Hiring and firing

A few weeks ago, the BBC held an interesting mental health debate on Victoria Derbyshire's current affairs' programme. This featured a panel of experts alongside a studio audience, who shared their experiences of a wide range of conditions, with additional contributions from viewers via social media.

The broadcaster had commissioned a special survey to inform the discussion and one statistic arising from this was that 56% of employers would prefer not to take on someone with mental health problems. Employers in the UK are prohibited by law from discriminating in this way, but, with a little ingenuity, recruitment decisions can probably be steered in any direction an unscrupulous boss wishes.

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This attitude potentially excludes a large percentage of the working population from employment, given that such conditions affect 1 in 4 people. And it certainly won't help Work and Pension Secretary Iain Duncan Smith to achieve his recently stated aim of getting more disabled people off benefits and back to work, including those with mental health issues.

Recruitment decisions also depend on the honesty of a candidate in completing any monitoring requirements and in answering questions about sickness absence. Many will conclude that it's in their best interests to be, let's say, economical with the truth. Comedian and mental health advocate, Ruby Wax, who participated in the debate, admitted that she wouldn't tell a prospective employer about her problems, were they not already well known.

About 10 years ago, I went through a recruitment process that involved completing a series of psychometric tests ahead of an interview with the managing director, to whom the role reported. During my meeting with him, he suddenly asked 'Do you have OCD?' - presumably my answers had somehow given him a clue. I didn't take the question amiss, as I was aware that he had personal knowledge of the disorder, from his involvement with a related charity. Nevertheless, I recognised that it was a highly inappropriate query in that situation. 

I didn't take the job - for other reasons - but met him again by chance years later, and reminded him of our previous meeting and his question. He immediately looked stricken and said 'I shouldn't have asked that. I'm sorry.' He was right to be dismayed; it's no more acceptable to ask an interviewee about their mental health status than it is to ask them if they plan to have children. 

One of the key factors in employers being reluctant to hire those with mental health issues is the continuing perception that these are something you can, and should, just snap out of. In fact, as Ruby Wax pointed out, a mental illness is also a physical illness, ie a problem with the brain. And you wouldn't expect someone to snap out of a brain tumour, would you?

I'll be taking a closer look at how people view physical and mental illnesses differently in a future post. In the meantime, if you'd like more information about the Equality Act 2010 and pre-employment questions, check out the Rethink Mental Illness website.

Troubled teens

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Half of all adults with OCD also suffered with the condition as a child, but this will often have gone undiagnosed and untreated. 

Early recognition is important to prevent the disorder taking a grip, however, it can be hard for the layman to distinguish between compulsions and ordinary behaviour; lining up toys in a specific way, for example, is very common in children and is part of normal development. Likewise, typical - and possibly rather difficult - adolescent behaviour may be misinterpreted as a mental health problem.

During a recent routine visit to the nurse at my GP's practice, we got talking about my blog, which prompted her to ask, 'Would it help young people? We get a lot of 17-year-olds in here with OCD.' I pointed her in the direction of relevant resources, including OCD Youth, a branch of OCD Action run by young people for young people.

It was only later that I wondered about her specific reference to 17-year-olds. Although the condition can strike at any time, and its exact causes are still unknown, significant life events are a trigger for some. The late teenage years are undoubtedly a time of change and stress, with youngsters either facing important exams or entering full-time work for the first time.

A few weeks after this chat, a friend told me that her daughter, who is in her early teens, had read my novel. A few chapters in, she had come downstairs and asked her mum, 'Do I have OCD?'

From my friend's description of her daughter's behaviour, she is certainly showing signs of it - with various ordering compulsions - and apparently reacts badly when family members don't comply with her rituals.

She had also queried, 'Is there something wrong with me?', which I found heartbreaking. It's hard enough to fit in as a teenager, without throwing a mental health condition into the mix. On the other hand, if she does have a problem, it's better she find out now and address it, before it takes over her life. 

I encouraged my friend to do some further research, so that they could be clear as to exactly what they were dealing with and how best to handle it. She admitted that the family already accommodated her daughter's demands 'to avoid all the screaming'. It's natural that a parent should wish to reduce their child's anxiety, but pandering to unreasonable behaviour is a short-term fix, counter-productive, and definitely to be avoided when tackling OCD.

There is plenty of help out there for young people, as well as their families, and peer support is a crucial element: just realising that you're not alone can be an immense relief.

The OCD Youth website, which is aimed at those up to the age of 25, contains a wealth of information, in addition to a members' forum, and the group also runs social activities and online meet-ups. If you need advice for yourself or a loved one, it's a great place to start.

UK readers might be interested in checking out this week's Horizon programme 'OCD: A Monster in My Mind': it's on BBC2, at 8pm on Wednesday 26 August.

Just in case

My guiding principle in life is 'Hope for the best, but prepare for the worst', which is a maxim that has led me to take a whole host of precautions to avoid problems.

Many are based on past experience, such as the time I locked myself out of my flat, as I rushed to welcome the breakdown mechanic who'd just arrived to restart my car. In the months that followed, I made a conscious effort to ensure that I had my keys before I put (literally) a toe over the threshold, until this became an ingrained habit.

This kind of 'once bitten, twice shy' measure is sensible and probably quite common. Others, however, are based not on experience, but the infinite what-ifs that an anxious mind can dream up.

Often I light the oven before having a bath in the evening, so that I can prepare dinner as soon as I'm finished. One day, it occurred to me that I might have an accident, or collapse, and be unable to get out to turn it off. Ever since then, the fear of a fire breaking out has driven me to take my mobile into the bathroom. Mind you, I don't know what scenario would leave me unable to climb out of the bath, yet still able to reach the window sill for my phone...and, come to think of it, why not have it to hand every time I have a bath, in case I need to summon help?

Meanwhile, back to the front door, where I never use the security chain and always remove the key from the lock and hang it on a nearby hook, so that anybody with spare keys can easily access my flat in an emergency - such as my collapsing in the bath, perhaps?

This is designed to help others as well as myself, but some measures will only come into play upon my ultimate demise: these include the document that contains every last detail of my domestic life.

The aim of this is to make it easier to tidy up my affairs, but it also feels like a protective charm: now that I have it, it will never be needed. Of course, it won't grant immortality, but perhaps it will ward off premature death. And the spare copies I've secured off site will enable me to rebuild my life - administratively, at least - should, say, my flat burn down. You never know, if I can't reach that oven...

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In fact, I've created a folder on my PC called 'Just in case' (a much nicer name than 'In case I die') to store both this document and instructions for my funeral, though I haven't actually drafted these yet.

So, just in case, I'd better lay out the basics here, which are: a humanist ceremony; a cardboard coffin*; music to include Stay Another Day (East 17), Hoppipolla (Sigur Ros) and Don't Stop Me Now (Queen), with a singalong to the last one; and, if it's spring, bunches of daffodils instead of wreathes. Oh, and please, please don't wear black. 

Now that I've shared that information, I'm pretty sure I'll live to 100!


*Cardboard makes much more sense for a cremation - assuming I haven't already gone up in flames with my flat - and I particularly like this one.

Over the limit

A healthy lifestyle benefits both physical and mental health, but isn't always easy to maintain, especially when the goalposts as to what constitutes 'healthy' keep moving. The basics remain constant, however: don't smoke; don't drink to excess; eat a balanced diet; get enough sleep; and take some exercise.

On the plus side, I follow a good diet and don't smoke. On the negative, I suffer from insomnia, do no exercise, and my drinking, well, it can get a little out of hand. 

Don't get me wrong, I don't mean twenty-something-on-holiday-in-Ibiza out of hand. It's the middle-aged, middle-class, a-few-glasses-of-wine-a-night-can't-hurt kind. Not drunk, just drinking.

It began a long time ago, with up to a glass and a half of wine to accompany dinner, on two or three evenings a week. As I live on my own, this was usually lone drinking - which some see as the proverbial slippery slope - and I drank more when I was with my partner or friends. 

This gradually crept up to two glasses on multiple nights a week, albeit small ones; as I always refill a 250ml bottle from a box, I can be precise about the quantities, at least. I finally decided to do something about it when, a few months back, I began half-filling a second bottle, for a third glass.

The increase in volume was certainly a concern. Somebody I used to work with was a recovering alcoholic and once told me he'd started with a glass of whisky a night but, before he knew it, was up to half a bottle. Where would I stop?

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More worrying, though, was that I could always find a reason - good or bad - for drinking. 'It's been a tough day.' 'It's Friday.' 'You have something to celebrate.' The excuses came thick and fast.

In the past, I've implemented rules in order to cut down, such as only drinking at weekends or when socialising with other people, but always ended up breaking them.

Sometimes I'd give up drink entirely, which I actually found quite easy - too easy, in fact. At the end of the target length of time, I'd pick up my drinking habits right where I'd left off, telling myself I could obviously stop any time I wanted: exactly how addicts of all kinds fool themselves.

Self-medication is no solution to any mental health condition, but substance abuse is an all too common problem amongst those suffering from a whole host of disorders. I assume that alcohol serves to relax me from my state of almost permanent anxiety, although I'm not consciously aware of it, as I don't get noticeably inebriated. 

However, any positive effect is temporary, and if I develop a full-scale addiction, I'll have a permanent, and much bigger, problem to overcome. Besides, I don't ever want to be faced with having to give up alcohol for good, just because I can't control my intake now.

So, on Saturday 11 July, I reverted to my 'only drinking with others' rule, and, to date, I've stuck to it. Not only have I massively reduced my consumption of alcohol, but I've hardly missed it at all. Long may it continue.

Minority report

Previously on The Reluctant Perfectionist… 

Last month I published a post that began ‘A comment you often hear from people with OCD, in response to inaccurate representations of the condition, is “It's not all about cleaning!” What they mean is that cleaning compulsions don't result from a desire to clean, but from the anxiety that is caused by not cleaning.’

This generated the following feedback from one reader: 

‘When I say it's not about cleaning I don't mean anything about cleaning compulsions actually. I mean it's not about cleaning… When most OCD sufferers correct that stupid stereotype about cleaning they are trying to say that it's not about cleanliness or order. Their cleaning habits and sense of order are the same as anyone else's.’

My previous post may not have been entirely clear on this point, but it’s true that many people with OCD don’t have issues with cleaning or ordering. It’s quite natural for them, therefore, to want to correct the assumption that the disorder revolves around these. 

For those who do, however, it can be frustrating to hear others say ‘It’s not about cleaning/ordering’ – somebody I know with cleaning compulsions has expressed this particular frustration to me. To cover both eventualities, perhaps we should say ‘It’s not always about cleaning/ordering’? 

In fact, the condition is about a whole host of different obsessions and compulsions. 

The self-help guide Overcoming Obsessive-Compulsive Disorder lists the top three most common obsessions, ie prevalence amongst sufferers, as:

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1. Fear of contamination (38%)
2. Doubts about harm occurring (24%)
3. Excessive concern with exactness, order or symmetry (10%)

While the top three compulsions are:

1. Checking (29%)
2. Repeating acts (11%)
3. Mental rituals (11%)

‘Ordering or arranging acts’ trails in at fourth, with a measly 6%. 

From these statistics, I seem to be in a minority within a minority, in having ordering as my main issue. The different kinds of obsessions and compulsions are not mutually exclusive, of course; sufferers usually experience a number of each, to varying degrees.

While these figures are likely to have changed since this book first came out, the general trend does seem to reflect my own experience: I’ve only met one other person with ordering as their chief problem. As it happens, this was during an order and symmetry seminar, at one of OCD Action’s conferences, so the odds were stacked in my favour.

It was like being at a party surrounded by strangers and suddenly – and gratefully – finding somebody with whom you have a shared interest. Not, in this case, writing or adventure travel or Star Trek, but how we arranged our belongings!

As we exchanged confidences, I experienced a sense of relief that ‘It’s not just me’. Discovering that somebody else carried out the same rituals also seemed to validate them somehow, though I could still see how irrational they were.

So, if you’re like me, too, I’d love to hear from you – my particular OCD world can be a rather lonely one!

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For more information about the most common OCD obsessions and compulsions, see this page.