How to approach mental health issues in the workplace

In trade body UKIE's recent Games Industry Census, 31% of the respondents said they live with anxiety, depression or both. The national average in the UK is 17%.

Similarly, in the IGDA's Developer Satisfaction Survey in 2019, 28% of the respondents identified as having a disability, with the most common disability mentioned (11%) being psychiatric or mental illness.

In its white paper on 'Mental health in the game industry', mental health charity Take This highlights four risk factors that explain well-being issues being higher than average: crunch, job instability, job loss, and job-related uncertainty. Take This also released a report titled Crunch Hurts in 2016, which highlights that insomnia and depression are common consequences of crunch.

But despite mental health being a well-known issue in the industry, a lot of studios still don't know how to approach it, and fail to address their staff's emotional well-being at the same level as their physical health.

"I understand that small things are often really big things. But you are still good and whole and beautiful"

Rebekah Saltsman, Finji

"I have spent the last several years coming up with new ways to work around my anxiety, which is often paralysing when it comes to my work life," Finji CEO and co-founder Rebekah Saltsman says. "Simple to-dos often feel overwhelming. I understand that small things are often really big things. I understand that sometimes getting an envelope to the Post Office is impossible. That sometimes you can't answer an email. That in the winter, when you haven't seen the sun, you need to stand outside as often as possible during the day and work at night. I understand that it can take just one change to uncover or nullify your own coping mechanisms. And that all of this is okay and we can work with this because even with all of this, you are still good and whole and beautiful."

If mental health awareness wasn't built into your company culture from the start, knowing where to begin can be a daunting task.

"Bringing in a professional to work through an office wide social-emotional health curriculum would be a very good start," Saltsman continues. "Talking about therapy and the resources available to the staff is a very good place to start. Posting information on how to get help is a good place to start. Creating a culture where it is okay to ask for help is a good start. Creating a production plan that builds in release valves so those who need help can get it is a good place to start. These are pretty hard things to do, but we can keep working toward them and being better employers and co-workers."

The GamesIndustry.biz Academy will explore all the solutions highlighted by Saltsman, and other studio heads, so you can make sure you are equipped to identify mental health issues and make your company a safe and welcoming space.

Normalise conversations about mental health

Conversations around emotional well-being should happen openly, and staff should feel comfortable talking about their issues. You may have difficulties supporting people with other measures if they don't feel comfortable having these discussions in the first place. And it goes beyond just telling someone they can 'talk to you any time,' though that's obviously a good place to start.

"It's essentially [about] normalising it, making it a part of the culture," Raw Fury CEO and founder Jónas Antonsson says. "So for instance, I suffer from anxiety myself. Everybody knows that, it's not something I'm ashamed of. I talk about it openly. And I think it's just a matter of creating an environment where people feel that they are allowed to be human beings, with all the good and all the bad that comes with it.

"Creating that environment is the key because then it's not a process. It's not a thing that people feel somebody wrote down because 'we want to be inclusive'. It's a part of the DNA of the company they're in. We're a strange company. We don't have the classic hierarchy here. There's no management, everybody's helping each other out. And I think that helps as well."

"It's a matter of creating an environment where people feel that they are allowed to be human beings"

Jónas Antonsson, Raw Fury

Love and compassion are the two things that should be leading your conversations around mental health with your staff, Saltsman says, and you should respect their comfort level.

"Have a conversation on a walk outside, or at least get out from behind your desk," she says. "Ask if they need time and mean it, with no strings attached. Do as much as you can to help a person who needs you."

Max Downton, brand manager at Splash Damage, lays out an example of what a studio can do as a good starting point to get conversations going.

"A studio [I know] had a whiteboard where they would all stand up in the morning and say what people are working on. And on it they had a collection of smiley faces and if you were in a bad headspace that day, you would move your grumpy smiley face and put it next to your name. What it did was just normalising discussions around mental health."

Evaluate your current practices and processes

Companies that haven't really thought about mental health issues in the workplace should start by evaluating what they're doing -- and not doing.

"We did the workplace well-being index with [mental health charity] Mind last year," Mediatonic people director Mark Stephenson says. "It was really interesting and gave us some really great feedback about how we could improve. It showed us where we are now and benchmarked us. It's also a commitment to our people. It showed everybody at Mediatonic that we're serious about this, that we want to become better."

In the same vein, Finji identified ways the studio could keep running if someone in the team needed flexibility. It's all about making sure your business is equipped to ensure the well-being of your staff, without risking bankruptcy.

"We think about this a lot as parents," Saltsman says. "If a child falls at camp and breaks a wrist, how will we handle the work week when we have to schedule medical appointments? These are the same kinds of questions you need to ask for your team. If someone is burning out on your watch, who can help? If someone has a storm of things going wrong, can you support them by helping take care of their work responsibilities? If they have Seasonal Affective Disorder, what ways can you support them during their off season? Can your setup handle this?"

Check on your staff regularly

Regularly check that you're providing enough support for your staff to maintain a healthy mental state. This will complement the two previous points: once you get mental health conversations started and you check on your practices, evaluate how your staff feel about both on a regular basis.

"We have constant anonymous feedback surveys that are going around the studio," Downton says. "I think the other side of accountability is talking to [staff] and saying: 'Do you feel like you can go to your manager to talk about this?' or 'Do you feel like you get the right support in this area?'. It's about constantly checking in on that feedback loop and not just doing one-off training and saying 'Okay cool, the studio is mentally healthy now'."

Finji implemented a bi-annual survey for its staff.

"That covers things like average hours of work per week, internal communication issues, feedback on our health insurance and HR provider, communication issues with outside partners," Saltsman explains. "We want to know because we cannot protect our people if we aren't aware of what is going on."

Have external experts talk to your staff

A great way to increase awareness around mental health -- which in turn can make employees more comfortable discussing their own issues -- is to have an external expert at the forefront of your actions.

"If you have a company and a culture already established that doesn't include [mental health awareness], the key is to get someone that actually is dealing with this to speak and lead that effort," Antonsson says.

That can mean someone coming in on a regular basis (more on that below), or just having a one-off talk on the subject to kickstart the process. For Splash Damage, the epiphany happened during a talk from an army veteran, Rob Shenton, which led to various mental health initiatives at the studio.

"Call a local group and spend the time to talk to someone who knows"

Rebekah Saltsman, Finji

"He left due to struggles with mental health and, as with many ex-servicemen, struggled transitioning back into civilian life," Downton says. "He was very frank and honest about his struggles with mental health. That was an eye opening moment for lots of people."

Saltsman adds that it's always better to have someone from outside the company pitch in rather than the task falling on your employees.

"Call a local group and spend the time to talk to someone who knows. I would make an appointment with a therapist to talk about the ways mental health conditions would exhibit in the workforce. I would bring actual professionals in to talk to your HR company and your teams."

Organise training for your staff

Education is essential. Whether it takes the form of a talk, or training for your staff, or both, is up to you -- and your budget. Saltsman advises training to be done in small collaborative groups rather than have huge company-wide seminars.

Training can touch upon awareness of various illnesses, or it can be mental health first aid training, which explores how to react to crises more in-depth.

"We've recently trained up some mental health first aiders," Mediatonic's Stephenson says. "They attended a two-day course, learning about the different aspects of mental health and how to approach them, the different problems that people might face and how they manifest, how to address them in the workplace, how to tackle a mental health emergency. And also understanding mental health from their point of view, understanding how it can be triggered, so we can take steps to address that through processes so people are less likely to have mental health issues working at Mediatonic."

Mediatonic didn't want to rely solely on line managers and HR. Instead, with a cross-section of people aware and prepared, its employees would feel there's always someone they can speak to.

"One person will get stuck with being 'the mental health person' just because they might have their own individual passion," Mediatonic's marketing manager Haley Uyrus adds. "But obviously that's not great for them or for the company because it shouldn't just be weighted on an individual. It's a really great thing to know that across the different teams we have people that can spot those things, so it's not resting on just one individual's shoulders."

"If you don't see that learning being implemented on the ground then it's worthless"

Max Downton, Splash Damage

At Splash Damage, more than 100 line managers have gone through similar training so they can more easily recognise patterns and behaviours, and learn how to have these conversations with people around them. To make sure this turns into a culture change, the training will be repeated.

"If you don't see that teaching and that learning being implemented on the ground then it's worthless," Downton says. "So line managers will be required to do the training again. It's something that we're gonna be doing every 12 months or 18 months, as people get promoted into managerial roles too."

Have internal resources and a community staff can turn to

It can take time for people to build up the courage to talk about their emotional well-being in the workplace, especially new starters. Making sure your company provides internal resources, while also providing support for home workers.

"We have an employee assistance program," Downton says. "It's an anonymous phone line that you can call with any concerns. It doesn't necessarily have to be mental health, it can be financial, it can be anything. They listen to whatever your concerns are and put you in touch with someone specialist in that area."

Mediatonic has a mental health well-being portal on its intranet with resources and signposts for things like the Campaign Against Living Miserably (Calm) and mental health charity Mind.

"[You] can get more information, you can read up things yourself in your own time, and if you want to come and ask for some more help you can," Stephenson says. "But you can also find help on your own if you want."

Splash Damage set up an internal Slack channel for anyone affected by mental health issues -- 60 people joined within an hour of its creation. The UK games industry Slack has a mental health channel, too.

Having a community of like-minded people who understand what you go through can be invaluable help for people suffering from mental health issues. 2Dogs CEO and creative director Ken Hall realised the importance of community in 2000, when working on B-17 Flying Fortress: The Mighty 8th with veterans from World War II.

"Just working with those guys really opened my eyes to the long-term effects of mental health issues," he says. "These guys, at 80 years old, were still waking up on the floors of their bedrooms trying to get out of burning tanks. What helped them get through all that was the fact that they met regularly together.

"It really underscores that community is the absolute biggest thing. In this day and age when everything is trying to divide us, it's more important than ever to focus on finding ways to come together and making sure that we do retain that sense of community, because that is our strongest tool in the box."

Treat mental health the same way you treat physical health

It's worth repeating and repeating, and repeating a bit more, until every single company in the industry understands it: mental health needs the same care as physical health. Your employees' well-being, all of it, should be your priority -- if you only care about half of it, maybe you shouldn't be in a manager position.

"I remember watching a podcast with Karamo from Queer Eye and he was saying the same thing: if you were on a diet or going to the gym to lose weight you'd tell everyone," Downton says. "You'd be like: 'I can't come to the pub tonight, I'm going to the gym, I'm on a diet'. But if you're taking care of your mental health, no one wants to talk about it, no one wants to say: 'I'm staying in tonight and I'm gonna watch Brooklyn Nine-Nine for the five millionth time and order takeaway and just be sad for a bit'."

"I don't expect anybody to hide that they've got a cold, and I wouldn't expect anybody to hide that they've got anxiety"

Mark Stephenson, Mediatonic

Stephenson adds: "The reason we talk about [mental health] a lot is because we want to remove the stigma. We want to get to the point where people talk about mental health the same way they talk about physical health. I don't expect anybody to hide that they've got a cold, and I wouldn't expect anybody to hide the fact that they've got anxiety, because it means we can then address it, we can try and help."

Offering benefits that promote a healthier lifestyle is a way to show your dedication to supporting your employees' mental health the same way you support their physical health -- with the two being closely linked.

"There's an intrinsic link between physical health and mental health, so we pay for gym memberships for people, we've got Cycle to Work schemes," Downton says. "We do as much as we can to at least open the door for people to take care of their physical health for free.

"We look at things like yoga studios nearby, massages and those things that just make people feel better. Even if studios are worried about where to start with mental health, even things as simple as just thinking about well-being more generally in a physical sense is really valuable, and really useful as a good place to start."

Make therapy an option

Splash Damage has on-site counselling, every other week for a full day. Mediatonic has an employee assistance plan which entitles people to counseling sessions -- staff can get eight counseling sessions a year, for free.

But these solutions may not necessarily be financially sound for a small studio. If your studio isn't big enough to allow for such an arrangement, make sure you're loud and clear about the benefits of therapy.

"We encourage our team members to seek out therapy from qualified medical professionals and we will always provide support and encouragement for this," Saltsman says. "We don't consider having a therapist to be a weird or bad thing, it is another way we can stay healthy so we can keep on making beautiful things. Therapy appointments or doctor check-ins are not crisis moments for the studio. We expect and plan for folks' basic wellness to overlap their work schedule sometimes. It is a time for us to say: 'Your health is the most important thing, it's okay'."

Antonsson adds: "We go to the doctor without thinking about it. If you have a pain, you go. This should be the same thing. I advocate for that, if people are feeling mentally exhausted or feeling that they have a long-term issue they need to deal with."

Offer flexible working solutions

A flexible working schedule is an invaluable asset for someone with mental health issues. Strict working hours or having to be in an office every single day can aggravate symptoms or trigger crises. Make sure you provide your staff with various, flexible options.

"One of the tenets we have is that you can work from anywhere, at any time, in any way that you feel comfortable with, as long as you get the things you need to get done and are mindful of the people that you are working with," Antonsson says. "This freedom alleviates a lot of normal-day stress. If people need to all of a sudden pick up their kids or run to the store, if there aren't any meetings they need to reschedule, they just run and do it. It just takes away so much stress from: do I need to get someone to sign off and say 'Yes, you can go'."

Finji also has flexible work options, and offers unlimited vacation time for its staff.

"So long as no one abuses this, we will keep this policy in place," Saltsman says. "This means that if someone needs to go down to half-time or needs time off for either physical or mental health issues, we have a system in place to take care of our people. In 2019 we had a perfect storm of team health issues, and we were able to see the weak links in our policy and our backup plans. Our goal moving forward is to make sure that no one on the team feels like they can't take time off."

Make sure remote workers don't feel isolated

More and more games companies choose to work virtually. That's the case at 2Dogs, which has people distributed across Canada, the UK, the US and several other countries.

"That allows access to much better talent," Hall says. "It also means that we're able to let people work from home, which in some ways is fantastic for their mental health, but it also creates a lot of isolation... We're trying to increase the amount of general discourse through our chat platforms, like Discord. It's okay not to just talk about work but to treat that platform as the water cooler and just engage with each other."

Raw Fury is based in Stockholm, but it has remote workers in the US. Antonsson tries to create an environment where everyone feels included.

"We use Microsoft teams, where we talk internally about everything," Antonsson says. "[We] have calls twice a week. They're not meetings. You can jump on that call if you have time, so you can share stuff, talk to each other, just trying to emulate that feeling of actually working with other people."

Whether you want to use Skype, Slack, Whatsapp or Discord, it's important to remain in contact with your remote workers, especially if they suffer from mental health issues. They are entitled to the same support as people who come to the office every day.

"If you have a remote worker who is struggling it's important to know what steps they can go through and who their local mental health charities are," Downton adds. "If you're employing remote workers all around the world, it might be worth doing a little bit of legwork looking into local support structures for those people. If I've got someone who's working in New Zealand, the time difference is massive. I can't be there to support them, but knowing how I can support them in other ways is really valuable."

"To address mental health in the workplace we have as low pressure a work environment as possible"Ken Hall, 2Dogs

Address your potential crunch issues

Crunch is always the elephant in the room when it comes to discussing mental health in the games industry. To make sure your employees' well-being is looked after, it's simple: don't crunch.

"One of the things we do to address mental health in the workplace is having as low pressure a work environment as possible," Hall says. "So we don't have overtime and crunch. We're lucky we've got a great team, so we can trust everybody not just in terms of their honesty, but also in terms of their time management skills. So we don't have to be intensive with the hour tracking."

Stephenson adds: "We make sure that people are not having crazy hours. And if anybody does appear to be working longer hours than they maybe should be, we'll address that with them and try to avoid it. We try to be really proactive about it."

Rely on external resources

By now you should have a better idea of what can be done to improve mental health awareness at your company, but if you still have questions, turn to professionals..

"Never be afraid to reach out and ask questions if something is beyond you or you're not sure," Hall says. "It's always better to speak with an expert and, if there's a problem with somebody and you're not sure how to approach it, you don't want to make it worse. We've been lucky enough to work with a whole bunch of groups, with Take This being the first. But we've also been lucky enough to attend some things like The International Game Summit on mental health (TIGS).

"We also have a lot of streamers who have helped us along the way. Marie 'Mxiety' Shanley runs a mental health podcast that is very informative and she really tries to engage her community, not just in talking about mental health, but talking about their mental health."

In terms of external support, Saltsman recommends CheckPoint, a charity that provides mental health resources for gamers. She also points to the US National Suicide Prevention Lifeline -- on 800-273-8255 -- which offers 24/7 support. In the UK, the Samaritans have a similar lifeline on 116 123. As the LGBTQ+ community is at higher risk of experiencing poor mental health, she also recommends having a look at your local Pride Center.

"The company that we use for our workshops and mental health training is a company called Luminate," Downton adds. "This can come as a shock to other studios, but places like Bupa, Health Assured, Medicash, which are obviously traditionally seen as physical health companies, also have a lot of things for mental health."

Finally, Antonsson has a few books to recommend. The first one is called The Four Agreements.

"It's a practical guide to Toltec wisdom basically," he says. "It's short, it's very relatable, it's very understandable. It's nothing new, it's just basic human truths that sometimes it's great to just remind yourself of. Then there's Emotional Intelligence 2.0 by Travis Bradbury. It looks at how it's good to think about your own emotional intelligence.

"Whenever I have any deeper conversations with the people around me that are tied into these subjects, I usually point them to read up on Stoicism -- read the diaries of Marcus Aurelius, who had all the stresses of the world on his shoulders and somehow managed to be a very humble down-to-earth man. His diaries are an amazing read. "

Remember that mental health is an easy business case to make

Mental well-being, much like unconscious bias, will always face doubters, people who are lucky enough to have never encountered such issues and who don't care about that aspect of health. For those people, it's worth noting that your staff's happiness is good for your business.

"As dispassionate as it sounds, if you have people who are at work but not fully at work, people who are struggling, their productivity goes down," Downton says. "If you have people who have signed off from work because of any mental health related issues, then they're not at work. So at its most cynical level, it makes sense to invest, and invest heavily, in mental health support.

"If you had a set of stairs in the building that people are constantly breaking their ankles on and taking time off work, you would fix the staircase. Long term, when you think about things like retaining staff, if you're a company that demonstrates a commitment to the well-being and happiness of its staff, people will probably be more likely to stay."

In its Crunch Hurts reports, Take This points out that productivity losses related to fatigue are estimated to cost employers $1,967 per employee each year. Each year, depression costs US employers $44 billion in lost productivity.

"I can't imagine working with people that I love and, at the same time, not caring about their whole self," Saltsman says. "How can you not care about the health and safety of your people? But let's also talk about the practical side to this -- it is better in the long term to give people who need to heal a chance to do this outside of the workplace. Having sick or hurt people at work does not help anyone and there is a lot of pressure to force them to work with policies like super limited sick days or paid time off. If the goal is to do the most efficient and best work, people need to be healthy."