Mental Health in an Unequal World – Stigma and Discrimination in the Workplace
The World Health Organisation recognises World Mental Health Day on 10 October every year and this year the theme is Mental health in an unequal world.
We felt that this presented a valuable opportunity for organisations to better understand how inequality can be both identified and addressed, in order to ensure that all people are able to enjoy and maintain positive mental health, regardless of factors like age, gender, marital status, religion, race, or disability.
One of the ways that we explore this in our managing mental health workshop is to explore the stigma surrounding mental health as well as the discrimination that can occur when that stigma is not addressed.
What is stigma?
Stigma around mental health is still prevalent in the workplace. It is defined as ‘a mark of disgrace associated with a particular circumstance, quality, or person’ and it can occur due to lack of awareness, prejudice and/or misunderstanding.
Many employers do not understand mental health, when it becomes an issue, how to spot the symptoms of compromised mental health and what to do about it. This is not helped by the fact that mental illnesses are often less visible than physical illnesses and that their impact is often underestimated, and the issue therefore ignored.
Equally, because mental health is generally misunderstood, people with mental health issues are sometimes unfairly labelled as a lazy, or selfish, dangerous, or incapable/incompetent.
This attitude can affect how they are treated at work, not to mention their career prospects, so it is no surprise that many people are reluctant to reveal that they are experiencing mental health challenges at work.
What is discrimination?
Discrimination means treating a person unfairly because of who they are. The Equality Act 2010 protects individuals from discrimination by various parties:
- Businesses and organisations which provide goods or services like banks, shops and utility companies
- Health and care providers like hospitals and care homes
- organisations that rent or sell property, like housing associations and estate agents
- Schools, colleges and other education providers
- Transport services like buses, trains and taxis
- Public bodies like government departments and local authorities.
It also protects individuals from discrimination by employers.
Under disability and equality law (governed by the Equality Act 2010), employers are prohibited from discriminating against employees on the grounds of certain protected characteristics (nine in total, which outline how people are protected from discrimination (whether intentional or not) by law). Employers need to familiarise themselves with these characteristics in order to ensure that people are given equal opportunity in the workplace. In all cases, these characteristics are protected from one-off actions as well as those that are a result of a policy.
We all have at least some of these characteristics, so the act essentially protects everyone from discrimination in one way or another.
The nine protected characteristics
- Gender Reassignment
- Marriage and Civil Partnership
- Pregnancy and Maternity
- Religion and Belief
- Sexual Orientation
Whilst stigma and discrimination can occur due to lack of understanding of mental health, it can also occur due to unconscious biases, which is why when exploring stigma and discrimination during our managing mental health workshops, we spend some time exploring any that we may hold.
Unconscious biases are social stereotypes about certain groups of people that individuals can form without being consciously aware of them. Everyone holds unconscious beliefs, many of which are formed in our early years and/or inherited from influencers in our lives, like parents, siblings, teachers, and bosses.
Sometimes these biases stem from our brain’s need and therefore, tendency to organise and categorise our world. Certain situations or circumstances can also trigger them: for example, biases may be more common or frequent when we are working under time pressures or trying to manage an excessive workload.
Whatever the case, unconscious bias is often the origin of stigma and it can be helpful to address any outdated beliefs and update our understanding.
How the nine protected characteristics can be impacted by mental health
One way of updating our understanding is to gain insight into how each of the protected characteristics are impacted by mental health.
Mental Health and Age
People of all ages can experience mental ill-health, although the things that may contribute to it and how it is experienced can sometimes be age specific. For instance, young people are more likely to self-harm as a coping strategy for anxiety, Schizophrenia is more likely to emerge in young people between 16 and 25 than any other age group, and depression can be a particular issue for older people.
Growing older does not make mental ill-health inevitable, but certain life events such as retirement, or physical illness and mourning friends who have passed on, can naturally have an impact on an older person’s state of mind.
Mental Health and Disability
Any illness that restricts someone’s ability to take part in normal day-to-day activities or to engage in learning or social interaction has the potential to create anxiety and depression.
This means that any form of disability (including, but not limited to long-term mental ill-health) can contribute to the likelihood of a person developing mental ill-health, particularly depression.
Equally, people who suffer with mental ill-health are also at increased risk of developing a range of physical health issues, including heart disease and diseases of the immune and cardiovascular systems.
Mental Health and Gender Reassignment
People who identify as transgender tend to experience higher rates of mental health issues than the general population. They may experience uncertainty and other uncomfortable feelings which can manifest in anxiety and/or depression. Equally, lack of understanding and in some cases, rejection by those around them can also exacerbate those feelings.
One study into Transgender mental health revealed high rates of suicide risk (84 per cent lifetime prevalence) and attempted suicide (48 per cent lifetime prevalence).
Mental Health and Marriage and Civil Partnership
People who are married or in a civil partnership are no more or less at risk of mental health issues that people who are not. However, they can be at risk of discrimination which can impact on their mental wellbeing.
Mental Health and Pregnancy and Maternity
Pregnancy is a happy and exciting time for many women, but for some it can be a challenging time. Some women experience mixed feelings about being pregnant and some experience negative feelings about it, worrying about how they will cope with the pregnancy or having a baby to look after.
As many as 1 in 5 women have mental health issues in pregnancy or after birth. Depression and anxiety are the most common and affect about 10 to 15 out of every 100 pregnant women.
Mental Health and Race
It is often assumed that people of minority backgrounds share the same struggles with cultural difference when in reality, there are as many differences within minority communities as there are within majority communities.
What is common to minority communities is the experience of being viewed and treated differently to majority communities and how that translates to equality of care and services. In addition, language difficulties can make it challenging to access support.
Mental Health and Religion
Evidence suggests that people who have a strong spiritual connection or belief are less likely to experience anxiety and depression or misuse alcohol or drugs and are less likely to die by suicide, because often their faith enables them to maintain positive mental wellbeing and promotes recovery.
Mental Health and Sex
Men and women experience mental ill-health differently.
Women are more likely to experience depression or develop eating disorders and men are more likely to misuse alcohol and drugs and die by suicide.
Whilst both men and women are equally likely to develop schizophrenia, the average onset for men is earlier than for women.
Mental Health and Sexual Orientation
From a young age, people in LGBT communities can face discrimination due to their sexual orientation or gender identity.
Family disruption and rejection from family is common for young LGBT people as are significant levels of verbal and physical bullying.
As a result, people from the LGBT community are more likely to experience isolation and low self-esteem and therefore are more likely to experience mental health issues. They may also be less willing to seek professional help and support due to perceived less favourable treatment by GPs and other care professionals.
What Do Employers Need to Do?
Employers have a duty to make reasonable adjustments to remove or reduce obstacles and to avoid disadvantages faced by people within their workplace, who are considered to have a disability.
Under the act, people with a diagnosed mental disability are protected from discrimination in exactly the same way as those with a physical disability and once a person has been confirmed to have a disability due to a mental health issue, it then becomes unlawful for them to be substantially disadvantaged or to be treated unfavourably because of it.
If we can get rid of the stigma surrounding mental health, we can better support mental health and reduce mental ill-health.