Interview: Dr Libby talks mental health at work and teaching

By 19th Jul 2018 Mylo Kaye, Podcast, Transcript
Mylo Kaye Interviews Team Mental Helth

Mylo Yeah, so welcome Libby. Well, we’ve just been talking a little bit about your kids and helping them understand their emotions, and I just found it really fascinating. Could you just maybe just go over that again about an example of your one of your kids? This podcast is all about mental health, and I thought it would be good.

Libby   Yeah. I think what we were, what we were talking about is one of the big things that we focus on when we go to schools and talk to teachers about mental health is the concept of the frontal lobe, and the thinking and feeling parts of the brain, so in children and young people. When something happens externally, a message gets fired up the brains into the brain stem and into the central bit of the brain, which is the emotional brain that starts firing. And in adults that happens too. But we’ve got this fully developed frontal lobe that enables us to think and, and kind of regulate those emotions. So rather than going bananas over something we can think about that, but as children don’t have that ability, so as adults, and as parents, or as supportive people around them, we’ve got to try and be that frontal lobe and buffer those emotional responses and be aware that they don’t have the ability to think in the same way that we do. –So it’s about trying to explain to people. So an example is with an angry child site, my hungry child, I will say to say to them try and count to 10. The theory is that by counting you are actually kicking and triggering that frontal lobe interaction. Sometimes if I’m angry I’m at home, I might say, okay, I’m might be bubbling inside, but I’m just going to count to 10 right now and openly count because I’m trying to model behaviour and let people know it’s okay to feel angry. It’s a normal emotion. It’s about how you manage it and regulate those emotions. 

Mylo     Wow. You’re trying to instil this in your kids, and by the sounds of it seems to be working with the example you gave me before that your little girl seems to say, Mommy, I’m not feeling too well today. 

Libby    Yeah, I’m not feeling too great today. Sometimes that could be physical, but that could also be that she felt quite worried about something that happened at school yesterday or, whatever. It’s just trying to engage that conversation and make it okay to be talking about that. I say I’m not feeling too great today either, I had something really sad happen, or I felt really worried about that, but it’s okay because I know that tomorrow hopefully I won’t feel as worried about it, I can talk to people, and it’s important to talk and share. That’s kind of what I’m trying to do. I think that’s really important for every child and young person to have the opportunity to, to do that. 

Mylo, I guess that has bigger implications as well. You hear all these stories of children’s sexual abuse. And I guess just talking about mental health is one part, but getting children to speak openly about everything could be even bigger. 

Libby   Yeah. There are so many different things that can happen to different people, some of which can be extremely traumatic and distressing. Obviously, when things like that are potentially disclosed, it’s about ensuring that that’s then directed to the appropriate people because obviously that can be extremely sensitive information. It’s not holding that responsibility when you’re not equipped to, but it’s important to let children feel safe and supported. There’s significant evidence to show that the wiring of the brain can be affected by how much support and nurture you have growing up. So for those children who may have experienced significant difficulties and may not have parents or caregivers that they go home to every day. So just having one supportive adult in their life that could be a teacher, a social worker, someone who they have regular contact with that can be hugely protective against mental health problems down the line. 

Mylo     I guess this links to your company, talk to us about Team Mental Health, what is it that you do and why did you start doing that with your business partner? 

Libby   Team Mental Health was set up by myself, my colleague who is a consultant, child psychiatrist, another colleague who is an experienced head teacher. My background is I’m a consultant forensic psychiatrist, so I’ve worked with a number of acutely mentally unwell people in prisons and secure hospitals. My sense was through talking to them in so many cases, there was a history of trauma, history of mental health problems developing at a young age and people not feeling able to talk about that. So then they might start self-medicating with drugs and alcohol. Things then escalated and got worse. My strong feeling was I wonder what would have happened if something had been detected sooner rather than later. So spoke with my two partners and we decided that we really wanted to shift the way mental health is perceived and the way it’s managed. So we want to raise awareness and we train people working in schools for children and young people to spot signs of mental health problems early so they can effectively sign post. It’s not about expecting people to become experts. It’s about them to be able to spot the signs, so help can be sought earlier and because we know that there’s a better outcome in the long term. I think with staff in school it’s really important as well as what we’ve massively focused on his positive mental health and well being and really trying to develop that emotional intelligence and resilience. But that’s not just important for children and young people that are important everywhere. Our initial training program was in schools, but we’ve also now developed one for the workplace because having mentally healthy workplaces is hugely important as well, and all those factors promoting positive mental health and well being, alongside spotting those signs sooner rather than later. So that’s what we do, and we hope that we can reach loads of people. That’s why we’ve done some online training, so we can get consistent messages to as many people as we can. That really to enable that meant mental health becomes a conversation that everybody has on a daily basis.

Mylo     Before we started recording, I said that my mental health, when I look back, I can see it start at roundabout 12 or 13 at the time, I just didn’t have a clue. I guess what you’re doing with Team Mental Health is trying to get those conversations at that age or earlier.

Libby   Yeah, absolutely. Have the conversations at that age. We know that one in 10 children and young people do experience a mental health problem, and over half of those are established by the time they’re 14. So it’s really important for things to be detected as early as possible. As we were talking earlier, you can’t expect children to explain and articulate what’s happening, which is why we’re saying to teachers in school and every staff member in school, everybody from the administration, to the dinner ladies, to the people who work in cleaning, and everybody needs to have some level of understanding and knowledge so they can spot signs, and raise concerns if there are any. It’s difficult to talk about what we need people to observe, to listen to hear and then reflect on that, and take action if it’s necessary. 

Mylo     So what could you do in my workplace, for example, what could you do for my staff who actually openly talk about mental health. But what advice would you have then for a company who, think, you know, what we need to start talking about this, but we’re unsure where to go with it, what’s kind of your advice and what would you be able to offer them?

Libby   Well, we have designed our training program reflecting on the recent thriving at work report that was published, which was a government commissioned report, and that was really helpful. What they say within is that everybody should adopt a certain number of mental health core standards in every workplace. Part of that is about providing healthy workplaces and environments and in allowing that work life balance. The second is increasing mental health awareness among employees. So one of the things we do is the online foundation training that we say that everybody really in an office should have, because what that allows somebody to do is on their own, take some time either at home or at work, run through the training, which takes less than an hour, and it tells you about the importance of your own positive mental health. It tells you practical strategies to support yourself and your mental health and well being, but it also highlights signs of features such as work related stress, anxiety, depression. It covers the use of substances that people may involve in their life because they’re finding it difficult to cope with the stress that they’re under. It’s about trying to provide information that allows them to recognise that they may be experiencing a problem and that that’s okay. There are lots of different avenues to seek support. The longer you leave a mental health problem, the worse it gets and the more likely you are then to require acute mental health services. Not everybody with a mental health problem needs to be seen by a psychiatrist, and it’s just about making sure that we can help people recover, so it doesn’t impact on them in the longer term. The sooner we deal with it, the less impact it has all around. 

Mylo     I have seen some stats recently, and I can’t for the life of me remember them, but it was without the proper support when an employee goes off work with stress-related illness, I think the chances of coming back is really low. Is that true? 

Libby   Yeah, that’s correct. Again, I can’t remember the exact number of weeks, but if somebody is off for a certain number of weeks, it’s harder to return because there are all different kinds of factors that affect that. But you could imagine yourself, you lose your confidence, your self-worth, self-esteem, self-worth, self-belief, that sense of belonging. It’s difficult to come back then, especially if you’re somebody who is experiencing depression or anxiety. So yeah, there are lots of ways to tackle work related stress and mental health problems at work. Actually what has been found is that the cost of presenteeism, so being at work with a mental health problem is twice as expensive, as being off work with a mental health problem. It costs employers more to have people in and people feel scared to ring up. So people who are experiencing stress or mental health problems will ring up and say they’ve got another problem because it’s easy to say, I’ve got a chest infection. Not actually, I’m just having a really bad day. That’s not saying we should just say everybody who has a mental health problem should take loads of time off work. That’s not true. But short, flexibility and an approach to that, maybe supporting working from home, or coming in just for a morning, being flexible and allowing an individual approach to managing someone’s mental health and well being is key. 

Mylo     Okay. So there are some really great tips I think for employees. So your a doctor, and study the Liverpool Medicine Medical School, you still do some work with the university? 

Libby   Yeah. With Liverpool University. We do some lecturing over there, which is great. So, I was very aware that when I was a medical student there wasn’t a great deal of focus and learning about mental health when I was a medical student and I felt very ill equipped actually. When I became a junior doctor, especially working in A and E, because you have a number of people presenting to and with mental health problems. And so that’s something we really want to assist universities to develop. We know that they’ve massively improved that since I was at medical school, but it needs to be something that is on a par with physical health. Everybody knows about specific medical cases in surgical cases, but mental health needs to be crucial because it is as important as your physical health. 

Mylo     And you say that there’s no health without mental health. 

Libby   Absolutely. One hundred percent. There isn’t. We all have mental health. Mental health is actually a state of well being where people can kind of cope with day to day difficulties, achieve, contribute to their communities. That’s mental health, that’s being mentally healthy. 

Mylo     So we’re all on almost like a sliding scale?

Libby   Absolutely.

Mylo     One point you can cope with, well maybe, maybe you can go over that scale and not care, but yeah, there’s like a fine balance between understanding social norms, and being in touch with your feelings, understanding your feelings and then either side of that. 

Libby   Yeah. We have to protect our own mental health and we have to take steps to have really positive mental health. So often people will talk about mental health problems and refer to them as mental health, it’s a mental health problem. It’s an illness, it’s like a physical health problem and being really physically healthy. So it’s the same concept and I think the more kind of conversations we can have like that to get that message across, big differences could be made. 

Mylo     Fantastic. I feel like we got tons and tons of really practical tips and advice that people can use in the workplace. What would you say then about doctors prescribing pills? What’s your opinion on that from Team Mental Health? 

Libby   I’m a psychiatrist, so I’ve spent a great portion of my career prescribing medications for mental health problems. I would say from my perspective, a doctor assesses a patient, they take a full history, they do a mental state examination. They should be having conversations with the patients to gauge their position. I’m weighing up the pros versus the risks versus the benefits and making an informed decision. Everybody is an individual and everyone will have different needs and different levels of risk that might be associated with their mental illness. So if somebody needs a medication, then it’s important for them to have it. Not everybody needs the medication and often you will always have medication prescribed alongside talking therapies which are hugely important. I’ve seen on social media quite a lot of comments that are very anti antidepressants. 

Mylo     Yeah, I’ve seen that too. I don’t get it because with my experience of mental health, like I said earlier, I think it started about 13 and, and now I’m 31 and I still go through phases where I think maybe I’ll be okay on medication for awhile, maybe this part of my life, I need that and I genuinely feel there is an imbalance in my brain and I need this medication to fix the imbalance. 

Libby    Exactly. Everybody is different. Antidepressants can have a huge positive impact when it comes to your mood and also your ability to engage with talking therapies. 

Mylo     So used alongside therapies, it’s shown to be really, really effective. 

Libby    Yeah, that’s the guidance, on the treatment of depression and anxiety. Antidepressants don’t necessarily work for everybody and some people won’t want to take them and that’s fine. 

Mylo     There’s a big stigma though, around happy pills, I hate the term. I find that a real shame on social media, there seem to be negative connotations to taking pills. 

Libby    Absolutely, because you wouldn’t have that with a physical health problem. If you had high blood pressure, you wouldn’t be saying, oh no way do I want to take those a blood pressure lowering medications. It’s a lack of understanding. I think some people have bad experiences, and that’s fine and they should be allowed to talk about that if they want to have their experience, but making sweeping statements and judgements without having proper training can be unhelpful. I think if anybody was reading something that said you should absolutely stop antidepressants, and you’re taking antidepressants and concerned, don’t just suddenly stop them. That can have a number of problems associated with it too. In terms of your physical health and your medical health, so you need to talk to your doctor and if you do want to come off the antidepressant medication than a special reducing regime needs to be put in place. 

Mylo     Okay. Some really great advice there. To wrap up then, I could talk about this all day long. It is so important in what you’re doing with Team Mental Health. I can see already making a huge impact, if there were any employees out there or people within businesses that are listening and a little bit unsure about, or scared about talking about mental health in the workplace and what they can do. What would be your advice to them? 

Libby    My advice really would be to learn a bit more about it. It’s not something to be to be scared about. Obviously, when somebody is acutely unwell that can make a lot of people feel extremely uncomfortable because seeing somebody who is very emotionally distressed is hard for everybody. 

Mylo     I almost don’t want to, or maybe this is my responsibility I’ll deal with it at home.

Libby    Yeah. People feel scared to talk about it, that’s about a lack of confidence because that’s a lack of understanding and actually, when you start to learn things and you realise that you don’t have to hold certain levels of responsibility, but you can signpost them effectively to get the right support, then things feel less scary and actually just having those conversations about the responsibilities that employers actually do have when it comes to protecting the mental health and well being of the staff that work for them. It’s really important, and almost when you put it in with a legal context, that can be helpful as well. That potentially normalises it in the business world because it’s another topic that’s okay to be spoken about, it’s something that needs to be addressed and it just needs to be on a par with everything else in the world. The case for workplaces, taking the mental health and well being of everybody there importantly is human. So it’s about the individual, the effect it will have on the person, the teams, the organisation as a whole. But there’s also a business case for it because the cost of mental health problems to employers is 26 billion pounds a year. It’s the leading cause of disability. It’s the reason why people don’t come into work. They might not necessarily say that, but it’s the biggest cause for work-related ill health. 

Mylo     I guess there wouldn’t be a lot of people that would actually talk about it would they? 

Libby    No, there isn’t. I think it was Time To Change did a survey, and it was literally 98 percent of people who phoned in with stress gave another reason because they felt unable to say that and raise that.

Mylo     So maybe lack of support, but actually just not having people within the organisation. I know Time To Change do an amazing job. Actually, advise companies have mental health ambassadors. That’s something that we’ve done at Dreamer. Well, I want to say thank you, Dr Libby, I feel that there are tons and tons of advice there. I know that any organisations listening, whether it’s a manager within a company or even somebody that’s dealing with mental health issues, hopefully, they can talk and raise it with managers. Checkout Time To Change and check out your website which is teammentalhealth.co.uk. Thank you.

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