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Friend of Tortoise Exclusive

Why is it still so hard to talk about mental ill-health?

Why is it still so hard to talk about mental ill-health?

This event is exclusive to Friends of Tortoise

in partnership with Deloitte

This is a digital-only ThinkIn. 

There’s no doubt that ‘awareness’ of mental ill-health has improved throughout the pandemic. We’re being encouraged to take care of our own and each other’s mental wellbeing in workplaces and on primetime television. So why is the stigma around mental health proven so doggedly resistant to change?

As the first in a series of ThinkIns that seek to critically examine, and ultimately progress, the public conversation about mental health and wellbeing, we zeroed in on the elephant in the room: many people still don’t want, or know how, to talk about it. How can we recognise, and start to shake off, our own awkwardness about admitting we’re struggling, or asking whether others are? Are we dressing our discomfort up as discretion? If we don’t know how to ask, what hope do we have of knowing how to help? Are all the “awareness” initiatives helping at all, or might they actually be making it worse? How much should businesses and leaders do to really create workplaces where mental health is taken seriously, discussed openly and managed well?


The Readouts that follow a ThinkIn often resemble a to-do list, but as Chris Creegan pointed out during the discussion: this stuff is inherently messy. 

We were in general agreement that there’s been a huge change in how we talk about mental health, namely that we do now talk about it. But the operative word here is ‘we’. We are much more comfortable talking about collective experiences of mental ill-health than we are personal experiences. And perhaps nowhere more so than in the workplace.

Dr Lucy Foulkes, honorary psychology lecturer at UCL, said companies were still paying lip service to mental health without understanding the depth of what’s involved, a thought that framed the whole discussion.

Here is a bit of sense of that depth:

– We’re not incentivised to speak up. A lack of productivity. Difficulties in dealing with stress. These are seen as weaknesses, where they are sometimes the product of mental ill-health. It is, Dr Foulkes said, “rational not to say anything because people know that saying things has negative consequences”.

– We’re not all speaking the same language. My colleague Luke Gbedemah pointed out that “we find ourselves using terminology and ideas and concepts that aren’t universally accessible”. Some would give a clinical diagnosis to what others might see as the stresses of life. Without shared understanding, worthwhile communication is hard.

– We are more comfortable talking about some mental illnesses over others. When it comes to discussing Borderline Personality Disorder, for instance, Steph Preston said that responses can vary from not knowing how to talk about it all the way to: “This is a bit too heavy.”

– We strive towards neat solutions, when it’s not always neat. “The issue is that sometimes there’s no trigger,” said my colleague Tomini Babs. “Someone can be depressed just because they’re depressed.” 

– We haven’t set reasonable expectations for recovery. “When you are off because you’re mentally unwell, the sound of the clock ticking of other people’s patience is really loud,” said my colleague Liz Moseley. It’s impossible to set a recovery time on any mental illness, but having the capacity within an organisation to give a colleague what they need feels like it should be a bare minimum for company leaders.

What we know, for sure, is that employees really care about this. “I could easily quit my day job and do a thousand webinars a month,” said Dr Ken Duckworth (whose day job is chief medical officer at NAMI, the largest grassroots mental health organisation in the US). Employees are demanding discussion and workplaces are responding. 

But as Emma Codd, Global Inclusion Leader for Deloitte, said, discussions like the one we had are just a first step: “Words are easy but if the everyday culture that you are living doesn’t actually embed that, if you don’t feel able to have a conversation about it without stigma, retaliation, lack of career damage, you’re not going to speak up. That’s the missing piece now.”

It’s a big piece, but Emma Codd gave us a starting point for the degree of seriousness with which workplaces should treat this issue. “We need to focus on psychological safety as much as we focus on physical safety.”

editor and invited experts

James Harding
Co-founder and Editor

Dr. Ken Duckworth
Chief Medical Officer of NAMI

Dr. Lucy Foulkes
Honorary lecturer in psychology at UCL

Emma Codd
Global Inclusion Leader for Deloitte