Mental health has been defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO 2004, p.12), whereas mental illness is defined as “a recognised, medically diagnosable illness that results in the significant impairment of an individual’s cognitive, affective or relational abilities” (Pape & Galipeault, 2002, p.6).
These two definitions certainly suggest that an individual with poor mental health does not necessarily have to possess a mental illness or diagnosable disorder. To date, there is no scientific monitoring and evaluation or published evidence on the state of mental health in the country and there is an absence of formal coordinating bodies and entities overseeing the promotion of mental health awareness and public education in the country.
Essentially, the WHO-AIMS (2009) report for Barbados called for the strengthening of the mental health system and various services to persons with mental illness, the development and management of a comprehensive mental health information system, the strengthening of relationships between various stakeholders in the private and public sectors and local health sector, the implementation of training and development for mental health workers who deal with and manage persons with mental illness, and the establishment of programmes and services directed at public education and destigmatisation on mental health and illness.
Against this background, Dr. Dwayne Devonish, Senior Lecturer in Management of the University of the West Indies, conducted a study exploring samples of managers in the private and public sectors in Barbados concerning their awareness and perceptions of mental illness within the workplace. The study examined several focus groups of senior managers in both private and public sector organizations to better understand how they view mental illness, their interactions and experiences with persons with mental illness at work, and their assessments of various forms of support and resources needed to improve the overall management of these persons within the organizational setting.
The key findings of the study from focus groups with various managers in Barbados revealed the following:
Both private and public sector managers clearly and accurately distinguished between mental health and mental illness. Mental health was classified as the presence and absence of a positive state of mind or psychological well-being, whereas mental illness was presented as a negative, medically recognised and diagnosable disorder. This suggested moderate to high level of awareness of mental illness and how it differs from mental health.
However, all managers agreed that a high level of stigma and discrimination exists in both sectors regarding persons with mental illness. These managers claimed that there was a relatively high degree of fear and ignorance of mental illness in public sector workplaces and a resulting desire for social distance from persons with mental illness at work. Many examples of these situations included (1) “other workers trying to avoid these persons or choosing not to work with them on group work assignments, (2) “workers and other supervisors laugh and make jokes at them”, and (3) “given that job candidates are not normally screened for mental illness when they enter the public sector (because selection criteria are restricted to job-based competencies and qualifications), many managers are unaware and ill-equipped to deal with these persons and their conditions”
Perceptions of dangerousness and unpredictability in persons of mental illness were consistent and pervasive among these managers. Male private sector managers interviewed were more inclined than female managers to exhibit feelings, thoughts and behaviours related to the perceived dangerousness and unpredictable nature of persons with such conditions.
However, managers were willing to hire and manage these persons only under these circumstances: (1) the mental condition was not typically violent or dangerous, (2) the person was shown to have a non-violent condition and was on a consistent programme of effective medication for their condition, and (3) there was some form of secure disclosure (restricted to management alone) of this person entering the organization.
Overall, all managers agreed that the workplace environment was a reflection of wider evidence of societal stigma and discrimination. They pointed to a number of ways in which acts of stigma and discrimination were a function of lack of understanding of persons with mental illness, socialization in the Barbadian culture, and associated negative stereotypes. These included: (1) the tendency of people to group (and label) all persons with mental conditions and disorders into one category (e.g. mad or crazy people), (2) the stereotypical view that persons with mental illness or poor mental health at work are normally lazy, unproductive and delinquent (and sometimes demonstrating ‘malingering’), (3) the belief that persons with severe mental illness should be locked away in a psychiatric hospital or mental asylum, (4) the belief that persons with mental illness or poor mental health are portrayed as dangerous and violent.
Conclusions and Recommendations
Overall the present study revealed that both private and public sector managers have relatively good understanding of mental health and mental illness. However, there is a consensus (at least among a small group of private and public sector managers) that high levels of stigma and discrimination exist in private and public sector workplaces in Barbados fuelled by a lack of understanding of mental health and illness, cultural norms, and socialization with respect to the treatment of persons with mental illness. Stigmatising attitudes and beliefs about persons with mental illness in both private and public sector organizations are consistent with existing research in other cultures.
Workplace mental health policies were also cited as important for encouraging and reinforcing mental health awareness and positive attitudes, protecting persons with mental illness from stigma and discrimination, and providing avenues of support for such persons and managers. Based on claims and suggestions from existing research (Akabas, 1994; Hanisch et al., 2016; Henderson et al., 2013), mental health education and promotional interventions, reinforced by robust and consistent workplace mental health policies (accompanied with sanctions and incentives), are most effective strategies for assisting management and persons with mental illness in the organisational context.
Employee assistance programmes (EAPs) aimed at providing support and assistance to persons with mental illness are typical in many public sector agencies and departments in Barbados but they are not as popular in the private sector. However, both public and private sector managers claimed that these EAPs need to be strengthened to better support managers and persons with mental illness and implemented across all sectors and industries.
Education and awareness programmes surrounding mental health and illness, organisational assessments of risks to mental health, structured and supportive workplace policies for mental health promotion and destigmatisation, and evidence-based interventions and support services for persons with mental illness are key considerations that need to be taken seriously in workplaces in Barbados.