my belly and I find it both an incredibly fascinating area of work, but also, more importantly, an area of work that if we do the right things it can have such a profound impact both at individual level and a family level, but actually at a social and economic level as well.

So, the job’s never done in the sense we’re just starting it. And it's just something that I find eternally fascinating, highly motivating. And of course, you know, as I started to kind of understand the issues and educate myself, I start to think about my own experiences and my own family's experiences, and losing, friends to suicide in my teens and uni days, and so, you know, it's really sort of, to me, it's about that passion, but also the kind of eternal quest to do better. So yeah, it's fantastic, I love my job.

Scott Powell: So, the current crisis, the COVID-19 crisis is throwing up all sorts of different challenges for people. They’re working from home. They're dealing with the pressures of being in close proximity constantly with their family members, but also being isolated from their routines from their colleagues, from their friends. We're seeing people losing their jobs and not to mention the anxiety that's caused by the constant 24 seven news cycle of cases and deaths and economic impacts. What are you seeing people contacting Beyond Blue about?

Georgie Harman: Look, it's just been quite an extraordinary few weeks actually because I think this pandemic poses huge challenges but also huge opportunities. What we're seeing is something that we've never seen before in terms of both the profound impacts that the pandemic is having on the mental health and wellbeing of many Australians. The speed and scale of the pandemic actually is taking a lot of us off guard. As humans, we're actually hardwired to crave stability and our brains really don't like uncertainty. Most of us have never lived through anything like this before. And as a result, at Beyond Blue, and across the sector, we've seen record levels of anxiety, stress, worry, fear. And I think what makes that really different is that this is affecting everyone. People who still have jobs, it's affecting people who are living alone, it's affecting people who are living in crowded households, it's affecting frontline workers, new types of essential services. It's affecting all of us in really quite different ways.

And I think what we're seeing is both those who already live with a mental health issue who are doing it really tough, but also significant numbers of people who've never struggled before actually reaching out to us for the first time. And what we've seen over these past few weeks is situation and people's responses and reactions to it actually evolving almost day by day and actually tracking a lot of the change in the pandemic. Initially, we saw a lot of direct concern around physical health. People worried about catching the virus, they were worried about keeping their family safe, they were worried about dying. In Australia, we thankfully, we seem to so far avoiding some of the terrible things we're seeing overseas. So, that initial health anxiety if you like, has evolved into a lot of financial stress, a lot of job stress, a lot of family stress.

And what we've been really worried about is a sense of exhaustion which I think there's probably quite a strong correlation to the numbers of parents and careers who are, you know, at home with kids, and you know, struggling with homeschooling from home and things like that.

Scott Powell: And it's, stress, that's layering on one another. So, there's the isolation stress, then there's the economic stress, then there's the stress of homeschooling.

Georgie Harman: Yeah, that's right. But what we are also seeing and I think this is one of the, you know, potential sort of paradoxical benefits of what we're all going through, is we're starting to see also people who actually have lived and struggled with mental health challenges for a number of years, actually doing quite well. And it's not, it's not and I need to make it really clear. It's not everyone, not, you know, people, for example, who've lived with really quite chronic anxiety for many years. Actually, not doing too badly and saying, “I've actually not had a panic attack for weeks. The ways in which they're describing it is, the classic to the paradigm of anxieties, intense and often irrational fear about something terrible, that will inevitably happen and you're in a constant sort of anticipating state and they’re saying, “It’s already happened, the worst has already happened”.

We've got the tools, this is our day to day life. And we've actually got a lot of the tools that a lot of others in the community that are struggling to the first time don't have. So, in fact, a lot of people are turning to us for support, for guidance, and for coaching. One of the things that I'm really hopeful about in this is that we, because we are all in this together, we may see a shift in the appreciation and empathy and a reduction in social stigma around people who actually do live with mental health challenges because they’ve got the answers.

Scott Powell: What are the most common challenges people are responding to with COVID?

Georgie Harman: I think it reflects the broad range of experiences that we're feeling in the community. Everything from anger, irritability, family conflicts, and unfortunately family violence. People relying on alcohol and starting to realise that's a problem. People who live with existing or underlying mental health conditions, anxiety, depression, PTSD, a lot of loneliness and, and also, just a lot of fear as well. We've never really experienced anything like this, but if we look to research around the world that has been done in response to previous pandemics or natural disasters, we can anticipate around a 20% to 30% increase in the number of people who experience anxiety, depression, and also post-traumatic stress.

Scott Powell: What would you give people tips about in terms of trying to get through the current crisis?

Georgie Harman: As human beings, we actually crave routine and stability. We actually have to try and replicate as much as possible, the routines that keep us on track. So, setting routines is really important. And obviously, maintaining those routines in different ways. So, if it's, you know, catching up with friends, we're doing that by Zoom, we're doing that we're having virtual dinner dates. I'm training from home three mornings a week, I normally go to the gym, but my personal trainer and my gym has set up virtual training sessions. So, it's about finding, keeping, and resetting routines. A lot of our sense of self-control has been taken away from us so but there are things that we can control and the routines that we set, whether that's as simple as getting up at the same time every day, going for a walk at least once a day.

The second thing and it's probably more important the first is staying connected. Connection, whether it's virtually or face to face is really, really protective of our mental health. It actually, shores up our wellbeing. And if we lose that connection, and we disappear into a vortex of loneliness and isolation, that’s not a good combination. For someone like me that lives alone, you know, I have to be very vigilant about maintaining those connections. All of my family live overseas. My partner lives interstate, I live alone. But also, you know, to me, it’s really affirmed the things that I know are my vulnerabilities. So in the first two weeks of the lockdown, I found myself drinking every night, you know, and it was the constant excuse of, “That was such a hard day, I just need a glass of wine.”

I used a weekend to actually reset myself and I wrote a list of things that I had to do every day and a list of commitments to myself, which sounds like a really simple thing to do but actually really helps. I have now gone back to my pre-COVID experience and routine of five alcohol free days a week.

The other things are, again, things that we can all control, it's eating as healthy as possible. It's exercising, whatever that looks like for us. For me, it's personal training, taking my dog for a walk. But for other people, it might just be as simple as gentle exercise in their lounge room. You know, doing those things that we don't normally have time to do. So, for me I'm in the middle of my ‘rona’ project, is a 5000-piece jigsaw puzzle. And it's, been a puzzler since I was a tiny tot, and it's my dirty little secret. And I am just loving it. When I stand in front of that table, and I look at all these pieces of, you know, chaos, and then piece by piece, put that picture together, I find that very mindful.

And the other thing is, for those of us who are lucky still to have a job try to maintain those boundaries around work and non-work activities. So, for me, it's a very sort of psychological but simple thing. Every morning when I sit down at my desk, I put my Beyond Blue badge on, and then when I clock off, I take it off. The other thing is I think, you know, we're, we're constantly being bombarded at the moment with online courses and do this and do that and learn a language. And be kind to yourself - you do not need to emerge from this pandemic, fitter, healthier, more buff and speaking three new languages if that's not going to work for you and if that's actually just going to put you under additional pressure, reset your expectations, be kind to yourself. Of course, try and stay as healthy as possible but you know, just don't put yourself under unrealistic pressure.

Scott Powell: Thanks for those tips. I recently also finished a thousand-piece puzzle and also had the, I guess the opportunity to share a meal with my family via virtual. There's lots of theories out in society about mental health. What are some of the common myths you hear regularly that people share with you and that you respond to?

Georgie Harman: Quite often when we say the word mental health, we think of mental illness. So, you know, there's a really important distinction there. So, there's mental health, which is the thing that we should all strive to achieve, just like good physical health. And then obviously, there's times and there's situations where, you know, a lot of us actually experience mental illness or mental health challenges.

The other myth that constantly sort of bemuses me is that there's still a lot of people that think that mental illness happens to other people. When in fact, the numbers belie that. So, there's, you know, in any given year, 2 million adult Australians who will be affected by an anxiety condition and a million of us who will live with depression. There will be eight suicides every single day. These are big numbers. For each of those particular individuals, they'll have families, they'll have workplaces, they'll have schools, they'll have unis. So, the ripple effects are quite profound. It's not something that happens to other people. It's actually about all of us. It's actually part of the human condition and the thought that this will never happen to me is a misfit that I personally faced a few years ago. My first sort of experience with depression, about four or five years ago, which I never thought it would happen to me, and I'm the CEO of Beyond Blue, and I did everything that I shouldn't have done, and it didn't help me at all. It can happen to anyone.

The other really major myth is that, mental illness basically means that you're weak, you're incompetent, you're not able to hold down a job, you can't be productive. And that you're basically you know, one of those people that we should just forget about and write off. One in five Australian workers experiences a mental health issue every single year. So, our workplaces are full of people who live with mental health challenges. And most of them, the vast majority of them, hold down those jobs are highly productive are great contributors to the team, produce fantastic outcomes. From time to time, they may struggle, they may need some reasonable adjustments and they may need some flexibility but you know, it's not about other people and they're sitting alongside us in workplaces right now.

Scott Powell: As restrictions start to ease, and people begin to head back into work and get back to some level of normality, it could be presumed that some of the current mental health challenges that people are experiencing subside as normality creeps back in. Is there actually truth to that? How would you share the challenges that we may see into the future as we do start to ease back into normality?

Georgie Harman: There isn't a playbook for this, but the best available evidence suggests that the mental health impacts will be longer lasting and for most of us, we will bounce back actually having potentially learnt some new skills about our mental health and wellbeing. But for between 20 to 30% of us, this will have quite a profound effect on us. And I think, unfortunately, this is a virus right, that doesn't discriminate, it doesn't get in the way of skin color or, you know, economic situation, etc., where we live. But unfortunately, we believe the mental health tale will discriminate.

There was some really sobering analysis by the Grattan Institute, which indicated that the long term social and economic impacts of the pandemic will disproportionately affect the poor, young and it's got a gender lens as well that lower-skilled women will experience the most difficulty following COVID-19 and that impact will last for years. So that's one part of it.

The other part of it, though, is that major disruptions can actually cause fundamental shifts in social attitudes and beliefs, which can actually pave the way for new behaviours and new policies, some of which actually persist in the long run. If we look back at the 2003 SARS outbreak, for example, that not only changed attitudes towards the use of things like face masks but also interestingly things like online shopping. The 911 terrorist attacks completely reshaped transportation security policies worldwide. Because of the circumstances we find ourselves in, the priority of work and family life has come into sharp focus. Many of us have been reminded of what's really and most important in life. I've been looking at some of the things futurists and the kind of behavioural scientists have been predicting. Many of those predictions are around, we'll have a greater focus going forward on crisis preparedness, social solidarity, which I think is a really encouraging thing, because again, if we come together as communities, that again, is very good for our mental health, looking after neighbors, you'll actually be connecting with neighbors and strangers in different ways.

And the last thing I'd say on this is, is that we do know that there's a phenomenon called post-traumatic growth, when in fact, for some people, we will actually emerge from this experience having considered all of those things and actually having rebalanced and refocused and reprioritised the things that are important to us, including our wellbeing. So, you know, for some people, they'll actually emerge more resilient and stronger and flourishing.

Scott Powell: Yeah, there's a lot of hope in that. That's exciting. Is there anything that surprised you about how people are responding to this crisis?

Georgie Harman: I'm a bit of a Pollyanna. I believe that most people are fundamentally good and kind and I think we've started to see the best of humanity through this crisis. I think the things that have taken me a little bit off guard are things like you know, the panic buying of toilet rolls. What was that about? And, you know, just it was so irrational and it kind of spun into this kind of self-feeding general panic.

The other thing that surprises me a little bit is just the speed and scale that this has happened. Both in terms of my work every day, where, we've had record numbers of people. And many, many newcomers contact us for the first time. The fact that it has been so unnerving for so many, I think, has been quite surprising. The speed and scale at which, we've seen people lose their jobs and what that's meant for them in terms of their mental health and wellbeing, you know, whole generations of people who have never faced the prospect or even thought about having to join a queue at Centrelink. And it happened overnight.

And our job now is to think about why and respond right now but also over the coming weeks and months to what those people are going to experience in terms of their mental health and wellbeing. What encouragement, what support, what referral pathways are going to look like, you know, we've got to do a lot of work to keep communicating to those people that, you know, if you're feeling this way, that is actually a very normal response to what's actually happening to you. There is support out there, please reach out for it. Don't wait a day, don't wait a month, don't wait an hour, pick up the phone, jump online, talk to someone you trust, get some help, because we really need to focus on the prevention and early intervention side of things.

Scott Powell: Yeah, there's certainly in my view, much greater awareness or understanding of the importance of mental health, in society with the public perception has really changed over the last few years. One thing that's been, I guess, really encouraging about the response to Coronavirus is that mental health was a concern right from the beginning. It wasn't an afterthought. What are your perspectives on why it was right there right at the start?

Georgie Harman: What we saw at Beyond Blue through all of our channels and services was this incredible surge of demand. And that happened very, very quickly. So, we were predicting about a 30% increase in demand by June we saw that by March. And it sort of hovered around that 30, 40% increase ever since. Beyond Blue was out there very, very early on talking about wellbeing, talking about looking after your mental health, talking about what was, you know, the common normal reactions that people and experiences that people would be feeling and just to really give that early advice about reassurance, and to create that sense of don't struggle, you know, pick up the phone, contact us, give us a call and you know, our friends at Lifeline and a whole range of other organisations, were doing exactly the same. So, I think we were out ahead, talking about this as a sector very early because we had to do quite frankly.

And the potential policy shifts and the investment shifts that I hope we will see continued is that you know, the thing that we that Beyond Blue and many others have been advocating for years, universal access to telehealth, the increase in understanding and respecting investments in digital solutions, and those changes happened overnight. So, we spent years fighting the notion that the technology wasn't up to scratch, the funding incentives weren't there. Clinicians were worried that, you know, their patients wouldn't get the same benefit, as if they weren't sitting in front of them. And we're doing it, we've done it, it's happened. Unwinding those kinds of reforms. I don't think you know, should we return to normal, I don't think so. In many ways, I don’t think so, you know, there's had to be a complete shift in mindset in the way that we deliver services and support. I think we've got a lot of positive learnings that we can take forward.

Scott Powell: Following on from that, do you there are sufficient facilities available to support people through this current crisis?

Georgie Harman: I think we need to continue the focus that we've had very strongly on prevention. I think we need to really still advocate very hard for new models of care, a lot more investment in the community in, for example, not necessarily hospital beds, but sub-acute and acute beds in the community that are staffed by different workforces, peer workers, you know, a whole range of kind of innovations that we've been talking about for a long time. I really hope that the agenda for those continues.

Scott Powell: Beyond Blue launched their dedicated Coronavirus mental wellbeing support service. Can you tell us a little bit more about that?

Georgie Harman: Yes. So, look, we were really fortunate to be a recipient of the Commonwealth Government 74-million-dollar initial mental health package. We received $10 million for the next six months to rapidly stand up and deploy a Coronavirus mental wellbeing support service. It operates 24 seven, it's completely free. And it's available to every single Australian no matter what their issue is, no matter what their circumstance. We're taking a digital-first approach to it. So, there is a digital site that has a whole range of useful content, advice, and information online for people. And sometimes that's all that people are looking for. The things people are really spending a lot of time looking at the moment is how to cope with losing your job, how to talk to kids about Coronavirus, how to stay mentally healthy and fight self-isolation, how to cope with stress, how to cope with loneliness. There’s links to digital tools and apps to help people manage their mental health. And there's also a dedicated phone line which is staffed by specially trained mental health professionals with links and referrals to other information and services, should people need that.

So, we've rapidly built a new service. in just two weeks, we've had over 80,000 visits from digital site, we've had 200,000 engagements with that discussion forum on the peer to peer online forums, which in its first week was seven times the record volume we saw in the bushfires for example. Over 2200, individual counseling sessions, so it's off to a really good start. But, our strong feeling and the feeling of many others in the sector is that the physical health effects of the virus will probably be, last for a much shorter time than the mental health impacts, the mental health impacts will probably have a very long tail.

Scott Powell: There’s lots of literature about the benefits of a mentally healthy workforce, what’s been your experiences of some of the key benefits?

Georgie Harman: When I first joined Beyond Blue, about six years ago, we had been working in workplace mental health for a while, but we just did a major piece of research around the economics of this and with a view to the need at that time, to still convince business, this wasn’t an optional extra, and to create the business case, and the ROI case, for investing in workplace mental health. For every one dollar that you invest in a workplace mental health strategy, you’ll see on average two dollars in return. So, the business case is really straight forward.

But then if you broaden that out, especially the younger generation, if they perceive that their workplace doesn’t value their mental health like it values their physical safety, they will make choices about whether or not they want to stay in that workplace. Is my workplace a mentally safe workplace is the second most important factor for those young workers. So, if you are not these things, if you are not taking it seriously as a business leader, or as workplace more generally, you’re going to not attract good people, you’re not going to keep them, and you’re not going to win the talent war.

But then I think more importantly it goes to culture and we are all as human beings don’t want to get up every day and work in a place that actually makes us feel bad about ourselves, or that is toxic or is unhealthy and we get much more out of our people if we create a culture that, allows them to thrive both as professionals but also as people. What is a mentally healthy workplace? It’s a workplace that allows us to work hard, to be empowered to deploy the skills and capabilities that we have, to understand what our role is in our individual jobs and how we contribute to the strategy and purpose of the business, that that leaves us with something left in the tank to take home to our families. And, it’s as simple as that. It’s actually not about services and drugs and medication and interventions, it’s actually about culture and practice and good business quite frankly.

Scott Powell: What would you like to see employers and employees do differently in regards to mental health with or without the pandemic we’re seeing?

Georgie Harman: Six years ago I literally had to bang on doors and say please let me into boardrooms and to CEOs’ offices to talk to them about this kind of thing. And now, you know, I’m overwhelmed by the amount of companies that are coming to us and saying, “Can you work with us, can you help us, can you advise us? Yeah, we get it now. We understand the business imperatives, we understand the human imperatives. It’s the right thing to do as well as obviously it’s going to improve our bottom line.” So, what I would like to see is that evolving further to not make mental health in the workplace seen as a special project or a particular strategy. I would like to see it evolving to just how we do things around here, it’s part of our business strategy. It’s not part of a diversity and inclusion project, it’s not of a special project, it’s actually embedded within the entire business strategy because it should be and it touches every part of business.

Scott Powell: Yeah, so five ago Aurecon launched a program to integrate mental health first aiders into the business, really to improve that mental health awareness and support both employees and their managers. What kind of initiatives have you seen businesses implement that have had a really positive impact to promote mental health?

Georgie Harman: Well look, I mean you guys are doing great stuff. If you have mental health first aiders in your workplace, that makes a huge difference because, they’re not only people who are identified as people who have been specially trained in how to support their colleagues and know what to do and say and where to go to get them connected into whatever support they might need. That’s a very powerful and evidenced-based approach. More broadly, mental health champions who, I think, should undergo some kind of mental health first aid course, or some kind of training but people who are respected within the business, are seen as trustworthy and influential, scattered across the business and are there every day as part of their, you know, how they speak, what they say, how they work, are constantly championing and holding everyone to account in terms of mental health.

And it’s not fruit bowls and yoga, the number of companies that come to me and say, “You know, we’ve got our EAP, tick, we have a morning tea for RUOK day, which can I say is very important, and we’ve got lunchtime yoga sessions and we offer free fruit to people. No, not good enough. The best companies are the ones who are actually saying to their staff, “What does a mentally healthy business look like to you? Give us your ideas, and we will build them into our practices and strategies. Often mistakes that people, like we make, is to try and predict or pretend we know what actually people on the ground want and need from us. So, we come up with often very expensive and sophisticated mental health strategies. And our staff go, all I wanted was actually for you to spend 10 minutes at the end of our weekly catch up just saying, “Hi. How’s it going?” You know very simple strategies that are often very cost-effective.

Those companies that are moving to the next level, they are building mental health lag and lead indicators into their executive performance agreements. They’re actually looking at these metrics as part of their overarching enterprise performance metrics and actually seeing the mental health of their workforce as a real predictor both in real-time but also in terms of future strategy and performance. They’re seeing mental health indicators as part of that suite. So, again, I think, not everyone is going to be able to get there. So start off slowly and Beyond Blue’s got a national initiative called Heads Up, headsup.org.au. It’s an online portal, lots of free practical advice, lots of templates, lots of ideas about how you can actually create your own mental health approach in your own workforce and we’ve got some engagement managers that can advise you on the best approach for your business but it’s not about organisations like Beyond Blue coming in and saying this is what you should do, or must do. You are the one who knows your business the best, your staff are the ones who know what’s going to have meaning for them. So, our job is to coach, not to tell you what to do.

Scott Powell: Lots of good support out there. Thanks so much, Georgie, for taking the time to share your thoughts, it’s very much appreciated.

Georgie Harman: Absolute pleasure. It’s been a great conversation.

+++++

Maria Rampa: Thankfully, the topic of mental health and wellbeing is no longer taboo and is front and centre of many conversations in our communities and workplaces. If you found this discussion useful, please tell your friends about it and if you’re struggling and need support, visit Beyond Blue or Lifeline. Links to these websites and Beyond Blue’s Coronavirus Mental Wellbeing Support Service can be found in the episode show notes. You can subscribe to Engineering Reimagined on Spotify and Apple or follow Aurecon on social for updates. Until next time – thanks for listening.