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Mental health podcast: the full transcript

If you were interested in our recent podcast on mental health you can read the full transcript of Ollie Smith's conversation with The Lang Cat director Steve Nelson below

Mental health podcast: the full transcript

Ollie Smith: Hello and welcome to another episode of ‘Planning People’, the NMA podcast. 

This week, we’re continuing on from a focus we took up last year in the aftermath of a revealing and candid interview with Quilter chief executive, Paul Feeney. We are here, of course, to talk about mental health. I should say at this point that there will be mention of some quite serious topics so, don’t feel bad if this one isn’t for you today, just chill.

Now, why are we doing this? Well, we want to emphasise that mental health affects all of us and whilst we aren’t going to make any grand claims about solutions, necessarily – I’ll try and leave the politics out of this – we do think a collegiate approach to mental health is helpful and that means having a conversation.

Doing that can be scary and daunting, but I’m pleased to say that I’m joined by a willing guest, who is keen to promote transparency surrounding this issue. Steve Nelson is director of consulting at The Lang Cat. He and I have been having a couple of conversations around this issue in the lead-up to this recording and we have some things prepared for you. Steve, thanks very much for joining us. Hello, how are you?

Steve Nelson: Hi there, Ollie, thanks very much for having me on. I’m fairly well, I’m fairly tired today, actually.

The sleeper train.                       

I took the sleeper train [0:01:00] down to London last night, which was, in retrospect, a suboptimal choice, I think.

A suboptimal choice, not conducive to mental or physical health.

No, absolutely not, but I’m here in good spirits. I’m looking forward to having a chat with you today. It’s a very serious subject, but I think we can shed a bit of light on it as well. So, looking forward to it.

I think so. As you’re well aware, nobody comes on the podcast without undertaking the dreaded quiz. This week, I’ve prepared a tasteful ten-parter on some of the statistics our listeners might not have heard about on mental health and some of them are even specific to the financial services sector. How kind am I, I’ve done that for everyone. Shall we begin?

Go for it, yes.

Question one, Steve, what is absenteeism?

Absenteeism. I don’t know Ollie. Surely, it’s the measure of... it’s the measure of absence from the workplace.

Absolutely correct and where it relates to mental health. A pattern of being absent from work. A really crucial issue, which I imagine we’ll discuss later on. But the important thing to say is that absenteeism can be good for mental health and that people take time away and hopefully, come back refreshed. Question two, what is presenteeism?

Well, it must be the opposite then Ollie.

That’s absolutely right. 

This is going very well. This means I’m ahead of [The Lang Cat consulting director Mike] Barrett doesn’t it.

Absolutely. That’s absolutely correct, Barrett did not do that well, sorry Mike. Steve, the lost productivity that occurs when employees come to work ill and perform below par because of their illness is the definition of presenteeism. Where that relates to mental health is very obvious and if you come to work and you’re not feeling great, but you don’t really realise that it’s time to take some time off, then everyone, including you, can suffer more. Question three, according to charity Mind, who were citing an academic paper at the time, what ratio of people will experience a mental health problem each year? This is the classic statistic Steve, this is the one we hear all the time.

Thanks for that. God, I don’t know off the top of my head. It feels like one in four or one in three.

It’s one in four, correct. One in four people will experience a mental health problem each year. Of any variety. It can be the milder things like mild depression, anxiety because of a specific issue or longer-term stuff or indeed, the very, very serious things. Question four, according to the NHS statistical body, NHS Digital, at any one time, what proportion of the population in England, aged 16 to 64, have a mental health problem? Present tense.

Present tense at any one time.

I’ll give you a clue, it’s less than one in four.

Yes, I’d say around one in 10.

It’s one in six.

One in six, wow. So, one in six people will have a mental health problem at any one time. Question five, a big one now. Is the percentage of people with really severe mental health disorders increasing or decreasing? We’re talking about your psychosis, your schizophrenia here. Is that going up or down?

Let’s not overthink it, I’ll say down.

It’s actually increasing.

It’s still increasing, right.

According to NHS Digital, in the year of my birth, 1993, it was pretty much bang on 7% of people had a serious mental disorder. In 2014 it was 9% so it’s going up. Question six, true or false: women are now much more likely to have a common mental illness such as depression or anxiety?

Now, I was reading this the other day. So, anxiety it’s true, I think.

It is true. One in five women report they have had depression or anxiety compared to one in eight men in England. However, question seven.  True or false, men are more likely to take their own lives?

That’s definitely true. 

It’s definitely true. Suicide is the biggest killer of men up to the age of 49 and men account for around three-quarters of that. That’s absolutely massive. It’s an epidemic some would say. Question eight. How many prescriptions were dispensed for anxiety, depression, obsessive compulsive disorder in 2016?  Think millions and think reasonably big, Steve.

In the UK.

Yes, in the UK.

How many different prescriptions? 10 million.

65 million.

65 million.

In 2006, it was actually, less than half of that, it was 31 million. So, all of that is on the rise, too. Question nine, the financial services section. According to the CISI’s December survey of mental health in financial services, which I thought was fascinating, what percentage of respondents felt comfortable talking to their manager about mental ill health?

Okay, well surely it has to be less than half.

Correct.

Felt comfortable talking to their immediate manager.

Yes.

15%.

It’s 46%. So less than half.

Really?

I think that’s probably better than some sectors, just as an indication, but it’s-.

It’s still poor, but it’s surprisingly high I find.

So fewer than half of respondents said they’d be comfortable talking to their immediate manager about mental health. I think that’s pretty damning. I think we do better than that. Question 10. According to the same survey, what percentage explicitly declared that they were not confident talking to their manager. Explicitly clicked on the survey: “I am not confident talking to my manager.”

20%.

It’s 31%. Now that’s an explicit problem right there. We’ll come on to the issue of middle management in a sec I’m sure, but suffice to say I think that says all you need to know. Steve, you’ve done very well there.

Thanks very much Ollie.

Some sensible answers and I daresay, you’ve done a lot better than Mike Barrett. Sorry Mike. To be fair, you had more questions that he did.

I had more questions, but proportionately-, let’s not make this all about me versus Mike though.

You get bragging rights. Steve, we’ve spoken about how there’s a bit of an intergenerational controversy surrounding things like mental health, which is a phenomenon that’s emerged and become a very common parlance in, certainly, the last few years. I think you used the word ‘snowflakes’. Just for anyone at home, what do you mean by that and why is it relevant or indeed irrelevant here?

Yes, snowflake. It’s one of the less pleasant bits of terminology that’s popped up in the last, I don’t know, five or 10 years. Partly driven by social media age, I think. Partly driven by these unhelpful labels and bands that get attributed to certain portions of society. So, I think we have millennials are suffering from that just now. 

So, anybody from the age of 18 to-, some people don’t believe this, but I fall into the description of millennial, being born in the early 1980s. Everybody’s exactly the same apparently, according to labels and unhelpful marketing. Snowflake appears to be a term that is being attributed to people, particularly young people, who exhibit some sort of feelings or opinions on certain things and it’s not very helpful.

Particularly in the field of mental health or expressing some kind of discomfort towards a situation. Now, that’s not the same as saying that some people are too ready to take offence, I think that’s probably quite true for certain people. Of course, that has to be true, but this labelling of people who exhibit any form of outward-, whether it could be empathy or feelings, particularly, from a male perspective, it’s just not helpful. It’s not cool.

I think this relates a lot, to the issue of sincerity. We spoke on the phone, prior to this didn’t we, a couple of time, about how one of the not so good side-effects of our conversations surrounding mental health is this reductivism. This idea that things get reduced to simple explanations or trivialised. Perhaps, even in the same way that people are categorised as snowflakes or millennials or even Brexiteers, dare I mention that word. Is there a solution do you think, to ensure that this conversation about mental health and that transparency is not reduced down to these trivial sections on certain topics?

I’m kind of sceptical, Ollie, as to whether there’s a magical solution off the bat, right. I think it’s a case of everybody has to get that little bit better at what they do. They have to get a little bit better at jumping to conclusions. I think people have to continue to be more open as well, people who do suffer from mental health issues or what have you, have to continue to try and find the right method of help and to try and articulate how that feels. Hopefully, conversations like this will help to demystify it a little bit.

I do have sympathy, perhaps sympathy is not the right word, but I do have a level of understanding or try to have a level of understanding for people who haven’t experienced this in any form of their life. So it must be quite difficult to differentiate between someone who is suffering from a proper, tangible medical mental health issue from people who are maybe just a bit down or fatigued or unhappy for whatever reason. I think when we’ve been chatting away from today and before this podcast, at the route of a lot of this is the fact that mental health is an intangible issue, you can’t see it.

You can’t get into someone else’s head. So, if someone exhibits a physical issue, say if you break your leg or break your arm, then there’s a very clear line of sight between, you’ve got something wrong with you, you’re going to get better, you’re going to get treatment and there’s that before and after and it’s very tangible. Everybody can see it. If it goes unsaid or if it goes unseen, then it is really difficult, yes, it’s really difficult.

I’m quite interested to hear what you’ve said about the difference between a very, very serious, tangible mental health problem and something that’s perhaps less permanent, but still justifiably needs dealing with. I think one of the problems that we’ve had as a result of this popularisation of the conversation around mental health is perhaps that things have become a little bit simplified and maybe now we need to broaden the discussion out a little bit to include a little bit more nuance.

I know people in my life, for instance, who’ve suffered for a long time with schizophrenia, who manage that condition as well as anyone else with any other health condition would do. But I know they might take offence to the idea that, on some level, their condition, which is long-term, chronic and permanent, might be equated with, say, an impermanent, but nevertheless serious bout of depression that someone experiences because a relative has died, for instance. So, I think there’s a lot of work that we can do there, to be more nuanced about that conversation.

I think that’s a fantastic point Ollie.  I think you hinted at it there. There’s an umbrella catchall phrase that we  have to really mindful to not go down the route of labelling everybody who’s suffered some degree of mental illness or episode or however you want to label it. It’s so different from person to person, it’s so individual. It’s so linked to your personality and your relationships and your friendship groups and what have you. It’s so individual to the person and you need to tread with a little bit more care and that’s the one thing that I’d like to get out of this, I guess. It’s that people tread just that little bit more carefully with everyone around them because you just don’t know what someone else is going through.

Yes, absolutely. It’s interesting you mention this idea of the individual. I don’t think of myself as an individualist, I like to think in terms of community or a collegiate approach, as I said earlier or in terms of shared responsibility for things and people, but this is very much about the individual isn’t it and it’s about promoting a self-awareness and empathy at an individual level that then can spread outwards isn’t it?

I think so and I think it’s interesting that you hit on the point there about introspection and that it often involves a lot of, certainly from my experience, a lot of soul searching for everything that goes towards how you feel and how you react to things. I think, certainly based on what I went through, albeit it’s a number of years ago now, it’s still something I carry with me almost on a daily basis. It’s something I think about and it is so individual and so personal to each person.

Let’s look specifically at mental health in financial services. Obviously, poor mental health can exist in any walk of life, career of community, but I wondered whether there are any specific scenarios that are unique to financial services that are perhaps, more likely to contribute to low levels of wellbeing? The classic one in my head is your fund managers at the moment, who are perhaps really conscious of results, of a target-based industry where people are-, there’s a demand in income, there’s perhaps a squeeze on intellectual resources and looking and understanding the world around them. 

It’s quite interesting, I looked at this chart yesterday, online, about how-, that conceptualised how people can be affected by the world around them and it starts off with this small circle in the middle and the individual relationships and things in people’s heads and around the outside there’s this huge outer crust, which is the macro-economic stuff, really. We know that as a result of how much exposure online nowadays that people’s economic situation gets that people can be vulnerable to that and it just strikes me that there’s a whole community of people out there, your City analysts, your fund managers, who are very, very focused on what is going on in the world right now and that might really affect them. I wondered whether that was ever being given enough credence.

Yes, maybe, I think the example that you had there, Ollie, about certainly people in a target-driven environment and certainly, when the markets are exhibiting less than good indicators, as we go through a period of volatility just now. So that’s going to affect a certain proportion of the population who work in a sales and new business-oriented manner.

Some people thrive on that environment, of course, and it’s what drives them and it’s what drives their personality and fair play to them. That’s one very real example. The example I think we were chatting about the other day that came to mind as well is in the platform space, which is an area of the market that The Lang Cat are probably most known for. 

Analysing and participating in and researching and what have you and we do a lot of work closely, with the platforms themselves but, as you know, a couple of platforms in particular, have gone through some fairly difficult technological upgrades and migration exercises, namely Aegon and Aviva and it just struck me the other day that these issues are very, very real and we shouldn’t lose sight of that. But often the people who suffer the most are the people on the frontline. The people who are way removed from the paygrades of the people who are influencing the decisions and making some of the decisions that have led to some of the issues. We’re not here to talk about them, but I think it’s worth pointing out that when we get into a bubble of critique and criticism and calling out these companies and I’m as guilty as the next man for doing that, that the people who are dealing with the complaints and the issues and trying to deal with 15 different phone calls and complaints and issues all at once, are the people who could be the most vulnerable. I think it’s worth, just before you start to flame someone online or jump into criticism mode, although the issues are real and tangible, it’s worth just pausing to think who’s most affected.

Yes, and we are all only human. Speaking as a journalist, we’ve done a lot of stories about this as an issue. I can count several occasions where I thought, I really feel sorry for the people in the call centre who are having to deal with this torrent of engagement from, perhaps, the advice community or disaffected customers. Or the people in tech who are just sat there at a computer at 11 o’clock at night tearing their hair out wondering why on earth this thing that they’re working on isn’t working and for what reason? So, we’re all human aren’t we.

We are all human, but we have to learn from these things. The people who are responsible for these kinds of exercises, providing they all continue to learn and things get better, then that’s OK. But it’s just to be mindful of the people who’d be affected I think.

You spoke just then, about the people pulling the levers, making the decisions. I know that we’ve spoken with each other about our own experiences of poor mental health and at the time that this was particularly acute for you, you were working for a major brand in the life and pensions and investment world, weren’t you.

I was, yes, I was.

Without naming names obviously, what was your employer’s response and how did that affect the situation?

So, there’s two main strands to this Ollie, right. So, a little bit of background because I don’t mind talking about it. This was-, what year is it now? 2019 so this is almost exactly seven years ago now, which was the really bad period of my life. There were two or three different things that had happened in the lead-up to this and I think I said on the phone, the analogy is, for me it was a bit like the boiling a frog analogy.  Something bad happened, but I was alright. And then something else happened and I was alright. And then something else happened and then something else happened and then, one last thing happened and that was too much.

I didn’t see it coming at all. At first-, it was ridiculous, looking back, I thought I had the flu at first because I literally could not get out of bed. I couldn’t function, I didn’t want to eat, I didn’t want to see anybody, I didn’t want to talk to anybody. I couldn’t focus for any length of time on anything, which is about the only skill I have really in life, is thinking. I thought: 'fuck, I can’t do this anymore'. It’s too much, I can’t cope.  I wrote a note to my two immediate bosses, I think it was on a Friday, it doesn’t matter, but I can’t quite remember. They were absolutely fantastic, like a fantastic human response. I got almost an instant reply saying: 'you’re not coming into work on Monday, we’re going to meet offsite, you’re not going to come into work, we’re going to meet somewhere else, somewhere neutral'. 

Whether she was acting on the advice of HR or whatever, it doesn’t really matter, but that was a good thing to do. We had a great chat, there was no pressure whatsoever on me at all to come back into work, which was fantastic. So, from an immediate human perspective that was really good and really positive, looking back. It’s only when you look back, you think what if this had been handled differently?  How might things have panned out? That was good.

The thing I found quite alienating, and I think should be better and I think large companies in particular need to be mindful of, is that the ongoing-, I was signed off work for something like six weeks I think, I can’t really remember. It might even have been eight weeks, it doesn’t matter. But the ongoing care for me was handed off to occupational health for completely understandable reasons because primarily it’s the company’s job to get the most out of people that they employ, right and they obviously have a duty of care to individuals for health and wellbeing. But fundamentally it’s about getting me healthy to get back to work. But I found that process was, especially in the context of what I was going through, was too impersonal. It was all by phone so I couldn’t see the person that I was talking to. 

It was very clinical.  I soon became aware that the transcriptions of our conversations were almost then being shared with management, which I understand why that was happening, but I was then given exposure to see them, which just wasn’t very cool, I thought looking back. I thought that side of things, even if it had been by Skype so I could have looked someone in the eye, could have been handled better. I remember as well, there was one phone call where I was having a really good day where I had this very strange phone conversation where I thought: 'God should I be more unwell at this stage? Am I conveying well enough how I was feeling yesterday versus today?' It was all just strange and if that was dealt with more on a human one-to-one basis, I think that would have been a lot better. 

So that’s certainly my experience of how the company treated it. So by and large, my immediate managers were fantastic. Absolutely fantastic and I would thank them if I saw them tomorrow in the street. But the process around managing me back to work, I think could have been a little bit better in that respect. I don’t know how you feel about what I’ve just said.

Well, it sounds to me like a very fair assessment. You know, some good, some bad, evident room for improvement. It strikes me you were working for quite a big company.

Yes, one of the biggest life and pension companies in the UK.

Yes, and perhaps there was a little bit too much process and paperwork there and not enough personality. I wonder whether there are ways in which smaller businesses can learn from that too. I think perhaps the things that they have on their side are the intimacy within which the work environment the employees work in and perhap, it’s easier to walk down the hallway and knock on your manager's door, even if there is indeed, an office, which there may not be. I also wonder where small businesses would struggle. Where they perhaps don’t have the HR firepower, if you will. They perhaps, don’t have those developed processes.

Firepower’s a good word. It all comes down to resources. If you’re working in a small company, then there’s an element of a lottery.  You know, will my boss-, like The Lang Cat, for example, there’s only 15 or 16 of us. So, will the owner of the company have the requisite empathy levels to handle situations or whoever indeed, has responsibility for people management, will they have the skills to do that? We’re luck at The Lang Cat. We’re disfunctional in many, many ways as you know, but I have a great relationship with Mark and there’s been one or two occasions, like nowhere near as serious as seven years ago, where I needed a little bit of help and it’s been grand. But you’re absolutely right, firepower is a really good point.

I think one thing that’s very relevant here, for our audience in particular, is this idea of start-up stress. You might have these small businesses that are not very old at all. They’ve been in business maybe for a year and it’s progressing onto the next stage of the business plan.  It’s good, but if it’s left it may not be good. So there’s that constant pressure to keep improving it and  one can see a scenario developing in which the owner/manager/the person who’s the mastermind of that entire process, perhaps doesn’t have the mental bandwidth to be able to spot, notice or cater for the needs of employees in a way that they might want to, in an ideal world.

I wanted to ask you about the ‘mental health care pack’ idea because we spoke about this, didn’t we, and I think there’s a bit of a debate to be had about whether this is wishy-washy. For listeners at home, the idea of a mental health care pack, this sounds very practical, it sounds like a box full of goodies. 

I guess it could well be, but importantly, it is a list of things that you may or may not wish to give to your boss, your immediate manager that says, with full transparency, I suffer with this specific problem and on my bad days I exhibit the following symptoms. So just shooting from the hip, for instance, I might be very restless if I’m having a really bad day with my anxiety, I might be up and down a lot making coffee in the kitchen. I might find it very difficult to sit still so, if you spot that, it might be a good idea to pull me to one side and say: 'Are you OK?  Do you need some time off?'  Even if it’s just for five or 10 minutes. 

The other thing is, of course, neutral topics of conversation, you could provide your boss with a list of things that it’s okay to discuss, that you’re not emotionally invested in, in a bid just to, perhaps calm a conversation down and to provide a little bit of light relief even, for the moments where it could be more stressful. I wonder what you thought of this Steve? I’m tempted to say, I love it as an idea, but I think like you, I’m wary of what other people might think of it. I feel like, if we wrote an article about it on our website...

I’m sure people who are listening right now can probably hear us smiling a little bit because when Ollie pitched this to me, I immediately thought of the Daily Mail comments and from certain sections of society and I do think it was just around the name ‘mental health pack’, which I was trying to get my head around. I think fundamentally the concept of this hints at a better and more productive working relationship between a boss/employee dynamic and actually what this is about is understanding what makes that person tick and, if they suffer from some kind of mental health issue, what things can be put in place to manage that as best we can in the workplace. So, whether that’s packaged up as a mental health care pack or not, how it’s named is irrelevant for me, but I think the goal of having an understanding of people who work for you is a good one.

Making it more mainstream. If you’re listening to this and you like that idea, then you have my friend, Caitlin Worthington, to thank for that.  Caitlin, if you’re listening to this, there you go, there’s your shoutout.  Let’s just talk finally about leadership. I mentioned at the beginning of the podcast, we obviously, had this conversation with [Quilter chief executive] Paul Feeney in the studio, in this very studio, about mental health in which he was tremendously brave and spoke quite transparently about his own experience. It strikes me that he’s displayed a lot of top down leadership in implementing what Quilter call ‘The Thrive Initiative’. Is it the case that we need a lot more of that in asset management, in financial services?

Yes, yes absolutely. I say that in the context of, we need it all over the place from leaders and role models because it seems like every month or so we hear of a tragic story from someone, whether it’s the arts or sport of whatever, who’ve tragically taken their own life. And these are people who are perceived to be successful, perceived to have it all, but clearly there’s no correlation between success and having everything and being mentally healthy. It clearly affects everybody.

So I think the top-down leadership’s a really good point and making it part of your culture of your business to say 'this exists' first and foremost because so often it’s a subject that’s hidden away and not spoken about. So there’s that aspect. There’s the leadership aspect of being open with your thoughts and your feelings and saying: 'hey, just because I’m running this company or running this show, it doesn’t make me immune to strains and stresses and imperfections'. I think that’s really good. Selfishly, from a male perspective, I don’t want to turn this into a gender debate, but that statistic you said at the start of the programme. What was it? 75% of all suicides and you don’t need to think too hard to find an aspect of your life that’s been touched by that. Whether it’s myself, a school friend, for example.

Yes, or just the commute home when the train gets delayed.

It happened in leafy West Lothian to me, last year. It’s incredible and not in a good sense. It’s ridiculous that this statistic exists and we all need to get better. So, getting back to your original question, yes, it can only be a good thing to say: 'I’m successful' and your example there of Paul Feeney. It is brave. It’s ridiculous that it’s perceived as brave in 2019 and I would love to see a future where it’s just normal, where it’s just, I keep coming back to the analogy of breaking your leg, but it’s something that happens to so many people and it can be extremely serious and chronic and you find a treatment path to work through it. Or it can be something that you recover from, which fortunately I did and it’s not a taboo and it doesn’t make you any different or it doesn’t make you weird or it doesn’t make you less of a person. It just is what it is and that’s a great goal to work towards.

Perhaps you’ve just answered my final question, Steve, which is if you want one thing to happen as a result of someone listening to this podcast, what would that be?

If I want one thing to happen?

As a result of someone listening to this and thinking: 'this has changed my attitude a bit, I’m going to do x in response'. What would that be?

Oh God, that’s a really difficult question, I’d want so many things to happen. I’d want someone who’s really struggling for that to be the thing that says, actually this is normal I’m going to get some help and going to get better. Even if that happened to one person that would be an amazing thing to happen.

What a very salient point on which to end. My thanks to you, Steve, for your honesty and bravery talking to me. I know it can be daunting so we really want to thank you for taking part. 

It’s a pleasure.

Citywire will be doing more content on this throughout the year so, if you’re interested, keep your ears open. We’ll be at the southeast and southwest events, Chepstow and I believe in Hampshire, doing a panel session on this. All that remains to be said is if you enjoy this podcast generally, please do subscribe to Planning People on iTunes and if you’re feeling particularly generous, please do leave us a lovely review. 

Until next time, it’s thanks and goodbye. 

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