The stories we tell

Thankfully for publishers, humans love a narrative. Perhaps we need them to make sense of our lives. Give us a random series of events and we will arrange them into a story with a beginning, middle and an end.

A cohesive narrative requires adequate words, which is where things start to go wrong when we talk about mental illness—especially in the workplace. The non-specificity of the phrase “mental illness” alone hints at a lack of desire to look too closely at—or speak too openly about—the multitudinous and wildly differing nature of mental illnesses in existence. The even less specific phrase “mental health issues” often seems to be preferred, where the word “illness” itself is taken out of the equation entirely.

Whatever drives our lack of specificity—fear, discomfort etc—the consequence is a grouping of highly varied conditions into a single term, as though they were one and the same. We don’t do so with physical illnesses. Yet there are nearly 300 disorders listed in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Addictions, Bipolar, Depression, Eating Disorders, OCD, Schizophrenia, PTSD: these (and their subsets) are a small handful of mental disorders experienced by people in the UK and, it’s statistically safe to say, within our industry. Each impacts sufferers in radically different ways and consequently requires different kinds of support. When we refer only to “mental illness”, we imply there is one form of suffering and therefore one mode of managing it in the workplace.

There is a reason why books on mental illness that focus on broad truisms and an ultimately upbeat message sell in droves: we crave narratives of certainty and reassurance. But here the dual problems of a narrowed vocabulary and the desire for relatability clash with another, more complex narrative: the truth of living with long-term, clinical mental disorders.

“Clinical” is the key word here. Take depression. “Situational” depression is short term, often brought on by a traumatic event or an accumulation of difficult circumstances and, while it can cause just as much risk to a person’s wellbeing as clinical depression, there is a high likelihood of recovery and usually a lack of recurrence. “Clinical” or “major” depression is a long-term disorder which does not lift with a single course of therapy or medication, and requires years of treatment, with an aim of bringing symptoms under control rather than recovery. I use depression as an example here, but the problems caused by conflating “situational” and “clinical” apply to several mental illnesses.

It’s often said that stigma around mental illness is much reduced today—but stigma around what sort of mental illnesses? When there are ad campaigns about supporting people with mental illnesses, the symptoms referred to are usually low mood, irritability, fatigue or difficulty concentrating. Essentially, symptoms of situational depression or anxiety. These fit a narrative we are fairly comfortable with and marry relatively squarely with most companies’ HR policies: if you are signed off for a number of weeks or months, get support from medical professionals and have a managed, phased return to work, you will most likely be able to return to full duties, without a recurrence. This is a narrative business can cope with.

But what of clinical depression? Or any other clinical mental illness that does not respond readily to a single course of medication, or the usual NHS allocation of therapy? A few weeks off might see you through one bout, but recurrence is common. As for relatability, with clinical depression, as well as those experienced in situational depression, symptoms can include hallucinations or even psychosis; physical manifestations can include movements becoming slow and lethargic, or conversely more restless; sensitivity to light and noise can become heightened; speech can become physically difficult, etc. All of these symptoms last not a matter of weeks or months, but years—or even decades. All this is impossible to relate to if you have not experienced it yourself. What, then, of those with other illnesses that have an equal or more highly pronounced impact on behaviour?

The workplace gap

By the end of 2016, a report found only 26.2% of people in the UK with long-term mental illness or phobias (as their primary, or most significant, health issue) were in employment. A 2019 report on mental health in business in the UK reported that 62% of managers have “had to put the interests of their organisation above staff wellbeing, either sometimes, regularly or every day”. The same report found only 20% of c.e.o.s believed their organisation “supported those with mental health problems very well”; a number that dropped to 10% among junior managers. These statistics are not specific to publishing (data for which is currently unavailable), but the lived experience of those of us with mental illness in the industry suggests they are reflective.

Here are two narratives about the publishing industry: first, we are a creative, artistic industry which celebrates difference; and second, we are a business, and when it comes to the crunch, every bit as profit-oriented and, ultimately, ruthless as our counterparts in what we deem more tawdry businesses. Both narratives are, to greater or lesser extents, true. But put them together and the cognitive dissonance is jarring—particularly when the ruthlessness is at the expense of people whose very difference we claim to celebrate.

For a creative industry—and we have some of the most brilliant creative minds in the world working in publishing—we show a staggering lack of creativity when it comes to addressing the systemic problems we face. We throw up our hands, express sorrow at specific events that we treat as outliers, then move on rapidly, continuing as we were before, give or take a few consultations with external advisers, hastily compiled surveys and one-off training days. However, the rapidity with which we move on from our mistakes will only ever be matched by the rapidity with which we repeat them. So how do we ensure that mentally ill employees are protected and supported, and that we don’t lose people who have so much to offer—and allow them to progress and thrive? The best, and I would argue only, place to start is to admit that what we are doing is not working; that the stigma over mental illness is far from eradicated; that we are failing in our duty of care. We need to re-write the narrative around mental illness. This has to start with educating ourselves.

Part of the problem of an industry that prides itself on its “niceness” is its severe unease surrounding (even hostility towards) employees who do not fit its ideal model: unfailingly polite, smiling and uncomplaining. Without going into my own experiences in detail, over 17 years in publishing, I have often been a functional clinical depressive: capable of doing my job effectively, but sometimes presenting as depressed. I have had periods of time where I have cried at my desk without even realising I was crying. While the response from companies varied, a common reaction was to stress my impact on those around me. Effectively, I was a downer. This resulted in guilt and shame, which inevitably made me more ill—and of course, I could do nothing to change my behaviour, because it was not a choice. It was a symptom of my illness.

I don’t dispute that mentally ill people’s moods impact others. But when someone is capable of working well, how different an outcome might companies have if, instead of being concerned with trying to control how someone presents, the emphasis was on understanding their illness and educating the team around them about it (with the sufferer’s consent) and on providing proper modifications to help them continue to perform their job. Others would be less concerned by the behavioural symptoms displayed, and the sufferer would be under less pressure to hide their symptoms or justify or explain themselves. I find it a little crass to make comparisons to physical illness to make a point about mental illness, because they are not the same, however, sometimes a blunt tool is better than none: when I have had occasional difficulty walking due to long-term physical problems, accommodation has been made to ensure my working situation is more comfortable. Yet when I’ve been depressed, the discomfort of others has been the primary concern. (I am deliberately speaking only on mental illness in this article, but suffice it to say the poor treatment of those with physical disabilities is just one way in which this analogy falls short.)

Redressing the balance

A shift in how we talk about mental illness in the workplace is just the starting point. Perhaps the ugliest problem we must tackle is the system of redress for those who encounter intolerance and discrimination, a system badly in need of overhaul. It is a fact that people with mental illness are not properly supported in publishing, and discrimination is all too common. It is also a fact that companies cannot admit to discrimination without opening themselves up to the possibility of lawsuits. Too often this results in a stalemate, with sufferers unwilling to raise or pursue complaints over how they have been treated for fear of their career being harmed or ended, and companies not addressing problems that they know exist due to fear that acknowledging them will lead to legal action. The result is the silencing of sufferers—sometimes literally, via NDAs, a problematic tool for an industry that prides itself on supporting freedom of speech—and the covering-up of poor practice within companies.

I am not saying the solutions will be easy or quick. It takes courage to admit that we have been wrong: the allure of re-writing the past to make ourselves less culpable, and to fit with the image we have of ourselves, is understandable. But if we really are the creative and liberal industry we like to think we are, we have to start a fresh page, one that begins with a narrative based in honesty and transparency, underpinned by a genuine desire and impetus for change. If we don’t, the contradiction between the story we like to tell about ourselves and the truth of our actions will culminate in a messy and unhappy ending.