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Mental Health – The Professional’s Dilemma

Two years ago, I started on a journey by writing a simple piece titled ‘Breaking the Stigma’. It was open to all who would read it saying that I lived with depression, had been suicidal in the past and that regardless of any of that, was still a – somewhat successful – accountant. Regardless of whether the stigma I felt within the profession and workplace was perceived or real, I decided to break serve and speak openly for the first time in my life.

Two years ago, I started on a journey by writing a simple piece titled ‘Breaking the Stigma’. It was open to all who would read it saying that I lived with depression, had been suicidal in the past and that regardless of any of that, was still a – somewhat successful – accountant. Regardless of whether the stigma I felt within the profession and workplace was perceived or real, I decided to break serve and speak openly for the first time in my life.

My world has changed a lot since that day. This piece is based on what I’ve learned and seen through sharing my journey with organisations across the UK. It is how I have come to understand the problem we all face within our organisations and highlights a potential route for us all to follow in the hope of building supportive, inclusive and trusting, mentally healthy cultures for all our people.

I’m going to cover some topics and theories that aren’t often discussed in an HR context. In fact, the crux of this piece is more rooted in mathematics and computer science that it is psychology or people management. The thoughts and ideas here are raw and are yet to be fully refined. I would welcome discussion, feedback and thoughts on these areas.

My hope is to show that by considering a problem from different angles, even some ‘far outside the box’, we can bring fresh new ideas and solutions to age old problems.

The Paradox
We begin with a baseline assumption, that our people are not overly comfortable in talking openly about their mental health and wellbeing.

My fear, prior to speaking out, was that I would be ostracised and not treated fairly within my organisation. Professional practice is a competitive place where you are often openly graded against your peers and compete directly and indirectly for opportunities. I was scared of being judged negatively and this is a common fear that we see throughout the history of our species. You only need to check the news to see how commonplace it really is even to this day! I have heard this same story, or at least similar, from numerous people in the professions and in the wider business community. It is always the same fear underlying every conversation; “Will I be treated equally?”

That’s our baseline and where this journey begins.

I don’t just speak to individuals within an organisation, I also speak to the leadership teams and the decision makers. These conversations again always follow a somewhat similar story. Each and every one of them knows the importance of their people and their mental health and wants to support them in every way possible. Our organisations care about us all deeply and yet that is not something that we feel on a daily basis.

The leadership teams know that there will be people within their organisation who are struggling with their mental health. The statistics alone highlight it. One in six adults each week will experience a common mental health problem i.e. stress, anxiety, depression, and one in five adults has considered taking their own life at some point. It would be naïve of any organisation to believe no one in their teams is struggling.

We now arrive at our first hurdle.

Businesses and organisations, particularly larger ones, are logical. Almost all businesses nowadays rely on data and information to drive their decisions, as they should! I’ve been an advocate of business intelligence and analytical decision making since I started my career and it’s nice to see that businesses are moving towards such models! Logical decision making is perfectly reasonable. In fact, I’d be more worried if businesses weren’t relying on data and information!

The problem is because there is low trust and high uncertainty between employees (the individuals) and employers (the leadership teams) with regards to mental health and wellbeing, the information transmitted is incomplete and therefore truly informed decisions cannot me made. Consequently, appropriate resources cannot be allocated to address any problems that may exist within the organisation.

However, leadership teams care so much about their people and have a wealth of external information and statistics available, that they still want to do everything possible to support their people. The issue comes because with incomplete internal information, the only logical approach on how to address the problems they hear about from the external environment is to treat the symptoms (and not the root cause). Again, a completely reasonable approach given the circumstances.

They know that some people within their organisation are likely struggling with their mental health. What follows is often non-descript and non-tailored solutions; a mental health first aider course to train people on how to handle a mental health situation in the most appropriate way possible, a mindfulness course or series of yoga classes to help alleviate some of the symptoms of stress and anxiety, a motivational speaker telling their own personal journey to help encourage and inspire others to share – I hold myself accountable here! I wish I could do more, and it is something I am working towards!

Don’t get me wrong; these are all really good solutions to be implementing! I am so grateful to be able to help people in a way I never thought possible! But fundamentally, outside of an individual’s unique biology, the fundamental root cause of most mental health problems within an organisation, in fact of most problems in the world, are the following:

  • Not enough time
  • Not enough money
  • Not enough people

From an individual perspective, they are either working too many hours, aren’t receiving the recognition for the hours they are working so feel worse about it, or there aren’t enough people to perform the tasks or support the individual in performing their task.

None of the methods of addressing the struggling nature of the employees are actually addressing the fundamental problems underlying the symptoms. How can they though? These were never raised as a problem by the employees in the first place!

What follows is disenfranchisement.

The individuals within an organisation lose hope. They’re not receiving the support they need. They are left saying the same thing I said countless times to myself: “They don’t understand the real problem, so why should I even share my problems? All it does is leave me worse off and less likely to be treated equally.”

It’s a dilemma!

You know that talking about what you are feeling is the only way things will ever change, but you also know – believe­ – that if you do you will end up worse off!

It’s also cyclical!

A, leads to B, leads to C, leads to A.

This is a causality paradox. Or a vicious circle. However, you want to look at it.

However, there is hope for all of us, employees, and employers.

And that hope comes from Game Theory!

The Dilemma
The Prisoner’s Dilemma is a thought experiment used to help demonstrate why two rational – logical – individuals may choose not to cooperate – trust – even though it is in their mutual best interests overall to do so.

Sounds familiar doesn’t it!

There are two prisoners, A and B. Each prisoner is in solitary confinement and there are no means of communicating. There is insufficient evidence to convict the pair on the main charge, but they have enough to convict each individually on a separate charge. The prosecutors offer each prisoner individually a bargain by testifying against the other (betray). The outcomes are as follows:

  • A and B betray (do not trust) each other – each serves 2 years in prison (on the full charge)
  • A and B do not betray (trust) each other – each serve 1 year in prison (on the lesser charge)
  • A betrays B or B betrays A – the betraying (non-trusting) prisoner is set free and the prisoner who does not betray (trusting) serves 3 years in prison

In this dilemma, betraying – not trusting – your partner offers a greater reward than cooperating – trusting – them and as such if both A and B are logical then the most likely solution is for both A and B to betray each other and both to serve 2 years in prison.

The position of mutual betrayal is what is known as a Nash Equilibrium. It is the only outcome from which if either A or B deviate from the end up worse off i.e. A decides to cooperate and trust B, sees A serve 3 years instead of 2 and B set free.

The dilemma is that mutual cooperation and trust in fact yields a better outcome for both A and B than mutual betrayal – both A and B serve 1 year instead of 2 – but it is not the rational outcome because ultimately the choice to cooperate, to trust, from a purely selfish perspective, is irrational. This is the same problem within our organisations when people are considering speaking openly about mental health as I once did.

A (the employees) and B (the organisation) are both sat at the Nash Equilibrium already. There is a lack of “trust” from both parties as both feels that they will end up worse off if they deviate from this position – even though this is very likely not the case!

This is most obvious from the employee’s perspective. There is a common thread of fear throughout the conversations I have had. Fear of not being treated equally. Fear of being judged. Fear of being ostracised!

It is less obvious from an employer’s perspective, but I believe it’s still present. This is about trust and the provision of support. An employer fears that there could be significant cost implications for the provision of support and that this could spiral if unchecked and inappropriate. A logical – albeit emotional – response to the uncertainty of the situation. There is a lot of trust involved in any process within a business and here is no different. Trust the cost is spent appropriately! Trust any services provided are used appropriately. Trust none of it is not abused!

It seems we are at an impasse again, but once again; Game Theory provides!

The Solution
The Iterated Prisoner’s Dilemma is the same as the previous example, except it is performed repeatedly and each decision is now made with the knowledge of the previous decisions of both players. The same Nash Equilibrium of always betraying – not trusting – applies as before, but I won’t bore you with the proof.

What is fascinating about the Iterated Prisoner’s Dilemma, is that there have been competitions and tournaments to develop the best strategies for playing. The most successful strategies all hold similar criteria and I believe it’s through these criteria that we can see how best to develop supportive, inclusive and trusting mental healthy cultures within our organisations. They are by no means perfect – at least in description! – but they give us an insight into what sort of attributes can build mutually beneficial and trusting cultures. The criteria are as follows:

  • Nice
  • Retaliating
  • Forgiving
  • Non-envious

Nice, which is seen as the most important condition, is whereby a strategy will trust the other player until they break their trust. What this means in practice is that we should change our default position and start speaking openly on all fronts. We in leadership positions should start by offering comprehensive mental health and support packages for our people. We should trust that they will come to us with a problem and that they will use what we provide appropriately!

Retaliating, probably the worst sounding of all of them, is simply about not being a blind optimist and being accountable to the other player. In a practical sense, if trust is broken then action needs to be taken. As an employee, if you are unsupported whilst struggling, you need to make it known. If you are an employer and an employee take advantage of a service you provide, they need to know trust has been broken. All of us should be accountable to each other and it is only through working together and holding each other accountable that we can build such a supportive and trusting culture.

Forgiving, the natural counter to retaliation, is simply to be able to return to the default position of trust even if there is a breach of trust. Default back to being Nice. This is required to help bring any situation back to a place to mutual cooperation and trust. This is also about being able to let the past go. There may have been a breach of trust in the past, but we all need to move beyond that if the culture we all want to build is to thrive!

Non-envious is about remaining objective and focusing on the shared goal rather than the individual goal. The shared goal is a better environment for everyone in the present – and future – but often people can get distracted from this by looking at their personal position or focusing on the past. Everything changes and it’s about keeping that objective mindset – and not trying to point score!

The End
I find parallels like this fascinating; where science, mathematics and psychology intertwine! Whilst it may not solve the dilemma many of us or our people face, hopefully it highlights some of the foundations for us to allow us to build towards a brighter future.

Andy Salkeld, Finance Director – dscvr and Author of Life is a Four-Letter Word.

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