Preventing mental health problems in managers: A conversation between Eva Jané and Koldo Echebarria

Mental health problems affect a growing number of people, a trend exacerbated by the Covid-19 pandemic. Yet, they continue to be largely ignored by business and society. Directors and managers, alike, often suffer from their impact, in many cases resulting in depression, burnout, and serious mental health illnesses.

Eva Jané Llopis, Director of Health, Sustainable Development Goals and Social Innovation at Esade, talks with Koldo Echebarria, Director General at Esade, about the importance of mental health and what we can do about it.

TRANSCRIPTION:

Eva Jané Llopis: We are here today with Koldo Echebarria, the Director General of Esade. Thank you for joining us launching a series of talks about something very important to you I think; mental health.

Koldo Echebarria: Numbers say that something like one third of the students in universities suffer from mental health issues and there's also a very well-known psychiatrist working at INSEAD that has extensively written on this and he has done a lot of therapy with managers. He says that most of the management profession is in depression or really close to depression, which is something that makes sense from the pressures of the profession, and I think we need to be open about this. I mean it is an illness, we should have the capacity to cope with this illness and the only way we can do that is to be open about that and be open to treatment. We know there is treatment, so we need to confront it and avoid the stigma that is all over mental health issues.

The new generations are, if you want, superpowered. They have a lot of possibilities, they can make use of incredible technologies and they know how to use them, but at the same time they are super pressured. They have to become robot-proof, so they have a professional future which is much more demanding. This combination of being raised in an affluent society and at the same time being pressed by circumstances that demand much more of them, I think it's a complicated cocktail. I think it's a cocktail that normally comes with more mental health issues. If you add to that Covid, which is something we have not been prepared for, which takes out social life and creates new pressures, then the situation becomes very difficult.

I’m very critical of the reliance on the individual leader. I think that is a weakness, I mean if an organisation is so reliant on a powerful leader, it is a weak organisation. I think that leaders are important, especially in certain moments to make changes, to try to move in different directions, but what lasts is the institution. And that is a collective effort, it's not an individual effort.

Leaders are important, especially in certain moments to make changes, but what lasts is the institution, and that is a collective effort

Eva: This is very interesting, isn't it? Because when we start linking all the mental health problems and the issues, even the burnout, which is very much at the end of the spectrum of this stress, in many cases this is more due to the organisational ethos, the environment that's breathing that sort of stress because of many reasons; it could be the leadership, the top down approach, it could be just how people feel about the pressures in the organisation. Yet very few organisations are actually taking this at the core of their strategy and say "we're going to change the way we operate because this is actually hurting us because of all the stress on the burnout that creates." What is the paradigm shift that's needed here?

Koldo: If you have a culture which is very stable in general and not very prone to change, you will have more difficulties in adaptation. If you have an organisation whose culture is more of accepting change and making adaptations constantly and looking forward even to adaptations because there are opportunities in adaptation, the stress will be much lower. That's a very big issue; I don't think that in this context we can say “everything will be fine” because everything will not be fine. Everything will change, everything will mean new challenges, and we need to develop more resilience to cope with that.

Studies show that about 70-75 percent of people at the top have been identified as suffering from heavy stress

Eva: Let's go a little bit further with the stress, to the end of the continuum with burnout. Studies show that about 70-75 percent of people at the top have been identified as suffering from heavy stress. One third say it is extreme and it actually impedes their day-to-day operations. It leads many times to depression, as you mentioned, yet so very few people like yourself come out and say “I live with this, and I manage”. What do you think is important in dealing with, can you tell us a little bit from your own experience? Is it like having diabetes, is it an illness that can be managed?

Koldo: It is true, it is an illness, the problem is that we don't have the diagnostic tools that make it more objective in terms of the diagnosis. I mean, there's not a blood test that inevitably tells you that you suffer from a certain mental illness. You look for a number of symptoms and then you build a narrative in relation to these symptoms that makes the doctor say that you have these kind of mental health problems. If you break a leg, it's evident that you break a leg and nobody's going to discuss that you have broken your leg.

As it is, to some extent, ambiguous, there's this connection with weakness and mental health, this connection with lack of character and mental health. And of course when you are being perceived with this problem, it is not welcomed by other people that think you are a weak character type. The risk of being transparent is that you are being characterised as unfit for society and unfit for work, which is absurd, but anyway, there is this case.

Eva: What would you say, in your own experience, when you've been in moments where you were under a lot of pressure, in Haiti or even now during the times of Covid, during the times you're on the brink of a sort of losing it in a way. What do you do?

Koldo: I try to disconnect, that's one thing. I try to read, I try to listen to music, I try to watch a film that I like and takes me out of the…

Eva: Do you have time for that?

Koldo: Yes, I do have time. I read a lot and I love reading and I have time to read every day. The problem with management work is that you could devote 24 hours of your day to management. There’re always things that you can do, people that you can talk with, reports that you can read, there's always things that you can do, but that will destroy you if you don’t make space for other things and for decompressing in other activities, so I am quite disciplined on that and try to disconnect every day.

If you have a culture which is very stable in general and not very prone to change, you will have more difficulties in adaptation

The other thing that’s possibly useful is just silence. Trying not to talk during a period of time, and not to be disturbed taking noise out, and it works. But that's not an easy exercise for a manager, because in our daily routine there’s one activity after the other, it's a frantic routine. It's very difficult to manage in that routine a space of silence where you do nothing but stay in peace, and that's what you need to do. I think that helps, it connects you better with your inner self and allows you to be a little bit more reflective.

Then there are things that also can be done in a more structured way; you can have a therapist, which I think is very useful by the way, and it helps very much if it's done well. You need a therapist that you connect with, it's very important that you are comfortable with the therapist, it can be a very useful approach. Or you can have a counselor, or a close friend to whom you can discuss these kinds of important things, and that's by the way a tradition of the Jesuits, to have different figures that provide you with council, advise, or allow you to express what you feel, and some of them go into the personal area.