MHCA Chair Jennifer Westacott’s presentation to the Associations Forum's 9th Annual CEO Symposium

Presentation to Associations Forum’s 9th Annual CEO Symposium
Melbourne Convention and Exhibition Centre, Melbourne
Friday, 21 February 2014
MHCA Chair Jennifer Westacott
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Setting the scene – why we think this should be on the CEO agenda

Thanks for having me, it’s nice to be here amongst the leaders of our most significant not for profit organisations.

This is an important gathering. It’s an opportunity to share and look for ways we can work together to promote mentally healthy workplaces. This is my focus today.

I’d like to start by saying that it has certainly been an interesting journey for me becoming part of the mental health sector here in Australia.

It has certainly reinforced for me just how far reaching mental illness and its effects are in this country.

I guess my main learning is that, if we get our approach to this right, we will increase productivity, participation and the wellbeing of our people and our workplaces.

Today, I want to discuss with you:

• the current political and economic climate in regards to mental health 
• the impact of mental health on the community, especially in our workplaces
• the Mental Health Council of Australia’s vision for a new mental health system
• what a mentally healthy workplace looks like
• and how each of you can start to consider the sorts of changes you can make, in your workplaces, and within your sectors, to help us change the way we approach mental health in Australia

I hope that by the end of this presentation, you will begin to see how good mental health fits into your organisation’s agenda and how you can start to make a difference.

Because frankly, and I hope you will agree, mental health is everyone’s business.

When I look at the data, it’s clear to me that the management of mental illness and the promotion of mentally healthy communities and people, is a critical issue for all Australians.

The national reform agenda

To begin with, it’s important to quickly look at the current political and economic environment.

Mental Health is currently subject to a review being undertaken by the National Mental Health Commission.

The Terms of Reference for this review are focussed on the funding the sector receives, how it is spent and on the effectiveness of the services it provides..

Its focus is on ending duplication and waste and improving outcomes for people.

The Mental Health Council of Australia welcomes this review it is well timed from our perspective.

We intend to work closely with the Commission.

Our focus will be to ensure the voice of the consumers and their carers is heard and considered and that we lay the foundation for true systemic change.

We have already made a number of recommendations:

Firstly, the review must set out a vision for what an optimal mental health system should look like in Australia.

As we have said before; 

• a system that is focused on meaningful participation
• that prioritises promotion, prevention and early intervention 
• that is recovery oriented
• that is seamlessly integrated across services and programs
• and, that is accessible, effective and efficient

Secondly, the review should set out the structural reforms that will be required to move us from where we are now toward a world class mental health system.

History is already littered with incremental, ad hoc and stop gap measures and this is not what Australia needs now.

Finally, a priority task will be to identify major gaps in our existing services, and to point out those investments that are not currently yielding us the best outcomes .

It is clear that some people currently entering the system could be diverted from future high cost services with appropriate investment in early intervention and prevention.  

It is also clear that people who have entered the system with complex needs would be better served by much closer integration across existing programs.

If this review results in greater clarity about our shared priorities and goals for mental health, less confusion and duplication in services; and money better directed to the most effective interventions, then I am all for it.

Because in reality Australia’s mental health system is broken, systemically and fundamentally.

Australia’s patch work approach to mental wellbeing, cobbled together over the decades following the closure of our mental health institutions has not worked.

Fixing this, is fundamental to the Mental Health Council of Australia’s new strategic approach.

This year we have a new vision – a new mission

We want to see mentally healthy people and communities.
And, quite simply, we want to create the best mental health system in the world.

To do that, we need a careful and patient decade of reform, reform based in part on the findings of the Government’s review.

Reform that you all can, and should, be part of.

The Impact

For context, it’s important we all understand the impact of mental health on our community and our workplaces

4,536,000. That’s the number of Australians who will experience a mental illness in the next 12 months, according to the Australian Institute of Health and Wellbeing.
That’s one in five of us, or 20%.
With 11.6 million people in work according to the December Labour Force figures, that means roughly 2.3 million Australians are working with some form of mental illness.

And within this cohort, there are a lot of high functioning, healthy and happy people who participate and thrive despite the challenges they face.

But not everyone is doing well.

Around 50% of Australia’s unemployed have a mental illness, many of them long term unemployed.

We have some of the lowest rates of workplace participation by people with a lived experience of mental illness in the OECD.

And with many workplaces still developing their understanding about how to work with mental illness our community is feeling the impact.

Impacts like

• Absenteeism Workers not turning up to work because of their mental illness
• Presenteeism – workers not working at their full capacity because of mental illness
• Poorer physical health
• Higher employment related costs for business in recruitment and training, due to higher staff turnover
• Higher risk of workplace accidents, incidents and injuries
• Higher levels of stress leave and stress related ill health 
• Longer hours worked but at lower productivity
• Poor support for mental health in the workplace can also lead to lower levels of workplace morale, employee engagement and job satisfaction, which also impact on business productivity

Some of these problems come from our attitude; I’m talking about stigma and misunderstanding, in the workplace and in the community.

A recent study in the USA found that 70% of people did not want a person with schizophrenia as a co-worker.

Surprisingly, 40% of mental health workers surveyed believed the same thing.

One result of this stigma is people hiding their condition from co-workers and managers.

Some of these problems come from stress in the work place.

In a recent article in The Australian newspaper, the current Commissioner of the National Mental Health Commission, Allan Fels, observed that Australian workers with job-related stress and mental illness are absent from work nearly eleven weeks a year.

Professor Fels pointed out that more workers are absent from work because of stress and anxiety than because of physical illness or injury.

Research from the Australia Institute found that one in four Australians experience regular workplace related anxiety.

And 3.3 million Australians report a loss of sleep related to workplace stress.

This is affecting people with a mental illness and people without.

Both the stigma associated with mental illness, and our limited ability to create a positive working environment is costing our economy.

When we add up all the costs of mental illness, including absenteeism and presenteeism – some reports put the burden on the economy as high as $28 billion a year.

And this burden is being felt by every sector.

We as leaders representing a variety of sectors have a role to play in changing this because it is fundamental to a prosperous, cohesive community.

Creating the best mental health system in the world

One major barrier to participation and better outcomes is a lack of coordination between mental health services and between the various sectors people with a mental illness come into contact with.

This includes the education, housing and employment sectors, to name a few, and this, of course, has an impact on our ability to work.

For example, a young person seeking help with mental illness may have to explain their story to five, six, seven different agencies, again and again, each time becoming more frustrated and withdrawn.

Employment agencies are not linked closely enough to housing services, housing services and not linked to health services; and even health agencies still don’t talk to each other.

This lack of integration can actually make things worse for many people seeking help. This is disappointing to say the least.

The argument for collaboration

If we are to create the best mental health system in the world and mentally healthy people and communities, collaboration will be the key.

We as leaders in our sectors can drive this change, and encourage this collaboration, for the benefit of all.

Many people have been talking lately about collective impact.

What I mean by collective impact is a simple concept, driven by the following principles:

• a structured and disciplined approach to thinking about the total or whole of life needs of a family, an individual and a community
• a practical continuous dialogue that allows services to work together on the ground
• a collective focus on measuring outcomes and improvement in people’s lives rather than inputs

Let’s look at an example.

At the Mental Health Council, we convened a group called the Council of Non Government Organisations on mental health, or as we like to call it CONGO.

This group brings together people from a range of sectors, from mental health and primary health care, from education and employment and from the housing sector.

Last year this group was tasked with creating a set of targets and indicators for good mental health for adoption by the Council of Australian Governments.

We now have a set of targets and indicators that show us what good mental health looks like, in more than just a clinical health care setting.

And because it was developed by everyone, it can be implemented by everyone in agreement and in a way that works for each individual sector involved.

Indeed, if you are not part of this group, we encourage you to contact us and join us at the table.

You are the experts, and you can tell us what can be done in your sector to make things better for people with a mental illness.

Call to action

So what do we need to do to create a mentally healthy society

I want to focus on what we need to do at the workplace level.

And in this, I’m talking about two things

• One, workplaces where we can actively work towards a good environment for all our workers, regardless of their mental state, and  
• Two, workplaces where people who have a mental illness can thrive and contribute

Mentally healthy workplaces

Let me start with the overall issue of mentally healthy workplaces.

Just to recap on why this is critical:

• work is our pathway to economic and social wellbeing
• it is our sense of dignity and purpose
• at the most basic level, we will spend most of our waking hours there

But this is fundamentally an economic imperative and should be characterised as such. It is vital for productivity and innovation. Therefore it is vital for economic performance.

It’s not a ‘nice to have’, it’s a ‘must do’.

So a mentally healthy workplace ought to have the following characteristics

• a place people want to be
• a place where people can realise their full potential
• a place that contributes to our sense of happiness

How do you, do we as a community, contribute to this?

Here are some practical things to think about. Most of these are just common sense.

Workplaces should be collaborative and engaging. There should be very clear structures for direct engagement, for feedback and dialogue and a sense of shared ambition for the organisation.

We should design jobs and workplaces to support a balanced approach to life to minimise unnecessary stress and to provide maximum flexibility and fulfilment.

Why should people commute in peak hour for long periods, adding to their stress, when technology allows a much more flexible approach.

Obviously, this is not easy in some sectors but, where we can, we should.

We should set clear goals and targets for people with respectful performance planning so people understand where they are heading and how they are tracking.

Those should take account, when possible, of people’s personal aspirations and ambitions. That is what they want to achieve in their life rather than the tasks they are expected to perform.

I am a strong advocate of encouraging people to have outside interests.

We need to look at our customs and practices and how they add to or create stress.

We need to remember that, at the most basic level, the poor management of stress will put employers at risk of claims.

For employees, the poor management of stress will lead to poor productivity, poor cultures and low morale.

Some things to think about:

• how often are people on their emails on weekends. Some of Australia’s leading CEOs have a policy of not responding to emails on weekends
• how do we give feedback and comment and avoid critical, often humiliating, practices
• how do we manage structural change which is often essential, but so often is badly handled and can be crippling for some individuals
• do you have an employee’s assistance program so that there is a very clear path for people to seek help

Finally, we should all have a zero tolerance to bullying. We, as leaders, should seek to eradicate it at every turn.

As I said, none of this is rocket science but I want to make the point that a decent place to work is a mentally healthy workplace.

A decent workplace is a creative and innovative one. So this is core business.

Lots of companies I represent are taking this more and more seriously but we need to remember, as I turn to providing the right environment for people living with mental illness, that some types of mental illness are preventable.

Creating better workplaces can remove one of the triggers or causes of mental illness or the more severe escalation of an existing condition.

Mental Illness in the workplace

So what about those with a mental illness in our work places.

We know that people with lived experience of mental illness want the same work opportunities as other Australians.

That is: to earn an income, have a role in life, and enjoy a routine that connects them with their community and to other people.

It is true that work can be, and is, a vital factor in recovery and rehabilitation for people with a lived experience of mental illness.

For this reason, a key responsibility of all employers is to work hard to create mentally safe, healthy and supportive workplaces .

Through this, people will thrive, participate and enjoy meaning in their lives.

A key part of employment participation, of course, is flexible job design.

But let’s be realistic here.

The reality when employing a person who may have a disabling mental illness is that, at times, there will be challenges.

But much like the flexibility we would not begrudge a person with a physical disability, we should consider the same flexibility for someone who might not have such an obvious, or easily understood, ailment.

Of course we recognise that for some sectors providing full flexibility is problematic.

But surely it is not beyond us as a nation to look for ways to create jobs and workplaces that can be more responsive to the reality of living with, or just as importantly, caring for someone living with a mental illness.

A key starting point in all this will be creating an environment for people to disclose they have a mental illness.

Do your organisations have any policies or practices to ensure people are comfortable disclosing mental illness? Do your practices specifically provide guidelines for dealing with a mental illness?

And I include your own personal feelings on this. Honestly, do you need to change the way you think about this?

How do you deal with a problematic staff member, someone you might perhaps characterise as different or even difficult?

We must consider what might be behind that behaviour and act accordingly. We need to understand the origin of some issues and think about what’s happening in the totality of someone’s life.

(Don’t assume – ask)

And then, finally, how can you pass on your organisations knowledge in this area, and encourage those in your broader sector to do the same?

Whatever approach you take, seek advice, and share your learnings, act early, act now, and be the catalyst for change in your sector.

I’m calling for you to join us in making a difference, in making Australia a mentally well country.

A social movement

In many of my speeches on this issue, I have called for a social movement on mental health reform.

You are that social movement, as the peak associations and organisations in your sectors, you have the power to drive that change.

The change you make today will improve your sector, improve results, improve participation, improve morale and, most importantly, fundamentally change your day to day lives for the better.

I, and millions of Australians, will thank you.

Thanks for having me.

Questions…