Coaching employees experiencing mental health problems at work can not only prevent and manage stress, but help people flourish, says coach and mindfulness trainer Liz Hall.
Stephen Larke, a vice-president at IT consultancy Cap Gemini, had no previous history of poor mental health, and was performing well at work. So when he was diagnosed with clinical depression in 2015, it came as a shock to himself and his colleagues.
“The strange thing was I could function at work very effectively when it came to visible and urgent activities, even very demanding or high-profile ones. This made my plight invisible to those I worked with,” he says.
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Larke’s story (see case study, below) is by no means unusual. Not only is poor mental health seemingly on the rise, many suffer in silence, and it’s not always obvious at first. However, if an individual gets the right support, they can not only recover from a breakdown, but also become more self-aware and more resilient as a result. This was the case with Larke.
“With the right support, as in my case [including coaching and counselling], it is possible to make a rapid recovery and to emerge as a stronger and higher performing employee. I know that one year on I am a stronger, more resilient and hopefully wiser and more supportive leader than I was before,” he says.
Yet left unaddressed, depression and/or anxiety can spiral downwards, impacting productivity and the bottom line, and sometimes even leading to suicide. Just the other week, I spoke to an organisation wanting to introduce a programme combining mindfulness and coaching as soon as possible after one of their employees had committed suicide. This wasn’t the first such call I had received, and other coaches and mindfulness trainers I talk to report similar conversations with employees.
Mental ill health on the rise
The rate and unpredictability of organisational change certainly appear to have escalated since 2000, resulting in turbulence placing even greater demands and stresses on leaders, according to coaching psychologists Dr Anthony Grant and Dr Sean O’Connor (Grant and O’Connor, 2015).
And as Bennett and Lemoine have written, the acronym VUCA (volatility, uncertainty, complexity, ambiguity) is increasingly used in business circles as shorthand for “it’s crazy out there” (Bennett & Lemoine, 2014).
Some 77% of employees have experienced symptoms of poor mental health at some point, with 62% saying work was a contributing factor, according to UK charity Business in the Community’s (BITC) 2016 National Employee Mental Wellbeing poll of more than 20,000 people, released in October 2016.
In a study carried out among investment bankers by MetLife Employee Benefits, also published in October, 40% considered their job to be extremely stressful, and 67% would consider leaving if the situation did not improve over the next year.
However, despite these rising levels of stress, 70% of respondents to the MetLife survey said they would not ask for help about stress as it would look weak and affect their career.
And according to the BITC’s report, staff experiencing difficulties often keep quiet at work fearing they will lose their jobs or at least be sidelined.
Although two-thirds of employees surveyed by the BITC have experienced mental ill health caused by work, only a quarter said they felt able to talk to someone at work, and less than 2% said they have discussed their problems with HR. The BITC report also highlighted that leaders are disconnected from the reality of employees’ experiences with poor mental health.
So how can coaching help? Certainly, one of the advantages of a coaching approach is that employees can discuss poor mental health confidentially.
Some employees may be resistant to therapy or to using an employee assistance programme (EAP), particularly given the still prevalent stigma surrounding mental health issues. Although 23% of employees surveyed said they had access to an EAP, just two per cent had used it during their most recent instances of mental ill health, according to the BITC’s report.
Once through the door, coaching can help employees in a number of ways. In times of organisational change, it can be an effective or even vital support mechanism, according to Grant and O’Connor’s research (Grant and O’Connor, 2015).
They explored the impact of a cognitive-behavioural and solution-focused coaching approach among leaders in a global consulting and engineering organisation that had undergone significant and stressful changes. These included a new CEO, restructuring, and the introduction of a new business model. Coaching goals included being less reactive in meetings. Positive effects identified included:
- Increasing leadership resilience.
- Improved flexibility in dealing with organisational change.
- Enhanced solution-focus thinking.
- Greater change-readiness – the capacity to cope with or recover from the uncertainties organisational change brings.
In addition, coaching can be a just-in-time intervention, helping employees avoid becoming depressed and taking time off from work. It can offer a safe space where individuals can explore difficult feelings, thoughts and symptoms. It can help them develop tailor-made strategies to work with these issues and “normalise” what’s going on for them so they don’t feel alone. And where necessary, it can offer a portal to further specialist help, including therapy.
Although there is still a stigma around mental health issues in the workplace, and resistance in many organisations to working explicitly with emotions, a shift is taking place with more coverage in the media and an increased willingness from high-profile individuals to discuss their experiences.
One such individual is former global vice president HR at Unilever, Geoff McDonald. When he disclosed his own battles with depression in mid-2013, he saw a 12-fold increase in the number of employees at Unilever reaching out for help. In 2015, with Georgie Mack, managing partner of product innovation consultancy, Made by Many, McDonald launched the [email protected] movement with the aim of breaking the stigma of depression and anxiety in the working world.
Typical emotions and behaviour in change programmes
- Feeling: Anger: annoyance, bitterness, hostility, rage, frustration, resentment.
- Feeling: Shame: guilt, embarrassment, humiliation, regret, remorse.
Behaviour: Compliance, risk aversion, vengefulness
- Feeling: Sadness: despair, unhappiness, hurt, loneliness, gloom, pity.
Behaviour: lack of engagement
- Feeling: Fear: fright, nervousness, panic, concern, worry, anxiety, dread
Behaviour: fight, flight, freeze
Source: Kate Pearlman-Shaw (ORConsulting)
More employers are recognising the important contribution being more emotionally literate can make in times of change, transition and crisis. If employees fail to process emotions during times of organisational transition, this can mean they are not on board with change, underperform, or even become mentally unwell.
Bridges’ “Transition Curve” (Bridges, 2009), a psychological framework for supporting individuals and organisations during challenging transitions, sets out three phases or processes: the ending; the neutral zone; and the beginning. According to Bridges, it is particularly important to support employees to work through their emotions during the ending, which involves loss of the old ways, of identity, and the neutral zone, which is when critical psychological realignments take place.
Kate Pearlman-Shaw, leadership coach, psychologist and lead consultant at OR Consulting, describes a number of emotions and behaviours that typically arise during such times of change (see box, below).
It is important to ensure both external and internal coaches are suitably equipped to support employees who may be struggling. Make sure coaches:
- have professional indemnity insurance;
- adhere to professional codes of ethics, such as the Global Code of Ethics;
- can be explicit about their psychological underpinnings, even if they are not psychologists; and
- receive supervision and undergo continuous professional development to keep them up to date with the latest developments, such as neuroscience.
There are a number of psychologically informed coaching approaches that are well suited to supporting employees during challenging times, and experienced coaches are likely to draw on a range of them.
One is mindfulness-based coaching, which can help employees explore difficult emotions safely as my own research (Hall, 2015) has highlighted. While the idea of turning towards difficulties rather than away from them is counter-intuitive for some, it’s increasingly seen as crucial in stress management and prevention.
Drawing on mindfulness helps individuals become more self-critical and self-compassionate, which in turn boosts psychological health and wellbeing (for example, Frederickson et al, 2008). They become more resilient and better able to manage stress (Chiesa and Serretti, 2009), and develop greater self-awareness and awareness generally (Creswell et al, 2007).
Breakdown to breakthrough
In many cultures and traditions, crisis is viewed as crucial to transformation. While not necessarily vital to growth and transformation, research is increasingly suggesting that going through difficult times does promote growth.
Research on post-traumatic growth by Calhoun and Tedeschi (2013), for example, highlights common positive outcomes in areas including personal strength and relating to others.
My own research (Hall, 2015) among clients and other coaches highlighted all sorts of positive outcomes arising from going through challenging times. These include: heightened emotional intelligence (for example, increased self-awareness and ability to be kind to oneself); becoming better at self-care and managing energy; and appreciating the complexity of humankind and being less judgmental.
Many organisations are turning to coaching to help them shift their culture in challenging times, and supporting employees who are struggling.
At News UK, for example, coaching is helping to transform its culture following the telephone hacking and police bribery that rocked the organisation.
Where employers have a number of employees being coached, they can harness recurring themes too, as long as this is on a confidential basis. This allows them to build a picture of what might be causing stress and anxiety among staff.
As Larke points out, if coaching doesn’t take the wider system into account, its impact will be much more limited.
“A whole system approach is needed when looking at stress management, and parachuting coaches in on a short-term basis to work with stressed individuals may provide them with some temporary relief.
“This is not the same though as looking for and tackling the underlying reasons why a whole organisation is experienced by most of its staff as stressful… there are few quick fixes. Joined-up, well-thought-through system and individual coaching approaches work best,” he said.
All too often, certain employees end up as scapegoats instead of being seen as representing problems in the wider system.
Of course, certain individuals may be more prone to experiencing anxiety and/or depression, but they are often flagging up what’s going on in the organisation as a whole.
Between 1911 and 1986, canaries were used in British coal pits to detect harmful gases underground as they are particularly sensitive to carbon monoxide – an odourless, colourless and tasteless, but potentially lethal, gas. Coaching can help identify the employee equivalent of pit canaries.
McDonald advises employers to put in place a multipronged strategic framework for addressing mental health, one in which coaching plays a part, but is not the only part. This involves the following:
- Building a business case.
- Making clear the moral case for mental health support.
- Building levels of education and awareness around mental health.
- Communicating that it is normal to have mental health problems.
- Preventing employees from getting ill – this includes offering coaching, mindfulness, meditation, yoga, building quiet rooms where people can have “down time”.
- Ensuring help is “just one click away”.
McDonald says his own recovery was aided by cognitive behavioural therapy (CBT), medication, talking to people who had been ill and got better, some coaching, and slowly getting back on his bicycle and doing some exercise. He wishes he’d had access to a coach earlier on.
“Imagine if I had talked to someone who coached me to look after my wellbeing. I was very good at looking after myself physically – I ran marathons – but I used to sleep badly, didn’t eat as well as I should have, and the thing I never did was recover.
“I didn’t know about the importance of taking time out for myself and used to feel guilty if I was compassionate to myself. I wish I had been taught some of those things, and introduced to things such as mindfulness and meditation.
“I often draw the metaphor that someone taught us something very simple – dental hygiene – but nobody ever taught us basic mental hygiene. I would love to see more coaches doing this,” he said.
Stephen Larke, a vice president at IT consultancy Cap Gemini, was diagnosed with clinical depression for the first time in 2015. As a 47-year-old with no previous history of mental health issues, this came, he says, “as a shock, although in some ways an unsurprising confirmation that a pattern of feelings and behaviour that had built up over time was not normal or healthy and needed to be treated.”
He continued: “I had become accustomed to the pressures of targets, long hours, challenging clients and significant global travel over a period of many years, while juggling with the priorities of family life.
“I had, of course, experienced times of stress before and fleeting periods of feeling low linked to my feelings about work at a particular point in time. But this gradually morphed into a more constant and pervasive feeling of anxiety, stress and sadness, and was exacerbated by poor sleep, specifically waking up early.”
Many assume that it will be obvious if someone has become mentally unwell, but often this is not so, particularly with high-functioning individuals.
In Larke’s case, he was able to function very well with high-priority activities, but says: “For non-urgent but important activities requiring strategic thought or creative energy, I was empty.
“I would often spend hours staring at a screen and, if alone, feeling emotional and very low. I felt like my head was full and that I was unable to effectively deal with everything that was on my plate.”
“For me, work stress was the trigger for the symptoms to come to the surface, however, the root causes were more linked to loss, both in terms of bereavement and children starting to leave the nest and transitioning to a new phase of life.
“I was fortunate in that I received excellent medical treatment along with counselling, and also fantastic support from senior executives at work and my family and friends. This enabled me to return to work after a short break and to make some changes that have left me in a much healthier place one year on.”
Larke had started a programme of employer-funded coaching when he had stepped into a more senior position, five months before being diagnosed with depression. Coaching played an important role in helping him to unpack his emotions, and acted as a gateway to Larke getting the additional help he needed.
He said: “Coaching helped me to identify some of the reasons for how I was feeling and provided strategies for putting work stress into context and tackling specific stressful challenges. It also gave me space to pause and reflect on where I was in life.
“Having worked in a demanding industry for 25 years and continually progressed, it was good to reflect on where I might go next and what I was really trying to achieve in life. The coaching definitely helped me to realise that many of my feelings were about these broader feelings of loss than about just work stress.
“But I also had to realise for myself that I had become ill, and just as I wouldn’t expect a coach to address an insulin imbalance for a diabetic, similarly my treatment required professional, medical help from my GP, a psychiatrist and a trained therapist.
“My prolonged stress, sadness and early waking had led to increased levels of cortisol, which had become a neuro-toxin and needed treating. My coach encouraged me to get that additional help. It’s important for coaches to recognise when someone may have become clinically depressed rather than just stressed.
“Since going through my experience, I have become far more aware of the inconsistent way the topic is dealt with in the workplace. I have been prepared to speak openly about my experience to people I know well, and have found several others that have become unwell and not all have had the level of support that I received.
“There is a need to train managers in how to support staff, not just at the time of becoming unwell, but through the process of re-integration into work.
“And there is a need for senior leaders who have been through this experience to share their story. It would have helped me a year ago to be able to hear stories of people who had come out the other side.”
Larke says coaches also come under pressure to succeed – for example, when enhancing employees’ performance, which may mean mental health problems are seen in a poor light.
“For coaches, it is important that they don’t see someone getting help for a mental illness as a failure. A coach is likely to want their client to excel and few will have a success criterion that involves being diagnosed with depression or anxiety.
“But, in fact, and in my case, this was the turning point that allowed recovery to take place and the real benefits of coaching to then be more easily accessed.”
Liz Hall is the author/editor of Coaching in Times of Crisis & Transformation (Kogan Page, 2015) and author of Mindful Coaching (Kogan Page, 2013). She is a senior practitioner coach, and a mindfulness teacher/trainer. Email: [email protected]
National Stress Awareness Day (1 November, 2017) is organised by the International Stress Management Association (ISMA) to help provide information of stress, and strategies on how to address it for both companies and individuals.
Bennett NG and Lemoine J (January 2014). “What VUCA really means for you”. Harvard Business Review.
Frederickson, BL et al (2008). “Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources”. Journal of Personality and Social Psychology, vol.95(5).
Chiesa A and Serretti A (2009). “Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis”. The Journal of Alternative and Complementary Medicine, vol.15(5).
Creswell JD et al (2007). “Neural correlates of dispositional mindfulness during affect labeling”. Psychosomatic Medicine.
Grant A and O’Connor S (2015). “Executive Coaching in Times of Organisational Change”. In Hall L (Kogan Page, 2015), Coaching in Times of Crisis and Transition.
Hall L. “Nourishing the lotus flower”. Coaching in Times of Crisis and Transition (Kogan Page, 2015).