Computer voice
UX podcast episode 197.

[Music]

Per Axbom
You’re listening to UX podcast coming to you from Stockholm, Sweden. We are your hosts Per Axbom…

James Royal-Lawson
…and James Royal-Lawson.

Per Axbom
With listeners in 179 countries from Jamaica to Bulgaria.

James Royal-Lawson
So how often do you think about how mental health impacts your work? Do you are someone close to you have to deal with mental health issues. Where you work, what is the attitude of your organisation towards the topic of mental health? Is it something that even comes up? How would you respond to a colleague being open about their problems? These are just some of the topics that we’re going to tackle with today’s guest.

Per Axbom
And today’s guest is Jennifer Akullian who is the founder and executive coach at the Growth Coaching Institute. Jen is a thought leader and international speaker on the topic of mental health in tech and works to bring education and awareness to the tech community and reduce the stigma around mental illness. We invited her to share some of her thoughtful insights and advice.

[Music]

James Royal-Lawson
So Jen, tell us a little bit about what got you personally into the topic of mental health for tech or for designers.

Jennifer Akullian
Sure. So my background is I’m a psychologist, so I earned my PhD in psychology in 2009, and for a number of years practiced public mental health. And to be honest, it was really difficult and I burned out. After about seven years, I was looking for a different setting to work in, a different population to work with. And just through some connections, I was introduced to a CEO at a tech startup in San Francisco, who was interested in hiring a psychologist to work internally with the company and develop a coaching programme for all employees.

And so that’s what got me introduced to the world of the industry of technology. And I started doing that – moved to San Francisco started working with this team of about 50 people, and for a number of years was doing one on one coaching with that team at the startup.

And while I was getting introduced to the industry and the field and the people, I started recognising this, this realisation that mental illness was actually a much bigger issue in the tech population than I would have guessed, and the more I kind of dug in and started working with different organisations like open sourcing mental illness and MH prompt. I, you know, just dove deeper into this and started doing more advocacy work and realised even more the importance of the work I was doing from the coaching perspective, you know, for this team of people.

James Royal-Lawson
Is it actually shown that the tech industry has a higher rate of mental health issues than some other industries?

Jennifer Akullian
Absolutely. So this is what’s really interesting. So Open Sourcing Mental Illness is a nonprofit organisation in the states that does some advocacy work around mental illness and in this industry, and one piece of it is research. So starting in 2014, they developed a survey that was distributed to within the tech industry, looking at different aspects of mental illness.

They repeated this most recently this survey in 2016 and to give you an idea they had about 1600 respondents to the survey within the tech, the tech population, and what they found when asking, have you ever been diagnosed with a mental health condition by a medical professional, so a true mental illness?

We found that 51% of the respondents endorse this as yes. So to give you an idea of what this looks like, relative to the general population, the general population has about a one in five or 20% prevalence of mental illness. And so the difference between you know, 20% in the general population and 50 plus percent in the tech, the tech industry is very alarming. And this is you know, one of the reasons we continue to do the work in this area.

James Royal-Lawson
I mean that’s really fascinating. I know that the figures here in Sweden for mental health – there you see that more females – so the percentage of females reporting mental health issues is slightly higher than males. So when you think about the tech industry as historically being quite male dominated, especially when it comes to developers, then it is surprising even more to see such high figures…

Jennifer Akullian
Yeah.

James Royal-Lawson
…coming from the US.

Jennifer Akullian
Absolutely.

Per Axbom
And that makes me of course, want to ask why, what patterns? Are you seeing why is the tech industry especially, well, concerned about this?

Jennifer Akullian
So the short answer is we don’t know yet. The research is very preliminary, you know, even around different areas within tech, like what is the prevalence look like for designers or developers, we just don’t know yet.

But we have some theories. So one of the theories – well, I should back up a little bit – first of all, mental illness is predominantly a genetic disorder, it’s something you find, you know, running in family histories. But it is very highly impacted by environmental factors too like trauma growing up, so it’s not you know, it’s not just genetic but, you do expect there to be some either family history or traumatic event when you see this pop up in people. One of the theories is that the people that are working in tech right now have a very unique lifestyle to people working in more mainstream jobs. One of them being that – I’m sure you’ve recognised this – that we tend to work very much in isolation.

So we have a lot of developers who you know, work from home or even if they are in an office they’re, you know, in a corner on a computer with headphones, and don’t have a lot of human interaction. So this is something that we think contributes to maybe the already underlying prevalance of mental illness that might be found in this population.

We’re not sure if you know, people with sort of this mental illness history, are drawn to tech, or some people suggest that maybe people once they get into tech are developing mental illnesses because of the industry.

I point out the sort of the background of genetics environmental earlier because it’s probably not a situation where people are joining tech, they’re going into engineering into developing, you know, and then developing mental illnesses. That’s probably not true. But one thing – and you alluded to this earlier that’s important to recognise, is that burnout looks a lot like mental illness.

So the chemical kind of compositions in our brain of Norepinephrine, and Dopamine and Serotonin, which are often impacted with mental illnesses, especially mood disorders, which are found in one of the top diagnoses within the tech population from this survey.

Per Axbom
We always as designers want to ask why, and understand, but maybe that’s not what we should be focusing on but instead, this is prevalent in the tech industry…

Jennifer Akullian
Whether it’s, yeah, whether it’s – I want to point out – whether it’s burnout, or a true mental illness, it looks very similar. It’s impacting people in a very similar way. And so regardless of what it is, it’s a big issue that needs to be addressed.

James Royal-Lawson
I think that makes me want ask then, like we say, mental health issues, but, what kind of things are we actually talking about with that phrase?

Jennifer Akullian
So I can tell you exactly from the research that we do have so far. So mental health issues, or mental health conditions, or mental illnesses, when I’m saying those things I’m referring to a diagnosed mental impairment by a medical professional.

And the top diagnoses that we found in the tech population from these surveys is a mood disorder. So this includes depression, and bipolar among others. So about 73% of those that endorse that they do have a mental illness were found to have a mood disorder. About 60% were found to have an anxiety disorder, and this includes generalised anxiety, social anxiety, phobias, and obviously 70% plus 60% isn’t equal to 100 and this is because of dual diagnoses, so co-morbid conditions.

So, looking beyond that about 20% have been diagnosed with an attention deficit disorder, and about 12% with post traumatic stress disorder and about 8% with obsessive compulsive disorder. And again, some people are going to be diagnosed with more than one of these reoccurring.

Per Axbom
Oh, yeah, I think that’s an important point, that actually, when you think about it people tend to have several of these.

Jennifer Akullian
Yes, yep, that’s a very common thing, especially with mood disorders and anxiety disorders, or mood disorders or anxiety disorders with attention deficit hyperactivity disorder. Those are pretty common co-morbid disorders to see.

James Royal-Lawson
So, so when we’ve got – so we’ve got the diagnosed mental health issues but then, as you mentioned that, like burnout or some other kind of stress provoking or anxiety causing environments we have in our workplace, visualise themselves in very similar ways. If we then think about how can we help people we work with, with mental health. Can we do things that help both groups, both the diagnosed and non-diagnosed?

Jennifer Akullian
Yeah, absolutely. So one, one thing is around expectations for sure and it really comes down to the organisation and how they’re willing to work with the fact that, for example, developers fail a lot. Okay, this contributes to burnout.

There aren’t a lot of jobs where you work as hard as developers do and have things just constantly breaking and failing. And it kind of takes a toll on you and it definitely contributes to burnout. So you know, some of it is helping support our employees that do work really hard that do work really long hours and are constantly sort of exposed to this, this system of failure. And, and you know, just looking at expectations or work hours can help with that. And again, like whatever we’re doing for, for burnout is also helping people with mental illnesses, what we’re doing for people with mental illnesses is helping with burnout because they do look so similar.

So there are a number of different things that I recommend when I go around to different companies or conferences to help with some of these areas. I do work with HR executives for putting in place things like a mental health policy for employees and then I work with developers and designers and you know, people across the across the organisation about things that they can do for themselves and that they can do for others as well.

Per Axbom
So what should organisations do? Because I’m thinking, Well, how do I even know if people around me have mental health issues? If they don’t feel comfortable talking about it and don’t know, I’m not certain I would know how to respond in a good way.

Jennifer Akullian
Yeah, it is it is really complicated because what I found from sort of informally surveying a lot of people in tech is that they don’t trust their HR and their executives, they don’t feel comfortable, you know, going to them and disclosing that they have a mental health issue. They’re concerned that then their performance will, you know, be attributed to this and that they can be fired for it.

There’s actually at least in the United States a lot of protections against firing, or discriminating against someone with a mental illness. But that doesn’t change the fact that people you know, don’t feel comfortable disclosing that. And that really comes down to stigma, right? There’s a really big stigma around the world around mental illness, and people just don’t want to be stigmatised. So one thing that organisations can do is they can talk about it with their employees so often, this is something that just no one talks about kind of like, don’t bring up don’t talk about. And just by opening the conversation, especially if it’s, if it’s kind of directed by the executives saying like, you know, this is okay, we know this is happening, here are the ways that we are going to support you.

I’ve worked with a lot of executives who have chosen to disclose to their employees that they struggle with a mental illness, which is that self disclosure is actually shown in the research to be a really great way to help break the stigma, and to encourage other people to step forward and get self help themselves. So just opening the conversation, starting the conversation within the company is a really big aspect.

There are other things that organisations can do through their HR teams, like implement a mental health policy, that will explain for example, sort of like a mission, vision, values of what they want that to look like in the workplace. It can go through different accommodations or tweaks to the environment or expectations that can be put in place for employees to support them. And then also programming so specific programmes that you have for your employees to support them.

A final piece that I insist be included in organisations mental health policies are an overview of benefits. So when I when I make these with other companies, I make sure that they very clearly list out you know, if you have this plan, this is your copay for therapy, this is your copay for a psychiatrist, this is what your meds cost, this is what inpatient / outpatient looks like. So an employee can go right to the handbook right to the policy and be like, oh, like, you know, $15 I can see a therapist, and they don’t have to call their benefit provider and look it up and go through that hassle. So that’s another big thing that organisations can do to support their employees.

Per Axbom
My theory then is, so if organisations are, are more welcoming, more open, talk about it, discuss it with their employees, have support programmes, they actually lessen the symptoms of the mental health issues. So, but if you are always stressed about it, don’t want to disclose it because you’re afraid of being fired,of course that heightens your symptoms,

Jennifer Akullian
Right, absolutely.

Per Axbom
So it’s, it’s actually really about taking care of your employees so they can do a better job.

Jennifer Akullian
Absolutely. And it’s interesting, because, you know, my, my perspective is, if you’re running a company, you want your employees to be happy because you care about your employees. But even if you’re really selfish, and you’re running a company and you don’t care about the happiness of your employees, it’s to your benefit to offer these kinds of supports, because there’s a huge relationship between productivity and job retention, and burnout and mental illness. So you know, people who are, who are less happy are less productive and more likely to leave their jobs, you know, and retention is a big thing in tech, we want to keep our employees and we want them to be as productive as they can be. So even if it’s very selfish for the needs of your company, it’s in your best interest to provide these kinds of supports.

Per Axbom
Yeah, really good point. Yeah,

James Royal-Lawson
I mean, I think, I mean here in Sweden, we’ve got quite a good culture, or supposedly good culture at allowing people kind of time and space to recover from things or, you know, we don’t maybe – we aren’t seen as maybe punishing people in the same way as it can be seen in USA when you kind of count down how many sick days you’ve taken, they count them as holidays and so on. But my experience here is that even though we’ve got a more accepting culture around, being off to recover, that many times, management maybe don’t deliver on changing environments to make sure it doesn’t happen again.

Jennifer Akullian
So like if an employee is burning out and leaves, like what have we done to change for the future employees?

James Royal-Lawson
Yeah, or yeah, exactly. Like you maybe kind of, they have time off work to recover. But when they come back…

Jennifer Akullian
Right

James Royal-Lawson
…I’m not always convinced that the environments changed in a way which would properly eliminate or really reduce the chances of it happening again. And when we do, I mean, I’ve had colleagues and people that have been burnt out more than once, which I think is, you know, where I get the thinking from that it doesn’t it doesn’t vanish after once it stays around…

Jennifer Akullian
With that said that, you know, I mentioned earlier that there’s this culture of failure, right? And very long hours and the expectations at some of these companies are really high and the, you know, the executives, they might not have the ability to say, like, oh, we’re just going to push deadlines back and we’re going to tell you guys to work less hours. So while that may, might not be a possibility, you know, giving people time off is even more important, because yes, someone might be approaching burnout.

And then you know, their manager tells them take a few days off or take a week off. And that will restore them enough so that when they come back, they’re not right at that point of burnout again, it might take a few more months or something before they get there again. So you know, the importance of, of giving time off to recover, especially after a big deadline or big project where you’ve been working a lot of hours is really, really crucial. You know, if you don’t want to lose your employees to burn out,

James Royal-Lawson
I wonder if we also maybe need to be better at helping each other when it comes to the burnout aspect or, you know, heightened anxiety and stress that we’ve been better supporting each other when someone is trying to flag that maybe something is going too fast or is you know, showing signs that this is becoming too much that we maybe need to be better as supporting them and saying “Yeah, no, I think this will take longer than you’re expecting” or “it’s unrealistic that we do this.”

Jennifer Akullian
Absolutely. So one of the things that I still coach now – I coach through my own company so I work with a bunch of different teams at different companies around the world. But you know, one, one of the many benefits of coaching is that I will work with a whole engineering team – that meaning like I’ll work one on one with each of the people on that team, and I can get a very good grasp of how the team is doing. You know, and if the team does look like they’re burning out, or people are really struggling, you know, I can go to the manager without disclosing any names or information because it’s completely confidential, but be like, “Look, your team, your team is really struggling, your team is burning out”, like “they need a break once you’ve hit this milestone, once you’ve hit this benchmark.” You know, and that’s kind of a way of giving more insight for – to the managers that they might not get otherwise because not all employees feel comfortable going to their manager and telling them like “hey, I’m burning out” and aside from that, a lot of people don’t realise that they’re burning out so, that could just be a, you know, helpful piece of [info] to the organisation.

James Royal-Lawson
Do you find it’s an advantage not having the technical background when you do your work?

Jennifer Akullian
Yeah, it’s a good question. I do, I do. It’s definitely not necessary. You know, I’m not providing advice on what to do technically, that’s not my role. And so it kind of prevents me from going down these rabbit holes of, you know, technical work, I guess that someone you know, a VP of engineering might, might go down in a coaching conversation with the same employee. So I really focus on you know, the wellbeing how you’re doing, how you want to grow, how you want to be a better human, which doesn’t need to get into like, what technical piece is breaking right now and how am I going to fix it?

Per Axbom
Hmm, yeah. What I’ve seen actually more people talking about and doing now is check-ins. So check-ins at the start of meetings, to just get a feel for how people are doing and it can be simple things such as “how are you feeling” and draw on a post-it a weather symbol, that sort of a symbol, and you don’t have to comment it, you can just show it. And people just register that maybe this is a rainy day for you. And that’s great because that means you don’t have to talk about your issues, but you can actually make people aware of how you feeling anyway.

Jennifer Akullian
Absolutely. I am a big advocate of this. My favourite tool is, is actually I call it a stoplight. So at the beginning of meetings, I encourage managers or executives to do the stoplight exercise where they basically go around the room and say like, “how are you doing? Are you red, yellow, or green?” And like you said, people can just say, “Yep, I’m in the red today.” They don’t have to share anything else. Or they can say like, “Oh, I’m kind of yellow today. I didn’t sleep very well. Last night. I got into a big argument with my girlfriend.” You know and just being able to share that by itself is really important because again, a big percentage of the population we’re talking about tends to be more introverted and not as vocal with other people.

So sharing is a big part of that. But then the rest of the team knows like, Oh, you know, “Joe’s in the red today, like, you know, I need to be extra sensitive with him.” And, you know, “maybe not asked too much of him today”, you know, or, you know, “Jamie’s in the green” like, “this is a great day to go ask him for help”. So it can, you know, serves several, several different benefits. You know, if someone’s in the red consistently, their manager probably is going to want to check in with them and see how they’re doing which again, like you wouldn’t have any of that knowledge without doing the silly little exercise of the beginning of meetings

James Royal-Lawson
They’re both wonderful examples of how you can, you can surface empathy or you make, make things more on the surface so that it’s easier to take in as a, as another human being, because it’s not always easy to read people and not everyone has equally good skills in reading.

Per Axbom
So what I’m hearing is that there is only a win-win situation here that, the company will benefit, individuals would benefit. Even if they are selfish as you put it, which means that we should be focusing so much more on this and actually helping people feel better.

Jennifer Akullian
Absolutely. You know, whatever your motivations are, whether they’re you know, because you want your your organisation to be more successful through productivity and job retention, or you just want to take care of your people and you are invested in them being their best selves and happy it’s, you know, it’s to your benefit to provide these supports. At the same time you’re, you know, you’re supporting your accommodating people with a disability, with mental illnesses, and you’re accommodating people for burnout, which is very prevalent in this industry, especially.

Per Axbom
I learned so much. Thank you so much for sitting down with us, Jennifer.

Jennifer Akullian
You’re so welcome. Thanks for having me.

James Royal-Lawson
Thanks, Jen.

[Music]

James Royal-Lawson
In Episode 185, I asked Kellee Santiago – with a wonderful project that she had with producing Journey – the game Journey. Was there anything that they did wrong? And the answer that Kelly give us was, “yeah, we were all terribly burnt out by the end.” And I went on to say, “Well, if we skipped the whole personal personal health issues thing, my God, what a successful project.” And looking back, we shouldn’t maybe have been that flippant.

Per Axbom
No, actually it was even worse than that, because we were talking in the out show. I mean, we had we had picked up on that she said, “Well, we burned out” and I think she actually sort of laughed around it because it’s uncomfortable to say something like that. And, I said something along the lines of, because we were talking about what an exciting and fantastic project it was, and it was hugely successful and working on something like that, “it’s almost like you want to burn out” because we had picked up on it, and

James Royal-Lawson
You’re prepared to burn out ,

Per Axbom
Yeah, listening back when we, actually somebody called us out on it. And I didn’t at first understand why we were called out until I listened back. And to my horror realised what I had said, because that’s something I really don’t stand for. I’ll own that I said it, but it’s really something I did not stand for that made me feel really bad about, talking about it in that flippant way.

James Royal-Lawson
Yeah, same for me, I mean, I, my instant response, when we got some feedback was, “god no, we really, we really weren’t trying to belittle, you know, mental health and burnout. And I listened back as well. And I thought, “Oh, yeah, no, that’s actually almost even worse that we, I asked the question and got the answer.” And we didn’t, you know we laughed about it, like you said, and you know, well that means we’re not taking mental health issues seriously enough. We chose, we got we got their answer, we chose to ignore it and, you know, pat everyone on the back and said how good we are for such a great project, even though people got burnt out.

Per Axbom
And that is exactly what Jennifer has just been talking to us about is that there’s a culture, where you actually are expected to work long hours often, to get projects done for a deadline.

James Royal-Lawson
Even if it’s not where, even if it’s not long hours Per, I mean, here in Sweden, I wouldn’t say that, well maybe, I wouldn’t say generally we work really, really, really long hours. Unless you’re in the startup scene, possibly, but, but still, we’ve got this, this breakneck pace in which I think we’re expected to work at now. Which might be the result of Agile and, and the kind of iterative way of working perhaps, but, but we still got a lot of pressure on us to deliver.

Per Axbom
And when I was listening to her it actually made me think a lot about ethics issues, which was always top of mind for me now is that, because when you’re not at the top of your game, when you’re dealing with these issues, and that’s why I brought up that actually, if the companies help people, feel comfortable sharing how they feel, then the symptoms will actually be less than they are if you don’t feel comfortable sharing, which means that if you are not comfortable sharing, you actually could possibly put others at risk because of the way you work, you make decisions that are not the best for other people as well. So actually, it creates an evil cycle of people feeling bad, not making the best decisions, and then that will affect others and impact others as well.

James Royal-Lawson
If no one, if no one talks about it, then there’s that kind of silent acceptance, or you know, you start to think that, well, no one else is mentioning it. So it must be just me. So you have to kind of like just bite your tongue or buckle down and get on with it. And I watched one of the talks that Jennifer had given and she, she opens up with asking people, you know “how many out there wear glasses” or have kind of issues with their vision, and people put their hands up. And she goes, “Well, how many of you who have glasses have been told to try harder, to cure your vision?”

Per Axbom
Oh that’s good. Yeah.

James Royal-Lawson
And goes on to kind of like, you know, to make the connection then to mental health issues and, how could you possibly be expected to like try harder to cure your mental health issues or anxiety or stress and things. And that was, that was something that’s kind of, ” oh, yeah, that’s a good way of framing it.”

Per Axbom
And I liked what you said also, about how if people are actually off work, because they are burned out or close to burning out, and they come back and they don’t have that support, to actually, it be different so that actually they are helped when they are back at work. I’m now thinking of open space offices, where there’s so much sound – glasses made me think of that – people have headphones on, there’s sound everywhere. People are shuffling papers, coughing, talking on the phone – and if you have issues with sensory overload, with all your senses tingling, that can be, such a huge, take a huge toll on how you feel. And then you just crash when you come home.

James Royal-Lawson
Yeah, well, absolutely. I mean, I think that, we’ve got this whole thing where, we’re, you know, we’re expected now – teams are supposed to sit together, work together and so on, because it’s best for the team, the team is more effective. And I wonder how much of the, of the individual we’re losing sight of with those kind of blanket answers that say “teams work best in you know, when they sit together in, you know, open spaces”. That’s, that’s interesting to reflect on. And I love the example of the, kind of like the weather forecast.

Per Axbom
Yeah

James Royal-Lawson
I think, I mean I’d love to be able to start using, I’m gonna try and maybe start using that in some situations or meetings because I, you know, I know that some people are not as good at talking about these things or explaining these things. And you, you don’t need to know the reason. I mean, you can have a whole different, I mean a massive list of different reasons why you aren’t on top of your game today.

Per Axbom
Yeah

James Royal-Lawson
And it’s perfectly okay that it’s no one else’s business. But when you have to work with people, then it will be a healthier working environment if someone’s just aware that, today maybe isn’t your best day for whatever reason.

Per Axbom
Yeah. And just, it’s also a way of unloading what you’re carrying. Because I know that when I come to work, and I’ve had a bad morning, and somebody at work has the time to listen to me, unload for five minutes. I feel so much better. And if we can help more people unload with these simple simple exercises, then everyone will feel so much better.

James Royal-Lawson
Yeah. I think as well with the whole, the whole fear of failure thing or the fact that we’re, I mean, it was interesting what Jen said about how what we work with has so much failure built into it. And we talked about this that, you know, we have to be better at saying that it’s okay to fail. But I hadn’t maybe reflected on just how much failure we’re exposed to, and how, and how failure is a fundamental building block of what we do. But you know, we know full well, but it’s rare that a design is perfect first time round.

No matter how much research we do, it’s always very, very difficult to, to make it problem free because people are people, people are humans, and humans are individuals. So there’s always going to be something, and you’ve talked about inclusiveness or exclusivity, there’s going to be someone, maybe whose excluded anyway, even if you’ve got what seems like a perfect solution. So we’re constantly exposed to failure. And that must, that must actually put a lot of burden on us. Generally, even if we don’t have diagnosed mental health issues.

Per Axbom
Wow, this can lead to a lot of introspection I hope. I’m really glad we did the episode.

James Royal-Lawson
I am too.

Per Axbom
Yeah. So thank you for spending this time with us. And as always links and notes from this episode can be found on UXpodcast.com

James Royal-Lawson
If you want something to listen to next, then probably a really good episode after this one would be Episode 106 where we talk about imposter syndrome with Amy Silvers and Lori Cavallucci.

Remember to keep moving.

Per Axbom
See you on the other side.

[Music]

Per Axbom
Knock knock.

James Royal-Lawson
Who’s there?

Per Axbom
Lena.

James Royal-Lawson
Lena Who?

Per Axbom
Lena a little bit closer and I’ll tell you.

James Royal-Lawson
See this is where we need, this is where we need video because I actually did lean into the camera.