‘What is good for employees with mental illness is often good for everyone.’

Helen McCabe’s question hovers in the air: what do you wish leaders could understand about people wrestling with mental health issues?

“It is a really hard thing, I think, at the moment,” replies Dr Lisa Pryor, a Sydney-based consultant psychiatrist.

Pryor, whose name some might recognise from her time as Opinion Editor with The Sydney Morning Herald, is chatting with Helen McCabe, FW managing director and FW Leadership Series podcast host. 

Pryor first completed a law degree, before switching to journalism, then medicine and now psychiatry. Somewhat unsurprisingly, the conversation centres on mental health in the workplace and how leaders can best manage staff wellbeing.

“Everyone from bosses to teachers, basically the whole society is struggling with this, that there are suddenly so many more people with diagnoses,” Pryor says.

“It’s almost like we have to become instant experts in all these different difficulties. But one thing I would say, in terms of mental health problems in the workplace – prevention is much better than cure.” 

Pryor says creating a supportive culture is better for both the employee and the company’s bottom line.

“If you can create a healthy workplace where people don’t end up in crisis, or don’t feel overwhelmed, that’s going to be a better way to run a business,” she said. 

“Often what is good for employees with mental illness is often good for everyone.” 

She singled out bipolar disorder to illustrate her point.

“If you do have bipolar disorder, it’s really important to look after your sleep and maintain a good routine and look after your circadian rhythms. Because often when people start to become unwell, one of the first signs is their sleep goes off with it. If they’re not getting enough sleep that can trigger an episode,” she says. 

“So it’s really important if you have bipolar to have regular shifts, to not be expected to pull all nighters, to have breaks between work days. But that’s also really important for everyone.” 

Though, she stressed these sleep principles and breaks between work days are just as important for others, particularly single mothers or those with caring responsibilities. When it comes to anxiety, Pryor said while some experience severe anxiety which becomes a disorder, it is also a part of life.

“Everyone experiences some anxiety, and it can be helpful to us,” she says. 

“Getting some butterflies before you give a speech – often that can make you more focused and make you actually perform a little bit better if you have a little bit of anxiety. 

“But obviously, there can be a point where that anxiety becomes so high, that it’s overwhelming, and it impairs your performance, and also where it can be so pervasive that it’s a disorder. So both those things are true. It’s both normal, and it can be a disorder.” 

As for monitoring anxiety in a workplace, Pryor admits, it is complex.

“In terms of how we manage it, I think the evidence-based way to manage anxiety is often counterintuitive for people. So the more you step towards the thing that is making you fearful that’s actually a helpful thing and the more you avoid it, the more you reinforce anxiety,” she says. 

“Or, [for] example, taking lots of time off work for anxiety is probably going to make your anxiety worse. So I think it’s complicated.”

“You have to be the best, most caring boss you can be, but you don’t have to be that person’s psychiatrist.”

In her line of work Pryor sees mental health issues that are more common to women than men.

“Obviously, there can be an increase in mental health problems around the time that people have babies and also around the time of menopause. But I actually think that’s a secondary issue,” she said. 

“The difference I see the most in my day to day work is trauma related. And it’s about what happens in women’s lives that has nothing to do with their brain chemistry.”

These two areas of trauma are domestic violence and sexual assault. 

“I’m sorry that I have such a heavy answer to that question. But honestly, that is the thing more than anything, that would be the most common factor that separates the genders when I see people in distress,” she says.

As for what employers and people leading those individuals can do to help, Pryor says it’s two-fold. 

“The thing I would say as a mental health professional is that the most useful things we can do are probably outside the mental health system. I think that’s probably true for mental health problems generally,” she said. 

“So with domestic violence, it’s not necessarily just about counselling people. Once they’ve experienced trauma, it’s actually about making sure they have a safe place to live, and that they can get on with their lives. That they’re not harassed and followed by abusers through their life. It’s really practical stuff that’s important for people’s mental health in those situations.”

Yet, despite the complexity in a workplace sense, there are ways to help – starting at the management level.

“You have to be the best, most caring boss you can be, but you don’t have to be that person’s psychiatrist,” Pryor said. 

“It isn’t your job to treat that person, that person should have access to a professional psychologist to do CBT [cognitive behavioural therapy], maybe a GP or a psychiatrist to prescribe medication if that’s necessary. 

“Being compassionate and understanding, and also just meeting your legal obligations, and occupational health and safety obligations. That’s the most important thing.”

If you or someone you know is impacted by sexual assault, domestic or family violence, call 1800RESPECT on 1800 737 732 or visit 1800RESPECT.org.au. In an emergency, call 000.