The speed of the working world has accelerated enormously and the pressure on employees has increased. What can companies do about mental health? Dr. Natalie Lotzmann, Chief Medical Officer at SAP, advocates for an open approach to mental illness and more sensitivity – toward both others and yourself
Dr. Lotzmann, you have been involved in the topic of mental health at SAP for a very long time. How has the approach to it changed in recent years?
Over time, more and more employers have begun to understand that the performance of their workforce relies heavily on how the individual people in the company are doing. This can even be measured. We introduced the Business Health Culture Index back in 2009. Among other things, this takes into account important aspects of our employees' wellbeing: Are they able to balance their lives well? Is the stress they experience acceptable, or not? Do they feel sufficiently supported?
However, for most people it is still easier to say, "I have a broken leg" than "I have mental health problems." How can an open approach to the subject be further promoted?
It is always helpful for those affected to come out and talk about it publicly. Most of us will be affected by mental health issues at some point in our lives. I had cancer at the beginning of the year, which was a huge psychological burden for me. As a result, I fell into a very dark place. For me, too, my first impulse was, "I hope no one notices.” Then, I decided not to spend energy hiding it, but rather to fight back against societal norms and help stop periods of mental ill-health being a taboo.
What were the reactions like?
After I wrote about it on my blog and shared the article on LinkedIn, I received hundreds of emails and messages from all over the world. Many saw it as a brave example. They wrote about how much it had cost them to hide their health situation; some wrote, "I have a similar health issue. You have given me courage to face it openly."
What measures are in place at SAP to promote mental health?
Our strategy for promoting mental health in the workplace is based on four pillars: prevention, early detection, case management, and reintegration. Early detection is particularly important in the case of mental illness. The sooner someone receives professional help, the sooner they can regain strength and health. Therefore, we regularly inform our employees about the early warning signs and what they should look out for in themselves and others. In addition, regular surveys about stress perception, life balance, and general satisfaction are important for us.
What can someone who is affected and looking for help do?
Our message is: You are not alone. Find support. We have set up a live chat with psychiatrists which managers and employees can use at any time. There is also a confidential mail inbox that anyone can write to and receive individual counseling without anyone else knowing.
How should managers deal with the issue of mental health?
It's very important to train managers on how to deal with mental health issues within their team. Otherwise, they may look the other way out of helplessness and ignore signs. How a manager deals with mental problems in his or her employees has a lot to do with how he or she deals with himself or herself. Someone who doesn't admit their own weaknesses also has less empathy for others who show their weaknesses. That's why it's so important to promote the ability to reflect on your own behavior, to recognize your own patterns, and to encourage life-long learning in this field.
So, is it also about breaking away from old role models?
Many people learned early on from their parents not to be mindful of their feelings: “Don't make such a fuss!” “Pull yourself together!” This becomes part of our identity, our self-image, that we are always strong and capable, whatever happens. Recognizing that you have your own limits is therefore not easy for everyone. It is important for managers to consider this and not to stick to patterns learned during childhood.
Depression is one of the most common mental illnesses. About one in four women and one in eight men are affected during the course of their lives. How can colleagues or supervisors tell that someone is depressed? What are the first warning signs?
The difficulty is that most symptoms are nonspecific, which means that it is often only over time and in combination with other small changes that you can detect a noticeable before-and-after difference. Someone may seem depressed, more withdrawn, or be absent more often. The person may also not be as reliable as before, may need more time for tasks or may have not turned on their camera at all during video conferences for a while. Depression can come in many forms. It can also manifest itself in physical symptoms – for example, stomach, head or back pain. Tension or stress can often manifest itself in the muscles and even lead to a slipped disk.
What role does stress play in the development of mental illness?
A certain amount of stress is quite normal and necessary. Even a child who grows up without any challenges will fall far short of his or her potential. The trick is to manage the challenges so that they lead to growth and don’t become an unbearable burden. Our bodies and minds will signpost our limits. The question is whether we are sensitive enough to notice these signs in time.
Nevertheless, some people regularly go beyond these limits - until they are completely exhausted, perhaps even developing burn-out. How does that happen?
Some people have a very strong driving force inside them. In childhood, they may have learned that they were only loved if they got As at school or were the best at sports. However, the more their feelings of recognition depend on external factors, the lower their ability to act mindfully.
Our working world has also changed significantly as a result of globalization and digitalization. What role does this play in the development of stress?
The term VUCA (volatility, uncertainty, complexity, ambiguity) sums up the main challenges of our time well: The latter in particular - tolerance of ambiguity - will become even more important. The more an employee needs unambiguity, security, controllability, the more likely they will be stressed out by their environment and the more difficult it will be for him to get through his future working life in good health.
How can we deal with this?
We have to leave behind the idea that we can learn something once and then stick with it for life. The fields of work are changing rapidly. We should develop an attitude that embraces change and cultivates lifelong curiosity. In addition, not aiming for perfection, maintaining healthy balance, and regularly practicing relaxation techniques will help us keep up in the working world, as will investing in our own stress resilience.
How has the Corona pandemic affected people's mental health?
The lockdown, cramped conditions at home due to homeschooling children or caring for elderly relatives, the loss of regular social activities, fears, and insecurities caused by often conflicting news reports put many people under an enormous strain. Where there were already conflicts in the relationship or family, these often worsened. The same applied to psychological disorders such as depressive tendencies or anxiety disorders, which might, for example, have been compensated for or cancelled out by social contact. The full extent of the effects is currently still being realized. However, it is already clear that younger and older people seem to have suffered particularly badly, as did middle age women with the double burden of work and family, and people not in committed relationships.
Many people have worked or continue to work from home. How important is it for our mental health to have direct contact with colleagues and superiors?
Some need it more than others. In my team, right at the beginning of the pandemic, we introduced an informal morning meeting of half an hour every morning, where people chatted informally, told each other private things, shared a concern, or just laughed together about something. This was so well received that we have kept it up to this day.
For responsible leaders, in a virtual context it is especially important to maintain regular and direct informal contact with team members and to know their individual circumstances.
Otherwise, as always, it is important to be mindful of your needs and to find creative solutions for your social needs, even in the virtual world. My personal highlights during lockdown were cooking events with colleagues, where we prepared and enjoyed food together. The camera and screen were always close by, and after a short while, you almost forgot that you weren't sitting together in person.