Mental Health and Wellbeing in the Workplace. Gill Hasson

training in mental health will help you know when and how far you can help, when to ask for support, and when to refer someone to other agencies.

      Employers that genuinely promote and value wellbeing and good mental health and support people – whatever their culture, beliefs, and abilities – with mental health problems are more likely to create conditions that allow for everyone to give of their best, to be committed to their organization's goals and values, to be motivated to contribute to organizational success, to feel valued and supported, and to have a positive sense of their own wellbeing.

1 Understanding Mental Health and Wellbeing

      Defining Mental Health and Wellbeing

The World Health Organization (WHO) defines mental health as: ‘A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community’.

      Our mental health affects the way we experience the world; how we think, feel, and behave towards ourselves and others. WHO defines mental health as a ‘state of well-being’ and just as physical health is intrinsic to wellbeing, so is mental health.

      The mental health organization ‘Mind’ suggests that if you have good mental wellbeing you are able to:

       feel relatively confident in yourself and have positive self-esteem

       feel and express a range of emotions

       build and maintain good relationships with others

       feel engaged with the world around you

       live and work productively

       deal with the stresses of daily life

       adapt and manage in times of change and uncertainty.

      Both Mind and the World Health Organization's definition of mental health refer to a person's wellbeing. But is wellbeing the same as wellness?

      When you think about wellness, think prevention and health. When you think about well-being, think happiness.

       Susie Ellis. Chair of the Global Wellbeing Institute

      Certainly, happiness is important, but there is more to wellbeing than the positive feelings that come with happiness. Both WHO and Mind recognize that wellbeing involves not just happiness, but crucially, the ability to manage difficulties, problems, and challenges; the ‘normal stresses’.

In 2012, Cardiff Metropolitan University Professors Rachel Dodge and Annette P. Daly et al. published their report The Challenge of Defining Wellbeing. Having reviewed and analyzed past attempts by other researchers to define wellbeing, they concluded that ‘it would be appropriate for a definition of wellbeing to centre on a state of equilibrium or balance that can be affected by life events or challenges’. Consequently they define wellbeing as: ‘the balance point between an individual's resource pool and the challenges faced’.

      In other words, wellbeing occurs when a person is able to enjoy life and has the resources to draw on to manage life's ups and downs without feeling overly stressed. Therefore, an important component of wellbeing is resilience; the ability to cope with, as well as bounce back and recover from, difficulties and challenges.

Dimensions of Wellbeing; Social and Spiritual

      There is no health without mental health.

       World Health Organization

      One of the key aspects of mental wellbeing is our social wellbeing; the ability to build and maintain good relationships with others. Social wellbeing is the extent to which you feel a sense of belonging and social inclusion. The UK Faculty of Public Health suggests that social wellbeing is ‘the basis for social equality and the antidote to issues such as racism, stigma, violence and crime’ and that it is dependent on, amongst other things, ‘the norm with regard to interpersonal relationships in a group, community or society, including respect for others and their needs, compassion and empathy, and authentic interaction’.

Another feature of wellbeing – just as important as social, mental, and emotional wellbeing, but not so widely acknowledged – is spiritual wellbeing. Spirituality refers to a sense of being connected to something bigger and more everlasting than yourself.

      Spiritual wellbeing means the ability to experience and integrate meaning and purpose in life through a person's connectedness with self, others, art, music, literature, nature, or a power greater than oneself.

      Spiritual wellbeing is about our inner life and its relationship with the wider world . . . Spiritual wellbeing does not just reflect religious belief although for people of a religious faith it is obviously a central feature.

       Dr Ritika Srivastava

Physical and Mental Health and Wellbeing

      Distinctions are often made between mind and body but when it comes to mental health and wellbeing and physical health and wellbeing, we can't think of them as separate entities. Poor physical health can lead to a person developing mental health problems. And poor mental health can have a negative impact on our physical health and wellbeing.

A physical health problem can impact on our cognitive and emotional abilities; adversely affecting our daily lives, our work, and our relationships. Conversely, if our mental health is suffering as a result of, for example, stress, depression, or anxiety, we are less likely to eat and sleep well and may be less physically active which, in turn, can impact our immune system and so our ability to resist infections and illness can be depleted.

      Just as when we neglect and ignore our physical health we can become physically unwell, it's also the case that if we ignore or suppress difficult feelings we can become physically unwell.

      When we are exposed to stressful experiences or trauma, we can, without realizing it, banish the experience to the unconscious; it's too much to deal with and it's pushed down to the basement of our minds. Eventually – sometimes years later – the stressful/traumatic experience can present as a mental health problem, for example an anxiety disorder. But a stressful or traumatic experience can also manifest itself as a physical disorder.

      Case Study

One evening, Catrice was reversing her car into into the garage, when she heard a scream. She had reversed the car over her partner, Julie. Unknown to Catrice, Julie was sitting on the floor at the back of the garage, fixing her bike. Horrified and shocked, Catrice called an ambulance and Julie was taken to hospital. Although she had sustained serious injuries, they were not life threatening and in time, Julie recovered. However, a week after Julie's admission to hospital, Catrice developed a weakness in her lower limbs. Eventually she found that she was unable to stand; each time she tried, her legs gave way from underneath her.

      Following weeks of tests, x-rays, physiotherapy assessments, and orthopaedic referral, Catrice's GP, believing that she was experiencing a ‘somatic response’ – a physical response to an emotional trauma – referred her to a psychotherapist.

      Catrice had blocked the feelings – the trauma, stress, and guilt – she experienced as a result of Julie's suffering but those blocked feelings had manifested themselves as physical symptoms. With support from a psychotherapist, Catrice recovered; she was able to forgive herself for the pain and suffering Julie had been through as a result of her actions.

      People with mental health problems are more likely to develop physical health problems and vice versa. Furthermore, people with mental health problems can present to their GP or employer complaining of physical symptoms that have no physical cause. This can sometimes lead to missed or delayed detection of the