HR for Mental Health in South East Asia – An Easy Icebreaker

Alison Chisnell’s blog has sparked an awesome conversation around HR for Mental Health. I have followed it keenly, but felt rather powerless to participate in a meaningful way. You see, I work in South East Asia (SEA), and that presents some unique challenges to mental health. But I do believe there is something fundamental that HR pros can do in SEA to help break the silence.

The Context of Mental Health in SEA
Disability is still a terrible open secret for SEA families, with many a family member having spent their life in the back room while guests visit their house, so as not to be seen. I know this because I have been to a party and heard a voice I didn’t recognise from the kitchen but wasn’t allowed to go in since it was an aunty with Down syndrome who isn’t allowed out to see guests. With this attitude towards ‘being different’, it’s no wonder that mental health is a terribly feared, real secret.
Mental health in SEA is such an embarrassing subject that the true costs and difficulty in obtaining treatment are rarely open to public debate. Health insurance does not cover mental illnesses. It is a cost to be borne out of pocket. Singapore has a mandatory saving scheme that takes portions out of citizens’ salaries, but only from 2009 could this money go towards depression or bipolar disorders from 2011.  There does seem to be some development in mental healthcare affordability but it is very slow. Even if you have the money, the services may simply not be available to you in the lesser developed parts of SEA. And if you are a foreigner perhaps, there can be the added difficulty in seeking help that is culturally appropriate.
And then it gets really complicated when the silence around a mental illness is broken but the answer given is religion or black magic. SEA is a region known for its religious diversity and strength, perhaps it is not so know for its black magic though. Something that easily arches the eyebrow of a foreigner, black magic and possessions are a naturally accepted fact to SEA local. Mothers of my friends have been possessed, stories are passed about those who are cursed by previous generation’s bargains with bomohs, poor women will have metal plates implanted in their forehead to lure a wealthy husband. Putting this final layer over the mental health issue in SEA makes for a rather limited dialogue. 
Don’t Tell Your Colleagues
As a sufferer of anxiety, I recently sought professional advice in Singapore. I went to a private clinic and was so fortunate to have met a wonderful therapist, a Pakistani who migrated to the US, was a non-practicing Muslim, and had an inter religious marriage. I hit the jackpot of help and insight into my unorthodox intercultural, interracial, inter religious significant relationship and life. And that advice hit the jackpot with my credit card: $300 for one hour’s consultation. It didn’t matter how much they helped me, that kind of rate is simply unaffordable.
Apart from the great advice, one of the things I vividly remember from the session was being advised not to share my anxiety challenges with colleagues. The impact on my career and social standing would apparently be catastrophic enough that therapists remind foreigners not to share mental health concerns with SEA colleagues.
Mental Health In the Workplace
And this brings me to mental health in the workplace of SEA. A difficult terrain to negotiate is the concept of hierarchy, seniority and saving face. People in high positions who are respected seniors simply can’t be approached about erratic behaviour. Jobs are at the mercy of a boss’s self awareness and an employee’s remarkable skill to save the face of someone clearly ignoring significant mental health problems. Secondly, the power of a name and social networks in SEA make the importance of face saving essential to successful business. Mental health is not something anyone wants attached to their image in SEA. The fear from the top resonates right down to the fear of those on the bottom – the most vulnerable with the lowest likelihood of seeking treatment – and everyone suffers in silence.
HR in SEA is more involved in employee health than what I am used to, as we negotiate and manage the health insurance of employees. Surprisingly, for all this involvement in health, there will never be a mention of mental health. Sick days will be for a myriad of reasons, but never because of mental health. And one of the most difficult issues as a foreigner practicing HR in SEA is that despite all the influence and best intentions on your behalf, you’re not going to change the basic attitudes of the people in that country, change the government healthcare policies or create better public mental health services. 
So what can we do when we’ve got all the resources that we’re going to get, and it’s just not enough?
What HR Can Do
In my honest and very simple opinion, I believe one of the most important things a HR pro can do in SEA is to establish strict professional boundaries and partake in no gossip at all about employees. It’s sadly not a given for HR in SEA. Appraisals and employee’s life decisions will regularly be discussed mid-store or over lunch while the HR pro and colleagues wait for that person to arrive. How do I know? Because I’ve heard and seen these examples happen as I go about my daily life in SEA – a management meeting about a staff member in the pharmacy aisles, a discussion about someone’s maternity leave and career prospects with other colleagues at a restaurant table. If I’ve seen it, then so would have all the other people I work with, and they would have seen it for their whole lives in SEA.
Discreteness is not an easy image to cultivate against this backdrop, and it may be a solo effort in a team of HR pros in SEA as you come into a place with formed habits, or even cultural norms, that fly in the face of confidentiality. But it’s a worthy effort, and ultimately rewarding when a colleague finally takes comfort in the professionalism and understanding of your role that it’s no longer a ‘head cold’ plaguing them, but a very bad bout of depression. Anyone who has suffered from some sort of mental illness knows the power of just being able to call your infliction by the name it actually is – no-one takes comfort in excuses of being “blur like sotong“, a head cold, or tiredness, when the monster of depression or whatever other life stealing condition is haunting them. It’s a little bit like telling someone with a broken leg to get on with life by telling everyone they have a sprained ankle. It must feel so damn good to have someone to tell that actually, the leg is broken
Now, I agree, it’s not much. But it’s a start. And it doesn’t mean becoming the counsellor and hearing everyone’s problems. In fact, good HR will promptly stop conversations that are for real counsellors and therapists – we’re there for business. But HR is also about people, and people suffer from illnesses. Some discrete open mindedness is the least we can do, and could bring very real impact to organisations in SEA.
Btw, if you’re wondering how I can be employed in HR, and write about HR – here‘s my explanation.

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  • 24 January 2013