Presented at the 6th
US/Canada Forum on Mental Health and Productivity
Guest Blog by Joel Bosch
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| Joel Bosch |
Hoarding. Depression.
Two instances of Attention Deficit Disorder. These are personality characteristics of
different people that I have reported to over the years. Executives with corporate titles like CEO,
President, Director or Founder. I’m here
to tell you that people in the executive suite, just like the rest of society,
live with mental illness. I know this
because I’ve worked for them and, more importantly, because I am one of
them. I have lived with chronic
depression since I was 8 years old. I
also, by many measures, have had a rewarding and successful career in
consulting and financial services.
Today, I am here to share my thoughts on three vital issues: first, why
senior executives should lead more conversations in the workplace about mental
illness including suicidal behaviors and suicide prevention, second, why I
think it is important, and third, some ways we might be able to start more
meaningful dialogue.
In
the past, we’ve often treated mental health as a personal issue that
individuals must overcome on their own or with a health care provider. But
addressing mental health conditions such as depression, substance-related
disorders, personality disorders, and suicidal behaviors is just as important
as addressing any other public health issue.
Mental health problems are just as critical as childhood obesity,
cancer, hypertension, heart disease, stroke, or HIV/AIDS. Over the past
few decades, medical science has had great success bringing the death rates
down in many diseases. There has been no
significant reduction in suicide in over 50 years. Just like these public health issues, we must
tackle mental health problems like suicide together in an organized fashion as
a total community. Suicide and suicidal behaviors (or SSBs) are complex
heterogeneous behaviors commonly manifested in the presence of mental
illnesses. They are multifactorial and
complex because not all SSBs have the same underlying etiologic factors.
This
audience is made up of many direct service providers and researchers. I applaud the efforts of many people here
today that have set target goals for specific reductions in deaths by suicide. To that end, we heard this morning about the
need for making suicide prevention part of the overall corporate health and
safety fabric. We also heard some moving
and compelling personal accounts of survival.
I want to approach mental health from a different personal
perspective. It is my personal story. It is a story about one strategy I believe we
can all support to positively impact mental health in the workplace by reducing
stigma, increasing awareness and support, and thereby reducing the number of
suicides.
While a change of culture has
happened with many illnesses that were previously taboo, there is still a
silence around mental illness and suicide in general. This is even more noticeable in the
workplace. So how do we break the
silence? I think there are a number of strategies
– many of which we see today – public service campaigns, mental health parity
in insurance coverage, and workplace programs that provide employee assistance
just to name a few. These are all
important components to raising awareness, providing support, and changing
attitudes. However, I think one of the most effective ways to break the silence
is for business leaders that have experience with mental illness and suicide –
either personally or through someone close to them – to start talking about
it.
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| Flickr user Emma Wignet |
I
have worked in places where we talked about religion, politics, and even gun
control. We talked about our physical
health. We talked about our families and
what we did over the weekend. We talked
about our dreams and aspirations. So why
in the world wouldn’t we talk about our mental health in the workplace? We don’t because the stigma is so strong that
the topic is buried. Yet when leaders remain silent about mental
illness, there is a discernable and substantial cost to the rest of
society. Such silence contributes to the
misperception that successful people do not get depressed. It keeps people from seeing that treatment
allows many individuals to continue in or return to successful professional
lives. Silence also contributes to the
myth that people who are brilliant or full of life cannot possibly have so much
despair as to kill themselves. They do. Every day.
Just look at Robin
Williams. Most people I know were
shocked at the news of his recent death.
Honestly I was shocked that everyone was so surprised. I didn’t know Robin other than as a fan, but
I did know he had a history of depression and substance abuse. As a celebrity, this was both the fodder of
tabloids as well as the legitimate press.
Yet, he was very open about these challenges. And, as someone who has lived with depression
all his life, I know that frequently depressed people use humor to hide the
pain they feel – to keep people from seeing the dark inside that no one wants
to see. Like many of us who live with
the condition, I believe Robin Williams wore a brighter self in public to
distract from the darkness that settled over him behind closed doors. Most people don't see depression in others,
and that's by design. We depressed
people simply hide ourselves away when we've dimmed so as not to shade those
who live in the sun.
So the fact that
Robin Williams died by suicide was not surprising to me at all. It certainly is a sad and tragic loss of a
great entertainer. But watching the mass
reaction highlighted to me how little people know about depression and
suicide. I even sensed a restraint at
first to report his cause of death as suicide.
Then, when it became known he had Parkinson’s, it was almost a sigh of
relief, as tough that, instead of depression and suicide, was the real cause. It almost allowed the suicide to be explained
away and silenced. It is this silence
that helps perpetuate the stigma of mental illness. Successful people don’t get depressed. And depressed people are not successful. We know neither of those statements is
true. But the stigma perpetuates the
myths.
These
myths pervade all facets of society, and business leaders are the community
gatekeepers. It does not matter whether
you are speaking about mega-corporations or small business. Leadership is likely to come into contact
with those at risk for suicide or mental health problems. However, these individuals ordinarily are not
trained to be influential. From the
public health perspective, the reduction of stigmatization of mental illness
including suicide must be a first step at prevention efforts on a large
scale. The stigma of mental illness is a
complex construct of affective, cognitive, and behavioral at both individual
and group levels. There is a difference between those exhibiting a diagnosable
mental health issue and those that are able to have access to proper mental
health care. This too is part of the challenge. Business leaders and
those in the public arena have a unique opportunity to lessen this stigma, to
mobilize research efforts, to raise money, and to educate others who do not
have the same financial and educational advantages.
Where
I work we do talk about mental health, depression, and suicide. We talk about it because I talk about
it. People look to me to set the tone of
the workplace. More than anyone I am
responsible for establishing what is ok and what is not ok to say and do in the
office. Whether I like it or not. Whether I recognize it or not. As the senior person in the office, setting
the tone and defining what is acceptable is one of the most important roles I
play.
There are forward-thinking companies
out there providing programs and assistance to employees. Prudential offers an employee assistance
program, training for managers to spot distress among employees, and health
clinics that screen for mood instability and more. Still, the company
recommends employees stop short of telling managers about their diagnoses,
according to Ken Dolan-Del Vecchio, vice president of health and wellness. The
reason he gives is "We don't want managers to be acting as surrogate
counselors." No company would say
the same thing about heart disease or cancer.
Dupont trains managers to
identify signs of distress in workers. However,
Paul W. Heck, global manager of employee assistance and WorkLife services says
conversations with a boss about a diagnosis "would never be
encouraged." Managers at Dupont who
do identify distress are asked to remind employees of the assistance program
which offers free counseling. While
these efforts are laudable and provide valuable services to employees, it’s
obvious that corporate America still views mental health as something not to be
discussed. It is not just a matter of
confidentiality concerns for the firm.
The message is to keep silent.
But there is no way to break the stigma if we keep silent. And the reality is that the fear is
unwarranted and if discussion starts at the top, it can easily change attitudes
and behaviors.
There
is much that business leaders can do. While leaders are more likely to be committed and indeed
supportive if they understand what’s in it for the company, the most effective
way to gain leadership support is if they personally relate to it. Senior executives like to have a cause,
whether it’s cancer, homelessness, youth, or any number of issues, business
leaders frequently are champions. They
use their position and influence to engage the staff, corporate communications,
HR, and other resources, including the community, to work together to address
social needs. Their ability to effect
change is vast and untapped when it comes to mental health and suicide. We just need to get them talking about it.
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| Flickr user Dueker Fee Physical Therapy |
Two
years ago I had wrist problems and had to get physical therapy for several
months. In the beginning I went to a see
a therapist twice a week. Everyone knew
about my wrist problem. They knew where
I went twice a week, and they were sympathetic to what I was experiencing. Today, I no longer need physical therapy, but
I do go to a doctor every week. I go to
see a different kind of therapist. The
kind you talk to and get advice from. In
the beginning I told people I was going to see my psychiatrist. Now, I don’t feel the need to re-enforce
every time I go to see my therapist, because everyone already knows. The point is that just like seeing my
physical therapist, I have declared it ok to leave the office to see your
doctor, even if that doctor is focused on mental health. I’ve set an example that it’s ok to talk
about this at work, and, more importantly that mental health should be treated
no differently than any other health concern.
This
openness definitely has an impact. A
while back we were in the office on a Monday morning talking about the
weekend. One person had been at the
family house on the lake with the extended family – grandparents, aunts,
uncles. One of his aunts was going
through another depressive episode. The
employee admitted that in the past when his aunt was depressed he tended to
leave her alone and felt she should “just get over it”. But this weekend, he spent time talking to
her, listening to her, and reassuring her.
His exposure to someone living with depression in a different setting
allowed him to be more sympathetic and understanding. I’m sure if a friend or co-worker exhibited
signs of depression, he would be able to be more supportive of them too. Getting to know a co-worker living with a
mental illness changed his attitude.
While I would never have chosen to be born with depression, I have learned to
appreciate what it has given me. True,
it has presented some significant challenges and difficult times. But these challenges have also given me a
tremendous amount of strength and resilience.
I draw on this both in my personal and my professional life. Having been in financial services for much of
my career, I have experienced significant work challenges. I led the effort to keep a major financial
service provider funded and operating as it went through a downsizing from over
14,000 to under 4,000 employees. Back in
2007, during the early stages of the financial crisis, I was at a major
financial services company when an industry analyst used the bankruptcy word
speaking about the company. The press
descended in droves, customers were concerned, and a year later the company was
acquired by another bank. In all these
situations and many more, I have been counted on as a leader during substantial
adversity. Yet these challenges cannot
compare to the difficulties I have faced with depression. It is through the struggles with depression
that I learned how to attack really difficult situations and how to get through
the tough times at work.
Depression
has also given me an increased empathy toward others. While I think this manifests itself daily in
the way I manage, it certainly helps in those situations when it is most
needed. As soon as I had started a new
job, an employee whom I had not met did not show up for work for several
days. No one knew what happened until we
heard through one of his friends that he was in the hospital psychiatric ward
after attempting suicide. He had served
in Afghanistan and had PTSD. He had just
bought a house that he and his fiancée were going to move into. But before moving in, his fiancée broke up
with him. When he got out of the
hospital, he contacted another executive he knew. This person knew my background with metal
illness and suggested the two of us meet.
When we met, it was clear he wasn’t ready to come back to work, so I got
him to agree to meet me for coffee twice a week. This was my way of making sure he got out of
the house and allowed me to help him with referrals for things like therapists
and support groups. I talked with him
about being in therapy and how it had helped me. Because the people who hired me knew of my
advocacy around mental health, I was brought into the conversation and was able
to provide support as this young man started down the road to recovery. I’m happy to say he got the help he needed
and now, years later, he is thriving.
In the
alpha-male-dominated, type A, adrenalin-charged executive suites of corporate
America, admitting to weakness of any sort is viewed as taboo and a job-killer. The prevailing view is that
people at the top get paid a lot of money and should be able to handle whatever
their job throws at them. It is
incredibly difficult to find examples in the press of senior executives that
have taken a leave or resigned due to mental health reasons. And we know death by suicide is often
attributed to other causes. However, we
are seeing it in the press more and more.
Last
year Barclay’s compliance chief resigned after taking a leave of absence for
stress and exhaustion. In 2011, Lloyds
new chief executive took a leave of absence after 8 months on the job for
stress related problems. Last year the
CEO and the CFO of two different companies in Switzerland died by suicide and
their deaths were reported in the press.
And I’m sure you are all aware of the recent string of Wall Street
suicides. So while the perception is that people at the top can and
should handle anything, the reality is somewhat different.
Cleary
there are people at the top are who are experiencing mental health
problems. People in the highest offices
of corporate America do live with mental illness. Personally, I think depression is a much more common affliction with
executives, entrepreneurs, and leaders than society is willing to
admit. And just going by the
numbers, many, many more have a family member, relative, or friend living with
a mental illness. There have to be senior executives that have been impacted by
suicide. It seems to me depression is
the family secret we all share.
Frequently, a bereavement leads to depression which, in turn leads to
suicide of a family member which can lead to another period of bereavement,
depression, and suicide. It can be an
evil circle.
So
how do we create awareness and a sense of urgency around mental health in
corporate America? How do we make sure
suicide prevention efforts are supported and sustained? There are many strategies. I’ve already mentioned things like
anti-stigma campaigns, health care parity, wellness clinics, and employee
assistance programs. Together with mass
media and extensive research into the causes and treatment of mental illness,
we should see a change in corporate cultures.
These are critical efforts and we should continue supporting them.
I’d like to propose one more strategy. That is a concerted campaign targeting senior
executive leaders to become mental health and suicide prevention
advocates. And how do we accomplish
that? Let’s reach out to senior
executives in a number of ways. Above
all, we have to make talking about, and then communicating about, mental health
concerns acceptable in their rarified sphere of influence. Only then can we create support groups, arm
them with thorough training about mental health and suicidal behaviors, create
speaker’s bureaus of senior leaders who are open and sharing, and teach them to
become knowledgeable advocates. First,
let’s provide support for the leaders themselves. Cleary there are people
at the top are who are experiencing mental health problems. Why not create a support network for these
individuals? Let’s provide a safe
environment for senior executives to talk with their peers about what they are
going through – personally and professionally.
Philip Burguieres
was the youngest CEO of a Fortune 500 company ever. In 1996, this self-described workaholic had
to leave his job because of depression.
It was several years before he returned to work. Today, he is a vice chairman of the Houston Texans
football team. He is actively sought
out by CEOs with similar stories. He has
been rather public about his very private support of a secret network of CEOs
with depression.
We
could extend Phillip’s example to create a safe community for senior executives
challenged by mental illness to talk, share, and find support. It could even be positioned as an extension
of the increasingly popular executive coach strategy.
Let me give you another example. Last year, the UK arm of Deloitte, the
international business advisory firm, appointed a British senior partner, John
Binns, as its mental health and personal resilience advisor. Deloitte is one of the most forward thinking
companies with respect to human resources of all the places I have worked. After taking a leave for depression, John
created a group of nine Mental Health Champions at Deloitte UK, partners in the
firm who were trained to discuss and support mental health in the workplace. He provides one-on-one advice for individuals
in the firm who want to speak about mental health issues affecting them or
their family. He also provides mental health awareness and advisory services to
other businesses across the UK.
We know that most
deaths by suicide are by individuals with a diagnosable mental health issue but
only a minority those individuals receive any mental health service. Confronting mental health in the workplace
should be an effective method of reducing deaths by suicide. As the
stigma is reduced and more people get the care they need to recover, efforts
like zero suicides among people who are receiving care become more impactful.
Moreover, to the degree benefits like employee assistance programs,
wellness programs and general awareness and prevention programs are used in the
workplace, advocacy by senior management is the best way to make these efforts
a sustainable and core part of the organizational culture.
So
why do I think this will work? Why
should corporate leadership become a major force in mental health efforts
including suicide prevention? Why will
it make a difference for people with mental illness and suicide attempt
survivors to be open in the workplace?
For me the answer is simple. I’ve
been through this before. Coming out of
the mental illness closet is not the first closet I’ve come out of. Twenty-three years ago, when I was accepted
into business school, I made the decision to be open and honest about being
gay. It may not have been a
revolutionary act at the time, but it was a time when almost everyone in
corporate America still was in the closet.
I decided that I didn’t want the next generation to experience the same
prejudice, ignorance, and stigma that I experienced. I told myself that if I were someplace that
didn’t want me because I’m gay, I could take my Stanford bachelor and Kellogg
MBA degrees and go somewhere else.
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| Flickr user Dennis Wilkinson |
This
spring marked my Kellogg 20th anniversary. I ran into someone I knew quite well during
school, but had lost touch with over the years.
While re-connecting at the reunion, he mentioned that he was against my
being open while at business school; that he didn’t agree with it. But now he sees what’s happening with gay
marriage and thinks my being open must have made a difference. I look back at the past 25 years and I know
the important role every out and open gay person has played by simply being
honest about who they are. And one
important lesson we have learned is that to ask others to accept us means we
have to accept ourselves.
I
think the people living with mental illness and suicide attempt survivors at
the corporate level need to come out of the closet. We are the best positioned to shatter the
silence. If we can combine this openness
with top down driven change in the business world, I know we can make a
significant impact on the stigma around mental illness and suicide. I talk about mental health in the workplace
because it’s the best way I know to break down the stigma. I want to make a difference, and I can afford
to take the risk in an effort to effect change.
As the senior executive in charge, setting the tone and defining the
organization’s core values is one of the most important roles I play. Living with depression has not always been
easy. However, in many ways it has made
me a better person, a better manager, and a better business leader. Living with depression has been challenging, but
it has not kept me from succeeding.
