[NEPHP] Empathy as a Service: Supporting Mental Health in the Tech Workplace

At any given time, 1 in 5 Americans are living with a mental illness, such as depression, bipolar disorder, generalized anxiety disorder, substance use disorder, burnout, or ADHD. Statistically, all of us working for an organization with 5 or more employees have at least one colleague who is affected. At the same time, the tech industry is often characterized by high stress, long hours, workplace pressure to be available by phone and e-mail after-hours or sometimes even while on vacation, social pressure to constantly network and attend conferences and make a name for yourself, and the precarious balance between trying to do good by contributing to open-source and maintaining some semblance of free time that doesn't involve coding. Given how this demanding environment increasingly blurs the line between our professional and personal lives, how can we ensure that the most vulnerable among us aren't being left behind?

As a community, the single most damaging thing we can do is continue to treat mental health as a personal shortcoming that can't be talked about openly. We shouldn't think of it as "somebody else's problem"; the 4 in 5 of us who don't currently have mental health disorders must do our part to help end the stigma. This talk will begin with an overview of key statistics about mental illness, followed by the efforts of the non-profit organization Open Sourcing Mental Illness to gather more data about mental health in the tech industry, the ALGEE action plan taught by the Mental Health First Aid training course, and finally conclude with ideas and strategies for making our tech workplaces more accommodating and inclusive.

Transcript

1. Empathy as a Service:
   Supporting Mental Health
   in the Tech Workplace
   Nara Kasbergen (@xiehan)
   2017 Northeast PHP Conference August 11, 2017
   #nephp17
   

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2. Topics covered
   1. What are we talking about?
   2. Why I speak up about this
   3. What can we do?
   ○ pragmatic, common-sense, action-oriented; anyone can do these things!
   4. What must we do together?
   ○ difficult, aspirational; everyone has to do their part
   

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3. What even are we talking about?
   

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4. 1 in 5
   Americans living with mental illness
   at any given time
   Source: Mental Health America
   

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5. 1 in 11
   Americans living with diabetes
   Source: CDC.gov
   

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6. 1 in 12
   Americans living with asthma
   Source: AAAAI
   

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7. 1 in 5
   Americans living with arthritis
   Source: CDC.gov
   

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8. Mental illness is one
   of the most prevalent
   chronic health conditions,
   but we don’t talk about it
   

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9. An incomplete list of mental illnesses
   Depression
   Generalized anxiety disorder
   Bipolar disorder
   Substance use disorder (alcoholism)
   Eating disorder (anorexia, bulimia)
   ADHD
   PTSD
   Obsessive-compulsive disorder (OCD)
   Impulse control disorder
   Antisocial personality disorder
   Schizophrenia
   Dissociative identity disorder
   Autism spectrum disorders*
   Burnout**
   

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10. depression is at least
    13x more prevalent
    than schizophrenia
    in the United States
    

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11. Symptoms of major depression
    ● Feelings of sadness, tearfulness, emptiness, hopelessness
    ● Angry outbursts, irritability or frustration
    ● Loss of interest or pleasure in normal activities
    ● Sleep disturbances (insomnia or sleeping too much)
    ● Tiredness and lack of energy
    ● Changes in appetite
    ● Anxiety, agitation or restlessness
    Source: Mayo Clinic
    

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12. “Telling someone not to be sad
    because others have it worse
    is like telling people they
    can’t be happy because others
    have it better.”
    - Unknown
    

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13. Source: robot-hugs.com
    

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14. Source: robot-hugs.com
    

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15. Source: robot-hugs.com
    

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16. 56%
    of U.S. adults with mental illness do not
    receive treatment
    Source: Mental Health America
    

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17. 15%
    of those with severe depression
    die by suicide
    Source: Mental Health America
    

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18. rate at which women experience depression
    compared to men*
    2x
    Source: Mental Health America
    

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19. #3
    ranking of depression among the top three
    workplace problems, following only family
    crisis and stress
    Source: Mental Health America
    

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20. $51 billion
    estimated annual cost of absenteeism from
    work and lost productivity
    Source: Mental Health America
    

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21. $26 billion
    estimated annual direct treatment costs
    Source: Mental Health America
    

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22. 59%
    percentage of Americans (ages 19 to 64) who
    get their insurance through their employer
    Source: Kaiser Family Foundation
    

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23. 20.8 weeks
    average wait time for Canadians
    seeking mental health treatment
    Source: Fraser Institute
    

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24. Why people do not speak up
    ● Fear of dismissal
    ● Fear of being taken out of promotion consideration
    ● Fear of being taken off high-value projects/contracts
    ● Fear of reduced hours (for hourly workers)
    ● Fear of being asked to take unpaid medical leave
    ● Fear of being treated differently
    

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25. “Leave your personal
    life at home when you
    come to work.”
    

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26. Why I speak up about this
    

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27. I’m a software engineer.
    I identify as mentally healthy.
    

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28. Ni Mu. July 13, 1988 - September 14, 2016
    

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29. it's on Medium
    or
    bit.ly/2oYYyOR
    (warning: it's 6,000+ words)
    I wrote a blog post
    

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30. September 16, 2016
    NationJS in McLean, VA
    

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31. Open Sourcing Mental Illness: osmihelp.org Ed Finkler (@funkatron)
    

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32. Source: osmihelp.org/research
    

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33. “I could do so many awesome
    things if only my own head
    didn’t get in the way.”
    - Ed Finkler (@funkatron)
    

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34. What can we do?
    

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35. Common characteristics of tech workplaces and culture
    ● The work is challenging and stressful
    ● Our jobs are highly collaborative
    ● Many of us have relocated for a job
    ● Most of us work remotely at least part of the time
    ● We're often expected to be available outside work hours
    ● Someone needs to fix things when they break overnight
    ● There is a heavy emphasis on drinking culture
    

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36. Relocation
    

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37. Relocation
    Positive:
    ● Much easier to feel a part of
    the team and helping toward the
    mission if you are on-site
    ● Can bring you closer to a
    community of practitioners in
    your field than where you
    currently are
    

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38. Relocation
    Positive:
    ● Much easier to feel a part of
    the team and helping toward the
    mission if you are on-site
    ● Can bring you closer to a
    community of practitioners in
    your field than where you
    currently are
    Negative:
    ● Takes someone away from the
    existing support structures
    they have already built up
    ● Generally stressful
    ● Making new friends as an adult
    is surprisingly hard!
    

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39. Relocation
    Solutions:
    ● As a community, stop saying that the best way to succeed
    in tech is to relocate to Silicon Valley; become more
    accepting of alternative choices
    ● If you are a manager, take another look at your hiring
    practices and see whether remote employment is an option
    ● Create a "Welcome Wagon" for new colleagues who have had
    to relocate to join your company
    

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40. Free idea: "The Welcome Wagon"
    ● Take the new employee out for lunch or dinner with the
    team. Avoid alcohol at their first social event.
    ● Team members take turns introducing the new employee to
    activities and events in the area, e.g.
    ○ Invite them to join your book club meeting!
    ○ Invite them to go rock climbing!
    ○ Invite them to join your bocce league!
    ○ Invite them to go volunteering with you!
    

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41. Remote work
    

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42. Remote work
    Positive:
    ● Flexible hours
    ● Easier to attend daytime
    therapy appointments
    ● Easier to stick to medication
    regimens
    ● Easier to take breaks
    ● (Usually) quiet & peaceful
    

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43. Remote work
    Positive:
    ● Flexible hours
    ● Easier to attend daytime
    therapy appointments
    ● Easier to stick to medication
    regimens
    ● Easier to take breaks
    ● (Usually) quiet & peaceful
    Negative:
    ● Sense of isolation
    ● Harder to build strong
    relationships with co-workers
    ● Harder to tell if colleagues
    are doing OK (health-wise)
    ● Can make it more challenging to
    maintain work-life balance
    

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44. Remote work
    Solutions:
    ● Make funds available for employees to join a co-working
    space (or encourage your colleagues to do so)
    ● Fly in remote employees or hold company-wide off-sites
    together to make sure they feel part of the team
    ● Look into the latest research on remote work culture,
    improvements you can make to integrate remote employees
    

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45. “But what about
    open plan offices?”
    

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46. Open plan offices
    Positive:
    ● More conducive to
    collaboration, creative
    problem-solving between
    multiple employees
    ● Easier to construct because of
    things like fire code
    ● Can increase sense of team
    unity, camaraderie
    

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47. Open plan offices
    Positive:
    ● More conducive to
    collaboration, creative
    problem-solving between
    multiple employees
    ● Easier to construct because of
    things like fire code
    ● Can increase sense of team
    unity, camaraderie
    Negative:
    ● Noise reduces productivity
    ● Lack of privacy
    ● Increased stress
    ● Increased peer pressure
    ● Highly conducive to the spread
    of disease (cold, flu, etc.)
    

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48. Open plan offices
    Solutions:
    ● Allow employees to work remotely (or increase the number
    of days per week or per month when they can do so)
    ● Urge employees to work from home when sick
    ● Set aside small meeting spaces for quiet work
    ● Have the company provide noise-canceling headphones
    ● Encourage employees to decorate their workspace
    

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49. On-call rotations
    

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50. On-call rotations
    Positive:
    ● A huge burden being shared
    among the team improves sense
    of team unity, camaraderie
    ● Engineers have a way to prove
    their understanding of the
    technical systems and ability
    to manage a crisis
    

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51. On-call rotations
    Positive:
    ● A huge burden being shared
    among the team improves sense
    of team unity, camaraderie
    ● Engineers have a way to prove
    their understanding of the
    technical systems and ability
    to manage a crisis
    Negative:
    ● Expecting the unexpected can be
    very difficult for those with
    serious anxiety disorders
    ● Lack of sleep or interrupted
    sleep is bad for mental health
    ● High stress can lead to burnout
    

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52. On-call rotations
    Solutions:
    ● Fix tech issues to make being on-call less stressful
    ● If someone is called in the middle of the night, give
    them adequate time to catch up on sleep
    ● For employees with serious anxiety disorders, see if
    there's a way to take them out of the on-call rotation
    without making them feel like they're not contributing
    

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53. Alcohol at tech events
    

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54. Alcohol at tech events
    Positive:
    ● One or two drinks can make it
    easier for some introverts and
    those with social anxiety to
    socialize with their peers
    ● It's become an expectation in
    tech culture, and if you don't
    offer it, those who want to
    drink will go find a bar
    instead of staying to mingle
    with others at the event
    

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55. Alcohol at tech events
    Positive:
    ● One or two drinks can make it
    easier for some introverts and
    those with social anxiety to
    socialize with their peers
    ● It's become an expectation in
    tech culture, and if you don't
    offer it, those who want to
    drink will go find a bar
    instead of staying to mingle
    with others at the event
    Negative:
    ● Non-drinkers feel unwelcome
    ● Recovering alcoholics feel
    threatened by the environment
    ● Free alcohol and drinking
    culture are so pervasive that
    there are probably more
    functioning alcoholics in tech
    than we're aware of
    

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56. Alcohol at tech events
    Solutions:
    ● Offer nice alternatives (fancy sodas, mocktails) for
    non-drinkers to make them feel included
    ● Put a limit on the number of free drinks (use tickets)
    ● Have activities other than drinking (e.g. board games)
    ● In a recurring series, try alternating dry/non-dry events
    ● Add workplace wellness programs on substance abuse
    

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57. Managers: Lead by example
    ● Don't micro-manage
    ● Leave the office on time
    ● Take regular vacations
    ● Don't send or answer e-mails at 2am if possible
    ● Be receptive to feedback on your own performance
    ● Be a good listener
    ● Be open to talking about your health and mental health
    

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58. Other action items for managers
    ● Make sure your employees understand their benefits and
    what mental health treatments are covered
    ● Revisit your hiring practices with an eye to mental
    illness and neurodiversity
    ● Make sure your employees feel valued and are on projects
    that they find fulfilling and empowering
    ● Get the OSMI handbooks (leanpub.com/u/osmi)
    ● Consider offering the Mental Health First Aid training
    

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59. Mental Health First Aid (mentalhealthfirstaid.org/.ca)
    ● In the US:
    ○ 8 hours over 1 or 2 days
    ○ US$50-100 per person
    ● In Canada:
    ○ 12 hours over 2 days
    ○ CAD$150-200 per person
    ● Community grants or student
    discounts sometimes available
    

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60. ALGEE, the Mental Health First Aid action plan
    

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61. What must we do together?
    

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62. Support marginalized people in tech
    ● Chronic harassment, bullying, and microaggressions can
    lead to depression, exacerbate eating disorders, and
    cause or worsen other mental illnesses
    ● Even in tech, women are still judged by their appearance
    ● People from marginalized groups feel they have to
    over-perform (to counteract the "lowering the bar" myth),
    which leads to increased stress and a greater likelihood
    of burnout
    

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63. Embrace neurodiversity
    ● Mental disorders like ADHD and autism are the result of
    natural variations of the human genome
    ● "People with differences do not need to be cured; they
    need help and accommodation instead."
    ● Some of our greatest inventions are attributed to people
    with atypical neurology
    ● "Mental illness gives me superpowers." - Ed Finkler
    ● hbr.org/2017/05/neurodiversity-as-a-competitive-advantage
    

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64. Things we can only change as a culture
    ● Working ourselves to death - the over-emphasis on hard
    work, and stigma against vacation and healthy breaks
    ● The need to always be available by phone or e-mail
    ● The peer pressure caused by social media
    ● The belief that you must be in Silicon Valley to succeed
    ● The stigma against talking about our feelings
    ● The idea that engineers don't have empathy
    

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65. “Empathy is the antidote
    to shame.”
    - Andrea Goulet (@andreagoulet)
    

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66. "Empathy as a Service"
    

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67. There is no app for this
    

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68. “I could do so many awesome
    things if only my own head
    didn’t get in the way.”
    - Ed Finkler (@funkatron)
    

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69. Resources
    Want to help?
    ● reach out. ask. listen.
    tell your friends you care.
    ● osmihelp.org
    ● mhprompt.org
    ● if-me.org
    ● mentalhealthfirstaid.org/.ca
    ● crisistrends.org
    Need help?
    ● talk to someone: a friend,
    relative, counselor, etc.
    ● forums.osmihelp.org
    ● suicidepreventionlifeline.org
    or 1-800-273-8255(TALK)
    ● PEI: 1-800-218-2885
    ● Ontario: dcontario.org
    ● Quebec: 1-866-277-3553
    

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70. Questions?
    Thoughts? Comments?
    nara@nara.codes
    @xiehan
    osmihelp.org/donate
    dedicated to Ni Mu
    

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