The Big Read in short: Breaking mental health stigma — Hey boss, is it OK to not be OK?

Each week, TODAY’s long-running Big Read series delves into the trends and issues that matter. This week, we look at what it takes to break the mental health stigma at the workplace. This is a shortened version of the full feature,​ which can be found here.

• With mental well-being in Singapore a growing concern, a tripartite advisory on mental well-being at workplaces was issued last week  
• While the advisory guidelines are a step in the right direction, more can be done in ensuring that cultural changes are enacted at the workplace, say experts 
• One expert pointed out that it is up to bosses to take the first step by opening up about their own mental health vulnerabilities  
• Mental health needs to be viewed on par as physical health, say doctors and psychologists 
• Employees should also be mindful of their own mental health, and draw boundaries to safeguard their well-being

SINGAPORE — For more than two years since she started working at a bank, Mavis (not her real name) has been keeping a secret from her bosses: She suffers from depression and anxiety.

While her company has hired counsellors, Mavis has never used their services, and seeks external counselling instead. 

“Some have told me that (the company counsellors) will report back to the bank, though my boss said that this doesn’t happen — but you never know,” she said. 

The 25-year-old associate also fears that her chances of a promotion will be stymied if her condition is out in the open.

“In my industry, you are expected to work very hard and expected to have endurance… Those  who can work a lot and handle a lot are seen as better.” 

This is what some employees here have to face. But what about the employers? What do they have to say? 

Those interviewed by TODAY stressed that they are open to listening to their staff about whatever problems they may have, including mental health issues. However, they admit that a line has to be drawn, especially when it comes to business-critical roles. 

If the employees continue to fall short of expectations or are unable to work for long periods of time due to their mental health conditions, the employers said they may have no choice but to refer the workers to other roles within the company or fire them. 

Still, having to support staff who have reached their breaking point may not be the biggest challenge when it comes to mental health issues at the workplace in Singapore. 

It is actually tackling the stigma surrounding mental illness and encouraging employees to speak up about their problems, based on TODAY’s interviews with workers, employers, human resource (HR) experts, general practitioners (GPs) and psychologists. 

While calls to improve mental health awareness in the workplace are not new, the issue has taken on an added urgency this year with Covid-19 creating new stresses and pressures for everyone. And with more people forced to work from home as the pandemic rages on, the boundaries between work and rest have been blurred, taking a further toll on the mental health of many employees. 

But even before the coronavirus struck, the mental health situation here has been a growing concern: The Singapore Mental Health Study conducted between 2016 and 2018 found that one in seven people experienced a mental disorder in their lifetime, compared with 

one in eight people in 2010’s Mental Health Study.

Just earlier this week, TODAY reported that the Ministry of Manpower (MOM) is investigating allegations made against a firm here where a former employee has committed suicide allegedly due to harsh working conditions.

Against this backdrop, a tripartite advisory on mental well-being at workplaces was issued last week by the MOM, Singapore National Employers Federation and National Trades Union Congress. 

While these guidelines are a step in the right direction, more can be done in ensuring that these initiatives are not treated as a paper exercise, and that cultural changes are enacted at the workplace, HR experts and mental wellness advocates told TODAY. 

CHALLENGES FACED BY EMPLOYERS

While larger firms may have more resources to implement the tripartite advisory guidelines, this is not always the case for small and medium enterprises (SMEs), many of whom are feeling the crunch from the current economic slowdown. 

Mr Adam Esoof Piperdy, chief executive officer and founder of events company Unearthed Productions, said that SMEs like his are in a “very precarious position” during the pandemic and it may not be practical for them to tick every box in the advisory. 

“Such measures would (require) quite a high investment. I think what we would rather do is to have more informal practices of checking in with each other,” he added. 

Even for larger firms with comprehensive mental health initiatives, the issue of employees not speaking up about their conditions remains a problem — one that has been exacerbated by remote working. 

Ms Anuradha Purbey, people director at insurer Aviva Europe and Asia, said: “While mental health awareness has been gaining traction in Singapore, for many it is still considered taboo to acknowledge their struggles.”

She added: “At Aviva, we want to make talking about mental health as normal as talking about physical health and continue to do what we can do to remove this stigma.”

While there are firms which are willing to cut some slack for employees with mental health issues, they also said that there is a limit to how much employers can do. 

Mr Piperdy, for example, said that he will try his best to get any colleagues struggling with mental health to seek professional help or give them days off if they are unable to cope. However, since the event industry is a client-facing role, he cannot continually make concessions at the risk of letting his clients down.

“At the end of the day, the job scope doesn’t change… if they’re not able to manage the workload that comes in, which is something we actively do, then I think we will help this person to transition to another job, maybe we will look for opportunities for this person.

“We have successfully redesignated some of them, to find suitable jobs in more fixed, permanent (roles) such as working in a venue instead of working for an events company,” Mr Piperdy added. 

“But we are actively trying to avoid that by having early intervention, coaching and mentorships.”

TAKING THE FIRST STEP: BOSSES SAYING ‘IT’S OK TO NOT BE OK’ 

Firms that TODAY reached out to said that they have come up with a slew of measures to promote mental wellness at the workplace, many of which are in line with the tripartite advisory’s guidelines.

These include having one-on-one confidential counselling services, dedicated peer support groups, and mental wellness workshops. 

While companies ramping up their mental wellness initiatives is a positive sign, HR experts said that this has to be coupled with bosses who lead by example in creating a more open company culture. 

Earlier this week, Bloomberg reported that Economic Development Board managing director Chng Kai Fong had opened up about his mental health struggle during the pandemic at a technology conference on Nov 22. 

Otis Asia Pacific president Stephane de Montlivault, who is a member of the WorkWell Leaders Workgroup, said that being more open about his struggles with mental health meant that employees of the elevator company were more willing to share their problems as well. 

“I shared my personal situation as I happened to also have a number of difficulties (amid Covid-19). I lost a colleague and very close friend who died in a car accident… and shortly after that my father-in-law had a heart attack and was in the ICU,” he told TODAY. 

“I was facing a lot of stress, and had sleeping issues, anxieties.”

When he shared these issues at a forum with his employees, many of them started opening up, and subsequently many were willing to go to their bosses directly with their problems, he said.

He added: “This actually caused us to take some actions in some cases when we found that people had difficulties when we were constrained by not being able to come to the office.” 

Agreeing, Ms Anthea Ong said that bosses who are willing to reveal their vulnerable side send a clear signal to employees that having mental health issues does not mean that they will not be able to succeed at work. Ms Ong, a former Nominated Member of Parliament, is the founder of the WorkWell Leaders Workgroup, a community of leaders from various companies and national agencies which champion workplace mental well-being. 

“That’s a very big part of stigma in the workplace, (which) stems a lot from concerns with career progression and advancement,” she said. “When leaders are the ones sharing, then it says that it does not affect your promotion options, your career progress, and your potential.” 

Veteran HR practitioner Carmen Wee said that for cases where an employee’s mental health condition becomes too severe to continue working at a company, firing the employee should be a last resort. 

Other alternatives such as no-pay leave, counselling and job coaching should first be considered. 

Even when making a decision to part ways, the company must also be sensitive given the pandemic situation, where it may be difficult to find employment. Employers can introduce the affected workers to new jobs that may be more suitable, or link them up with job courses. 

“Each person’s circumstance is different, so the company needs to examine and come up with an individualised plan,” said Ms Wee.  

PHYSICAL AND MENTAL HEALTH SHOULD BE SEEN ON PAR 

Although awareness of mental health here has grown, there remains a common misconception that physical health takes precedence over it, when both in fact should be viewed on par, said psychologists and GPs whom TODAY spoke to.

Dr Geraldine Tan, director and principal psychologist of The Therapy Room, said that whether it is a physical or mental illness, patients can be “struck down” by it for a prolonged period. 

“When they have their diagnosis of anxiety and depression, they cannot go into the office, and someone else has to take over, so it is as bad as having surgery, or breaking your leg,” she said.  

Agreeing, GPs said that they would give medical certificates (MCs) regardless of whether it is a physical or mental ailment. 

Dr Sunil Kumar Joseph, a GP who runs Tayka Medical Family Clinic in Jurong, reiterated: “Mental illness is treated the same as physical illness from a medical point of view, so there is no issue.” 

If employees are hesitant to get MCs for their mental ailments, some companies have a policy where a limited number of sick days can be taken without having to produce an MC.

Some employers also provide medical leave based on trust, rather than having to always provide MCs. 

Mr Jeffery Tan, chief executive officer of charity organisation Jardines Mindset Singapore and group general counsel of Jardine Cycle & Carriage, said that if employees report that they have mental health issues without an MC, it will come down to “managerial discretion and empowerment by the supervisors”. 

“Even for physical ailments, we don’t always need to be able to produce an MC before we can go off; we can see someone is struggling with an ailment, they can take an afternoon off. 

“This is coupled with an element of trust in a safe environment, as opposed to starting off by saying ‘if I have this, are people going to game the system and be less than truthful?’,” he added. “I think those are all the wrong dynamics.” 

WHAT EMPLOYEES CAN DO THEMSELVES 

Dr Douglas Kong, a mental health expert and performance coach, said that those who are stressed at work may not be able to identify the signs until it is too late. 

He has seen several cases of employees who would not admit to their stress and anxiety, only for their mental health conditions to worsen and affect their productivity. 

“So people think that mental illness is terrible, that you must not have it… But the point is that if you can deal with it earlier... it can allow the person to overcome it and get on with their lives and work,” said Dr Kong. 

Mr Adrian Choo, founder of career strategy consulting firm Career Agility International, said that employees must know “when to back off” when caught in a stressful situation. 

“Employees themselves need to know when they are being stretched and are hitting the limit… (They) need to ask themselves what is more important, your health or your career?” he said. “Because if you are burnt out, you are of no use to your company anyway.” 

For Mavis, the bank employee who is hiding her mental health condition from her bosses, only a significant cultural shift in her company will prompt her to open up about her struggles to her superiors. 

“But right now, it is a far cry from that,” she said. 

WHERE YOU MAY GET HELP

Samaritans of Singapore: 1800-221-4444 (24 hours)

Singapore Association of Mental Health: 1800-283-7019 (Mon-Fri, 9am-6pm)

Care Corner Counselling Centre (Mandarin): 1800-353-5800 (10am-10pm)

Alternatively, you may email pat [at] sos.org.sg.