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Four Myths About Collaboration and Teamwork

The time spent by managers and employees in collaborative activities has increased by 50% or more in the past two decades (Cross et al., 2016). But this doesn’t mean employees know how to work together well or that leaders know how to build high-performing teams. In this post we will explore four common myths associated with teamwork.

Myth #1: Teamwork can overcome talent gaps

Technical (task) competence matters. For a team to be effective, team members need to be able to do their job, not just work together effectively (read more about effective collaboration here). Research indicates that it is difficult, if not impossible, to overcome a lack of talent through teamwork (Tannenbaum & Salas, 2020b).

Myth #2: Adding stars boosts team performance

Towards the end of the 1990s there were too few workers to replace retiring baby boomers (Keller, 2017). This led America’s largest and most prestigious consultancy firm, McKinsey, to declare a “War for Talent” and recommend their clients focus on recruiting and retaining the “best and brightest” (Satell & Windschitl, 2021). As companies began to follow this advice, however, dark unintended consequences emerged.

For example, at Enron, then the seventh largest company in the US, star performers were “rewarded inordinately, and promoted without regard for seniority or experience” (Gladwell, 2002). Individuals began to undermine colleagues, crushing teamwork in the process. Enron was charged with corporate fraud and collapsed taking one of the big five audit companies, Arthur Andersen, with it (Curwen, 2021). The point here is that having a ‘star’ or ‘talent’ mindset can seriously harm teamwork.

Scott Tannenbaum and Eduardo Salas, authors of Teams That Work: Seven Drivers of Team Effectiveness (2020a), further explain, “The relationship between talent, teamwork, and performance is actually a bit complex. For example, research shows that simply adding stars won’t always boost team performance. And you shouldn’t assume that individual excellence is enough unless you are working on tasks that require no coordination” (Tannenbaum & Salas, 2020b). Just because top performers excel in task competence doesn’t mean they possess teamwork skills. So, adding stars may boost team performance, but it’s not a given.

Myth #3: Conflict is bad for teams

“When the majority of a team’s disagreements are interpersonal in nature, performance tends to decline. But if most of their disagreements are task or work related, then the way they handle those conflicts determines whether performance improves or declines”, says Scott Tannenbaum (Duncan, 2020).

Where interpersonal relationships are not strained, a little discord can actually be beneficial to team performance, particularly when it involves team members speaking up about errors and concerns (Salas et al., 2015; Shaw et al., 2011). Without conflict, teams are at risk of a type of cognitive bias called groupthink in which consensus overrides the best idea (The Decision Lab, n.d.).

The research on team performance shows that established teams outperform newly formed teams (Coutu, 2009). But there is a danger of groups that have been together for some time becoming homogeneous – a death knell for creativity and learning. Pioneering team researcher J. Richard Hackman says, “Every team needs a deviant… Deviants are the ones who stand back and say, “Well, wait a minute, why are we even doing this at all? What if we looked at the thing backwards or turned it inside out?”… In our research…It turned out that the teams with deviants outperformed teams without them. In many cases, deviant thinking is a source of great innovation” (Coutu, 2009).

Myth #4: Team performance is linked to the intelligence of individual team members

In a study published in the esteemed journal Science, researchers found that team performance was related to the group’s collective intelligence (Woolley et al., 2010). However, collective intelligence was NOT linked to either the average or maximum intelligence of individual team members, but to “the equality in distribution of conversational turn-taking”. In other words, groups where a few people dominated the conversation were less effective than teams where each of the team members contributed about the same amount to discussions.

Learn more about How Leaders Help Their Teams Build Trust.

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The Science of Teams and Effective Collaboration

“There are many opinions about what makes teams work. Some are well-grounded, most are pure conjecture” – Scott Tannenbaum & Eduardo Salas (2020b).

We have all had experiences working in teams, whether at school, college or in the workforce. But how much do we really know about how to collaborate effectively? If you’re an employee, you are expected to be a team player. Question: Were you ever taught how? If you’re a leader or manager, you may be lucky enough to have had some formal training about what makes teams work. But much advice is simplistic and, frankly, unreliable (Kruse, 2020).

So, when it comes to teamwork, most of us are “winging it” and hoping for the best with exactly the results you’d predict: sometimes great, but very often not-so-much. However, this needn’t be the case. It turns out that extensive research on teams has been conducted in the last 60 years, and “We now know what effective teams do, think, and feel” (Kozlowski & Ilgen, 2006; Salas et al., 2018).

The problem is that much of this research is buried in academic journals and is inaccessible to the public. The ‘secret sauce’ lies in the actionable tools and tips that emerge from this evidence. 

When it comes to teamwork, human behavior is nuanced. What we do in one situation is different from how we act in another. Our environment matters. The people around us play a role. The specifics of the tasks are a further influence. Variables galore. Welcome to the wonderfully messy world of teams research! Next, we will take a look at how key researchers in this field have made sense of this complexity and discuss the overarching themes in their findings.

Drivers of Team Success

Scott Tannenbaum, a former business school professor, and Eduardo Salas, an industrial-organizational psychologist, are the authors of Teams That Work (Tannenbaum & Salas, 2020a). They examined hundreds of individual studies and over 35 meta-analyses with two key questions in mind:

• What drivers of team effectiveness show up consistently?
• Which of these drivers would be actionable if team members and leaders were aware of them?

Tannenbaum and Salas identified seven drivers of team success: capability, cooperation, coordination, communication, cognition, coaching and conditions. In this blog post, we will consider a few of the capabilities that drive team effectiveness

Capability

Tannenbaum and Salas use the term capabilities to describe the mix of knowledge, skills and other attributes a team needs to possess. Some capabilities are specific to particular settings, such as patient handover protocols in health care settings, whereas others are transferable, such as:

• Communication skills,
• Giving and receiving feedback,
• Conflict management, and
• Interpersonal skills (Duncan, 2020)

Another attribute that consistently predicts team success is what Tannenbaum and Salas call “collective orientation”. People who are high in collective orientation think of the group first, whereas those high in individual orientation think of themselves (Driskell et al., 2010). The research shows not everyone needs to have a collective orientation, but the team needs enough people who do (Duncan, 2020).

Myth or Fact? Teamwork can overcome talent gaps

Technical (task) competence matters. For a team to be effective, team members need to be able to do their job, not just work together effectively. Research indicates that it is difficult, if not impossible, to overcome a lack of talent through teamwork.

Verdict: Myth.

Myth or Fact? Adding stars boosts team performance

According to Tannenbaum and Salas, “The relationship between talent, teamwork, and performance is actually a bit complex. For example, research shows that simply adding stars won’t always boost team performance. And you shouldn’t assume that individual excellence is enough unless you are working on tasks that require no coordination” (Tannenbaum & Salas, 2020b).

Just because top performers excel in task competence doesn’t mean they possess teamwork skills. So, adding stars may boost team performance, but it’s not a given.

Verdict: Myth.

Myth or Fact? Teamwork can be taught

Figure 1 summarizes what the science of teams indicates are important capabilities for team effectiveness. Many of these teamwork skills can be taught.

Verdict: Fact.

 Actionable Tips for Team Leaders

• Don’t form a team by defaulting to whoever is available. Start with the goals, then identify the knowledge and skills needed to meet the objectives. Finally, compose the team to get the capability mix right. Remember to consider collective and individual orientation.
• If there are gaps, determine if someone in the team can be trained up. If internal development isn’t feasible, two further options are temporary access to an expert, or recruiting new talent (Tannenbaum & Salas, 2020b).

Figure 1. Capabilities that are drivers of team effectiveness.

Is there a downside to collaboration? Read more in this post.

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How Nutrition Impacts Your Mental Health

“Let food be thy medicine, and medicine be thy food” – Hippocrates

The links between nutrition and physical health have long been known. For example, you are most likely aware that a healthy diet protects against non-communicable diseases such as diabetes, heart disease, stroke and cancer (World Health Organization, 2020). However, the association between nutrition and your mental health is less well known and understood. A new scientific field called nutritional psychiatry is beginning to show that “what we stick in our mouths matters to our mental health”, according to one of the field’s pioneers, Professor Felice Jacka (Fleming, 2019).

Jacka explains that “bloggers and self-styled dietary experts” have “brought nutrition research into disrepute” (Fleming, 2019). The aim of her research, and those of other colleagues in the field, is to apply scientific rigor to the many questions we all share regarding our diets, mental wellbeing and brain health.  We will now take a look at a few of the key nutritional psychiatry studies.

Nutrition and mental health: Diet and depression meta-analysis

A meta-analysis pools results from multiple studies and is thus a powerful method of understanding the research in a particular field. A meta-analysis published in 2014 explored whether there was a correlation between dietary patterns and depression in adults (Lai et al., 2014). The authors identified 13 relevant studies involving more than 100,000 patients. When the data from all of this research was pooled, two distinct dietary patterns emerged – a ‘healthy diet’ and a ‘Western diet’. Using statistical processes, the authors concluded that people eating a healthy diet reduced their chance of experiencing depression by 16% (1 in 6).

This is quite remarkable given how serious depression is and that it can be difficult to treat. The mainstays of treatment are medication and psychotherapy (talk therapy). However, around 4 in 10 people don’t respond to antidepressants after a 12-week trial (Henssler et al., 2018) and more than half of patients receiving psychotherapy don’t experience a significant reduction in their symptoms (Cuijpers et al., 2021).

Nutrition and mental health: Cause or effect?

What the meta-analysis clearly established is that diet and mental health are correlated. However, the question it couldn’t answer is whether depression caused people to have a poor diet, or an unhealthy diet was an underlying cause of the depression. Scientists often say ‘correlation is not causation’ to make it clear that finding links (correlations) between phenomena is not the same as uncovering the cause. For example, if A and B are found to be linked, A could cause B, B could cause A, or some unknown factor (let’s call it C) could be the underlying cause of both A and B.

We know that mental and brain health are impacted by a complex mix of “biopsychosocial” factors. Biological factors relate to genes and medical conditions; psychological factors include personality traits and self-esteem; and social factors cover influences like education, employment, income, neighborhood and access to healthcare (Bruce, 2021; Food and Mood Centre & Deakin University, n.d.; Telloian & Grohol, 2021). Environmental factors including childhood abuse and significant life events also play a role.

The value of dietary research is that it relates to a modifiable lifestyle factor; we can’t change our genes, our personality, our past, and some aspects of our present circumstances, but we can certainly change our lifestyle behaviors such as the way we eat and our level of physical activity.

Professor Jacka became particularly interested in causation because if it turns out that poor nutrition is a cause of depression (rather than depression causing poor nutrition), then diet can be used to treat and prevent mental health conditions.

The SMILES trial: An overview

Jacka and colleagues ran the first randomized controlled trial (the gold standard of research designs) in the world investigating the question “If I improve my diet, will my mood improve?” The SMILES (Supporting the Modification of lifestyle In Lowered Emotional States) trial was published in 2017 (Jacka et al.).

SMILES was a 12-week study involving 67 people with moderate-to-severe, medically diagnosed depression. Participants were randomly divided into two groups; 33 received a diet intervention and 34 received social support (the control group). All patients continued with their usual treatment for depression (medication and/or psychotherapy) making the dietary changes or social support an adjunct (add-on) treatment. All participants completed a baseline assessment prior to starting the study that covered physical health (including a blood test), lifestyle, education, occupation and income. After 3 months, participants attended a follow up appointment where they completed the same measures as the baseline assessment.

Participants in the diet intervention received seven individual support sessions with a dietician. The goal of these sessions was to teach them about the recommended diet, a modified version of the Mediterranean diet, and to encourage adherence. Participants were provided with recipes, meal plans and a sample hamper containing the main components of the diet.

Compliance with the diet was calculated using a measure developed by the researchers called the Modi/MedDiet score, and depressive symptoms were measured using a standard psychiatric tool called the Montgomery-Asberg Depression Rating Scale (MADRS).

The SMILES trial: Interpreting results

So, what were the results? Participants in the dietary intervention group had a much greater reduction in their depressive symptoms over the 12-week study period compared with those in the social support group. This was calculated by comparing the follow-up and baseline MADRS scores. Importantly, these results were independent of changes in physical activity and were closely related to the extent of dietary change. In other words, those who improved their diet the most (as measured by the Modi/MedDiet score) experienced the greatest benefit in relation to their depression.

Even more impressive is the fact that almost a third (32%) of the participants in the diet group achieved remission of their depression compared with only 8% of those in the control group. Remission of depression – by changing what they put in their mouth!

The SMILES trial is a landmark study because it demonstrated the direction of causality. High quality nutrition caused an improvement in mental health. Here is how the authors summarized the implications of this finding:

“The results of this trial suggest that improving one’s diet according to current recommendations targeting depression…may be a useful and accessible strategy for addressing depression in both the general population and in clinical settings” (Jacka et al., 2017).

Or to return to the original question, “If I improve my diet, will my mood improve?”, the definitive answer from the SMILES trial is “Yes.”

Interested in mental health? Learn more about why having mental health literacy matters.

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Can You Be Too Much of a Team Player?

Is your performance suffering due to endless demands for input, access to resources or meetings? If so, you’re not alone. The expectation to collaborate, to be a team player, has taken over the workplace. According to research published in a Harvard Business Review (HBR) article titled “Collaboration Overload”, many of us are spending around 80% of our time in meetings or responding to colleagues’ requests (Cross et al., 2016). With the equivalent of one day per week left to complete our own work, taking assignments home or logging extra hours at the office has become the norm.

The cost of over-collaboration

Where the story gets really interesting is that research involving more than 300 firms shows a small group of around 3% to 5% of individuals are responsible for up to a third of value-added collaborations (Cross et al., 2016). A study from the University of Iowa showed that a single “extra miler”, someone who frequently goes above and beyond the scope of their own role, can enhance the effectiveness of a team more than all the other members put together (Li et al., 2015)! These employees are the ultimate team players. But at what cost?

It turns out that there are downsides to what University of Oklahoma professor Mark Bolino calls this “escalating citizenship” for both the organization and the individuals (Bolino et al., 2003). For the firm, progress can slow as decision makers become unwilling to act without input from these top collaborators.

For the individuals, the increasing demands lead to a tipping point where they’re no longer effective. Worse still, when network analysis is used to identify super collaborators in organizations, the leaders are usually surprised by at least half the names on the list (Cross et al., 2016). This means a great deal of collaborative effort goes unnoticed. Though disappointing, it is not altogether surprising given that requests for advice can originate from other parts of the business, or even externally, beyond the radar of line managers. Those who are seen as the best sources of information and in the highest demand as collaborators (top center and right of Figure 1) turn out to have the lowest engagement and career satisfaction scores (smallest bubbles in Figure 1). Being over-taxed and under-recognized takes a toll. According to the HBR research, without intervention, these once-high performers either leave, taking valuable knowledge and networks with them, or stay and spread their disengagement to peers.

So, what’s the solution? First, we need to understand three types of collaborative resources: informational, social and personal. Informational resources are knowledge and skills. Social resources represent our awareness of, access to and position in social networks. Finally, personal resources are our energy and time. Importantly, there are differences associated with sharing these resources. When we share informational and social resources, they don’t diminish our supply. We can pass on our knowledge or network awareness and still draw on these resources as needed for our own work. But personal resources are fundamentally different. Time and energy spent collaborating means less is available to attend to our own responsibilities. 

The problem, according to the HBR article, is that the default collaboration request is for personal resources, typically in the form of calendar invites (Cross et al., 2016). The authors, Rob Cross, Reb Rebele and Adam Grant, recommend leaders tackle collaboration overload by: (1) redistributing work, and (2) rewarding effective collaborations. As we shall see in the tips below, whether we are a leader, manager, super collaborator, or a colleague making requests for collaboration, we all have a role to play in reducing the impact of collaboration overload.

Redistribute the work

Actionable Tip: Leaders should identify employees at the greatest risk of collaborative overload

The first step in the process is to better understand the supply and demand for collaboration in your organization. Any system that records the volume, type, origin and destination of requests is a potential data source. Examples include employee surveys, electronic communications tracking, 360-degree feedback, CRM programs and network analyses (Cross et al., 2016). This exercise will identify the staff who are considered the best helpers and therefore most at risk for collaborative overload.

Actionable Tip: Encourage behavioral change of top collaborators

Cross, Rebele and Grant (2016) recommend that leaders (and managers) support their top collaborators to shift behaviors by:

• Showing them how to filter and prioritize requests
• Giving them permission to say no or allocate less time to requests for collaboration
• Encouraging them to provide social resources such as an introduction to a colleague if the request is not exactly aligned with their expertise
• Providing informational resources (specific knowledge) as needed, as opposed to personal resources (such as formal membership on a team requiring regular attendance at meetings)
• Recommending that personal resources be invested in activities they find energizing rather than exhausting to reduce stress and disengagement.

If you’re the extra-miler, it’s important to understand that you’re at risk of burnout as your workload escalates (Maslach & Leiter, 2016). While it would be ideal if your manager initiated the actions listed above, as discussed earlier, they may not be fully aware of the collaborative demands on you. Be proactive: schedule a conversation using the list above as a guide.

Actionable Tip: Encourage behavioral change of those requesting input and advice

Leaders and managers also have a role to play in reducing the demands made of super helpers through shifting organizational norms (Cross et al., 2016). Ideas include:

• Encouraging help seekers to locate information themselves by searching company reports, knowledge bases and other repositories
• Guiding help seekers to minimize email requests and meeting invitations when a quick phone call or in-person conversation could complete the request
• Facilitating face-to-face contact by co-locating interdependent staff
• Allowing staff to make decisions without excessive checking in with leaders or stakeholders by streamlining approval processes.

For tips on how to improve teamwork and collaboration, read our post The Science of Teams and Effective Collaboration.

For tips about when to form a team, read this post.

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Does IQ Predict Success in Life?

What’s more important – “book smarts” or “street smarts”? Cognitive intelligence or emotional intelligence? IQ is one predictor of success but not the only one. IQ matters, but so does EQ (Emotional Intelligence). Here’s why.

IQ and EQ: Different types of intelligence

Emotional intelligence (EI) burst onto the scene almost three decades ago after psychologist Daniel Goleman’s revolutionary book, Emotional Intelligence: Why it can matter more than IQ, was published (Goleman, 1995). Goleman’s work was highly influential because it challenged the prevailing view that general intelligence, that is, “book smarts”, predicts success in life.

Goleman was intrigued by the observation that some people with a high IQ flounder while others of modest IQ do surprisingly well. He concluded that the ability to recognize and manage our own emotions and to recognize and respond effectively to the emotions of others was the hidden piece of the puzzle. He used the term “emotional intelligence” to describe this “street smarts” capability. In the process, Goleman fundamentally changed our understanding of what intelligence is. His expanded model of what it means to be intelligent places emotions at the very heart of aptitudes for living and working.

General intelligence, or general cognitive ability, is measured using standardized intelligence tests and reported as a score known as an intelligence quotient (IQ) (Cherry, 2021). IQ scores reflect abilities including visual and spatial processing; knowledge of the world; fluid reasoning; working memory and short-term memory; and quantitative reasoning (Cherry, 2020). Emotional intelligence can also be measured, with the score referred to as an emotional intelligence quotient, or EQ. EQ scores relate to emotional and social skills that help us understand ourselves and others (Hawkins, 2020).

IQ is an important component of success, particularly in relation to academic achievement. People with high IQs tend to perform well in school, make higher salaries, and be healthier (Richardson & Norgate, 2015). However, experts now consider that IQ is just one predictor of life success. Among the complex array of further influences is emotional intelligence (Cherry, 2020). The higher the level of EQ a person has, the more likely they are to succeed at work, in their personal and professional relationships, and to bounce back after failure (MacCann & Roberts, 2016).

Emotional intelligence (EQ) at work matters… now

In the workplace, someone with a high EQ will understand and empathize with their co-workers, know how to make adjustments to meet deadlines, handle criticism well and use feedback to improve their performance (Cassata, 2021). But, how important are these capabilities? How much do they really matter at work?

According to the World Economic Forum’s The Future of Jobs Report 2020, emotional intelligence is among the top 15 skills workplaces will require in 2025 (World Economic Forum, 2020). Indeed, many companies already use EQ tests in their hiring processes (Cherry, 2020). These types of assessments are used to help organizations understand how prospective employees might manage their emotions and stress, interact with co-workers and clients, and which tasks and responsibilities they will be best suited to (Cassata, 2021). The Future of Jobs report also includes statistics on “reskilling/upskilling programmes” globally. Emotional intelligence appears in the top 10 lists of “current skills in focus” for developed nations including the Unites States, the United Kingdom, France, Germany and Australia (World Economic Forum, 2020).

If you are in a sales or marketing role, you may be familiar with one of the ideas of Nobel prize-winning psychologist Daniel Kahneman. He found that “people would rather do business with a person they like and trust rather than someone they don’t, even if that that person is offering a better product at a lower price” (Deutschendorf, 2015). We are social animals; therefore, social and emotional skills matter.

What if you’re not client facing? You still need to interact with your peers. Emotional intelligence author Harvey Deutschendorf says, we all want “to work with people who are easy to get along with, supportive, likeable, and can be trusted. We want to be beside people that do not get upset easily and can keep their composure when things do not work out according to plan” (Deutschendorf, 2015). To make such a positive workplace experience possible, we need to be or become the kind of co-workers we’d like to have!

If you’re a leader, emotional intelligence is a non-negotiable. Daniel Goleman’s research found that 80 – 90% of the abilities that differentiate high performing executives relate to emotional intelligence (O’Neill, 2019). Research firm Egon Zehnder International found a similar link between successful executives and emotional intelligence, discovering EQ trumps previous experience and IQ (Deutschendorf, 2015). This is because at the C-suite level of leadership everyone is “book smart”. Having a high IQ simply grants entry to the game. What distinguishes performance in this leadership game, then, is “street smarts” or EQ.

The verdict: IQ? EQ? Or both?

It’s complicated. IQ is one predictor of success but not the only one. IQ matters, but so does EQ. The good news is there is plenty we can do to develop our EQ (starting with developing a growth mindset).

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Resilience: What It Is, What It Is Not, and Why It Matters

While the definitions vary, most include notions of adaptation and adversity. The Mayo Clinic says that resilience means “being able to adapt to life’s misfortunes and setbacks (Mayo Clinic, 2020), while the American Psychological Association notes that resilience is:

“. . . the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress. . .. It can also involve profound personal growth” (APA, 2020).

Unbeatable for the image it conjures is the remark by Dr. Amit Sood, the executive director of the Global Center for Resiliency and Well-Being, that, “Resilience is the core strength you use to lift the load of life” (Hurley, 2020).

What resilience is not

It does not mean having a smooth or painless life. The road to resilience is fraught with barriers, obstacles, setbacks, and challenges, and, while some people seem to naturally possess traits that make them resilient, we can all grow our resilience. Doing so involves learning thoughts, feelings, and behaviors that anyone can develop; in this sense resilience is more ordinary than extraordinary. And guess how it happens? If you said, “through dealing with problems and challenges”, you’re onto it! It’s like a muscle that, when you work it with regularity and intentionality, becomes stronger over time. We will see on each of the five roads to resilience what that intentionality “muscle” looks like and how you exercise it.

Why does being resilient matter?

Angela Duckworth’s seminal research into grit, a type of resilience, has clearly shown – repeatedly, in many domains of endeavor – that it is not talent (though it helps) that gets people across the finish line to success – but persistence: the willingness to get back up and try again after being knocked down, over and over (Duckworth, 2019). People who have not developed their resilience may respond to setbacks by feeling overwhelmed or helpless, or relying on unhealthy coping strategies, such as avoidance, isolation, and alcohol or drugs. One study showed that patients who had attempted suicide had significantly lower resilience scale scores than patients who had never attempted suicide (Fletcher & Sarkar, 2013).

It’s not that resilient folk experience no stress or challenge, but that they use their emotional strength to cope with trauma and hardship. Resilience matters because, by finding ways to utilize resources, strengths, and skills to overcome challenges, hardy folk empower themselves to bring forth their highest potential, to help others in the greatest way possible, and (usually) to play a solid role in creating a better world.

What are resilient people like?

What does a paragon of resilience look like? Katie Hurley, a licensed social worker, writes that resilient people tend to have the following characteristics:

• They have an internal locus of control (looking primarily to their own inner advisor and focusing on how they can control the outcome of events, as opposed to external forces doing so)
• They have social support, knowing who they can rely on when needed. They know how to build this when their networks are down.
• They have problem-solving skills, identifying (multiple) realistic ways to solve problems.
• They see the glass half-full, using skills of optimism to sustain their belief in their ability to handle whatever comes their way.
• They have coping skills: techniques to reduce stress and anxiety.
• They do self-care, making both mental/emotional and physical health a priority.
• They have self-awareness, knowing their strengths and how to utilize them for the best outcomes (Hurley, 2020).

How do you see resilience manifest in your life?

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Why Does Having Mental Health Literacy Matter?

It is likely that someone you know will be diagnosed with a mental health disorder sometime in their life. Mental health literacy can be a powerful tool to support them (and take care of your own mental health).

Given the prevalence of mental illness, we can safely assume that most of us will either be that person or else be a close contact of someone who receives a diagnosis. In other words, mental health literacy is relevant because we cannot get away from the reality of mental ill-health.

If people instantly recognized when they began to have a problem and sought appropriate treatment, some mental health conditions might be more consequential than a seasonal flu yet not of grave severity or duration. But studies have shown that that isn’t how things tend to happen.

Low recognition of mental health disorders

Obviously, to treat a problem you must know that there’s a problem. The seminal study of Jorm and associates used a representative sample of Australians, showing them a vignette of a person suffering from either depression or schizophrenia: two common mental health disorders. While most subjects recognized that there was a mental health problem, the label “depression” was only used by 39% of the sample; only 27% of the study participants recognized schizophrenia. Jorm (2000) refers to other studies which had similar findings.

We can question whether getting a label right is important. Jorm also cites research showing that G.P.s often miss mental health disorders in their patients. They are, however, much more able to detect disorders when the patients themselves present their symptoms as reflecting a psychological problem (Kessler et al, 1999, in Jorm, 2000). Patients, of course, can’t do this if they don’t recognize that they have a problem!

Divergence between the lay public and the professionals

But let’s say you had recognized that your partner was ailing because of having some sort of mental health problem, and let’s say you even labelled it correctly, as depression. What then? As we suggested above, your action(s) to resolve/heal the condition would be, academics tell us, largely dependent on whatever conceptual model you might be holding in your head to explain phenomena such as mental health conditions. This, in turn, would affect the choice of treatment that you and your partner might opt for, how well you both might comply with a given treatment (such as taking anti-depressant medication regularly), and how stigmatized (or not) you might feel by being identified as a person (or a partner of a person) with a mental illness.

When academics have examined mental health literacy, they have typically found the public to have a poor understanding of mental health, which has impeded their help-seeking and meant that they do not receive treatment 50% to 80% of the time (Furnham and Swami, 2020).

Moreover, some studies have shown that the public in numerous countries do not share the same opinions as mental health professionals about various aspects of mental health, including whom they should consult for help and explanations for the causes of mental health disorders, with lay individuals favoring psychosocial explanations and professionals favoring biological explanations (Swami, Furnham, Kannan, and Sinniah, 2008). Related to this, Jorm’s research found that the Australian public rated psychiatrists and psychologists less highly than G.P.s and counselors for help in treating maladies such as depression. In Ethiopia, traditional sources of help, such as witchcraft, herbalists, and holy water were preferred over medical people (Jorm et al, 1997).

Similarly, what the public believes about medication contrasts sharply with both controlled studies and mental health professional views about the efficacy of anti-depressant and anti-psychotic medications. “Natural remedies”, such as vitamins and herbs, are viewed much more positively by the public than psychotropic medications and are not viewed as having the negative attributes of those medications, such as perceived side effects of lethargy, dependence, or brain damage. The public tends to see psychological interventions such as counseling as being highly effective for psychotic disorders, and even dementia (Jorm, 2000)!

The consequences of poor mental health understanding

Where does all this lack of mental health literacy leave us? A high prevalence of mental health disorders coupled with low recognition of the problem leads to no or possibly inappropriate help-seeking. The resultant low rate of treatment means untreated individuals are likely to get worse, or at least they do not get better. What, then, are the consequences of this?

Noting that 70 – 75% of adult mental health problems and mental disorders start to manifest during adolescence or early adulthood, Wei and colleagues have cited consequences of untreated mental health problems in adolescents and young adults: poor vocational achievements, problematic interpersonal and family functioning, and reduced life expectancy due to associated medical conditions, such as diabetes, heart diseases and stroke, respiratory conditions, and suicide. Yet worldwide research shows that between 70% and 80% of young people and adults do not receive the care that they need (Wei, McGrath, Hayden, and Kutcher, 2015).

With specific reference to the divergence between the views of the public and those of mental health professionals about what constitutes appropriate treatment, we can note that negative beliefs about medication, for example, might yield low to no compliance with medication regimens. Negative views about certain professionals (say, psychiatrists) could result in the individual with the mental health concern simply not turning up for needed treatment. Beyond that, widely different views from professionals may mean that a close and influential contact of a person needing help – say, you, in the above scenario of a depressed partner – could end up not recommending a potentially helpful treatment, which the unwell person might then miss out on.

Finally, the Australian Institute of Health and Welfare, in their snapshot look at health literacy (2020), notes that people with low health literacy are more likely to have worse health outcomes overall and adverse health behaviors, such as lower engagement with health services (including preventive ones, such as cancer screening), higher hospital re-admission rates, poorer understanding of medication instructions (so using prescribed drugs improperly), and lower ability to manage self-care (AIHW, 2020).

Reflection Exercise: What’s your level of mental health literacy?

Griffith University in Australia has developed the Mental Health Literacy Scale (MHLS) (2015), a 35-item measure which assesses all attributes of mental health literacy. You can click here to access it to gain an understanding of your knowledge of various aspects of mental health (O’Connor & Casey, 2015).

References:

• Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: Detailed Findings, AIHW, viewed 17 February 2020, https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-detailed/contents/table-of-contents
• Furnham, A., & Swami, V. (2020). Mental Health Literacy: A Review of What It Is and Why It Matters | International Perspectives in Psychology (hogrefe.com)
• Jorm, A.F., Korten, A.E., Jacomb, P.A., et al. (1997). “Mental health literacy”: a survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182-186.
• Jorm, A. F. (2000). Mental health literacy: Public knowledge and beliefs about mental disorders. British Journal of Psychiatry (2000), 177, 396-401.
• Kessler, R.C., Chiu, W.T., Demler, O., Merikangas, K.R., & Walters, E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.
• O’Connor, M., & Casey, L. (2015). The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry Research. DOI: https://doi.org/10.1016/j.psychres.2015.05.064
• Swami, V., Furnham, A., Kannan, K., & Sinniah, D. (2008). Lay beliefs about schizophrenia and its treatment in Kota Kinabalu, Malaysia. International Journal of Social Psychology, 54, 164-179.
• Wei Y., McGrath, P.J., Hayden, J., & Kutcher, S. (2015). Mental health literacy measures evaluating knowledge, attitudes and help-seeking: A scoping review. BMC Psychiatry, 2015 Nov 17;15:291. doi: 10.1186/s12888-015-0681-9.