1. How to Identify Signs of Mental Illness Robin E. S. Miyamoto, Psy.D. Clinical Psychologist Assistant Professor John A. Burns School of Medicine Department of Native Hawaiian Health Department of Family Medicine and Community Health

2. Today’s challenge is to think bigger... Wellness Stress Mental Illness

3. Illness Model: Depression In a given year, 18.8 million American adults (9.5% of the adult population) will suffer from a depressive illness Approximately 80% of persons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life In a 3-month period, patients with depression miss an average of 4.8 workdays and suffer 11.5 days of reduced productivity Depression is estimated to cause 200 million lost workdays each year at a cost to employers of $17 to $44 billion Research shows that rates of depression vary by occupation and industry type. Among full-time workers aged 18 to 64 years, the highest rates of workers experiencing a major depressive episode in the past year were found in the personal care and service occupations (10.8%) and the food preparation and serving related occupations (10.3%) Occupations with the lowest rates of workers experiencing a major depressive episode in the past year were engineering, architecture, and surveying (4.3%); life, physical, and social science (4.4%); and installation, maintenance, and repair (4.4%)

4. Symptoms of Depression Difficulty concentrating, remembering details, and making decisions Fatigue and decreased energy Feelings of guilt, worthlessness, and/or helplessness Feelings of hopelessness and/or pessimism Insomnia, early-morning wakefulness, or excessive sleeping Irritability, restlessness Loss of interest in activities or hobbies once pleasurable Overeating or appetite loss Persistent sad, anxious, or "empty" feelings Thoughts of suicide, suicide attempts

5. Relationship between Stress and Mental illness Acute Stress Chronic Stress Mental Illness

6. What is Workplace Stress and Why Should We Care? Mental health and stress-related problems are steadily on the rise – 67% of employees say they experience a great deal of stress at work Sources of Workplace Stress –Working more hours –Productivity demands –Information overload –Increasing pressure to balance work and home lives Job Stress is estimated to cost US industry $300 billion a year in absenteeism, diminished productivity, employee turnover and direct medical, legal, and insurance fees

7. We are always on...

8. What Else Causes Unhealthy Workplaces? Effects of Workplace stress –Increases the likelihood of developing health problems (musculoskeletal, cardiovascular, gastrointestinal, coronary heart disease and mental health disorders.) –Impacts person’s wellbeing –Decreases job satisfaction The psychosocial work environment, the organization of work and the management culture of the workplace have the most dramatic impact on employee stress and health outcomes. Workers with high work-life conflict registered 13.2 days of absence per year compared to 5.9 days in those with low work-life conflict.

9. Stress Continuum Ready Adaptive Coping Optimal Functioning Wellness Features Well trained and prepared In control Optimally Effective Behaving ethically Having fun Reacting Mild and transient distress Or loss of optimal functioning Always goes away Low risk for illness Features Irritable, angry Anxious, depressed Physically too pumped up or tired Reduced self-control Poor focus Poor sleep Not having fun Injured More severe and persistent distress or loss Higher risk for illness Causes Life threat Loss Inner conflict Features Panic or rage Loss of control of body or mind Can’t sleep Recurrent nightmares or bad memories Persistent shame, guilt, blame Loss of moral values Ill Persistent and disabling distress or loss of function Clinical mental disorder Unhealed stress injuries Types PTSD Depression Anxiety Substance Abuse Features Symptoms and disability persist over many weeks Symptoms and disability get worse over time Stressor

10. Symptoms of chronic stress and mental illness Anxiety, depression, panic attacks, phobia Reduced concentration Disturbed sleep pattern Excessive forgetfulness Long hours/short hours Social distance Bad temper/loss of humor Physical symptoms – palpitations, breathlessness Frequent minor illnesses

11. Audience participation What is the number one risk factor for high levels of personal stress? being FEMALE Because we are always taking care of other people first

13. How much is happiness worth? A Warwick University study found that people in a happy state of mind are 12% more productive. A recent Gallup poll found only 13 percent of employees are actively engaged at work and emotionally invested in their jobs. Sixty-three percent of more than 230,000 full- time and part-time workers describe themselves as "not engaged," at work, and 24 percent say they are "actively disengaged" in their jobs.

15. What can you do? Don’t punish or reprimand employees who ask for help Raise awareness of the signs and symptoms of depression among managers and employees through training Managers and employees who are able to recognize the signs and symptoms of depression such as tardiness, complaints of fatigue, reduction in work output or quality, safety problems or accidents, and changes in attitude may help in the early identification and referral to screening and treatment services for affected employees

16. Why a Healthy Workplace Program? Benefits to Employees Increased job satisfaction Higher moral Better physical and mental health Enhanced motivation Improved ability to manage stress Benefits to the Organization Improved quality, performance and productivity Reduced absenteeism, presenteeism and turnover Fewer accidents and injuries Better able to attract and retain top-quality employees Improved customer service and satisfaction Lower healthcare costs

17. Interested in Starting Your Own Healthy Workplace Program? Hawai‘i Psychological Association sponsors Healthy Workplace Awards each year Visit the website for more information and an application: http://hawaiipsychology.org/phwa/index.html