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Effective workplace communication with employees with psychiatric disability

Chapters

Talking about learning

Assisting employees with psychiatric disability to learn new skills, routines or behaviours requires particular communication skills.

All employees, including those with psychiatric disabilities, need to know that they are continuously learning the skills of being a worker. Everyone has to learn these skills and go on learning to develop new skills and learn new tasks. You need to assist supported employees to understand their role as learners and why it is important to learn and keep on learning work skills.

  1. Work shows other people we are independent adults.
  2. Going to work shows other people that we are productive members of the community.
  3. Work is a chance to learn and develop new skills.
  4. Through our work, we set ourselves goals for getting better at things.
  5. When we see ourselves getting better at things, we feel better about ourselves.
  6. When we work well, we contribute to our organisation and that means everyone gains.

Like any learners, people with psychiatric disability need to know:

Today you are going to learn how to put the labels on the jars of dip.

Yesterday, you checked the labels before the dips were packed, didn't you? And did you notice some jars of dip had the label on the wrong way up? Well, they should have been fixed up in this section. Remember that's part of our job.

Today we'll concentrate on two things. First, we'll make sure the jars come off the line the right way up. Second, we'll put the label on so that it's straight and fixed firmly to the jar.

Stay with me and watch everything I do. Then I'll go slowly over anything you want me to and you can ask questions. After that, you can have a go.

I'll watch you and tell you how you're going. Does that sound OK to you?

An employee with psychiatric disability often faces particular challenges as a learner owing to problems their condition causes in 'engaging' in the learning process. The employee may:

To support employees with psychiatric disability, you must get to know as much as possible about the way their condition impacts on their learning at work. Observe them, communicate with them, and with others who know them well, and, above all, keep on trying to find out more and new ways to assist their learning in the workplace.

Dougal

Dougal is 28 and first came to Merrinvale Enterprises six months ago. He has had obsessivecompulsive disorder for nearly 12 years. He was in a psychiatric hospital for over a year at one stage, and has been in and out for a few weeks at a time often since then. He still takes a lot of medication. Dougal is tall and moves very slowly. He speaks slowly too, in a flat but booming voice, without much expression in it.

Dougal is very anxious all the time. He wrings his hands a lot and often breaks out in a sweat. He has to go about things in very particular ways or he becomes even more anxious.

When he first arrived he did not say anything. For several days he just stared at people with a very worried look on his face.

Dougal's support worker from the mental health service, Oscar, has told Merrinvale staff that it's best to keep things calm and quiet around him – no loud music or people rushing around doing things. Dougal feels more secure when things are calm.


From Nathan's diary

Dougal gets distracted very easily and this week we've had the dips on the turntable. The turntable is one of the things he gets obsessed by. He just stands there mesmerised, his eyes following it round and round. I've been trying to train him in the packing but there's no chance of getting anywhere with it while this is going on.

When I told him firmly to go and get on with his job, he started pacing up and down and didn't stop for over an hour. In the end, I had to give him his model airplanes magazine. Oscar, his case worker from the Mental Health Team, had told us to do this if Dougal is really upset about things. He sat down, found the page about the model he's making at home and read through it over and over again talking away to himself. I was surprised – it seemed to calm him down and about 20 minutes later he came back and started working well.

Strategies

  1. Increase the employee's ability to hold and fix attention. For many people with a mental health problem, new learning causes anxiety, sometimes to an acute level. Help calm the person by:
  1. Validate the employee's feelings. Listen to and acknowledge the person's lack of confidence and do not dismiss it.

Say: I suppose you think this is going to be hard to do. It probably will be, but don't worry, I will help you.

Don't say: Oh come on, it's easy. Anyone can do this.

  1. Provide reassurance and information on progress. Help the employee learn by providing concrete and specific information about what they are doing and how it is going – every step of the way. Stay close by so that feedback is always available and the employee feels supported by your presence.
  2. Reduce the memory demands on the employee. Many mental illnesses affect memory functioning. It will help the employee to learn if you:
  1. Show the employee how to cope when things go wrong. It can sometimes be useful for you to make deliberate errors – to demonstrate the fact that the world doesn't end and everybody makes mistakes.
  2. Build success into the employee's learning experiences. Always start with something you know the employee can either do already, or will learn quickly and easily. Then take small steps, and remember that success builds success.

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