Mental Health Matters: Are We Doing Enough?

Keynote Speech at Marsh Mercer Benefits’ Annual Conference: 31 May 2019

Credit: Ng Min Hua, Johnson & Johnson who was in the audience. :)

Good afternoon, ladies and gentlemen. I’m honoured and so very delighted to be here with you. Could I please seek your indulgence and invite you to take a mental pause with me by taking three deep breaths? <PAUSE> Only we humans can do volitional or intentional breathing but we don’t do enough of it. Thank you for your trust with this experiential prelude to my sharing today.

Today’s theme, Healthy People = Healthy Business, is a timely one yet one that is also ironically long overdue, in my view. Our biggest asset is our people — whether as a country or a business. Yet it’s taken us a surprisingly long time to finally be where we are today to have a strategic conversation on the direct impact of health on performance. And it’s no wonder that we have taken even longer to speak up about mental health.

Interesting fact: Did you know that health and wellbeing was enshrined 70 years ago in the UN Universal Declaration of Human Rights as ‘the right to a standard of living adequate for health and well-being’. The understanding of this right follows the World Health Organization (WHO)’s definition that health is a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity. In other words, ladies and gentlemen, there is no health without mental health.

The Lancet Commission 2018 Report estimates that poor mental health will cost the global economy US$$16 Trillion. It’s no wonder mental health was one of the three themes for leaders at the World Economic Forum last year in Davos (the other two were technology disruption and climate change). This comes in the form of direct costs in healthcare, medicine and therapy. But the largest costs are indirect: employees are prevented from reaching full potential and are forced to take more sick days, stunting innovation, productivity and economic growth.

I’m no expert in mental health, but I’m beyond vested in mental health. My deep and passionate advocacy on this issue through my multiple roles as a Nominated Member of Parliament, founder of Hush TeaBar as well as leadership and life coach stems from my personal and professional experiences.

1. My incredibly bright nephew was diagnosed with anxiety disorder at just 15, and last year with depression. He’s made several attempts to hurt himself and is currently out of the school system at the promising age of 17. He is not alone in his plight. The Lancet Commission has stated that mental health issues are the leading cause of disability in adolescents aged 15 to 19, worldwide.
2. A team mate at Hush TeaBar has been on treatment for major depression and mild bipolar for years. His employment experience has been patchy because of workplace discrimination until he joined Hush TeaBar. Another one who is Deaf struggles with deep anger issues from young because he was constantly bullied for his deafness. The young man whom I work with at another community project called A Good Space almost jumped off from the 15th floor of a HDB flat when he was just 19. They too, are only examples of a larger trend. According to the Health Promotion Board, the mental wellbeing of working adults in Singapore is 13% lower than the general population. In 2014, studies found that workplace stress is the root cause of 90% of psychological conditions in Singapore.
3. The elderly is similarly affected by mental health issues. A study by NUS showed that one in five of those aged 75 and above show signs of depression: There’s the old uncle living in my block at Marine Crescent who was depressed from the death of his wife and started sleeping on the bench in the void deck at night. Just the other day, a young taxi driver shared with me about his 87 year old grandfather jumping to his death by climbing up the flower pot racks along his HDB corridor after his breakfast, his whole family was still having their breakfast inside the flat when they heard the loud thud

Then there’s my own close shave with depression 13 years ago when my world collapsed in the most colossal manner when I was left with $16, a broken heart and a broken business. I won’t go into that here but I hope you are curious enough to go grab a copy of my book, 50 Shades of Love, that has been out in the bookstores since January. Or order online at www.50shadesoflove.org.

In case you are starting to think that I’m the epicentre of mental health issues, ladies and gentlemen, let me absolve myself — not with any delight at all — by sharing some more sobering numbers: The latest IMH study in Dec 2018 showed that one in seven persons in Singapore experience a mental health condition in their lifetime, an upward trend from one in eight just 8 years ago. Globally, this number is one in four persons. Will we head there? Let’s do a dip test. How many of you know someone with mental health conditions? Two thirds of those with mental health conditions in Singapore do not seek help because of stigma, discrimination and neglect, according to an IMH study. For those who are employed, another study found that 86.5% do not seek help for their mental health difficulties.

Let’s pause for a moment and think of stigma and discrimination. I would like to invite you to think about how you would describe a person with mental health conditions. <PAUSE> A 2017 Public Attitudes Survey by National Council of Social Service (NCSS) found that 4 in 10 had gross misconceptions and therefore prejudices about persons with mental health conditions. “Lack of discipline and willpower is one of the main causes of mental health issues.” or “Persons with mental health issues should not be given responsibility.” were some of the comments collected during the study. 1 in 2 people felt that they had very little knowledge regarding mental health conditions.

This extends to the workplace. The same study found that close to 1 in 2 Singaporeans were not willing to work with persons with mental health issues — that’s every other person in this room! In addition, 72% of employers in Singapore were found to consider stress and mental health as issues affecting productivity in a 2017 study. yet only half of them have emotional wellness and psychosocial support programmes.

I was pretty disturbed by the findings, to be honest. Even if they validated why we started Hush TeaBar in 2014 to promote mental wellbeing and inclusion at workplaces through popup silent tea experiences led by Deaf facilitators, supported by persons with mental health conditions. So in May last year, 25 C-suite leaders and I came together to form the WorkWell Leaders Workgroup, a groundup leaders’ initiative to champion workplace mental wellness as a leadership priority. These leaders represent organisations such as Johnson & Johnson, DBS, Dell EMC, PWC, Accenture, BP, Shell, Dow Chemical, NUHS, NHG, MOE, NCSS, NVPC etc. We meet quarterly to share, discuss and co-create inclusive practices with each other as well as to collectively influence systemic challenges such as mental health insurance.

Let me share with pride the strides that some of my fellow Workgroup members have made.

1. Other than Employee Assistance Programme and Worklife Services for employees and their families at no cost, Johnson & Johnson recently launched a new Employee Resource Group here in Singapore called ‘Mental Health Diplomats’ to build a more inclusive culture and encourage peer to peer conversation about mental health and wellbeing. Some of these diplomats are also employees with lived experience. At the recent TEDx@JNJ where I was also an invited speaker, the company’s Chief Mental Health Officer and another senior executive shared their personal mental health experiences to employees worldwide.
2. Dow Chemical is one of the few organisations that have a Chief Inclusion Officer that reports directly to the Group CEO. The Singapore office made workplace adjustments including Employee Assistance Programme and raising awareness of self care through innovative activities like Hush. They also provide Quiet Rooms in all their office sites where employees can spend some private time to take naps, meditate and relax during work hours. Feedback from employees has been positive. [Workplace adjustments may be perceived to be costly but NCSS’ survey of over 500 companies found that every $1 invested in workplace adjustments gives an average of $5.65 in returns in productivity increase, drop in absenteeism, medical claims savings and reduction in hiring costs. 8 in 10 companies surveyed that implemented mental health friendly initiatives also saw significantly improved staff morale.]
3. In Accenture, mental wellbeing is more than a leadership priority, it’s increasingly their organisation’s DNA what with a clarion call to be Truly Human. They have a clear roadmap on developing a mental health friendly culture including training Career Counsellors in mental health support and senior leaders being mental health champions. Just recently, one of these champions whose day job is leading a business that generates a total revenue of $1billion shared why he chose to come out with his mental health difficulty. Because this is the kind of conversation that we must have to normalise mental health.

I think coming out and sharing your own experiences really speaks of a different level of leadership. Because you help open up the space of trust for your team members to know that if they have mental health difficulties, it doesn’t mean that they are less. I personally have so much admiration for this kind of leadership. But the biggest beneficiary is actually ourselves…by being authentic and humble, we become better leaders and humans.

Other leaders like Shell developed resilience learning modules for all their employees. NUHS even has a mascot for their mental wellbeing programme. NCSS has their wellness warriors who are also trained to spot the signs and symptoms of mental conditions, and support the wellbeing of all staff.

So how can you start your journey to make your organisation a mental health-friendly one? We now have a Mental Health Toolkit for Employers from NCSS, fresh from the oven, which you might find useful that outlines a 9-step journey. Write in to NCSS if you want a copy.

1. Committing to the cause
2. Planning your approach to a mental health friendly workplace
3. Developing a mental health friendly culture
4. Increasing mental health awareness in the workplace
5. Managing mental health in the workplace
6. Recruiting persons with mental health conditions — if you are still asking job applicants to declare their mental illness, please abolish this discriminatory practice. Instead, we should have the necessary support structures in place. My experience as an employer of persons with mental health conditions for the last 4 years can attest to this being the right, and smarter thing to do.
7. Implementing workplace adjustments
8. Supporting recovery and return to work
9. Evaluating your approach

The toolkit also provides relevant resources including community partners that you can work with. I would urge you to get creative too on this journey of change and culture-building for wellbeing. My wonderful team at Hush TeaBar has also asked me to remind you that bringing the Hush@Workplace Experience to your organisation is positively one of the most innovative and meaningful ways to inspire your employees to understand emotions (they learn how to sign different emotions from the Deaf), take that much-needed pause to reflect and connect with themselves and develop empathy through their interactions with our team of Deaf and persons with mental health conditions. This empathy also translates to empathy for each other at the workplace so we are now also seen as a team bonding provider! You can find more information on Hush in your goodie bag so be sure to get in touch with Ning Pei to find out more. Ning is a person-in-recovery herself and her transformation in the last 4 years has been so beautiful to watch.

We try to practise what we preach at Hush. We have a clear policy of not texting after 9pm and weekends on work matters unless they are objectively critical. We have flexible work arrangements as a virtual team (and also because with a differently-abled team, there are frequent counselling sessions they have to go for). We check in with ourselves and each other every morning by sharing our daily intentions at work through our WhatsApp group chat. Yet we are just scratching the surface of what we can continue to do with creating an inclusive workplace.

Ultimately, we must recognise that quality of work and life is defined not only by markers of economic growth, and our material wellbeing, but also subjective wellbeing. We must constantly question whether our workplace environment empowers our people to be be the best version for themselves and be ready for challenges ahead.

I am deeply inspired by the trail being blazed by the New Zealand Government in presenting the first national budget guided by well-being. In the words of PM Jacinda Arden, “Wealth is about so much more than dollars can ever measure. […] and it’s time we focused not just on GDP, but on GWB — general wellbeing.” It is perhaps no surprise that New Zealanders have been among the most contented people on the planet according to the World Happiness Report that ranked the country 8th in 2018.

Singapore, on the other hand, ranked 34th in 2018, a drop from 2017’s 26th place. Not that I’m advocating that we must push ourselves to be top-ranked but as a country and society, we definitely have much work laid out for us in this area of wellbeing. I made an impassioned call to the Government at my recent Budget speech to make mental health a national priority now rather than allowing it to languish in the shadows. Why? Just on the simple basis of urgency — ageing has been rightly prominent in our national policy-making narrative given that one in 4 will be aged 65 by 2030. We waged a war in 2017 on diabetes because one in nine people will be affected yet the prevalence for mental health — which is upward trending, is one in seven. We don’t have to be policy wonks or experts to know that mental health has largely been shoved to the important but not urgent quadrant.

Having said that, I’m heartened that we are making progress. In 2017, we officially moved the narrative of mental health from a medicalised approach to a social and community one when we launched the 5-Year Community Mental Health Masterplan. GPs and polyclinics are being trained to provide mental health services in familiar environment so more will come forward to seek help. NCSS launched a compelling national campaign called ‘Beyond the Label” last year to wage a war on mental health stigma and this year, the President’s Star Charity Challenge will be focusing on mental health which gives a big boot to national awareness of this issue. There is great need to change attitudes and perceptions of mental health through education and legislation. As a parliamentarian, I think I have finally ‘harassed’ the Ministers of Education and Manpower enough for them to review efforts to make mental health education mandatory in schools and institutes of higher learning, and for workplace health & safety to include psychosocial health & safety. Including appointing them to the tripartite oversight committee on workplace health & safety to contribute on mental health & safety.

I want to conclude by sharing the inspiring effort by HSBC. John Flint — husband of an old friend, when appointed the Group CEO in 2018, started a very progressive conversation with the bank’s 238,000 employees across 66 countries on how to be the best version of themselves. These conversations include wellbeing, mental health, harassment and bullying and are translated into concrete measures such as simplifying and strengthening governance procedures to make it easier for employees to do their jobs, and work more flexibly.

And among those who have gone through mental health conditions, John has learnt that they are the ones who often possess a resilience, a resourcefulness, an empathy and an EQ that the rest do not possess, and that they can only be assets to the company. I can’t agree more with my own experience with the Hush team members.

We mustn’t forget that ‘human’ comes first when we talk about human resources or human capital. Mental health is a human condition (robots don’t have mental health difficulties, at least for now!). Workplace wellbeing has a direct impact on productivity and innovation, and in the quality of life of our employees.

Every employee is a member of our society. Therefore it is clear that a caring, inclusive, innovative and resilient Singapore can only come from caring, inclusive, innovative and resilient workplaces. Healthy people makes for a healthy business, a healthy economy and a healthy nation. So leaders, this is your contribution to making a difference to our society, our world. This is your legacy.

I wish you a meaningful journey in the work you do. Someone once said, a life without health is like a river without water. May you be well. ❤

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Anthea Ong is a Nominated Member of Parliament. (A Nominated Member of Parliament (NMP) is a Member of the Parliament of Singapore who is appointed by the President. They are not affiliated to any political party and do not represent any constituency. There are currently nine NMPs in Parliament.)

The multi-sector perspective that comes from her ground immersion of 12 years in different capacities helps her translate single-sector issues and ideas across boundaries without alienating any particular community/group. As an entrepreneur and with many years in business leadership, it is innate in her to discuss social issues with the intent of finding solutions, or at least of exploring possibilities. She champions mental health, diversity and inclusion — and volunteerism in Parliament.

She is also an impact entrepreneur/investor and a passionate mental health advocate, especially in workplace wellbeing. She started WorkWell Leaders Workgroup in May 2018 to bring together top leaders (CXOs, Heads of HR/CSR/D&I) of top employers in Singapore (both public and private) to share, discuss and co-create inclusive practices to promote workplace wellbeing. Anthea is also the founder of Hush TeaBar, Singapore’s 1st silent teabar and a social movement that aims to bring silence, self care and social inclusion into every workplace, every community — with a cup of tea. The Hush Experience is completely led by lovingly-trained Deaf facilitators, supported by a team of Persons with Mental Health Issues (PMHIs).