Why you need to rethink mental health risk

Emily Khan:

Hi everyone and welcome to this episode of our Business in Focus podcast. I am Emily Khan, a director here at PwC and I am your host for this episode. Every year mental health awareness week represents an opportunity for us all to recognise the importance of our mental wellbeing. This year, the social isolation imposed on many of us by the COVID-19 pandemic has made it more important than ever to look after ourselves and those around us. One in 14 adults in Great Britain said they often or always felt lonely during the winter lockdown according to the Office for National Statistics. That’s up 40% since last spring. This worrying trend hasn’t gone unnoticed by business leaders. Our recent CEO survey found that 61% of CEOs are worried about the declining wellbeing of their people.

To discuss this important issue, I am delighted to be joined in our virtual studio today by Ben Higgin and Poppy Jaman. Poppy is CEO of the City Mental Health Alliance, a not for profit organisation aiming to create an environment where mental health is discussed in the same way as physical health in the workplace. Ben is a PwC executive board member with responsibility for technology and investments and is also one of our firm’s mental health advocates.

Very warm welcome to both of you, and I am going to start our conversation today with the most important question of all, how are you, Poppy?

Poppy Jaman:

Hi, good morning Emily, thank you very much for inviting me today. Yeah, I am good this morning actually. I’ve done yoga, and that always is a grounding way to start the week. We had a really lovely weekend. For the first time we saw some family members, it was my in-laws' 52nd wedding anniversary, so it was just lovely to see them after such a long time, albeit with hot water bottles in the garden.

Emily:

Absolutely, that sounds familiar and congratulations to them, and sounds like a lovely weekend for you.

How are you, Ben?

Ben Higgin:

Also, very good, thank you. I am actually in our office to record this podcast, which I always quite enjoy. I am a man of structure and I quite like, I am one of the only people who has missed that commute, because I actually walk into the office. It has been really nice actually to walk in, didn’t rain, which was a bit of a relief, so yeah, I am doing well, thank you.

Emily:

Absolutely recognise what you say there about the power to commute and it being an opportunity in your day that you don’t have in the same way when you are at home. Maybe, that’s very linked to the issue we are here to discuss today.

Poppy, I am going to come to you first, if I may, to get us really going with this important conversation. I mentioned there in my intro that the pandemic has really put mental health on the agenda for many businesses, if not for the first time, then in a different way than it maybe was previously. We are starting to see leaders applying business acumen to that challenge around mental health as around their other major risks. I would love your experience; how has the pandemic changed the conversations you’re hearing businesses have about mental health and their risk appetite in that agenda?

Poppy:

Absolutely, the City Mental Alliance is a decade old, and for a long time it felt like we were moving this agenda slowly up a hill, because some people got it. Some organisations like yourselves, just got it and were running with the agenda, because actually if you don’t create an environment where your people can flourish, it is going to have an impact on business. Putting together a business strategy that’s appropriately resourced, to not just prevent people getting unwell, to actually encourage and invite innovation and foster wellness, was just many businesses got it; but a lot, like I said, didn’t. The thing that happened during the pandemic, and it has been terrible for all around the world, but the one small silver lining I would say is that mental health is on the boardroom agenda, and business leaders worldwide are talking about mental health and wellbeing in a way that they never have before.

The statistic that you shared right at the beginning, 61% of leaders are thinking about, CEOs are thinking about the wellbeing of their staff, but actually a 100% of people have at some point, over the last year stopped and thought about their own wellbeing and their family wellbeing. Actually, the multiple accumulative stressors of running a family, home schooling, adapting to the change when you are used to a structure, what does your strategy look like when you are actually having to change strategy every single day rather than what we are used to, which is three-year plan, lets get on with it, we are all moving in one direction, like all of that had to change. Leaders also, our job is to hold our teams, our organisation, so that they feel safe, and the organisation feels like it’s moving forward. Well, how do you do that when you are feeling vulnerable yourself and constantly making decisions that you don’t know what the impact is going to be from one day to the next, let alone week to week, which is what it felt like right at the beginning. What I saw was CEOs all around the world are talking about the impact it had on them, with their teams, with their executive teams, with their boards. That changed the conversation around mental health forever and I hope that stays, because leadership vulnerability matters, and when leaders step out of their comfort zone and say, ‘I am struggling too, but we together can make this work, so let’s all pull in together and work how to solve this together,’ it completely changes the conversation.

Last year, it was about 27 events that I spoke at, and most of them were with CEOs, within their organisations talking about how to create an environment that is connected, where people’s values are at the forefront and people have been heard. The question, ‘how are you,’ genuinely sought out with curiosity, how people were, rather than a flippant greeting.

Emily:

It is such a rich picture of change that you’ve talked about there Poppy, and certainly it's something that I’ve seen and felt as an employee during that time, the nature of that leadership conversation changing, that authenticity that you described, and leaders recognising and talking openly about the challenge. I certainly consider myself lucky to be at one of those organisations that perhaps saw it before the pandemic.

Ben, I would like to bring you in here, because clearly on our executive board, you are one of those leaders having a conversation about how you create an environment for us over here at PwC. Give us a feeling for how the topic is discussed, alongside other issues, how is it treated as a board issue in the context of all the priorities that we are working through as an organisation?

Ben:

Yeah, it’s been really interesting. I echo a lot of what Poppy said. It has become very personal for everybody, and especially leaders. It’s been a very strange environment, where businesses always faced challenges, and need to understand the nature of those challenges, need to understand risks, etc., but this has been something that nobody has ever encountered before. There has always been an element of, well some people have seen it before, they’ve done it before, there is experience out there, and that just hasn't existed, and it hasn’t existed for leadership teams.

This has gone right up the agenda, one, in terms of the business response to the pandemic, but alongside that, obviously a business like ours, it’s all about people, and so the people aspects of that, they kind of our business response to the pandemic. It is something that gets discussed just a lot more. I can remember previously, you’d be invited to quarterly sessions, where we would talk about mental health, or we would run workshops that normally coincide with a week or a specific day, whereas now it seems to feature in every conversation that we have at the board. We will look a lot more at data, understand that data, and have to think much more creatively about how we try and look after the wellbeing of our people.

Yeah, it has become very personal for people, everybody has had to face a really difficult time. It’s been, fair to say, harder for some than others, but it’s been different for everybody, and everybody has had to cope with the level of change. That level of change always drives uncertainty, anxiety. As leaders, it’s our job to reflect on that and think about our workforce and think about how we tackle that, because we are about servicing clients, and the only way we can do that is by having super talented people and making sure they can make the most of their talent, and that means looking after them.

Emily:

I certainly recognised that from my own experience here, but I am thinking also about, we’ve been doing some work on the program called, ‘rethink risk,’ in the risk business, and we are seeing that across sectors actually, what you described there was, we are very much a people business. That people risk is very square and centre across all industries, clients that we’ve been talking to about how they are rethinking risk post-pandemic. It does feel like very much a common and shared challenge for business leaders across the economy that we need to respond to together.

Why don’t we move on to, on how you respond to that challenge? We are all agreed that the moment is now. Ben, maybe, you could bring to life for us some of the things we’ve been doing at PwC, and then Poppy could give us a broader picture of change around the world, perhaps, and what do you think?

Ben:

There has been quite a lot of actually. There are certain components, for example, actually one of the things that we did quite early on was open up our offices to people who needed to be here, and that was thinking particularly around mental health and understanding that there will be people, who need to come into office, it's actually quite critical for them, and it’s a critical need for them to be able to be in the office in order to be able to function. That was one of the decisions that we made quite early on.

Since then, there have been a whole stream of different things. You talked about risk before, the wellbeing of our people is right up there on our top risks register. We talk about that and talk about the risk to the business. As I said, the response has had to increase, because the risk has increased. Our appetite remains low in the sense that we want to manage this risk, but the risk itself has increased quite significantly. Of course, if that’s happened, then you have to respond to that risk, and so we’ve had to think about how we communicate with our people, the sorts of things that we talk about. Our chairman and senior partner, our head of people have been very active doing live streams that have involved professionals in this space, mental health professionals, helping our people to understand some of the ways that they may be feeling, how they can start to cope with that. Actually, just exposing that kind of conversation, between the most senior people within our organisation to our people, to say, it’s okay to be talking about mental health, and especially at the moment, because everybody is having such a difficult time.

That communication right from the top has been vitally important for us as a business. There are other things that we’ve done in terms of, we’ve made headspace available for all of our people, we’ve launched Frog platform, which is a new platform, which actually is really important for signposting people in their local area.

There has been a whole approach to thinking about how do we, in the context of an elevated risk, elevate our response to that risk. There have, of course, also been some real practical challenges that we’ve had to face. Some of our people have had to be in the office actually for work reasons, if they’ve been doing work, for instance, with the NHS and that creates a new challenge and a new dynamic. Again, we have to think about how we respond to that and support those people in those projects.

Emily:

Thanks Ben, and it’s fascinating to hear you talk about it being on the risk register so clearly as that. That is something, as you said, that feels new in the conversation, that it is being treated very much as a business risk in that way. I am conscious, as we were talking, you just used a phrase that I am hearing a lot at the moment, ‘its okay not to be okay.’ That feels like a very common phrase here in the UK, and that we have the advantage of being in a culture where that’s quite an open conversation in society, not just in business, but that its not the same all over the world. I will be very interested in your perspective, Poppy, as we are talking about this challenge on that difference in the international scene and the role that big organisations like ours can play in that context too?

Poppy:

Absolutely Emily, and just to add to what Ben and you were saying, last year was the first time I saw mental health and wellbeing on the risk register with mitigating actions and resources by boards, which again, if you would have said that to me two years ago, I would have been like, there is no ways, big banks and big financial services sector organisations are going to do that, because it is not a priority in that way. It’s incredibly heartening to see that this has been taken so seriously, because it is this serious. The World Health Organisation has said that mental health of the world is going to be the next big thing that we in society are going to have to address for ourselves and the next generation, but it is not just about risk, it’s about innovation.

When we foster cultures where people can talk about really difficult stigmatised agenda such as mental health or mental illness, it’s a real signal to us that our organisation, or our team, or we as individuals, where people can bring some of their most difficult discussions, which then means that we are also at the same place as they are going to be able to bring their best ideas, because there is a lot of trust there, and that is how we foster innovation.

This whole agenda in getting it right, it’s not just about looking after people, it’s also going to be hugely impactful on the bottom line, because of innovation, and people being able to feel a sense of loyalty to the organisation and a sense of belonging to the organisation. For all of those reasons, it's brilliant. But in terms of your question around the world, and this is connected to innovation, as the pandemic has evolved, and Zoom culture or video calling culture has evolved, actually we are able to access pretty much anybody in the world from our homes right now, which has completely revolutionised the way organisations work. But one of the things that I think is really important that we pay attention to during this process, is cultural differences and cultural nuances. City Mental Health Alliance, two weeks ago, we had our first roundtable in India and we are really proud to say that we are going to be launching our India chapter soon.

The discussions there were, when we talked about the campaigns, for example, the relevance of, ‘its okay not to be okay,’ is just not there. We have to make sure that when we are launching campaigns such as the ones that we’ve got in this country, where the narrative around mental health is a good 20 years old, we don’t just adopt those and try and scale them up, because from business perspective, scaling up is a thing that we as boards talk about all the time, because its efficient, but the cost of efficiency can be that we lose the message completely. When you are in a culture, where actually the implications of having a mental health issue is not just stigma for yourself in the workplace and possibly people seeing you as weak, or not being able to do your job in the future, etc., which is something that we are accustomed to in this country as the stigma issues, but actually in a culture like in Bangladesh and India. My heritage is British Bengali, it has a huge implication in terms of your marital status. It has a huge implication in terms of how your family is seen within the community. You have to understand that and actually to say to a Bengali firm, for example, ‘it's okay not to be okay,’ I think is quite irresponsible. When we roll out mental health initiatives across the world, because we have to, if we are in 60 countries as a business, it's absolutely our responsibility to make sure that employee assistance programs are available both in the UK, and India, and the other countries that you are in, but it is really important to make sure that those employee assistance programs are culturally nuanced and they understand what the relevance of, say for example, talking therapy is in that country.

In India, I’ve seen evidence in research that talking therapy has a bigger impact if in the first instance extended family members are included, because of the extent of the relevance, and the importance, and significance of extended families. Now in this country, we just wouldn’t do that, it's all about the relationship with the individual. Those kinds of things are really important, but I do want to bring that fact to list, not just think about on a global level.

We saw the resurgence of Black Lives Matter and antiracism narratives within our businesses. When you just pause and think about our black colleagues in our relevant businesses, how is the employee assistance programs that your organisation's have got, are the people that are delivering the therapy skilled to understand the impact of the intersectionality of racism and mental health, the intersectionality of gender and equality and mental health. Those things are really important all over the world. When we start working across the globe with true business acumen, we start to learn a lot about how we can improve our cultures and the support that we provide to people in every country. It's not just about being specific in different countries, it's how do we learn from each other.

Emily:

There's so much in that answer, Poppy, to unpack. You've really shone a light on the intersectionality of mental health and other priorities that many businesses are grappling with. It is certainly very striking here. We've had a lot of conversations about the inclusion agenda, including on this podcast series in the last year, and that being a strategic priority and something that we are focusing resources on, and measuring, and managing, and talking about more. We are also thinking about mental health, and it's how you can start to do the two together and understand how they impact each other. Clearly, to some extent, data is at the key of both of those challenges and building insight and understanding. I am interested in your views on, if you think of the progress that many companies all over the world have made on gender reporting or ethnicity reporting, what's going on in terms of mental health reporting, is that another of those agendas where we can start talking about what gets measured gets done, is that the sort of space we're moving into?

Poppy:

Yeah absolutely, for me, sometimes people think, ‘well actually mental health, you can't really measure it, what does that actually mean,’ but you absolutely can. Because when you're fostering inclusion and belonging within an organisation,so, if I can come to work and feel like this organisation understands me, gets all of me, and I really belong to this community, I bring my whole self, or I choose to bring my whole self, a majority of myself to the organisation and that then fosters mental health, my mental health, because, like you said right at the beginning, loneliness, is a major risk factor for poor mental health. If we can feel like we've got connections at work, as well as in our local community, as well as in our family, our risk of developing mental illness reduces significantly and our mental well-being and our opportunity to flourish increases significantly. Actually, when you're measuring what people, your black colleagues, your LGBTQ colleagues, what women in your organisation are saying and feeling, and if you score high on all of those, you are also scoring high on creating a culture of psychological safety and fostering mental health and wellbeing.

It's really important not to look at mental health or health and wellbeing in isolation. It really has to cut across the diversity and inclusion agenda, because what we are trying to do is, we're attracting talent because we create this sense of belonging within the organisation. It's not just leaders and brochures talking about this in a really polished way, it's actually our young people and young talents that are coming into the business, saying, ‘this organisation is great, I can come to work and be X Y and Z.’ That should resonate, not just in the UK or US, in all of the countries that we are in. We need to then look at what are the cultural points that we're testing in all of the parts of the world and are those questions in the surveys that we are doing relevant for that culture and that community, and how are we ensuring that it's not just about equal opportunity, it's about equity. So, how do we make sure that a colleague in Bangladesh, or India, or Africa, has actually got the same leadership opportunities that other colleagues have got in maybe the Western world and what is the difference there and how do we actually create equity. Rather than saying, ‘here's a leadership program or here's a talent development program, it's accessible to everybody, but then what you get is about 80% to 95% of people that apply are Europeans, and you haven't actually stopped and asked yourself what that's about. For me, it's how do we foster really nuanced ways of encouraging people to get involved and feel like the organisation is creating a space for all of them, which then creates great mental health.

Emily:

I love that, Ben, tell me a bit about how you think we are approaching that challenge and the building blocks we’ve got in place?

Ben:

Yeah, it is such a fascinating area and I agree with Poppy. Actually, I will look at them as multiple data points,I work in technology, so, for me, having data and being a data led organisation is actually the key to then creating transparency, because you can't have the transparency until you've sorted out the data. There has been some fascinating work. We've surveyed our staff for many years, but we've increased the focus of those questions on wellbeing over the years and see how that move has been in itself interesting, to then ask our various inclusion networks to focus on components of the results of that and to therefore understand whilst you've got the data, what’s lying behind the data to get you a greater level of insight is really important, because that's how you actually tackle some of these issues. The techniques are getting more and more sophisticated. We actually have a trial of human performance analytics. It was an optional thing that our people could join if they wanted to and what it allowed them to do is, they had a smartwatch, and that monitored things like their heart rate, etc, and gave sort of raw data, which then they could look at what was happening in their day, and it would coordinate with their diary, it would coordinate with the firm making various announcements.

They individually could see what were the sorts of things that were raising their heart rate during the course of the day, which allows them to think about managing that, and managing anxiety, and managing stress. Of course, for us as an organisation, we could see the hole and say okay, what is it that we're doing that is impacting people in a way that we just never would have been able to understand. For me, if you take that data led approach, if you then supplement it with the diverse perspectives about people to help us understand the data and that is a super important piece, because you can get lost in the data, but if you can get people to help you understand that; that to me is the key to be able to understand people on a large scale in a way that we've never done before.

Emily:

I recognise the description you give there, of the watch. I fairly recently started using a smartwatch and actually I am benefiting from learning about myself, just from the data, let alone the wider organisation is starting to make good choices about my way of working that set me up for success at any given day, really interesting. I am going to take us back to, you both mentioned in your first answer something about this being personal for leaders and we've all been through this universal experience over last year of the stresses and strains of the global pandemic. I would like to talk for a minute about the role of leaders in all of this and what it means to be a leader in this space. I am going to come to you first, Poppy. You've talked very compellingly there about the need for creating a culture and a safe psychological space at work for people to bring their whole selves, and there's intersections between mental health and diversity. Looking specifically at the actions leaders can take, what do you think people should be thinking about as they approach this challenge.

Person 1:

Yeah absolutely, and just before I answer that question, the whole smartwatch thing said, I just have to share this, because it was quite amusing. When we were still doing events in real life, and I was just about to go up on stage to do whatever keynote or panel, my smartwatch would just literally be beeping, because my heart rate was so high. It was just that I'd never noticed that before, I had never realised how anxious I was getting just before going on stage. It was really helpful for me to actually then think through how I would do a few breathing exercises, etc., to just help that. Then actually my coach said to me, it's quite good, because that's what we need, we need a bit of an adrenaline kick before you go in on stage, so maybe you shouldn't be trying to calm it down, but Emily just what you said about learning yourself through data and information is crucial.

On that note, I asked myself what am I doing, as a leader when it comes to race and gender discrimination, and the impact of mental health. It's all very well me going on stage or being on the Zoom stage and talking to leaders and businesses about what they can be doing, but what was my responsibility to the Black Lives Matter movement and actually what was my responsibility to the number of disproportionate deaths that happened in black and brown communities around the world as a result of the pandemic and the health inequalities that exist in society. One of the things that I did was I deeply reflected on my personal actions and what I can do. I put out actually a leadership commitment or my commitments around gender and race, and they included these five things. One of them is always asking myself, who is not in the room. Throughout my career, Emily, I found that I've often been the only woman and usually the only person of colour in a room. I've been very privileged that my career progressed enough that I can be working with CEOs, but most of the time it is men, and it is usually white communities. I asked myself who's not in the room and I give myself permission to ask that question in the room. In the past, I used to get held back by the fact that I am a brown woman, so everybody would think, ‘well of course, Poppy is going to raise this agenda,’ but actually, if I'm not leading this, then who is going to be, so I've given myself permission to do that.

The second thing I've done is, I will not sit on any panel, or any conference now without sending my leadership commitments ahead to them and saying, ‘is there going to be diversity on the panel, is there going to be diversity on the conference, and not just the side shows, main stage, tell me what the diversity index of your events look like,’ because events are very visible occasions and they are career progressing, but again and again you get the same voices and ensuring that there is difference and diversity thought in events is one of my responsibilities, but it's also my responsibility to make sure that other women are on stage alongside me, and if that means I need to step out of it. I am really happy to do that. That's changed in the last, since I published my commitments, four or five big events that I've been on, and the panel dynamics of that.

Then what I've done is, I've made sure that that's in the system of my organisation. My board knows hat, my PA knows that, so this is all discussions that are had. I am changing systems that perpetuate discrimination rather than just me individually doing this.

Then finally what I've done is, I've put that out to all of my CEO colleagues and many of them, I think 11 people so far have adopted the same commitments, and we are all working in different parts of the world to push this agenda forward. For me, it's not just about my responsibility in society, my responsibility as a business leader, it's my responsibility as a human being and an individual to hold myself to account on this stuff.

Emily:

That's really inspiring commitments there, I certainly share a couple of them, but I'll be giving the others to look and seeing, if and how I can apply those in my role too.

Ben, you clearly are one of our mental health advocates here at PwC and have made a decision to be authentic and try to break down the stigma around mental health personally, give us a feeling for why that's so important to you and why you've made that choice?

Ben:

For me, we need senior people within organisations who aren't afraid to say that mental health is something that affects everybody. There is still quite a lot of stigma out there, despite the fact of what we've been through over the past 12 months with the pandemic. There is still stigma out there, so it's really important. I've had my challenges, there were certainly periods in my life where I would say I wasn’t mentally healthy, and I've been very open about that, and very open about actually how I’ve learned from it and grown from it, and naturally I feel like I'm actually much better prepared to deal with a whole host of things as a result of that. You need parts of that visibility. It's actually about authenticity of leadership in my view, that's who I am.

There are some of the things that I've been through and if I want to lead people and want them to follow me, it's important that they understand who I am as a person, and that I am authentic. Also, as well, if you set that tone within the organisation, that's the first step to empowering your own people to look after themselves as well, I feel very strongly that people should be able to work in a way that suits them, to make sure that they are the best that they can be. We've just launched our new deal and it includes real flexibility in terms of the way people work, acknowledging that the world has changed significantly, and people, they're not going to want to be in the office all the time. We know lots of people will rather avoid the commute and work from home, and they've got commitments around home schooling, but even beyond that, there were commitments that existed before that were quite often just became the challenges to the individual, and this becomes part of empowering them to do what they need to do to work within their own life, if you like.

Emily:

You’ve really brought it very neatly into a conclusion there, Ben, which is just about right because we've covered an awful lot of ground, but we're running out of time here today. I like to end these conversations with something really practical that listeners can do having listened to the discussion. I'm going to ask you each for kind of one quick tip, if people have enjoyed the discussion and thinking about what it means for them, what it means for their organisation, what's the first thing they should do when they stop listening today?

Poppy, I'll come to you first, if that's okay.

Poppy:

Continue to ask the question how are you with authenticity and curiosity to create change.

Emily:

Love it, Ben, how about you?

Ben:

I am going to be cheeky. I am actually going to go with two things. On a similar vein to Poppy, ask your leaders what conversations they're having around this topic, because once you ask them, you'll understand whether they are having them, and if not, it will force them to.

The other practical thing I would say is, we are going to go through another period of significant change, and with that change comes challenge, so don't be afraid to try and stop in the day and think that this change is coming with people going back to the office, and the new evolution of the workforce starting to happen. It's going to be difficult and accept that and understand how you can help yourself to deal with that.

Emily:

Thank you so much Poppy and Ben, it's such a fascinating discussion. That draws us to the close of another episode of Business in Focus. Of course, thank you to everyone for listening. If you would like to read Poppy’s leadership commitments you can find them, as well as two other really helpful toolkits, the global thriving at work framework and the mental health and race in the workplace toolkit, all on the CMHA website. We'll include the links in the description of this episode and on our website at pwc.co.uk/businessinfocus.

Finally, don't forget to subscribe to keep up to date with future episodes. Thanks everyone, stay safe.

Participants

• Emily Khan, Director, PwC
  
• Poppy Jaman, CEO of the City Mental Health Alliance (CMHA)
  
• Ben Higgin, PwC UK Executive Board Member