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Playing the Mental Health Card

It’s easy to be cynical when a high-profile person cites ‘mental health issues’ as a seemingly convenient excuse for poor behaviour. But psychologists say there is room for both empathy and accountability and are calling on organisations to have meaningful preventative measures in place for high performers.

WHEN former NSW deputy premier John Barilaro cited mental health issues in refusing to appear again before the parliamentary inquiry into his appointment as Senior Trade and Investment Commissioner to America, the public reaction wasn’t entirely empathetic, and some commentors responded with eye rolling and frustration.

It is becoming increasingly common for high profile individuals to point to mental health issues when called out for bad behaviour. So how do we balance the need to address situations of concern with the need to protect and respect an individual’s mental health?

Psychologist Jane Enter has decades of experience working with high profile individuals, many times during crisis situations. She says there is room for both empathy and accountability.

“We can address the underlying mental health issues while still holding a person accountable for their actions,” Enter says. “That is true of public figures and those in private situations.

“There is no benefit in dismissing a person when they tell us they are having challenges, regardless of our perception of the ‘timing’.

“For those in high profile positions, there is an enormous amount of pressure, so it should come as no surprise that mental health issues arise.”

While there’s often little sympathy on the street for high priced CEOs and the like, most of us wouldn’t be in their shoes for quids. With boards and shareholders alert to the smallest misstep, and stock prices twitching in response to every move, who can these C-suite denizens talk to when things get rough? When can they let their guard down? Where can they seek solace?

With the stakes so high for executives and the companies they lead, shouldn’t their mental health and wellbeing a priority?

There is, quite rightly, an increasing expectation for organisations to provide preventative mental health care for its heavy hitters – or risk the consequences.

Stress – a double-edged sword

In its recent revision of the International Classification of Diseases, The World Health Organisation defined burn-out as “chronic workplace stress that has not been successfully managed.”WHO says around 35 percent of top executives are working in a state of burn out. That’s a lot of stressed-out executives.

The irony is that many C-suite execs owe their success to their willingness and ability to push themselves to extremes and work under incredible pressure.

Psychologist Tracey Gamble says most C suite executives have been promoted and rewarded for consistently going above and beyond expectations and shouldering extra pressure, but the long-term effects of this stress can be devastating.

"High level executives are used to working under these conditions - it’s often how they got to where they are.

"But there comes a point when the executive crosses from being in a mobilised state, into a state of almost collapse, what we know as burn out.”

“It is a slippery slope," Gamble says. "Our nervous systems cannot sustain too much activation from a physiological standpoint. If there is too much adrenaline and cortisol running through our system or if we are not getting enough rest and downtime, our system will just drop us into collapse. Unless we can regulate our way out of this situation, our bodies will force us to stop and take stock.”

Burnout and poor decision making

Professor Rob Phillips, CEO of Australian medical equipment manufacturing company Uscom says in some cases, stress can lead to inordinate risk taking with a low likelihood of success.

“Sustained stress and risk of failure produces uncertainty, anxiety and ultimately a break-down of rational decision making and normal relationships, and sometimes destructive behaviour,” .

“Executives with a history of achievement, suddenly faced with personal failure are not equipped to distinguish between reasonable risk taking and incompetence.

“This can rapidly lead to a toxic, hostile and destructive work environment with all these stresses likely to be transferred to colleagues or reflected in poor leadership and decision making.”

Gamble agrees, saying the fallout within an organisation of a previously high achieving executive trapped in the throes of burn out can be devastating.

"When a leader encounters these problems and reaches a crisis point they are no longer leading authentically, they are more impatient and demanding of others and this can adversely affect the culture of the whole organisation.

“There is trickle-down effect that harms everyone else within that organisation. You may then find middle managers feeling undervalued and unappreciated and are not being managed in the best way. This can be toxic for an organisation.”

Duty of care and corporate culture

Strategy and Risk Advisor Peter Deans, CEO of 52 Risks, says many companies are overlooking the mental health and wellbeing of their executives, who are often subject to unrealistic expectations. 

"Unfortunately, it’s only when the situation gets critical that it is taken seriously,”

“The life of a CEO can be lonely, and they often keep health issues hidden. It is clearly incumbent on boards to keep an eye on the physical and mental health of its key executives."

Gamble said organisations need to do more. She says most executives she works with reluctantly self-refer for treatment, often when they are already at breaking point.

"By the time I see them they are feeling helpless and hopeless and any sense of joy or achievement in their role has left them,”

“They are no longer thriving in the challenge. All their systems and healthy behaviours are at breaking point.”

She is also aware that while she may be treating an individual, there may be a wider company culture to blame.

“Individual burnout is only a small part of the problem. Burnout is a result of corporate culture, so organisations need to understand the effect their workplace culture and expectations are having on their executives,”

"One issue that arises is the degree to which these high level executives feel isolated and distrustful within an organisation. They often don’t have a cohort of peers to have conversations and de-briefings with and they are sitting with that all by themselves.

“Organisations need to be having authentic conversations with their employees around how people are travelling.”

Gamble believes corporations need to undertake wide ranging in-depth conversations with their executives, and implement meaningful change, not superficial or tokenistic gestures with no real substance.

“Sending an executive off to a wellbeing day or meditation course, then sending them back into the same toxic corporate environment is futile,”

Companies must focus on prevention as well as crisis management

Mathew Simpson is founder of Raindrum, a private rehabilitation provider in Byron Bay whose clients include high profile individuals, often in crisis.

Simpson says in acute or crisis situations, Raindrum aims to engage with each individual and corporation to provide a discreet, situationally appropriate rehabilitation program.

“If someone is in a crisis situation and literally needs to be pulled back from the precipice, we make sure the solution is fit for purpose and everyone is supported,”

“In these cases, we build a health scaffolding around an individual to get them back into good physical health, ready to re-establish their mental health and wellbeing through counselling and ongoing support.’

Ms Gamble said this health scaffolding is vital to sustainable change.

“Getting a person’s nutrition and sleeping back to normal and their body back moving is very important. This enables their autonomic nervous system to return to a regulated state and allows the individual to gain some perspective,” she says. “We can then do the work around the psychological issues.”

Having timely access to suitable programs to address crisis situations as part of a risk management strategy is only one component of an overall mental health program.

Simpson says preventative programs, where high profile individuals regularly undertake counselling and training, are key to reducing or avoiding crisis situations.

“It’s no longer enough to simply have a plan in place for crisis situations. We would like to see greater director focus on ongoing preventative programs within company ESG statements and risk management protocols.”

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