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Owning & Managing a Business Can be Hazardous to your Mental Health

1.0 Introduction

Owning and Managing a Business Can be Hazardous to your Mental Health.

This article provides an overview of business ownership in the context of mental health.

If you are one of the millions of small and medium business owners around the globe, you probably have a good idea of how tough (and sometimes lonely) it can be at the top of the business – and how owning and managing your own business can be hazardous to your mental health.

It is well-known that our mental health can deteriorate, for a variety of reasons, and, if left unchecked, can lead to mental health problems.

Although depression and anxiety are likely to be the most common issues an owner faces, it is important to remember that mental health symptoms and conditions come in many forms.

2.0 Why Be a Business Owner?

Many of us are drawn to small business because working for others provides its own stresses, for example, the feeling of lost control as others make decisions we may feel unable to influence.

Being a business owner offers a level of freedom and control that we may be unable to achieve as an employee.

3.0 Factors Affecting Mental Health in Owners

Although the symptoms of mental health conditions can be similar between people, the triggers can be very different.

There are a number of factors that could lead to a deterioration in a business owner’s mental health, including:

  • Excessive stress;
  • A toxic work environment;
  • Poor leadership;
  • Uncertainty;
  • Long hours;
  • A lack of sleep; and
  • So on.

These can lead to burnout which, in turn, can lead to mental health conditions such as anxiety and depression.

Increased competition in your particular market or industry means added pressure to perform and stand out from the crowd, as well as potentially making it more difficult to be financially successful. Business costs may also be rising, possibly faster than your ability to increase sales and revenue – meaning the bottom line is impacted, aka less profit.

Using a contemporaneous example, the business uncertainty surrounding Brexit, especially for export-orientated businesses, can have a profound impact on business planning and sales generation.

4.0 A Blur between Personal, Family & Work

Small business ownership, especially, can be tough because there are few support structures for owners.

As an owner, you are responsible for everything and the lines between personal and family pressures and work are blurred or even non-existent.

Finally, the financial pressures are very real, as it is the owner’s money at stake not a large company’s money.

5.0 I’m In Control!

Business owners may be reluctant to seek, ask or talk about any mental health issues they may be facing due to the need to be perceived as having everything under control.

This means that business owners can, effectively, end up in rather stressful jobs.

With this in mind, most employees will be unaware of the stress attached to owning a business and how challenging cashflow, for example, can be. When margins are tight, paying wages can be extremely stressful. There are real life examples where owners have paid staff wages through their credit cards or overdrafts to ensure their employees get paid – mainly due to a feeling of guilt and not wanting to let them down. It can be stressful knowing that your employee’s family relies on the wage you are paying their loved one.

There is also the stress on marriages, especially if a couple is in business together.

6.0 The Value of Mentors

Other business owners understand what you, as a business owner, are going through. They understand the impact that long hours, for example, can have on the owner’s well-being and their families.

A business mentor can assist by helping the owner find ways of being more effective with their time, among other things.

7.0 Addressing Mental Health Issues

It is imperative that you do not do nothing.

There are a number of things owners can do, at both at an individual and organisational level:

  • Know the risks to mental health and well-being in your business.
    • What are the triggers?
  • Talk about mental health and well-being.
    • This helps to normalise it.
  • Leaders in your business need to be on board.
    • They must send the message to all staff that the business takes mental health seriously.
    • Role model what good mental health looks like and what we do when someone needs our help.
  • Get some education around mental health.
    • The reason that myths and fear exist is because of lack of awareness and knowledge.
    • There are workshops, coaches and even online courses now which help plug this knowledge gap.
  • Have the conversation with your people.
    • Not saying anything to someone who is struggling is not the way to go.
    • Simply asking “Are you OK?” is a really good start and shows the person that you have noticed and do care.
  • Sleep, nutrition, relationships and exercise all correlate with mental health, so check in on your people to see how they are going with these areas.
    • For example, if someone tells you that they have not been sleeping for two months, that is going to take its toll and something needs to be done.
  • Know who to go to.
    • Have an accessible list of contacts that you can call on for a range of different mental health and well-being matters.

It is important to seek support from someone who:

  • Has received appropriate training;
  • Is a registered practitioner; and
  • Has frequent supervision.

8.0 Pursing Good Mental Health

In the pursuit of good mental health, it is important to:

  • Understand our stressors;
  • Name our stressors;
  • Admit they exist; and
  • Aim to avoid them.

If our stressors cannot be avoided, we should attempt to better manage them.

Finally, when possible, it is important as a business owner to make time and take personal care of yourself.

Can Mushrooms be the New Cannabis?

In the attached article, from The Economist, investors are hoping that medical psychedelics will be the new cannabis.

It briefly looks at how Ketamine and psilocybin (which gives mushrooms their magic) are being researched for their potential effects on psychiatric conditions such as depression, anxiety, and addiction.

Reference

The Economist. (2019) Medical Psychedelics: Shroom to Grow. The Economist. 16 October 2019.

Mental Health in Japan: The Rise of Recluses

Did you know that the pressures from work and society are causing more people in Japan to shun the outside world.

In the attached article by The Economist we can read about “Mika Shibata’s youngest son”, aged 26, who has not emerged from his bedroom for a year! (The Economist, 2019, p.49).

In an article by Andrew McKirdy, for the JapanTimes.co.jp, he states that a Government survey suggested that 613,000 people, between the ages of 40 and 64, are believed to be hikikomori.

This is up from the estimated 541,000 people aged between 15 and 39 that a 2015 Cabinet Office survey found to be hikikomori.

References

McKirdy, A. (2019) The prison inside: Japan’s hikikomori lack relationships, not physical spaces. Available from World Wide Web: https://www.japantimes.co.jp/life/2019/06/01/lifestyle/prison-inside-japans-hikikomori-lack-relationships-not-physical-spaces/#.Xil8ymieSUk. [Accessed: 23 January, 2020].

The Economist. (2019) Mental Health in Japan: The Rise of Recluses. The Economist. 30 November 2019.

Patients Dependent on Benzodiazepines: Make Alliances

Research Paper Title

Making Alliances With Patients Dependent on Benzodiazepines: A Provider’s Experience.

Abstract

Tens of millions of benzodiazepine (BZD) prescriptions are written annually for the outpatient management of anxiety disorders and insomnia.

Many prescribers do not follow published treatment guidelines for these disorders.

Psychiatric-mental health nurse practitioners (PMHNPs) regularly meet patients who have been treated with BZDs for years.

The dangers posed by outpatient BZD use are recognised, especially among older adults, and their use should be minimised or eliminated.

There are multiple manualised approaches to outpatient down-titration of BZDs, but little evidence about which methods really work.

To effect change, it is essential that PMHNPs establish a sound therapeutic alliance with these patients, especially by using their skills in therapeutic communication.

One major conflict that may occur early in the relationship is the patient’s expectation that the BZD medication regimen will continue indefinitely and their unwillingness to risk discontinuing the drug.

This conflict commonly raises non-adherence to a down-titration plan or patient termination of the relationship.

It is essential that PMHNPs take the time and patience to build strong therapeutic alliances with patients to design and implement a successful BZD discontinuation regimen.

Reference

Amberg, A. (2020) Making Alliances With Patients Dependent on Benzodiazepines: A Provider’s Experience. Journal of Pyschosocial Nursing and Mental Health Services. 58(1), pp.29-32. doi: 10.3928/02793695-20191218-06.

Suicide in Older Adults: A Critical Problem

Research Paper Title

Suicide in Older Adults.

Abstract

Suicide in older adults is a critical problem that nurses and other health professionals need to address. Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognise suicide risks and intervene to provide effective care for this vulnerable population.

Reference

Sorrell, J.M. (2020) Suicide in Older Adults. Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.17-20. doi: 10.3928/02793695-20191218-04.

Examining the Role the Inflammatory Process & Immune System Play in Mental Disorder

Research Paper Title

Inflammatory Response and Treatment-Resistant Mental Disorders: Should Immunotherapy Be Added to Pharmacotherapy?

Abstract

Treatment resistance continues to challenge and frustrate mental health clinicians and provoke psychiatric researchers to seek additional explanatory theories for psychopathology.

Because the inflammatory process activates symptoms of depression, anxiety, and psychosis, it is a reasonable route to follow for primary and/or indirect contribution to mental disorders.

The current article reviews the research literature regarding the role the inflammatory process and immune system play in mental disorders as well as novel treatments under investigation for resistant depression, anxiety, substance use, and psychotic disorders.

Reference

Limandri, B.J. (2020) Inflammatory Response and Treatment-Resistant Mental Disorders: Should Immunotherapy Be Added to Pharmacotherapy? Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.11-16. doi: 10.3928/02793695-20191218-03.

MedSupport: Patient Perceptions & Perceived Support

Research Paper Title

Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport.

Background

This cross sectional study examined patients’ perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting.

The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.

Methods

A cross-sectional study was performed. The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire.

Diagnosis and treatment information were obtained at the clinical visits and from patient records.

Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study.

Results

The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86-89) and a convergent validity toward the available variables.

The MedSupport mean score was 3.8 (standard deviation.9, median 3.8).

Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support.

Patients diagnosed with behavioural and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.

Conclusions

The MedSupport inventory was suitable for assessing the patients’ perceived support from health care service regarding their medication.

Awareness of differences in patients’ perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.

Reference

Drivenes, K., Vederhus, J.K., Haaland, V.Ø., Ruud, T., Hauge, Y.L., Regevik, H., Falk, R.S. & Tanum, L. (2020) Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport. Medicine (Baltimore). 99(1):e18635. doi: 10.1097/MD.0000000000018635.

New Channel 4 TV Series on Mental Health – Losing It: Our Mental Health Emergency

Introduction

As attitudes to mental health change during a surge in the number of people asking for help or harming themselves, this series joins the frontline care services in Nottinghamshire

Outline Series 01

Channel 4 begins broadcasting a new series on mental health on Tuesday 21 January 2020 at 10 pm.

Titled Losing It: Our Mental; Health Emergency, the series gains access to Nottinghamshire Healthcare, one of the UK’s largest mental health trusts.

With demand rising and resources stretched like never before, this series explores the unprecedented pressure on mental health services and the seemingly impossible decisions that clinicians have to make every day.

The series places viewers at the heart of the complex decision-making process, giving a unique insight into the pressures and challenges mental health trusts and patients must deal with daily.

Told with a frank first person perspective, this series gives a very personal view of mental illness in 2019; the tragedy, humour and complex challenges.

Outline Series 01, Episode 01

Two weeks after becoming a mum, Laura is sectioned having tried to drive into a brick wall.

And is 11-year-old Briena really suicidal, or is the underlying diagnosis more complicated?

About Nottinghamshire Healthcare NHS Foundation Trust

Nottinghamshire Healthcare provides integrated healthcare services, including mental health, intellectual disability and physical health services.

Over 9000 dedicated staff provide these services in a variety of settings, ranging from the community through to acute wards, as well as secure settings.

The Trust manages two medium secure units, Arnold Lodge in Leicester and Wathwood Hospital in Rotherham, and the high secure Rampton Hospital near Retford.

It also provides healthcare in prisons across the East Midlands.

Its budget for 2019/20 is £465m.

Why Do It?

The Trust made the decision to take part in the series in April 2019 to try and further reduce the stigma associated with mental illness.

The production company, Story Films, has an impressive track record in making sensitive films that deal with difficult topics.

Filming took place across Nottinghamshire during the summer of last year and features patients with a wide variety of diagnoses, including young people, families and people in crisis.

Production & Filming Details

  • Production: Story Films.
  • Distributor: Channel 4.
  • Release Date: 21 January 2020 (UK).
  • Running Time: 50 minutes.

A Review of Effective/Cost Effective Interventions of Child Mental Health Problems in Low- and Middle-Income Countries (LAMIC)

Research Paper Title

Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review.

Background

This systematic review protocol aims to examine the evidence of effectiveness and cost-effectiveness of interventions for children and adolescents with, or at risk of developing mental disorders in low- and middle-income countries (LAMICs).

Methods

The researchers will search Medline Ovid, EMBASE Ovid, PsycINFO Ovid, CINAHL, LILACS, BDENF and IBECS. We will include randomised and non-randomised controlled trials, economic modelling studies and economic evaluations.

Participants are 6 to 18 year-old children and adolescents who live in a LAMIC and who present with, or are at high risk of developing, one or more of the conditions: depression, anxiety, behavioural disorders, eating disorders, psychosis, substance abuse, autism and intellectual disabilities as defined by the DSM-V.

Interventions which address suicide, self-harm will also be included, if identified during the extraction process.

The researchers will include in person or e-health interventions which have some evidence of effectiveness (in relation to clinical and/or functional outcomes) and which have been delivered to young people in LAMICs.

They will consider a wide range of delivery channels (e.g., in person, web-based or virtual, phone), different practitioners (healthcare practitioners, teachers, lay health care providers) and sectors (i.e., primary, secondary and tertiary health care, education, guardianship councils).

In the pilot of screening procedures, 5% of all references will be screened by two reviewers.

Divergences will be resolved by one expert in mental health research.

Reviewers will be retrained afterwards to ensure reliability. The remaining 95% will be screened by one reviewer.

Covidence web-based tool will be used to perform screening of references and full text paper, and data extraction.

Results

The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at relevant conferences.

The results will be presented descriptively and, if possible, meta-analysis will be conducted. Ethical approval is not needed for anonymised secondary data.

Conclusions

The systematic review could help health specialists and other professionals to identify evidence-based strategies to deal with child and adolescents with mental health conditions.

Reference

Grande, A.J., Ribeiro, W.S., Faustino, C., de Miranda, C.T., Mcdaid, D., Fry, A., de Moraes, S.H.M., de Oliveira, S.M.D.V.L., de Farias, J.M., de Tarso Coelho Jardim, P., King, D., Silva, V., Ziebold, C. & Evans-Lacko, S. (2020) Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review. Medicine (Baltimore). 99(1):e18611. doi: 10.1097/MD.0000000000018611.

Veterans: We’re Afraid to Say Suicide

Research Paper Title

“We’re Afraid to Say Suicide”: Stigma as a Barrier to Implementing a Community-Based Suicide Prevention Program for Rural Veterans.

Background

Suicide is a significant public health concern for veterans residing in rural communities.

Although various initiatives have been implemented to prevent suicide among veterans, efforts specific to rural veterans remain limited.

Methods

To aid such efforts, the researchers examined stigma as a potential barrier to community readiness in the implementation of a community-based suicide prevention program for rural veterans.

In this qualitative study, community readiness interviews were conducted with 13 participants in a rural community.

Themes included lack of awareness regarding veteran suicide, rare discussions of veteran suicide, and suicide-related stigma within the community.

Results

Results suggest that prioritising destigmatisation may be particularly important to implementing community-based suicide prevention programming in rural communities.

Conclusions

In particular, addressing community misconceptions regarding veteran suicide, while increasing knowledge of the extent to which veteran suicide occurs locally may facilitate increased awareness and thus community readiness to prevent suicide among rural veterans.

Reference

Monteith, L.L., Smith, N.B., Holliday, R., Dorsey Holliman, B.A., LoFaro, C.T. & Mohatt, N.V. (2019) “We’re Afraid to Say Suicide”: Stigma as a Barrier to Implementing a Community-Based Suicide Prevention Program for Rural Veterans. The Journal of Nervous and Mental Disease. doi: 10.1097/NMD.0000000000001139. [Epub ahead of print].