Too Long. Didn't Read.

You may have noticed that I just published a piece called Broken the Stigma? which is my unedited research report and dissertation into mental illness stigma within the professional services workplace. It is a 5,000 word piece designed to be submitted and published within academic journals. I wouldn't fault any of you for not reading it!

I'm going to attempt to summarise the background, the experiment, the results and the implications below in an 'easy access' format in my usual conversational writing style. It may not be as precise or detailed as the original, but you might make it through without yawning or getting distracted.

This is the capstone of my work on Breaking the Stigma and leads to me some interesting thoughts about where I go in the future, which I will discuss briefly at the end.

The Background

My story with mental illness is well documented, so I won't bore you with that again! Needless to say my personal experiences motivated to investigate this field, but I needed to support my reasonings and understand and explain why it is important. So some bullet points (for the slide deck that will undoubtedly follow):

1. Mental illness stigma within the workplace is one of the largest barriers preventing people from seeking help. This is often driven by fear of discrimination and being treated unequally. Many people report that this stigma is often worse than living with the mental illness itself.

2. Mental illness stigma is more than just discrimination. It also includes prejudice and stereotyping. These three terms are the 'holy trinity' of stigma representing different psychological processes of cognition, affection and behaviour. However, stigma also expands to include perception, expectation and experience meaning that people make expect stigma even if it is not present.

3. Workplace interventions such as Mental Health First Aider Training or other education resources are most successful in targeting (cognitive) stereotyping. Contact interventions with people experiencing or who have experienced mental illness are better at targeting (affective) prejudice.

4. Almost all support within organisation is placed upon the individual experiencing mental ill health. They are often required to "seek help" and make the first move, which places additional pressure on the individual and they fear being "found out" should the speak out.

5. Common mental illnesses such as depression and anxiety are often co-morbid (exist simultaneously) with stress. In fact, stress is prognostic (can cause) of common mental illnesses. Therefore if stress is part of your workplace, supporting mental health needs to be part of your workplace. The duty of care of an employer (at least in my opinion) should extend to support the health of an individual that they could be negatively impacting

6. Accounting, Legal and other professional services are widely regarded as some of the most stressful work environments due to the requirements of exceptional quality work in rigid timescales. There has been a rise of stress and stress related reports from these professions.

The Experiment

I created a website to conduct the experiment. I used a known scale (The Managerial Stigma Towards Employee Depression Scale) designed to investigate stigma in the workplace. I needed to make some tweaks because I wanted to use a vignette (description) of a person to make it more real. I also wanted to consider perceived stigma (what we think other people think) as well as actual stigma (what we think). I had a hunch based off my work with professional service firms in the past that perception would be worse than reality. I needed to prove it though!

Once someone had signed up to the website, they were presented with the description of an employee below:

Note that there are no gendered pronouns (I didn't want this to impact upon results) and that they quality of their work remains unchanged (My people experience mental illness and their work remains exceptional so I didn't want this to factor into results either).

The trick was that people were randomly allocated to one of three experimental conditions. The first included a sentence stating that Sam's symptoms were due to a diagnosis of general anxiety disorder, the second stating they were due to diabetes and the third didn't include a sentence. Everyone was then asked the same questions.

The idea here was to see whether being diagnosed with a common mental illness impacted on the stigma presented and the stigma perceived to be presented towards an individual.

The Results

Before discussing the results there are a few caveats. Sadly we didn't recruit enough people to be able to generalise these results to the entire UK professional services workforce. Also there are limitations to the results as this is based of self-reporting and social desirability bias may impact results (people always believe in themselves more than others etc). Finally, there is evidence to show that stigma may be connected to the symptoms and not the diagnosis and my experimental design didn't include a third control point of "no symptoms, no diagnosis". These are all things that can easily be overcome in future studies that I may undertake or that organisations themselves could undertake.

I summarise these results with a simple song and a meme:

Everyone Else is an Asshole - Reel Big Fish

What the study found was that being diagnosed with a mental illness, physical illness or no illness has no significant impact on the stigma towards and individual nor the perceived stigma towards that same individual. However in all cases, perceived stigma was significantly greater than actual stigma. Also, in all cases, this stigma is primarily driven by affective prejudice (see implications for why this is important!).

Thee really good news here is that in all cases, people disagreed to somewhat disagreed with the majority of statements. It's always important to check what the data really shows and this is a great case in point. It would be easy to say that "we believe it's worse than it is" and the like, but here even our perception of others highlights that we don't believe they will stigmatise people with mental illness!

This is good news!

Have I finally broken the stigma? Is the stigma really broken? Was it never there to begin with?

Sadly, due to the limitations of the study I can't answer this question for certain. But it's a good indication and something that can guide future studies in this field. But finish this article feeling slightly more positive than when your started!

The Implications

Keep doing what you're doing! This is a good trend!

There are ways that you can improve. Affective prejudice remains the largest component of the stigma, both real and perceived. The best was to address this is through contact interventions. These are simply meetings, talks, discussions with people who have experienced or are experience mental ill health. Better yet, have these with people who are from internal to your firm (or at least working in adjacent sectors such as other accountants, lawyers and professional services workers) as this will show that these characteristics are acceptable and supported within your organisations.

I fully appreciate that one of the primary implications for this study has essentially proven why what I'm doing is so important to the companies I support and cherish. It certainly wasn't intended as I started this, but it's fascinating to see it born out of the research and experiment.

My future?

I'm considering what the future holds for me right now. I somehow found myself as an expert in mental health and psychology within professional services. I want to continue to support these organisations and the people within. I want the people who are starting their careers all the way to those approaching the end of their careers, to have the benefit of everything that I've learned so that should they ever experience mental ill health, or a loved one experiences it, or a friend, that they can approach it knowing that they're not alone and that they're supported.

One thing I'm considering is starting to offering counselling, coaching, whatever word you want to attach to it... support to people specifically within the professional services workspace. Countless people have said to me when I've asked them whether they would speak to a therapist that "why would I speak to someone who doesn't know what I do" or "they don't understand the pressure I'm under". I DO know what these people experience daily. I've seen both sides of the coin and then some. I could see this either being as an external person partnered within organisations, or as an internal in-house coach/occupational psychologist that could help develop and support cultural change. The inhouse route would be fascinating right now as the world is adapting to a "post-Covid" way of working and the impact on mental health and the individuals is so new that it would allow real thought leadership.

Another thing I'm considering is undertaking a PhD to enhance this work (as I outline in future research). I am curious as to whether industry sector has a causal relationship with stigma towards mental ill health and whether certain interventions are more or less successful in certain industries. I'm also interested to see if there is an "optimal" way of working within professional services. What is the best way to structure and run these organisations to support the people within? Every professional services firm talks about people being as how they differentiate themselves; so how do we support these people within the workplace setting? My problem with a PhD is that whilst I could do it alone, I feel it would lack purpose and direction and that it would be much more relevant to understand this with an organisation to answer their questions.

Maybe I can do both of the above simultaneously?

I don't know.

But I'm putting this here as it's a discussion I would welcome to have with organisations. Many have asked "what services can you offer?" or "how else can we work together?" I'm now in a position where I can say that here are some ideas and I'd welcome a discussion. Please feel free to reach out as I'd love to hear from you.

Conclusion

Once again, thank you to everyone who took part and thank you to everyone who made it to the bottom of this piece. I am always amazed by how people to continue to support me and support what I do. It means the world that people took part in this study. I said initially everything would be made available to benefit all and here it is.

Thank you

Andy Salkeld

just another guy