Sunday, 25 July 2021

Can we design a department to promote mental wellbeing?

Important - this is a brain dump of thoughts and ideas, and I am in no way a doctor or any other kind of medical professional.

I wrote last month about feeling extremely rough. I downplayed my experiences for the sake of a more readable post, but eagle-eyed readers of that post will have noticed that they are symptoms of clinical depression. Over the last month I've added a few (sleeplessness being an exciting new dimension) and I've started reading a rather good book on the subject by Dr Tim Cantopher. In this, Dr Cantopher talks about the current (published 2012) medical understanding of clinical depression, how it is a physical illness and what that means, and various treatment and preventative approaches.

The model he describes is the limbic system, responsible for a whole variety of functions including emotions, acts as a kind of fuse and like any fuse it is designed to blow when put under undue stress. This can cause all manner of conditions, one of which is depression. The reason it blows is usually cumulative and the actual trigger may be quite innocuous but when one reaches that point, it's game over for a while and proper rest and recovery is needed to reset the fuse.

Now, my lived experiences resonate strongly with this description. The book goes into a load of different pathways to this point, many of which are quite heartbreaking. I'm not going into any details here as (highlighting again) I'm not an expert and I don't think anyone would thank me for attempting to rewrite someone else's book. But it did get me thinking, and that at long last brings us to the point of this post.

The foundations for depressive illness are often laid in childhood, but there are plenty of opportunities for things to go wrong in adult life. Things which can be significantly unhelpful include unreasonable expectations thrust upon us, little to know praise, learning helplessness from erratic responses from authority figures, general erosion of one's sense of self-worth and value... The list goes on but many of these look to me like things that come up in any good management training. 

So where does this thinking go? Clearly, management has a huge role to play in the welfare of their staff. This is hardly insightful. But this responsibility cannot be discharged via a checklist of task. Performance development plan? Check. Conversation about the future? Check. Asked how they are? Check. Useful things to do, but without the empathy that should be driving them they are worthless.

A good manager can, in the work context, with very little effort provide for the psychological welfare of their reports. Or at the very least, they can avoid the pitfalls. Stepping back, a positive workplace culture can create an environment where people can perform without being put under stress and have the safety to take a step back when they need to. This is all common knowledge and hard enough to get right. But can we go further? 

When designing an organisation structure and layout, one looks at the needs of the organisation and optimises accordingly, weighing against the inevitable compromises. If the important thing is the processing of payments, then that part of the org design is optimised and that improvement may come at the cost of, say, making recruitment slightly harder. To do this, one can look at the way information and tasks flow around the department and where the bottlenecks and other pain points are. Now, what would a department which is optimised for psychological welfare look like? Or even, an org which is designed with staff welfare as one of several priorities? If the department itself is designed to promote a positive experience, eliminating uncertainty and providing ingrained ways for the staff to be empowered (note, not just FEEL empowered), what difference would that make - especially when a strong culture and individual management practice is layered on top?

My answer for the moment is that I don't know, but I want to find out. Staff welfare and staff satisfaction are particularly hot topics at the moment and with everyone feeling the burn of the last eighteen months that is right and proper. The NHS and other experts have been concerned for a time that the next public health crisis will be around mental health as a result of COVID. It would be nice to not be part of the cause of that. It seems to me that there is a something to explore, which could vastly improve the work experience for the people senior leaders are supposed to represent, support and (in some ways) protect. If I get the chance, I would one day like to see what is possible here.

If you're interested in the book, it can be found on Amazon here.

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