Book: Life Is a Four-Letter Word

Book Title:

Life Is a Four-Letter Word: A Mental Health Survival Guide for Professionals.

Author(s): Andy Salkeld.

Year: 2020.

Edition: First (1st), Illustrated Edition.

Publisher: Practical Inspiration Publishing.

Type(s): Paperback and Kindle.


  • Do you ever feel you’re a fraud and about to be found out?
  • Do you feel an expectation to keep going and to be strong?
  • Do you ever think what it would be like to just… ‘STOP’?

You are not alone. Mental ill health impacts one in four people every year, and professionals in high-pressure jobs are especially vulnerable.

Life is a Four-Letter Word is a mental health survival guide for professionals, from a high-flying Big 4 accountant who has struggled with depression, anxiety, stress and suicidal thoughts and learned a lot along the way.

Andy now advocates positive action around mental health, working closely with business leaders across the UK to help them build mentally healthy cultures. He is a renowned speaker and writer on mental health, entrepreneurship and finance.

Strategies used by Families to Cope with Chronic Mental Illnesses

Research Paper Title

Strategies used by families to cope with chronic mental illnesses: Psychometric properties of the family crisis oriented personal evaluation scale.


This study was aimed at investigating the psychometric properties of the Family Crisis Oriented Personal Evaluation Scale (F-COPES) for Turkish society, which assesses the coping skills of caregivers of individuals with chronic mental illnesses.


The study was conducted with 153 family caregivers of patients with a chronic mental illness admitted to the inpatient and outpatient units of two university hospitals and İzmir Schizophrenia Solidarity Association.

For the language validity, the translation-back translation method was performed, for the content validity, expert opinions were obtained, for the construct validity, exploratory and confirmatory factor analysis was performed.

For the reliability analysis, Cronbach α reliability coefficient was calculated and the test-retest reliability analysis was performed.


The content validity index of the scale was 0.96.

The Cronbach’s α reliability coefficient for the overall scale was .80. Factor loadings of the subscales ranged between 0.56 and 0.69 for the Acquiring Social Support subscale, between 0.43 and 0.74 for the Reframing subscale, between 0.53 and 0.74 for the Seeking Spiritual Support subscale.

The model fit indexes were as follows: χ2  = 176.369, df = 116, χ2 /df = 1.52, RMSEA = 0.059, CFI = 0.90, IFI = 0.91, GFI = 0.88.


The results of the present study show that the levels of psychometric properties of F-COPES in Turkish society are acceptable.

It is thought that it would be useful to use the F-COPES in the assessment of coping behaviours of individuals who give care to patients with a chronic mental illness and that it can be used as measurement tool in studies to be conducted with caregivers of patients with a chronic mental illness to assess their coping skills.


Sari, A. & Çetinkaya Duman, Z. (2019) Strategies used by families to cope with chronic mental illnesses: Psychometric properties of the family crisis oriented personal evaluation scale. Perspectives in Psychiatric Care. doi: 10.1111/ppc.12457. [Epub ahead of print].

Mental Health & the HSE


In their Annual Report and Accounts 2017/2018, the Health and Safety Executive (HSE) stated that there were “0.5 million work-related stress, depression or anxiety cases (new or long-standing) in 2016/17” (HSE, 2018, p.9).

What is the HSE?

“HSE is the independent regulator for work-related health and safety in Great Britain. We are committed to playing our part in the wider health and safety system to ensure that others play theirs in creating healthier, safer workplaces. We also deliver wider functions such as regulatory schemes intended to protect the health of people and the environment, balancing the economic and social benefits that chemicals offer to society.” (HSE, 2018, p.10).

HSE and Stress

HSE states that where (work-related) stress is prolonged it can lead to both physical and psychological damage, including anxiety and depression, and that work can also aggravate pre-existing conditions, and problems at work can bring on symptoms or make their effects worse.

They go on to state that whether work is causing the health issue or aggravating it, employers have a legal responsibility to help their employees. Work-related mental health issues must to be assessed to measure the levels of risk to staff. Where a risk is identified, steps must be taken to remove it or reduce it as far as reasonably practicable.
Some employees will have a pre-existing physical or mental health condition when recruited or may develop one caused by factors that are not work-related factors.

Employers may have further legal requirements, to make reasonable adjustments under equality legislation.

Information about employing people with a disability can be found on GOV.UK or from the Equality and Human Rights Commission in EnglandScotland, and Wales.

There is advice for line managers to help them support their employees with mental health conditions.

What is the Stevenson Farmer ‘Thriving at Work’ Review?

In 2017, the UK government commissioned Lord Stevenson and Paul Farmer (Chief Executive of Mind) to independently review the role employers can play to better support individuals with mental health conditions in the workplace.

The ‘Thriving at Work’ report sets out a framework of actions – called ‘Core Standards’ – that the reviewers recommend employers of all sizes can and should put in place.

The core standards were designed to help employers improve the mental health of their workplace and enable individuals with mental health conditions to thrive.

By taking action on work-related stress, either through using the HSE Management Standards or an equivalent approach, employers would be able to meet parts of the core standards framework, as they would:

  • Form part of a mental health at work plan;
  • Promote communications and open conversations, by raising awareness and reducing stigma; and
  • Provide a mechanism for monitoring actions and outcomes.

Can Mental Health and Work-related Stress be Interlinked?

Work-related stress and mental health problems often go together and the symptoms can be very similar. For example, work-related stress can aggravate an existing mental health problem, making it more difficult to control. And, if work-related stress reaches a point where it has triggered an existing mental health problem, it becomes hard to separate one from the other.

Common mental health problems and stress can exist independently. For example, an individual can experience work-related stress and physical changes such as high blood pressure, without having anxiety, depression or other mental health problems. They can also have anxiety and depression without experiencing stress.

The key differences between them are their cause(s) and the way(s) they are treated.

  • Stress is a reaction to events or experiences in someone’s home life, work life or a combination of both.
  • Common mental health problems can have a single cause outside work, for example bereavement, divorce, postnatal depression, a medical condition or a family history of the problem.

However, an individual can have these sorts of problems with no obvious causes. Employers can help manage and prevent stress by improving conditions at work. But they also have a role in making adjustments and helping the individual manage a mental health problem at work.

Linking HSE’s Management Standards, and Mental Ill Health and Stress

Although stress can lead to physical and mental health conditions, and can aggravate existing conditions, the good news is that it can be tackled.

By taking action to remove or reduce stressors, an employer can:

  • Prevent an individual becoming ill; and
  • Avoid those with an existing condition becoming less able to control their illness.

HSE’s Management Standards approach to tackling work-related stress establishes a framework to help employers tackle work-related stress and, as a result, also reduce the:

  • Incidence of mental ill health; and
  • Negative impact of mental ill health.

The Management Standards approach can help employers put processes in place for properly managing work-related stress. By covering six key areas of work design employers will be taking steps that will:

  • Minimise pressure;
  • Manage potential stressors; and
  • Limit the negative impact that the work could have on their employees.


HSE (Health & Safety Executive). (2018) Annual Report and Accounts 2017/18. Available from World Wide Web: [Accessed: 18 November, 2019].

HSE (Health & Safety Executive). (2019) Mental Health. Available from World Wide Web: [Accessed: 18 November, 2019].

Society, Culture & Diversity

Current thinking on mental health suggests that it is best to consider the whole person – rather than try to separate mental health from other areas of life. Each of us is a complex blend of physical, emotional, social, cultural, and spiritual factors.

The way we cope with life and respond to life events is affected by our experiences, and individual characteristics such as personality. This means that there is no such thing as equality where mental health is concerned. Some people are disadvantaged by emotional or social deprivation. Others are disadvantaged by the fact that they are perceived as being different, and they experience discrimination as a result. Some people appear to have a greater risk of developing mental health problems or a serious mental illness for no obvious reason.

There is a lot of evidence to suggest that social and economic deprivation makes a person more susceptible to all kinds of ill health, including mental ill health.

Mental health problems are more common in socially disadvantaged populations and in areas of deprivation. They are associated with unemployment, low education levels, low income, and a poor standard of living. This same underprivileged population experiences the highest prevalence of anxiety and depression.

There is strong evidence of a connection between poverty, unemployment, social isolation, and schizophrenia. Deprivation is also associated with a number of negative experiences, such as having symptoms for longer, experiencing more frequent episodes of illness, having a poorer quality of care, and having a lower chance of recovery.

In the United Kingdom (UK), we need to pay proper attention to positive mental health and well-being. We can do this by promoting positive mental health, providing support so that the quality of life is improved, acting against social exclusion, and promoting the rights of people by addressing inequalities in mental health.

Being perceived as different to the majority of people around you has an impact on mental health. This means that people with physical disabilities, gay, lesbian, bisexual or transgender people, people with learning difficulties and people from black and minority ethnic groups are all more likely to experience mental health problems.

There is substantial literature regarding the impact of health of all forms of discrimination, whether on the grounds of race and ethnicity, age, gender, religion or sexual orientation. It adversely impacts mental health, affecting a person’s dignity and self-esteem. It can lead to a sense of alienation, isolation, fear, and intimidation. It can make it difficult for individuals to feel socially included and to integrate into society.

Difference is a problem not because of the perceived difference itself, but because of the attitude of the majority of the population towards people who appear different. We live in a culture that encourages similarity. We notice when people dress differently, live differently, or act differently. Western culture has been slow to recognise how badly people are affected by being treated less favourably because of perceived difference.

The law now protects certain people and groups from discrimination and disadvantage. However, in order to foster positive mental health in society, we all need to think about our attitudes and find ways to treat one another with equal respect and care.

Mental health first aid training can make an enormous difference to the mental health of society because it models good practice, by offering kindness and support to people in mental distress – regardless of their ethnic heritage, sexuality, religion, economic status, health, ability, age, or gender.