This document summarizes an interview with Lucy Brogden, Chair of the National Mental Health Commission, about mental health and wellbeing in workplaces. Some key points discussed include: - Initiatives to improve mental health are taking a lifespan approach from prenatal to elderly care. Workplaces play an important role in prevention and recovery. - Having open conversations about mental health, especially in schools, can help reduce stigma. - Proper job and work design is more important for workplace wellbeing than isolated initiatives like yoga classes. Ensuring good sleep and a safe environment are also important. - Industry-led models like Mates in Construction have been successful, but each industry should determine the best approach for their needs

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MENTAL HEALTH
AND WELLBEING IN
WORKPLACES
Omesh Jethwani, Government Projects & Programs Manager,
held an in depth conversation with Mrs Lucy Brogden,
Chair of the National Mental Health Commission on
mental health and wellbeing in workplaces.
MENTAL HEALTH
Issue Three | June/July 2018 | MBA NSW 17

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1
On 2 August
2017, the Turnbull
Government
announced your
appointment as
‘the next Chair
of the Australian
Government’s
National Mental Health
Commission’. How
has your journey
been so far as the
National Mental Health
Commissioner?
I was actually appointed to the commission
in 2014 as a Commissioner and the
announcement in August last year was to move
into the role of Chair of the Advisory Board of
Commissioners. I have had nearly 4 years in the
Commission and about 6 months in the chair
role.
In the four years I have certainly learnt a
lot and been able to contribute a lot to the
Commission. There is a strong appetite across
Australia for reform within the mental health
sector. We can acknowledge that we have
made a lot of progress in the last 30 years or
so to improve access to care for people and
quality of care but we've still got a very long
way to go.
In 2014, I was part of the Advisory Board
of the Commission that put the big review
of the system to the Government with a
series of recommendations for improvement
and we were very pleased that the
Government accepted all but one of those
recommendations. Along with many others,
we are working on the implementation of those
recommendations which see Governments
across the country both State and Territory level
moving to a proper step care model in mental
health.
We see the cultural shift and the structural
change to a truly personal model of care in
mental health. In that respect it is quite an
exciting time. We are also monitoring the role
of the Insurance Scheme. So there is really
an awful lot that's going on in terms of mental
health in this country.
2
Are the above initiatives solely
targeted at the workforce?
All of these initiatives are what we call
structural and system reforms and we are
taking a whole of life lifespan approach. So
actually our philosophy and our modelling
and our design starts at prenatal care for
both mothers and fathers prior to conception,
pregnancy support in the perinatal stage in
terms of mental health and well-being right
through the lifespan to our elderly.
It also surprises people that the highest rate of
suicide by age in this country is men over 85.
We need strategies right across the lifespan to
support people. In terms of the cultural reform
that I talked about, in terms of a person-centred
approach, the workplace sits very close to the
centre of that circle. We spend the majority of
our waking hours at work and so our workplace
has a strong role to play in both prevention and
recovery.
In terms of why men over 85 kill themselves,
as with all suicide, it’s a multi-faceted situation
but there is strong evidence that loneliness has
a role to play, a sense of burden can also be
an issue, failing physical health can also be an
issue. It is a complex area but it needs to be
well understood and well supported.
3
To a classroom of six-year-olds
in a show and tell, how would
you describe your role and
responsibilities?
That's a great question! I have three children,
ages 14, 12 and 10 and I spend a lot of time
trying to explain to them about mental health. I
have spoken at their schools about what I do.
It is interesting because most people are very
comfortable with me talking to children about
mental illness but there is the occasional person
who still thinks that this is something that
shouldn't be talked about but our own children
talk about it very openly.
But In terms of telling, what I would say to a
6 year old is that, we have to look after our
physical health. We need to eat well, we need
to exercise, and we go to the doctor when we
don't feel well. We all have to look after our
mental health and how we feel on the inside in
terms of being happy, or sad, or just not sure
about how we feel.
We can do that by making
sure that we certainly eat and
sleep well, which is good for
our physical health and mental
health and that we get the right
amount of sleep and that's why
our mums and dads try to put
us to bed at a good bedtime.
Sometimes if that doesn't work,
we need to go and see the
doctor because we are having
trouble understanding how we
might be feeling on the inside and
that is OK too, to get that kind of
help. My role is to make sure that systems and
services are there for those people too.
4
Have you ever been confronted
with a question raised by students
on the definition and meaning of
mental health?
Lots of kids are interested but I’ve got to say
there is a really good awareness in terms of
children understanding broadly the concept
around being depressed or anxious. When you
get further down the illness spectrum, things
like eating disorders and schizophrenia etc,
there is less awareness. But equally, children
are really good at asking questions and are
sponges of knowledge. They are happy to lead
a conversation and learn more all the time.
5
On 2 February 2018, the Australian
Institute of Health and Welfare’s
(AIHW) web report estimated 4
million people having experienced
a common mental disorder in 2015.
That is nearly 20% of the country’s
population and it is predicted to
increase quite significantly. What
are the main factors, in your opinion,
causing the numbers to increase?
This is a hideous term but it is the term that
health policy people use. That is the burden
of disease. That is what we would expect in
a population like Australia, around 20% of the
population to experience a mood disorder, at
the very mild to moderate end of the spectrum.
In terms of the increase, the increase they
are talking about is not the proportion of the
population but as the population grows more
people will be seeking support.
It's a good thing and is a reflection on the work
that is being done by many people to reduce
stigma. People are getting more comfortable to
put up their hand and seek help and say that
they are struggling with an issue, that they are
not sure what's going on for them. So there
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is a plus side in that. People
are prepared to seek help and
identify the issues they are
struggling with.
On the other side, we as a
society need to manage the
known risk factors that are
likely to lead someone to
experience a mood disorder,
particularly depression and
anxiety. We need to create
a stronger sense of hope in
society.
We are very good in Australia at being critical of
things rather than actually providing people with
a message of hope. Young people often hear
that they won't get a job and will never be able
to afford a house. These are stresses.
As a society, we need to create more
opportunities to convey the hope and talk about
the positive. We need to understand the risk
factors and what is stressful for people and
that is where particularly the workplace has a
role to play because there are stresses in the
workplace that can be managed and mitigated.
6
Do you think the way media has
reported mental health has been
one of the major factors that has
created negativity and caused society
to be critical and less supportive?
I don’t know that there is a direct correlation to
the media but I think the media certainly has
a positive role to play. The Mindframe media
guidelines that the Commonwealth Government
funds and supports has a program that goes
out and trains journalists and media students
around issues to do with mental illness so that
they can improve the quality of their reporting
and how they describe issues to do with mental
health and suicide. We have seen a really
big improvement in that regard. There is still
a sense that bad news sells and good news
doesn’t. I am not convinced that that is the
truth but there seems to be a perception out
there. I would like to see people putting a more
positive lens on the society that we live in.
It is ok to be critical and identify issues but to
put some balance in there that it is not all bad,
it is not all negative and that it is not all broken.
There are many good things going on in society,
there are many good things going on in our
community that we should be highlighting some
of the positive too.
7
Do you think the R U OK National
Day is an action that should be
practised regularly rather than a
yearly event?
The R U OK theme would encourage everybody
to regularly check in on friends, family, and
colleagues, particularly if they think there is
a reason for concern and that the day itself
is a good reminder that we should be doing
this quite regularly. We do hear great stories
of people outside of the R U Ok Day actually
checking in with people and feeling more
confident about asking someone if they're
okay and this is all great progress that we are
making.
There are people who often say “I'm worried
about asking someone if they're ok, just what
if they say no”. We know there is no harm in
asking someone if they are ok. The R U OK
model doesn’t expect people to all become
psychologists overnight. It just asks us to be
truly human and sit with that person if they are
struggling and be a support to them, listen to
them and be present. If people want to know
more, there are great tools on how to have
conversations.
There is a website “Conversations Matter”
(www.conversationsmatter.com.au/) they can
go to if they feel they need some skills, but
really we can all reach out and be human to our
friends and colleagues.
8
AIHW’s recent update web report
stated that $9 billion or $373 per
person was spent on mental
health-related services in Australia
during 2015-2016, an increase from
$354 per person in 2011-12. While the
lump sum seemed extremely high, on
average per person, it seems to barely
scratch the surface and it does not
emphasise the importance of these
services. Why do you think this is the
case?
You have made a very valid point and this is
something we talk about quite a lot. If you
look at the burden of disease and the amount
of the population affected by
mental illness and you look
at the proportion of budget
spent, Government money
spent on the issue, it's certainly
significantly less.
But at the same time, a lot of
this is not just about money
or more money — while more
money would be fantastic. It
is also about doing things that
we know work and doing them
well. There is catch up to be
made in terms of the investment that we make
as a society into mental illness. That reflects
possibly the stigma of the past where people
with mental illness were not talked about, they
were often hidden away in asylums. There
is certainly catch up to be made but there is
certainly opportunity to spend the money that
we do have more effectively.
9
Has any research been carried out
previously which has listed the top
3 industries to suffer most from
mental health issues? If yes, which are
the top 3 industries?
There is a lot of research by industry and
occupation. I am not sure how helpful it is to
put a ranking on industries because I think
to someone suffering, it does not matter
where they are suffering, they are all suffering.
Depending on where we work, we all have a
role to play in reducing that suffering in terms of
prevention and recovery.
We know that there are issues for first
responders, we know there are issues for our
military and some of those are quite obvious in
terms of the trauma they encounter.
But equally the trauma encountered by people
working in professional services can be just
as debilitating and just as stressing. I prefer
to take a view that says that there are risks
in any occupation and that we have a legal
responsibility across all occupations but we
also have a moral responsibility to support our
colleagues irrespective of the profession that
we work in.
10
In March 2017, you presented
at Mates in Construction
Workplace Mental Health
Conference addressing Industry
Leadership. What are your personal
views of the Mates in Construction
model and do you think this is a model
that should be introduced for all
industries?
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Issue Three | June/July 2018 | MBA NSW 19

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Mates in Construction was
introduced and Mates in
Mining and in Energy too.
It’s really up to the industry
to know what works best
for it.Certainly the Mates
model is working very well
in the industry that it is in.
But equally there are similar
groups doing similar kinds
of work in other industries. I
take a view that these things
are best ironed and accepted
when they are evolved out of the community
or the profession that sits behind it. Each
industry needs to look at itself and work out
what is going to work best for the people in that
industry, what model they are going to be most
receptive to.
We are doing some really interesting work
at the moment through every mine based in
Newcastle. Icare in New South Wales is looking
at small and micro businesses and what they
might be able to do. I know that the accounting
profession is looking at what they can do for
their members and vets are looking at what
they can do to improve wellbeing. It is a matter
of knowing your community and designing a
program with your community that is going to
work best for you.
11
Organisations are
encouraged to develop a
comprehensive mental health
and wellbeing strategy. What are
some of the strategies that you could
recommend to our readers?
I would suggest to readers that they look at
the Heads Up website (www.headsup.org.au/),
which is an initiative of “The Mentally Healthy
Workplace Alliance” and hosted by Beyond
Blue. There are some things that businesses
of all sizes can look at to do. But the No.1
recommendation for business that we say they
need to look at is their job and work design.
A lot of people think it is about yoga and fruit
bowl; that is kind of my hashtag, beyond yoga
and fruit bowl. That’s just playing at the margin.
It is really about good job and work design;
so how are you structuring the work of your
team, how are you structuring the day, are
people able to get enough sleep, is it a safe
environment for them physically and mentally.
Or would someone be safe to disclose that they
are struggling with a mental illness.
Sleep is the No.1 issue — are you allowing
people to get sufficient sleep and recovery for
their journey and for their wellbeing. It’s about
providing the right support and some of these
things are for larger organisations to look at.
Do they have an Employee Assistance Program
(EAP), are they addressing issues to do with
bullying, are they addressing issues to do with
instability in the workplace.
There is a range of things that organisations can
do. But what we also know is that it is important
that organisations address the negative before
they start looking at the positive if that makes
sense. So if there are examples of bullying
and intolerance in the workplace that they are
working in, to manage those issues first, before
they bring in the shiny fun stuff.
12
Suicide and suicidal
behaviour in the Australian
construction industry is
costing $1.57 billion dollars each year,
as much as 98 per cent of which is
borne by government. In your opinion,
is Australia on a par with the rest of
the world in reducing suicides?
In terms of reducing suicide, our rate did come
down slightly last year, year on year to the
prior year but it does still sit at stubbornly high
levels. Suicide is a complex issue and very
multi-factored. Mental illness plays a part in
that but also issues to do with impulsivity, drug
and alcohol addictions etc play a part. We are
working to do the right thing.
We’ve got the Fifth National Mental Health Plan,
which for the first time actually now includes
suicide prevention. So it is the Fifth National
Mental Health and Suicide Prevention Plan
(www.coaghealthcouncil.gov.au/Publications/
Reports). So that is a welcome step at the
highest level.
We have seen fantastic community level
projects being developed across the country.
Things like Mates in Construction is a terrific
response from a sector that knows it has got
issues and is wanting to help work with the
community and members to
address some of those issues.
We’ve got the LifeSpan trials in
New South Wales funded by the
Paul Ramsay Foundation looking
at a systemised approach and we
have got the Aboriginal & Torres
Strait Islander Suicide Prevention
Program.
There are a lot of people from
grassroots right through to
leading academics all working
together with Government to try and address
the rate. The goodwill is there, the knowledge
is there, the programs and structures are there.
At the end of the day, a lot of this comes down
to people feeling connected to their community
and feeling a sense of help and being able to
access care when they need it.
13
Certain industries and
workplaces are seen
employing Mental Health
First Aid Officers to promote good
mental health, prevent mental illness
and have the tools to support people
with mental health issues. In your
opinion, would this scheme work to
reduce the number of cases? If yes, do
you think government would provide
employment incentives to assist
organisations?
In principle, the more people trained around
Mental Health First Aid is a fantastic step but
it is one step in a number of steps. If we go
back to that earlier answer, if we started things
like good job and work design and good work
practice, that is going to be a strong mitigating
factor to actually reducing issues to do with
mental health. Having people trained to help
people is really important and is an important
contribution.
But to me it should be no different to the
physical first aid officers that organisations
have. Some of these things need to be
ironed out by the business themselves and
by the industry themselves. They have a legal
obligation under Workplace Health & Safety
legislation to provide a workplace that is not just
physically safe but psychologically safe. Look,
if it takes Government incentives, then maybe
you need to look at that but really these are
just the basic responsibilities of the employer to
provide these services and supports to people.
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5. ContentsFeatureArticle
14
With the
Federal Budget
announcement,
what, in your opinion,
are some of the positive
changes we can expect
to tackle mental health
issues in Australia?
Consistently over the past
10-15 years, we have seen
increased investment in mental
illness in this country which
has been fantastic both at Commonwealth
and State levels. This year the Federal
Government’s budget made mental health a
priority with an additional $338.1 million over
the next 4 years.
The Commission has a suicide target towards
zero. A lot of money has been allocated to
Lifeline and beyondblue to support suicide
prevention services. Digital mental health
services were boosted and already this year
we’ve seen a lot of money support the Royal
Flying Doctors service, childhood mental health
issues and ongoing and increased support for
organisations like Headspace.
There is every indication that these good
programs will maintain their support by both
Government and oppositions. This is something
that we have good bipartisan support on in
this country is improving the mental health and
wellbeing of Australians.
15
In your opinion, will
government funding
be available to Industry
organisations in the near future to
assist on behalf of the government
in addressing mental health issues in
workplaces.
In terms of mentally healthy workplaces, we are
not advocating that workplaces are the source
of treatment for someone. But we would ask
employers that they have a responsibility, they
have a responsibility for physical safety and
psychological safety.
There is no difference. A lot of the things you
are doing to provide physical safety for your
employees will also provide psychological
safety. If you are looking at doing good job
and work design, then the outcome of good
job and work design is physical safety and
psychological safety.
In terms of the risk, whether someone
develops a mental illness or a physical illness
or injury at work, it is not something that you
can screen for, it is the risk that you take by
having a workforce. Someone could easily hurt
themselves at work, someone could easily
develop diabetes or cancer while they are
working for you. You still have an obligation
to support that person whether it is a mental
illness or a physical illness. If people are trying
to separate the two then that reflects a lack of
understanding around mental illness that we
need to overcome.
16
What are some of the mental
health services that may be
provided on a larger scale
and some that may be cut back based
on demand and budget.
As far as I know and I haven’t seen any real
cutbacks in services at a Commonwealth
level. There is certainly shifting focuses and
investments while we transition to primary
health networks with various devolution
of responsibilities to the primary 31 health
networks to take responsibility for budget
allocation but in terms of cutbacks to services,
there is no recommendations to cutbacks for
services.
17
Susan David, PhD, an award
winning Psychologist on the
faculty of Harvard Medical
School and author of the new #1 Wall
Street Journal best-selling Emotionally
Agility, quoted that “normal, natural
emotions are now seen as good or
bad. But when we push aside normal
emotions to embrace false positivity,
we lose our capacity to develop skills
to deal with the world as it is, not as
we wish it to be.” Do you agree or
disagree with this statement?
I am familiar with Susan’s work and I think she
makes a really valid point and it touches on an
issue that I try and talk to. I am not a big fan
of the term ‘resilience’. I prefer the concept
of resourcefulness. Resilience implies that
you have a deficit to be overcome somehow
whereas resourcefulness reflects that we all
have capacity to overcome
issues that we personally find
hard to manage. Some of us
have a greater capacity to
respond to difficult situations
than others, some of it is
just our basic social problem
solving that we have grown
up with and had role models
for us, some of it is just our
physical capacities as much
as our cognitive capacities
to overcome but we really do
need to have some conversations that help
us understand the new kinds of emotions
and actually equip, particularly young people
going forward, to be able to tap into their own
capacities.
We need to problem solve and to manage
issues and that is where I agree that we try
and medicalise some issues but at the same
time we need a little bit more empathy that not
everybody has the same skills and capacities
and for some, perhaps its more capacity
building than the illness or a treatment that is
required.
18
In addition, Susan David also
stated that “Tough emotions
are part of our contract with
life. You don’t get to have a meaningful
career, or raise a family, or leave the
world a better place without stress
and discomfort. Discomfort is the
price of admission to a meaningful
life.” Do you think as a nation, we
cannot seem to differentiate between
a real problem vs a hurdle to overcome
and the difference between being sad
and suffering from depression?
Actually, I think we can. There are sceptics that
say everybody is claiming depression now but
most people can tell the difference between
being sad and actually depressed. If they can’t,
then that actually is a reflection that perhaps
they need insight support into understanding
the difference. But it is easy for critics on the
outside to say that people can't distinguish
but for someone sitting with those feelings, we
know how hard it is for people to ask for help.
But if they are actually asking for help, then
there is something going on for them that needs
to be respected.
If you need support in the industry
please contact your Employee
Assistance Program or call Mates In
Construction on 1300 642 111.
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