The information provided in the following training material is for informational purposes only. This content is not and should not be constructed as medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. The opinions, materials, and information contained in the training, other than the information at the cited Government websites, are provided for educational purposes only and should not be interpreted as necessarily representing the official policies or endorsements, either expressed or implied, or EEOD, NCSC, ODNI, or the U.S. Government. The material contained in this training course may be subject to copyright. Further reproduction or dissemination by any means is subject to original copyright restrictions and is generally prohibited without the copyright holder’s permission.
We spend much of our lives working with the goal to accomplish the mission and in the process, interacting with coworkers who share this same goal. To accomplish this goal while also enjoying our job, we recognize the importance of fostering a supportive workplace environment. This includes knowing how and when to offer support to our coworkers and when to be aware of our own need to sometimes seek support for ourselves. This issue of support is sometimes more difficult when dealing with the area of mental disorders. There is a great deal of misunderstanding about mental health that can be made more confusing when we see reports of violent incidences occurring on government grounds and media presentations suggesting the perpetrators often have severe mental illness. This can cause us to unconsciously link violence with mental disorders; however, in this course you will learn the truth about mental disorders, including the belief that high incidences of violence are associated with mental illness is actually a myth. And while there are times when behaviors of security concern do overlap with mental disorders and require further review, the overwhelming reason for an employee to visit an agency’s Employee Assistance Program (EAP) is to have an objective, trained professional help sort out generally temporary and minor emotional problems the employee is currently dealing with.
This course will take approximately 30 minutes to complete. It is designed to bring a mindfulness to the community about mental disorders and help answer some key questions: 1) What is the truth and what are simply myths surrounding mental disorders? 2) Should individuals with a mental disorder be able to hold a clearance? 3) How does inappropriately talking or gossiping about an individual’s mental disorder with coworkers cause hurt to that individual and further reinforce a myth or stigma? How is it the opposite of providing support and empathic understanding? 4) Do you unknowingly have a problem that would benefit from seeking treatment at an EAP? 5) How do you report behaviors of concern which may or may not be related to a mental disorder? After completing the course we encourage you to seek out additional information regarding mental wellness as part of a focus on ensuring a healthy and supportive workforce. Let’s watch out for each other and offer support in a caring way.
14.8 Million American adults have major depression.
Psychological conditions are common. Studies show that as many as 1 in 4 individuals experience a psychological condition at some point in their lives. Yet the stigma of having a psychological condition remains a concern of many individuals, including cleared personnel. In an attempt to reduce the stigma of psychological conditions, several celebrities have come forward with their own stories. Dwayne "The Rock" Johnson has been candid in describing his history of depression. Leonardo DiCaprio has discussed his symptoms of obsessive compulsive disorder. J.K. Rowling, author of the Harry Potter book series, has discussed her past depression. Catherine Zeta-Jones has shared about her bipolar disorder. Lady Gaga has been open in discussing her experiences coping with post-traumatic stress disorder. Psychological disorders are not a sign of weakness, nor do they prevent you from living a healthy and productive life. Behavioral health treatment works, and seeking treatment when needed shows good insight and judgment. Do not let shame, stigma or fear prevent you from seeking the care which can help you.
Dr. Martin Petrillo, PhD, ABPP Chief Psychologist Assessment Services
[Dr. Petrillo] The largest obstacle faced by people who could benefit from mental health care is the stigma attached to it. Although the stigma is not quite to the degree it was even a generation ago, it still remains. A 2010 study by the CDC indicated that the vast majority of people, over 87% in that study, agreed that the mental health treatment is effective in helping people live normal lives. However, when asked if others were caring and sympathetic to those with mental health symptoms the number dropped to 57%. Perhaps the most telling, was that when asked if others were sympathetic and caring to those with mental health symptoms the number dropped even further to 25%. So, we can see that the stigma associated with mental health care is present and very influential. But, we don't need a study to tell us that, just think about the words that are used to describe people who seek mental health assistance.
[Music] [TITLE CARD: What is the biggest obstacle facing people who can benefit from mental health care?]
[Dr. Petrillo] We've all heard the derogatory phrases, such as he is a whacko, she is psycho, he's not playing with a full deck. We would never describe someone in such a derogatory way who was suffering from diabetes or heart disease, yet as a society we feel less restrained when describing someone who has a mental health disorder.
[Music] [TITLE CARD: What do you mean by "type of words used to describe people who seek mental assistance"?]
[Dr. Petrillo] Mental illness is not rare, in fact some estimates put the rate of mental health conditions at 1 in 3 adults in a lifetime. I think that statistic highlights 2 very important facts; the first is that the prevalence rate is very high and the second is that there is a lifetime rate, meaning for the majority of people, mental health symptoms don't last a lifetime. What is unfortunate is that most people with mental health symptoms do not seek appropriate care and suffer needlessly. Another fact that is important to keep in mind is that mental health treatment works. It is effective, relatively inexpensive, and typically takes less time than most people think it would.
[Music] [TITLE CARD: Have the counseling services within agencies across the IC been an effective strategy?]
[Dr. Petrillo] Yes, it has been very effective. It's hard to prove a negative, and therefore difficult to say that days lost to sick leave or effectiveness at work have improved, however, there have been studies looking at similar programs that have demonstrated very clear benefits. The Rand Corporation published a research article in 2015 looking at the effectiveness of college and university counseling centers on their students. The study found that graduation rates were higher among students who utilized the counseling services than those who didn't. If you think about it, there are parallels between our IC agencies and universities; both are large organizations comprised of highly educated people who face similar demands, such as shrinking resources and high pace, and both are somewhat self-contained. I'm a firm believer in the benefits of having counseling services readily available and I am certain the benefits far exceed the costs.
A magazine dedicated to addressing stigmas, demystifying myths, and unveiling truth about those living with mental disorders. Take some time to go through this magazine, and remember the key facts; you may see them again towards the end of the course.
Words can wound. Our language is filled with slang terms that get carelessly spoken but can sometimes be perceived as rude or stigmatizing by those living with a mental illness. Statements like, “Are you crazy?” or, “He is nuts” can sometimes serve to reinforce stigmas when heard by someone with a mental disorder. The title of this magazine is an example of this and was left as is to emphasize this point. Some content developers thought having “Nuts” in the tile of this magazine was a clever play on words, while others felt it was demeaning. It was decided to use the title as a learning opportunity to illustrate that sometimes, even with the best intentions, individuals could misperceive certain words and suffer harm. So, think before you speak if using language that reflects a mental condition.
Stop the stigma of mental illness.
One in three have first-hand experience with mental illness. One in four adults experience mental illness in a year. That’s 61.5 million Americans. One in seventeen live with a serious mental illness.
Recent evidence suggests that good nutrition is essential for our mental health and that a number of mental health conditions may be influenced by dietary factors.
Myth: Mental disorders aren’t real illnesses, like heart disease and diabetes.
Truth: Mental disorders, like heart disease and diabetes, are legitimate physical illnesses. Research shows that brain chemistry, genetics, and life events are causes for mental disorders, and they can be treated effectively.
Myth: Mental disorders will never affect me.
Truth: Approximately 1 in 5 adults in the U.S. experience a mental disorder in a given year. Even if you never experience a mental disorder yourself, it is very likely that a family member, friend, or co-worker will experience challenges.
Myth: People don't recover from mental disorders.
Truth: People can and do recover from mental disorders as many different kinds of treatments, services, and supports are available. Most people with disorders show genuine improvement over time and go on to lead stable, productive lives.
Myth: All people who consider suicide want to die. There is nothing that can be done about it.
Truth: People who contemplate suicide are undecided about living or dying. They may gamble with death, leaving it up to others to rescue them. Frequently they call for help before and after a suicide attempt. The Suicide Prevention Lifeline (800.273.8255) can save a life.
Myth: In the scheme of illnesses, mental disorders are rare.
Truth: Mental disorders are more common than AIDS, cancer, diabetes, and heart disease.
If your coworker entrusts you with personal information, refrain from repeating it. Avoid the temptation to treat it as a bit of juicy gossip. Gossip often shames and embarrasses the coworker, but it also speaks volumes about those who spread it.
If tempted to gossip, stop first and ask yourself why you would want to repeat the information. If it isn’t out of kindness, out of the spirit of helping, then it’s best to keep the information to yourself.
1. Feeling nervous, anxious, or on edge
2. Not being able to sleep or control worrying
3. Worrying too much about different things
4. Having trouble relaxing
5. Being so restless that it is hard to sit still
6. Feeling afraid, as if something awful might happen
1. What percent of American adults are diagnosed with bipolar disorder? 2.6%, 7.3%, or 25%? The correct answer is 2.6%.
2. What percent of American adults are diagnosed with a personality disorder? 2%, 5%, or 12%? The correct answer is 5%.
3. How many American adults are diagnosed with OCD? 1.2 million, 2.2 million, or 5.5 million? The correct answer is 2.2 million.
4. How many American adults are diagnosed with PTSD? 2 million, 4.6 million, or 7.7 million? The correct answer is 7.7 million.
5. How many American adults are diagnosed with schizophrenia? 1 million, 2.4 million, and 6.2 million. The correct answer is 2.4 million.
When an individual or manager contacts EAP concerned about someone that they want to help, they should not attempt to use diagnostic language, but rather stay focused on the behaviors of concern and make sure they refer the person for help.
The vast majority of people seen in EAP’s are experiencing everyday life events that can cause stress. Specific mental health issues can occasionally arise, such as marital strife, adjustment issues at work, general life stress, etc. The good news is that the symptoms are often short-term, highly treatable, and can be managed with help.
It is not necessary to have a major mental health disorder, such as bipolar disorder or psychosis, to seek treatment from an EAP. Employee Assistance Programs are there to assist employees in dealing with all types of life events that impact an individual’s mental health.
Which of these is the correct way to describe an employee’s behavior to EAP?
“I think Sally is depressed and needs therapy.” Or, “I’m sure it’s nothing, but I’m a little concerned that Sally seems tearful lately.”
The correct way to describe Sally’s behavior is, “I’m sure it’s nothing, but I’m a little concerned that Sally seems tearful lately.”
[Round table discussion featuring Alan Rocha from the Texas Tribune, Dr. Lynda Frost of the Hogg Foundation for Mental Health, State Representative Garnet Coleman, Dr. Andy Keller of Meadows Mental Health Policy Institute, and Adrienne Kennedy from the National Alliance on Mental Illness]
MS. ROCHA: Representative Coleman, you've been very open about your issues relating to bipolar, and what consequences are there with not being open and up front about what you're dealing with?
REP. COLEMAN: Well first of all, if you're dealing in the work place, if you could have a confidential conversation with someone who understands what is happening with you and what the challenges are and to be as accepting as that, say as somebody who has cancer who can't get to work some days because of the cancer treatment.
DR. KELLER: I mean, I think a lot of times, you know, is we would expect with the health condition is you would go to your doctor and there would be screening for that and you'd be able to get help from your doctor to access specialists. That's really not the case for mental illness, it's something that, unfortunately, two-thirds of folks don't ask for help and I think that's really I think the tragedy around, you know, peoples' unwillingness to talk. I think, you know, as Representative Coleman said, folks are, you know, careful about all sorts of illnesses around work, but when it comes that you're not even willing to ask for help, I think that's the first barrier, is getting past that. And then when you want to ask for help, a lot of times you have to ask several times because you got to find somebody who could connect you with somebody and if you ask your family doctor a lot of times they have to go ask somebody, so I think there's really many barriers once people make that decision but, you know, I think the first barrier to overcome is to simply to ask. And I think as long as you're doing as Dr. Frost said, about talking to people who can keep it confidential who can kind of help you think through it, a lot of times that's a great way to access, whether that's a pasture, whether it's a teacher--if you're a student--whether it's a friend or a family member who can sometimes advocate and help you.
Dr. FROST: I think we also need to keep in mind that there are tremendous strengths that people who have faced big life challenges bring to the table and in looking at employment situations we're all trying to find a good fit where our strengths are appreciated, and so we've been talking about some challenges about disclosing some difficult life experiences but there are a great strengths that come with that and so I think everyone's hope is to find a place where that is valued and respected and it's a helpful thing in the workplace. So community mental health services play a key role. We want to address any kind of trauma, stress, challenges people have as early as possible, there's a lot of research that shows that the earlier you can address challenges the better off everybody is, the better off the individual is, the family member, the better off we all are as taxpayers, so having a robust system of supports in the community is essential to having the society that we want to have.
We want you to feel secure. In and of itself, seeking professional assistance for your mental health does not jeopardize your security clearance.
Only five percent to seven percent of violent acts can be attributed to individuals living with a serious mental illness.
[Music] [Title Card: Violence & Mental Health]
DR. STONE: The general public, I think, is at the mercy of what they read in the papers, uh, and so they often--and some of the crimes committed by mentally ill people are very dramatic and unusual. [Clears throat] For instance, some years ago, must be about maybe more than 20 years ago, uh, there was a fellow, Juan Gonzalez, on the Staten Island ferry that took a sword of some sort and killed two people. And that of course was very dramatic and was very much publicized, so that it's things of that sort that, uh, the public, not knowing the full statistical picture, are going to get the impression "Oh my god, mentally ill people you really better steer clear of them if you knew who they were because they are highly at risk to do something terrible and dramatic and violent." So, it gives the public the worry that "Oh my god, the people that are mentally ill are doing these things all the time and the people that do them must be mentally ill because it's crazy to commit murder." But the fact of the matter is from a standpoint of actual diagnosable psychosis by a qualified psychiatrist, the number of violent crimes that are committed by mentally ill people or psychotic people is relatively small, maybe 5 or 6 or 7 percent.
Statement: I’m not mentally ill, why should I get counseling?
Response: Making the decision to talk to a trained individual who is experienced in dealing with life stressors does not imply that an individual is “crazy.” Often the most immediate effect is to allow the individual to examine a problem objectively and assess options for dealing with it.
There were popular sayings many years ago, "Don’t bring your problems to work" and "Leave your emotions at the door." Well, let’s be real; we’re humans, and emotions come with the package. Emotions can’t simply be turned on and off like a light switch. Through Emotional Intelligence they can be brought to our attention and managed, but not omitted; nor would we want them to be. They alert us to danger and allow us to love.
So, if you are experiencing occasional feelings of sadness, anger, or grief, that is expected; however, if these feelings expand over a period of time, and are interfering with your relationships or work, you may want to seek help. Some of those warning signs are:
1. Change in baseline behavior (going from engaging to quiet, becoming tearful when normally very even-keeled, etc.)
2. Consistent late arrivals or frequent absences
3. Lack of cooperation or a general inability to work with colleagues
4. Decreased productivity
5. Increased accidents or safety problems
6. Frequent complaints of fatigue or unexplained pains
7. Difficulty concentrating, making decisions, or remembering things
8. Making excuses for missed deadlines or poor work
9. Decreased interest or involvement in one's work
10. Working excessive overtime over a prolonged period of time
11. Expressions of strange or grandiose ideas
12. Displays of anger or blaming others
13. Poor hygiene
Statement: I can’t believe people with a mental disorder can get or keep their clearance.
Response: Violence is often not tied to a mental disorder. The vast majority of people who have a mental health issue are never violent and are simply in need of mental health treatment and support. Furthermore, the decision to seek treatment when someone does have a mental disorder is viewed as a positive sign that an individual recognizes that a problem exists and is willing to take steps towards resolving it. For the vast majority, seeking professional help does not adversely impact their career.
IC employees are not immune from the normal life stresses and difficulties that confront the population at large. Regardless of whether an individual holds a security clearance, at some time in life he or she may face problems with interpersonal relationships, depression, alcohol, family issues, or similar difficulties. Often, the decision to seek help is confounded by individuals' misperception that their security clearance may be in jeopardy regardless of the problem for which they seek help. Some believe that their judgment might be considered suspect if they seek assistance in dealing with a stressful situation. Seeking help for routine life crises does not reflect adversely on an individual's judgment, and, in fact, security and counter-intelligence officers view the commitment to seek help as a positive judgment factor. Seeking professional assistance in dealing with a problem does not jeopardize an individual’s security clearance.
Statement: I wonder what will happen when I come up for reinvestigation?
Response: The background investigator will ask a standard question about whether you have sought counseling for problems other than marital or family issues, combat-related trauma, or sexual assault. Replying that you have visited EAP satisfies the investigator who will then seek no further details. If you seek treatment from an outside therapist, the background investigator will ask limited questions after you sign a release.
Statement: I wish people understood.
Response: The clinicians at EAP offer a safe and supportive environment to help you better understand your situation and how to cope. Counseling available from EAP is confidential, except within an extremely limited set of circumstances. EAP will review these limits with you before you meet with a clinician. No one from EAP will report to your manager, security officer, or anyone in your office what is discussed during counseling without your permission or knowledge.