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Effective workplace communication with employees with psychiatric disability

Chapters

Talking about talking and listening

Whether it is verbal, written or visual communication, it is all about sending and receiving messages.

Effectively supporting employees with psychiatric disabilities will depend a great deal on your ability to adopt specific and individual communication strategies.

One of your key roles is to assist supported employees to communicate as effectively as possible. Three elements are involved in the process of transmitting information between people.

Communication is only effective when the people with whom you're communicating:

At each stage of the process there are many potential barriers to effective communication. These include:

Support staff also need to be aware of a range of other things that can have impact on communication. For example, a person's cultural and language backgrounds may influence:

Whatever the reason, if the receiver does not receive the message in something very close to the way it was meant then communication has not occurred.

Communication problems are often a major factor in the psychological and social difficulties people experience because of mental illness. The interpersonal skills needed can be impaired and this can be a key reason for problems in getting and keeping a job.

No one can go to work and do their job properly without communicating with others. Supported employees should know their communication responsibilities:

Fulfilling these responsibilities requires both support staff and supported employees to use talking and listening skills.

Kaye

Kaye appears to have had a very unsettled life. She has been in and out of a large number of relationships, and had a lot of different jobs. Kaye is very unfit, is obese and smokes 50 cigarettes a day.

Mondays are often bad days for Kaye. She tends to get upset by things over the weekend and brings the troubles with her to work. This week she said she has not been able to sleep because she was worried about her daughter's comments about her (Kaye's) weight which had made her feel very low. Kaye says she will drop some weight over the next few weeks because she has stopped taking her medication. Em asked Kaye why she did that and Kaye said that she didn't want her daughter (who Kaye has never mentioned before) to know she was still on it. When Em asked if she should do that, Kaye said it would be fine – she often dropped the medication for a week or two and it did no harm.

Kaye has a very helpful case manager, Brenda, who often comes to Merrinvale with Kaye to discuss concerns and assist supervisors communicate with Kaye and deal with some of her issues. This week Brenda confirmed that Kaye does not have a daughter. She also indicated that Kaye has real problems sticking with her medication. The mental health clinic has tried all sorts of strategies with her but she continues to stop taking it from time to time.


From Em's notebook

Kaye doesn't want to do anything this week but told me a long story about how her grandmother survived after the ship she was on sank. Granny had all these diamonds but someone on the lifeboat stole them while she rowed them all to safety.

What's interesting is that Kaye said she didn't like 'Titanic' when she saw it on TV a couple of weeks ago – said it was 'Hollywood hype'. When she starts this sort of stuff, I usually try to cut it short and turn the conversation to something else. Lately though, it's only while she's telling you these stories that Kaye sounds alive. The rest of the time she barely says a word and just sits there with her head lowered all day, hardly moving from her chair. She has put on a lot of weight and it's awful to hear how breathless she gets with any exertion.

Strategies

  1. Know your own values. Each of us has our own reaction to and understanding of mental illness. This will affect how we deal with mental illness in the people we work with. The challenge is to try to understand mental illness from the point of view of each person living with psychiatric disability. Try to approach your job with a non-judgemental attitude, an open mind, and willingness to learn.
  2. Get to know the employee's communication 'comfort zone', for example, how much personal space they need, length of time in which to respond, type of language preferred, etc.
  3. Build rapport and trust. If an employee is having problems talking to and responding to others in the workplace, try to build rapport and trust by being open and honest with them. Tell them specifically what is happening and what impact this is having. Try to provide practical help to overcome the problems.

You ignore people when they say 'Hi' to you. I know you like to keep a bit of distance from people but how about just saying 'Hello' when you come in each morning.

  1. Encourage conversation. Conversation is the cornerstone of social interaction so anything you can do to assist an employee build and practise skills in this area is a benefit. Always speak in a 'gentle' (calm and moderately-paced) tone, and be as objective as possible.
  2. Promote good communication skills. You might think about establishing 'guidelines' with the employee. For example, you and the employee could agree to:

Guidelines will vary according to the existing social skills of the person and their cultural background. The guidelines need to be backed up with training, coaching, feedback and modelling on your part.

  1. Provide information. An employee with psychiatric disability may speak or write in a fairly complex way, and may have difficulty processing and making sense of what is said. If this is the case, try to use familiar and concrete language.

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