Charity Spotlight: Creating inclusive workplaces for employees with bipolar

Transcript

Debbie (00:05) Hello and thank you for joining us for this latest episode of the c-suite podcast produced in partnership with Bipolar UK, who provide peer support services to empower people affected by bipolar to live well. My name is Debbie West, and I was delighted to have the opportunity to host this episode as part of our charity spotlight series. On the c-suite podcast, we’re always really keen to explore issues that affect the workplace, and, in this episode, we’re thinking about how misconceptions about mental health are affecting people with bipolar and what businesses can do to provide better support. So, to that end, I was thrilled to be able to welcome Simon Kitchen, who is the CEO of Bipolar UK, and Emma Gibbons, the Vulnerability Lead at PayPlan. The first question I put to  Simon, was to ask him to tell us a little bit more about bipolar and to talk about some of the myths and the misconceptions his organisation is working very hard to dispel?

Simon (01:12) So bipolar is a severe mental illness. It’s characterized by extreme highs and lows of emotion as well. Though it’s worth saying that most people with bipolar at any one time are probably experiencing what’s called a balanced mood state. Some of the symptoms around bipolar can include not sleeping for two or three days, even weeks at a time. People can become unwell, can start sending emails at two o ‘clock in the morning. They can start taking part in very risky behavior, experience hypersexual behavior, significant overspending. The depressions can be very, very deep and very serious. People living with bipolar can experience a suicide rate of four times the national average, which is really horrific. So, it’s a very serious condition. It has a big impact on people’s lives. There’s a lot of people living with it, well over a million people living in the UK. We estimate that it’s one in 50 adults. Probably at least half of them are working. that’s every employer that’s got more than 100 staff have probably got at least one person living with bipolar working in their team. Astonishingly, despite the severity of the condition, less than half the people living with the condition actually have a diagnosis. And those that do, it takes 9.5 years to get one on average. And that’s really tragic because we talked about all the negative sides of the symptoms when people become unwell. But with the right support of a diagnosis of medication, effective self-management, which prioritizes sleep, avoidance of lifestyle triggers, perhaps some therapy, peer support, like what we provide as a charity, people with bipolar can lead really good lives and they can work, and they can be stable, and they can experience life without experiencing those severe symptoms that can be so, so damaging for them. So, we’re really positive about what people with bipolar can do and achieve about a third of our staff are living with bipolar. They manage the condition well and you would have no idea who was living with bipolar and who wasn’t living with it. So, with a diagnosis and with the right support with medication, people can live well with the condition. And I think all employers listening to this, if you take away anything, it’s not to be scared of the condition. There’s lots of amazing staff out there who are really talented in their different respective fields who can make a really big contribution to your company if they’re not already.

Debbie (03:33) Yeah, absolutely. Thank you so much for sharing that with us. To think that Bipolar is experienced by such a high proportion of the population, like you’re saying, if you have more than a hundred people in your organization, you’re likely to have somebody with Bipolar there. Obviously, what you’re doing is critically important. So, can you tell us a bit more about your role at Bipolar UK? When did you join that organization and really what is your vision for it?

Simon (03:57) Well, I’ve been Chief Executive at Bipolar UK for just over six years. And my mission is to empower everyone living with bipolar to live well, for their friends and family to be able to live well, and for them to able to fulfil the potential, do what they want to do with their lives, be it become a parent, to be able to progress within their chosen fields, to do whatever they want with their lives and not to feel that the condition itself is holding them back. And that is a very realistic ambition because we know that there’s tens of thousands, maybe even hundreds of thousands of people with bipolar who are doing that already. And we want that to become the norm rather than the exception. So, what we do as a charity is a number of things. First of all, we provide peer support. So, we’ve got over 80 support groups. We’ve got an e-community that over 15 ,000 people have signed up to. And we do one-to-one calls as well. So, we’ve got big ambition about getting those peer support services out to absolutely everyone affected by bipolar. So that’s everyone living with it, but also all their friends and family who are really profoundly affected who in practice provide a lot of the actual support people need to manage their condition. So that’s one big strain of our work. The other one is around advocacy. So, we know that peer support can really help, but we can’t fix the problem by itself. People need a diagnosis, and they need to have medication, need specialist medical support, like anyone would do for diabetes or for Parkinson’s, all the physical conditions that we know people manage in the workplace. It’s exactly the same for mental health and for bipolar. So, we do a lot of campaigning and advocacy work to get the diagnosis rates up and also to make sure there’s enough psychiatrists and psychologists to able to provide the support, specialist support that people need. So that’s the second part of what we do. And then the third part is around research. We know so much about bipolar already. We know Lithium is a really effective medication, but we know compared to other condition areas, there’s a lot more that we could know, and we could do. So, there’s a strong genetic component to bipolar, so we involved in lots of studies to look into that. Also, around studies into advanced choice documents, which is where people can start to plan their care to enable them to think about if they do become unwell, what kind of hospital treatment do they want to have? We also know there’s lots of studies that are ongoing that we want to be able to support to help people recover from their episodes. So having a severe bipolar episode can be a depression or a manic episode, can be really debilitating for people and takes a long time to recover. So, another study that we’re involved in is around, it’s called cognitive remediation therapy, where people start essentially doing brain gyms, get themselves some training so that if someone has had a severe episode, they can get back to the life that they had before and back into work as quickly as possible so they’re not outside the workplace. There’s loads that we do, getting peer support out there, being able to do research and obviously campaigning and advocacy as well.

Debbie (07:01) Yeah, absolutely plenty to do. Really good to hear about that. Thank you. And Emma, I’d like to bring you into the conversation now. Tell me a little bit about PayPlan’s relationship with Bipolar UK. How did that come about and how are you supporting the aims of the charity?

Emma (07:17) Yeah, absolutely. So, we actually first met with Bipolar UK back in 2021. And our partnership has really grown from strength to strength ever since. So, we initially reached out to Bipolar UK due to the increasing trend in clients that we were seeing disclosing mental health issues to us. And of course, and the impact that was having on their overall financial situations, particularly around clients living with Bipolar or on their journey to diagnosis and experiencing the highs and lows of that mood scale that Simon’s already mentioned. And of course, the financial consequences to that as well. And really, just to put that into some context for you, 85% of all clients accessing debt advice has said being in debt has impacted their mental health. It’s a real chicken and egg situation in terms of which one came first, the debt or the mental health crisis. And one, of course, will absolutely impact the other. Those two things are just so intrinsically linked. So, our partnership was really built on a complete and shared understanding really of the two organisations and how we could support each other. So reciprocal partnership was designed, including bespoke targeted training delivered on both sides of those organisations. And then bespoke referral pathways were also designed. So Bipolar UK can refer clients needing that free debt advice and that support directly into our highly trained advisors. And then those advisors can actually start working with them, making some different adjustments that can be made to really suit the needs of that individual. And that could include working with an advisor on a one-on-one approach, or even discussing some of the practical support that’s available, such as the debt and mental health evidence form. And then PayPlan clients disclosing or they’re identified as living with bipolar and needing that additional layer of support can then be referred directly as well into the Bipolar UK community. And this level of support is available for our clients, but it’s now very much mirrored within our own wellbeing strategy for our teams as well.

Debbie (09:17) That sounds great and so good to hear you talk about that really individualized approach, know, using the information that you’ve got from that partnership. And Simon, what can business leaders do to create positive change for people with bipolar? And do you have any examples you can share of work you’ve done with companies around that?

Simon (09:36) So one of the best things employers can do is just to have a safe space for people to be open about the condition and the support that they need and help educate themselves in terms of what that support might be as well because a lot of individuals with the condition, they won’t know anyone else necessarily who’s had bipolar. So, they’re kind of also feeling their way through it as well. So, one the things that we do is use a thing called an advanced statement, which is where people write down what they want the employer to do when they become unwell. So, if they become slightly manic or slightly depressed, how do they want their employer or their manager in particular to support them through that? And some of the things that we include in that will be a guilt-free sick day. we find people might be becoming slightly manic. They might need to take some time off to bring themselves back down again. Sometimes we will say as an employer, try to avoid having meetings before 10 o’clock, because if you’re suffering from a lack of sleep, make sure you catch up on your sleep and then start working, rather than trying to start at 9 o’clock like most other people would do. So little things like that mean that people can nip the episodes, the manic and the depressive episodes in the bud and deal with them much more quickly. Because the tragedy and the great the about the condition is the tragic is the worse the symptoms get and the more the severe episodes, the worse the condition will become. But likewise, if you can elongate out the episodes and you make them less severe, then the condition will in time become easier to live with. And there’s lots of lifestyle changes people can do to help facilitate that as well. So, a lot of the work we do of employers is to be able to just raise awareness of the condition itself. So, we will run sessions to help people explain what bipolar is, often bringing people in with, sometimes to talk about it with specific colleagues, if there’s been particular issues in the workplace. Help them not to assume what the condition is and what it isn’t. Often people can have very difficult relationships with their colleagues, and it might not necessarily be to do with the bipolar itself. And that’s really important to point out as well. And then we would always encourage people to do it as early on as possible. So, if you’ve got an open conversation with your staff about the condition, it means it doesn’t have to get to the point where you have to then start talking about some of the more serious things to do with grievances or performance management and so forth. But the important thing is to disaggregate out what’s the condition and what’s that person and what’s that individual. So be positive about it. There are lots of really talented people living with bipolar who are working and most of them are very private about their condition. I think that’s fair to say. And you will be working with people with bipolar and they’ll be working well, and you won’t be even aware that they’ve got the condition. But behind the scenes is probably a lot that they’re doing to be able to help keep themselves well. So, if you just let them know that you’re being positive about employing people with bipolar, then that’s it. That’s a really good step forward.

Debbie (12:31) Yeah, those are some really good points. And is it easy for employers to find that information? I know that you you’re saying about get as much information as you can, so you can take that sort of individualized approach with each person. Where can people go to find that sort of information?

Simon (12:45) Well, they can just go onto our website. So just type in bipolar in the workplace and we’ve got our report that we’ve done looking at bipolar and people’s experience of working with bipolar and some big, long list of reasonable adjustments that employers can make. And also, just our website itself has got all the information on the condition, how to manage it. We’ve got the e-learning package as well. And we’ve also got a mood disorder questionnaire if someone suspects that they might have bipolar or one of their colleagues does, they can use that just to help them understand some of the symptoms. It’s worth adding as well that there is government support out there. There’s a big scheme called Access to Work, which is to help people overcome long-term conditions and disabilities in the workplace. So bipolar is covered by that. So, it does take a while to apply for the support to come through, people, lot of our staff have used it it’s been very helpful getting some kit for them. They can do awareness raising training, we do kind of offer mentoring as well and helping employers to develop their advanced statements with their staff. So, all of that can be covered through Access to Work, which is a really good scheme if you can get through to it.

Debbie (13:53) Yeah, excellent. Yeah, thank you. And so, Emma, to return to you, what were some of the practical steps that you’ve taken to address some of the issues that we’ve been discussing so far and what have you done to make PayPlan’s own workplace a more understanding place to be?

Emma (14:11) Yeah, well, over the last two years, we’ve worked really hard on our own wellbeing strategy. So not only will our advisors be impacted by the calls that they’re receiving and could be experiencing vicarious trauma as a result of those calls, but they may also be living with a mental health condition such as bipolar themselves or even supporting a family member or a friend, perhaps. So, what we’ve realized is that what we’ve learned for our clients and the things we’ve put into place for our clients, all those reasonable adjustments and that tailored approach that we can make, it absolutely needs to be applied within our own organization. So, the partnership that we have with Bipolar UK is really supported with that. Some of the initiatives we now have in place include bespoke training for our managers. So, a very specific module on how to support colleagues in different situations, including living with Bipolar. And even identifying different indicators of a mental health condition in the first instance. So, they know really how to approach a member of staff on their team and how to support appropriately. You it could be a member of their team that is on that nine and a half year diagnosis journey and initiating that conversation could just make such a difference to one of their colleagues. But then again, it’s never a one size fits all approach, of course. But having that awareness is really key to actually providing that additional layer support that may not have been there before. So, some of the things we’ve introduced I can talk to you about. And one of those things is a trauma and agent wellbeing status that we have on our telephony system for those staff that are really experiencing maybe difficult conversations that are maybe triggering for them with their own conditions. And they can use that status and that enables them to get that immediate support that they need. That then can also be followed up due to the reporting and the MI that this particular status generates for us. And that has allowed us to look at that data and identify any of our colleagues that have actually been using that status and looking at any particular patterns that we may see. So can actually give you a perfect example of when that’s been really beneficial to us. And we actually identified a colleague that was using that particular status every Thursday morning without fail. It was a regular pattern, really linked to what Simon was just saying about that 9 o’clock, maybe early in the morning situation. So, we used this particular data to talk to the member of staff. And it was actually the trigger that she needed to really open up to us and to start to talk to us about what was going on. And she revealed to us that she had actually been diagnosed with bipolar and she was currently having counselling to support her because she was really struggling with that diagnosis because it was such an early stage for her. But at the same time as well, she was also relieved that she finally understood the last few years of being on the emotional roller coaster. And the counselling that she was having was every Wednesday evening. So, she was still emotionally drained, hadn’t slept very well. So, coming into work on a Thursday morning was just too much for her. And that’s why she was usually in that status. So, we were able to look at her shift pattern and make adjustments to accommodate that particular counselling. So, moving her shift pattern to later in the day, putting her on different roles and responsibilities. And that really helped to reduce any further impact that she was experiencing. Other things we’ve initiated are wellbeing champions. So, these are from all different areas of the business. So different advisors, different team leaders, managers, males, females. So real cross-section of individuals that can then be approached for that additional support that somebody may need. And those wellbeing champions have all been trained to become mental health first aiders too. And in 2022, we actually opened our wellbeing room to allow colleagues some time to really download, maybe after a particularly difficult call, or just to go in there and feel safe and get some time out that they would need for their own personal reasons. So, a real safe place to just decompress and gather their thoughts. And then every year in November as well as part of Safeguarding Week, we hold a wellbeing event and bipolar UK are always present and really support us so well with that initiative and talk to any member of staff that wants to go and have a conversation with them or needs any further information. And for us really, wellbeing is just a continual initiative and one that continues to evolve and change over time. But our partnership with bipolar UK is really key to that.

Debbie (18:35) That sounds so positive and it’s great to hear that you’re putting information into the hands of line managers so they’re well informed. And also, you’ve got these wellbeing champions who are another group of people who are able to have that conversation in a really informed way.

Emma (18:51) And just to keep up with the training because the training continues to change. In fact, we’ve actually got another session with Bipolar UK this Thursday, again, where they’re coming in to do some refresher awareness and training sessions. So, keeping that information up to date and fresh is really important.

Debbie (19:07) Yeah, absolutely. And it just goes to show that you are constantly having that dialogue rather than just assuming you’ve like ticked a box. It is something that’s emerging and ongoing and yeah, that’s such a positive account. Thank you. Thank you so much. So, Simon, we’re coming towards the end of the podcast, and I just wanted to go back to the very beginning where we talked about myths and misconceptions. Of those misconceptions, what are the positives and what positive strengths do people who are experiencing bipolar, bring into the workplace.

Simon (19:37) Everyone with bipolar is slightly different. I can use some generalisations though. Overwhelmingly people with bipolar are very compassionate because they’ve been through a lot themselves. They will have experienced trauma. Often that’s something that’s triggered the bipolar but also if they’ve ended up having to go into hospital with it. That’s a really traumatic experience for them and they will tend to be a lot more of understanding of others as well. That’s one thing which I think is very common. There are some strong links between bipolar and creativity, which have been well documented. There’s quite a few very famous artists who are living or have lived to the condition of being Vincent van Gogh is probably one of the most famous. But also, lots of writers and actors and so forth. One of our ambassadors, Nicky Chin, you probably have not heard his name, but you’ll know his music. He wrote ‘Living next door to Alice’ and ‘Tiger shoes’ and lots of famous songs in the 70s and 80s. He’s living with bipolar. So, there’s some really exceptional human beings who have got the condition. One symptom which we didn’t talk about, which is a really distinctive one for bipolar is called hypomania. And I think this is really important for employers to understand as well, especially about how you manage it in the workplace. The first symptoms of bipolar, a manic episode, people have lots of energy and they can be very focused and very productive in that phase. Consequently, a lot of people can be very, very high achievers because of that. And one of the problems with that part of it is that it will escalate, and people get higher and higher. And that’s when they start to become very erratic as well. So, it’s a really difficult place to be. know colleagues who have become slightly had a hypomanic episode and ended up going off and writing an entire advocacy plan or something like that. And it’s really tough quality work. But then they will have to try to bring themselves back down again, which is really tough. So, if you could bottle that, the condition would be much easier to live with, but it’s a very difficult thing to control. Consequently, we’d always say for employees, diagnosis is really important because you need to not give your staff too much to do because what can happen is they will take on lots of stuff and do it really well. And then they’ll take on more and more projects and then it will overwhelm them. So, if you know it’s the condition, then you can start to manage it around that. Some people self-manage by actually just being freelance. So, they’ll do a lot of their work in short lists. It doesn’t mean that people with bipolar are on work in the rest of the time as well. But it’s just an interesting symptom that people need to be aware of as well. So yeah, strong links with creativity. I’d also say people with bipolar can be very, very, very boring as well. They can be lawyers. A lot of them are doctors, nurses, accountants, all manner of different professions. People with bipolar in pretty much every profession. So, it’s not a good thing I would not want to judge you meet one person with a condition, you meet one person, but there are certain aspects of the condition which makes them really great colleagues to work with. So, I’m really lucky with the colleagues I work with. I really find it really easy working with them, and I have no idea who are bipolar and who didn’t. So, hopefully that’s something that your listeners can take away from it.

Debbie (22:41) So, Simon, the last question for you. You spoke earlier about all the work that needs to be done, and I’d just like to find out what are your priorities moving forward?

Simon (22:51) Well, diagnosis has to be the most important thing and understanding of the condition because we just talked about a lot of misconceptions that exist and some of the benefits of medication. If you can catch it early, then the outcomes can be much more positive. So, I think that’s what we really want to do people to be diagnosed when they first start developing the condition in their late teens and early twenties. From that, they can start to then plan their life, like giving some training on understanding the condition, how to manage it and so forth. That will be able to help literally hundreds of thousands of people in this country if we could do that. Unfortunately, the NHS is not set up to do that at the moment, so we have to do a lot of campaigns to change it. They should be, there’s nothing to say they shouldn’t do it. It’s much more efficient way of managing the condition to be able to diagnose early and to give people some basic support to manage a condition. But unfortunately, the NHS has adopted a crisis model where people have to go to their GP and often the GPs aren’t trained or aren’t confident in being able to manage a condition. So that’s really critical. And also, ongoing specialist support is really helpful. Medication has a really big impact on people’s lives. People can often be really, can be over-medicated and a lot of the side effects people associate, or the symptoms and behaviours people associate with severe mental illness is actually from the medication that people are taking, like the dry mouth. People can experience lots of weight gain from it, lack of concentration, dizziness. So, actually, if people can access to a psychiatrist who can then monitor that medication and review that medication on a regular basis, they can start to tweak it here and there. There’s about 26 different medications that people can take and an often infinite number of doses that they can take. So actually, if you get that easy access to a psychiatrist, to be able to taper it down when you need to or get to the point where people can take different dosage of medication under supervision. They can feel themselves becoming slightly more high, they can up their dose of a certain medication. That means they can bring themselves back down and then they’re in control of their condition, which is really important. But there’s big issues in terms of implementing that in the sense that there’s not enough psychiatrists and the NHS is geared around this crisis model.  So, actually if you get special support and diagnosis early on, it’s a much, much easier condition to manage. And it means that people don’t have to take any time off work. They can be contributing; they can be paying their taxes and society itself will be would be in a much, much better place. So, it’s a win-win all round. And that’s what we’re really passionate about what we do, because we know that we’re not asking for the moon on a stick, we’re asking for something really simple. And we know that it can be delivered within the resource of the NHS and society itself. So, we can do it.

Debbie (25:33) That’s really clear and really helpful Simon. Thank you. Now I’d just like to say a huge thank you both to Emma and to Simon for sharing all of those insights. You can find more about the fantastic work that Simon and his team are doing at their website, which is www.bipolaruk.org. I hope you’ve enjoyed this episode. Please do follow us wherever you get your podcasts and if you want to contribute to the discussion, you can find the c-suite podcast on LinkedIn and the usual social media channels. If you want to show your support for what we are doing, please rate or review the podcast, because those reviews really do make a difference. And finally, if you would like to get in touch with the show, you can do that via the contact form at csuitepodcast.com. But for now, from me, thank you for listening and goodbye.