A year of escalating needs 

The subject of mental health has been propelled towards the top of many organisation’s agendas, owing to the uncertainties, challenges and trauma of the global pandemic.  

We spoke to Dr Liz Royle of Power To Respond a specialist crisis and trauma company, who will be exhibiting at the LWSL 2021 event. Power To Respond have developed several initiatives to support organisations during the pandemic: digitalising OnDemand and blended options for organisations unable to access face to face training; creating bite-sized training for team leaders, enabling them to supporting their remote workers’ wellbeing; and developing off-line capacity for their psychological first aid App to bring crucial support to maritime workers stranded far from home. They were also finalists in the NHS Excellence in Supply 2020 awards for their work supporting hospital staff.  

 Dr Liz Royle told us ‘innovating mental health support is the easy bit!’ 

She continued ‘Crisis mental health work has always required flexibility and innovation but it’s not enough to provide an effective solution – the hard part is engaging people in using it and that can be harder when they work remotely. 

Research consistently shows that those most in need of mental health support find it most difficult to access it. There are many barriers to care – practicalities such as time, location, juggling responsibilities – but stigma remains one of the biggest obstacles and most resistant to change. Although we have made positive progress in talking more openly about mental health, the issue of self-stigma remains. 

Self-stigma is an internal form of stigma, where the individual labels themselves as unacceptable because of having mental health issues.  

We are hard-wired to avoid accepting our own mental distress. 

Most people see themselves as strong, capable and competent. Anything that is at odds with this, for example needing “help” or “support” is unacceptable to their internal belief system. Social Identity Theory explains that the more a person sees accessing psychological help as a threat to their sense of self, the less likely they are to access psychological help.  

 Even when the person is very accepting of mental health problems in others, they simply can’t accept their own. They may suppress uncomfortable feelings, explaining them away – I just need a holiday – or be genuinely blind to it. We can slowly acclimatise to a high level of discomfort. 

 Stress hormones can numb our feelings. This is nature’s way of protecting us from overwhelming sensations. Our primitive brain can block thoughts and compel us to avoid talking or thinking about distress. For all these reasons, phoning the employee assistance provider is a massive step that will be avoided until symptoms have escalated to crisis. 

 It’s not only the individual who avoids thinking about mental distress.  

 Often colleagues simply don’t know how to help so ignore the signs or respond with ways that can collude with the individual’s own avoidance:  

“Best not think about it – talking just upsets you …”  

Managers, colleagues, family and friends, no matter how caring, can also avoid the subject for their own deeper psychological protection. 

Psychiatrist and traumatologist Paul Valent described how human beings developed survival strategies – “Rescuing” and “Asserting” – to cope with distress and trauma in the people we encounter. Rescuing means responding to other humans’ distress by showing care, empathy and nurturing. Asserting means taking control and action that “fixes” things. Many of us can identify with these roles! Short-term, they can be very successful and leave the helper feeling empowered and good about themselves.  

However, in a chronic or severe situation, or where we have no influence over the outcome, then these survival strategies usually have limited success. When Rescuing fails to soothe distress, the helper feels resentful and burdened. When Asserting fails, they feel frustrated and powerless. They may become cynical or use victim blaming as a way of distancing themselves.  

It’s easier to blame someone than accept our own lack of potency. 

“They just aren’t resilient enough … They’re in the wrong job” 

 A collective avoidance?  

Few organisations want to advertise that their employees are vulnerable especially when it comes to workplace trauma. This can lead to a denial of a problem and not wishing to “air dirty laundry publicly.” 

Denial and victim blaming can be reflected across organisational culture. Not grasping these underlying psychological processes can create resistance when any mental health initiatives are introduced. This is frustrating for all involved as valuable resources are wasted, supervisory staff feel burdened and pay “lip-service” and ultimately the person in need lacks effective support and recovery. 

When we are trying to improve mental health across an organisation, whether it’s general wellbeing or responding to violence, accidents or other trauma, we have to start with a clearer understanding of the natural avoidance defences our brains have. This allows us to educate at a deeper level creating more lasting change’. 

If this article gives you food for thought, come along and talk to Liz and her colleagues at Lone Worker Safety Live 2021.