Rather than looking for a label or a concrete diagnosis of a mental health challenge, some professionals are instead examining an individual’s mental health based on an ever-changing, fluid, sliding scale—more specifically, a spectrum-based approach.
In an article today for the Canadian edition of the HuffPost, Liz Bernier, managing editor of Canada’s HR Professional Magazine, revealed that through her own research in the field, she recognizes the importance of “the Canadian Armed Force's spectrum based approach [that] presents mental health much like physical health in that it exists on a continuum”.
Furthermore, Bernier explained, while issues of mental illness and mental health are finally being acknowledged in the workplace, statistics show that most workers still do not disclose their situations to their employers. “Forty per cent of employees report that they are willing to disclose mental health difficulties to their employer, according to the Anxiety and Depression Association of America," she wrote.
It was during her examination of the Canadian Armed Forces’ (CAF) Road to Mental Readiness program for an interview back in 2014 that Bernier believes she may have found a successful concept for the examination, disclosure and acceptance of mental illnesses in civilian workplaces.
“I was interviewing two of the [CAF] experts . . . when I first saw mental health presented as a spectrum,” she explained. Based on what she saw in the CAF representation, Bernier concluded that the army’s approach aimed not to reduce an individual’s identified challenges to a specific diagnosis accompanied by diagnostic labels and “all the associated stigma”.
And while Bernier was quick to emphasize the importance, and necessity, of the diagnostic method historically practiced in mental health sectors, she was fascinated by the stigma reduction that resulted from CAF’s concentration on mental health and mental illness on a continuum-based approach.
Bernier admitted she has experienced her own mental health challenges and that, in conjunction with working a journalism beat in "workplace issues", she is amazed at "the lingering workplace stigma inherent in a mental health diagnosis".
“The military is a unique employer in that it can be an extremely high-risk environment for psychological stress injuries,” Bernier said. “Coupled with that is a very particular culture where "toughness" is prized and praised, while disclosing a mental health diagnosis hasn't historically been well received.”
In an effort to accommodate its inherent sensitivities surrounding the disclosure of mental health challenges, “the CAF's spectrum based approach presents mental health much like physical health,” Bernier added.
The Military Mental Health Continuum Model is posted on the National Defence and the Canadian Armed Forces website. In its explanation of the model, the CAF not only recognizes the fluidity of an individual’s mental health status, but the community-based responsibility for each member’s wellbeing.
“The health and well-being of CAF members is the shared responsibility of the member, the chain of command, and the individual,” the website states. “Leaders always have a role and responsibility to . . . support their members throughout the continuum of mental health.”
Visually, the CAF Mental Health Continuum is composed of four color blocks (green, yellow, orange, red) on a sliding scale from left to right. “The arrows under the four color blocks denote the fact that this is a continuum, with movement in both directions along the continuum,” the site explains, “indicating that there is always the possibility for a return to full health and functioning.”
Bernier emphasized the positivity of the spectrum’s recognition of ongoing changeability. “It exists on a continuum, is highly variable and can change from day to day, and perhaps most importantly, it requires ongoing care,” Bernier wrote. “Your mental health could be green or ‘healthy’ one day, and slide into ‘reacting’, ‘injured’ or ‘ill’ over a very short period of time.”
Rather than situating an individual on a “fixed point on the spectrum”, Bernier applauded the model for accepting the constant ebb and flow naturally occurring in mental health challenges, for removing the permanence of labels and “because [it] removes the illusion of separation between ‘us’ and ‘them’—mentally ill or healthy”.
Thanks to its recognition of constant change, the CAF model, Bernier believes, is highly applicable to civilian workplaces as well as to the armed forces. “We all exist somewhere on the continuum, and every single one of us has the potential to slide down the spectrum if faced with a stressor or catalyst,” she said.
The CAF’s website clearly encourages de-stigmatization by identifying its model and the mental health challenges it represents: “In this way, no one is ‘written off’ simply because they are showing symptoms of an illness, or are being treated for a disorder or disease.”
Traci Pedersen, in her article for PsychCentral.com last week, referred to a recent study published in the journal Military Medicine. Results of the study, she said, indicate that the stigma of mental illness continues to negatively impact American military personnel in their search for assistance.
Based on the study’s findings, Pedersen wrote, “Military personnel are making extensive use of outside mental health services, suggesting that the mental health services offered within the military are not meeting the needs of active duty service members.”
Echoing the stigma the CAF model is attempting to eliminate, Pedersen listed the study’s most common reasons individuals in the military service were seeking outside professional help. Among the reasons were “fear of reprisal for seeking services”, “mistrust of command”, and the potential for “a negative impact of seeking care on one’s career”.
Bernier, L., (March 6, 2018). HuffPost CA. Civilian Workplaces Can Learn From How The Army Approaches Mental Illness. http://www.huffingtonpost.ca/liz-bernier/de-stigmatizing-mental-health-spectrum-canadian-armed-forces_a_23377672/
National Defence and the Canadian Armed Forces. (Retrieved March 6, 2018). The Military Mental Health Continuum Model. http://www.forces.gc.ca/en/caf-community-health-services-r2mr-deployment/mental-health-continuum-model.page
Pedersen, T., (February 28, 2018). PsychCentral.com. Many in Military Seek Mental Health Care Elsewhere. https://psychcentral.com/news/2018/02/28/many-military-personnel-seek-mental-health-care-outside-of-military/133118.html