What working with a Senior Psychiatrist on a new software venture taught me about life, people and work. Written by Nick Parminter
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We’ve done a lot of work that I am proud of in our 3.5 years as a company, but perhaps the one I am personally most attached to is a new workplace wellbeing business that we’ve been working on, Moai Health.
I’m attached for a couple of reasons — one, mental health and the impact of environments and relationships on it, has been a topic of real relevance and interest to me in both my personal and professional life. The other, I got to work with my great friend Dr Paddy Davey — an NHS Consultant Psychiatrist, who has spent several years taking more than his fair share of the mounting mental health burden in the community — studying people, what makes them tick, and sadly, what makes them ill.
Mental illness will kill more people than cancer or heart disease by 2030, whilst it only occupies 7% of the NHS budget. ⅓ of the workforce face acute mental illness every year, which will double over the next few years. It now claims more sick days than any other illness, costing UK businesses £1.3bn a year (in absenteeism, presenteeism etc). ‘Pandemic’ isn’t a fashionable word, but it’s hard to view the impending mental health crisis any other way.
The good news is that, as with any other systemic issues (and pandemics for that matter), early prevention drives a disproportionate ROI. Our thesis is that workplaces have the potential to act like smart sensors to this creeping disease — and giving organisations the tools to detect and manage the mental health of their members will not only shift the financial burden they feel but also contribute to a wider societal response.
Moai is kicking off a handful of pilots at the start of June with some of the most intense working environments — British Army, NHS, others — and launches publicly later in the year. For now though, I wanted to share a few reflections from developing the product and incubating it as a venture.
Humans are sadly predictable
Spend enough time with a clinician from the psychology world and they will tell you how predictable people are. We are all driven by a primal set of needs, are influenced by early experiences, and generally belong to some sort of archetype. We form habits and thought patterns as a way of dealing with the overwhelming complexity in the world — this is the fundamental basis of most forms of behavioural sciences (including Nudge Theory).
Whilst some behavioural frameworks give rise to glib, have-a-go, frameworks for profiling people, others provide rich insight into the enablers for happiness and wellbeing. Common problems like loneliness, stress, exclusion, even bullying, are easy to spot with the right clinical framework. We’ve been lucky to draw on 200+ years of collective wisdom of Moai’s medical board to take a clinical approach to solving a wide array of workplace issues.
Equally, when creating “interventions’’ — the things that reverse developing negative patterns — these behavioural patterns (that pre-date digital products, and go a long way beyond work) are key to tap into. It means that it is very possible to use proven clinical frameworks to design workplace initiatives. Crucially for Moai, it is also possible to serve up these interventions algorithmically.
Statistical relevance matters
Although the wellbeing of people is primarily a qualitative issue, quantitative methods are very important to provide the scientific confidence to solve the problem. Whilst the ability to ask if someone enjoyed the summer party, or their ability to recall company values, may be useful insight — it is not relevant to managing the wellbeing of employees. Equally, whilst a 5-scale scoring system may look nicer than a 7-scale, it invalidates the science.
People make errors and are prone to swings — only a T-tested statistical model can spot these things. That’s why we ended up working with several academics who have been theorising and perfecting their models over decades — as well as using WHO and DofH proven measures.
Existing workplace surveys frankly lack this statistical validity when it comes to mental health. Good UX can’t solve wellbeing, stats can.
Culture happens whether you choose to build it or not
Beyond the mechanics of applying clinical science to the workplace, I’ve learnt a lot about wellbeing, culture and teams.
So much of a business’ culture is organic at a small scale. The little ceremonies, in-jokes, personal reputations and working practices that a small group shares sets the tone for how they connect with each other. Whilst these things contribute to “culture”, they don’t define it.
Culture is defined by the level of compassion, psychological safety, belonging and connectedness in an organisation. Whilst some practices tick a box (accidentally or otherwise), it’s a lot easier when you start to understand the underlying principles. Even something as simple as recognising people’s birthdays, or encouraging spontaneous conversations can have an incredibly powerful impact. It really doesn’t need a blog on values, or putting your card behind the bar.
Too much of what people put down to culture (me included, before Moai) is actually friendship and/or loyalty.
We’ve all been focusing on ‘lag indicators’
I’ve been aware of ‘engagement surveys’ since the days of the EON Hewitt engagement score, at Accenture. It was a very long survey, with a 3 month turnaround, which I only recognise now as a kind of employer brand survey (more focused on net promoter score than wellbeing). 65% was the ‘high performance zone’ — I’m not convinced anyone knew why.
The thing about engagement is that it is so important but also so derivative. Engagement surveys are to wellbeing and culture what a heart monitor is to heart health. We know what leads it, but yet the industry is still determined to measure the lag.
Compassionate leadership takes self-compassion
Compassionate leadership is massively important in building powerful cultures. Organisational compassion is the ability to notice suffering, empathise with it and then take action to alleviate it. Never harder or more important than in a remote working world.
The biggest single detractor of organisational compassion is ill-equipped managers.
Think about the first time you became a manager. Did you have an understanding of how to spot, empathise and alleviate the suffering of your team? Or were you more worried about your imposter syndrome, or next promotion? You probably became a manager because you were the best at what you did, not because you were the most compassionate, inspiring or the best leader.
Self-compassion is the ability to turn understanding, acceptance, and love, inwards. Without it, most people are incapable of becoming compassionate leaders. And without compassionate leaders, it is very difficult to develop a compassionate organisation. Self-compassion is therefore a big headwind for building a nurturing culture.
Individual resilience is good, collective resilience is better
Resilience has become one of the words of the last decade in the social media / corporate culture mixing pot, to go with purpose, authenticity and vulnerability. It’s a real shame. Because most of the people that use it aren’t talking about resilience at all, they are talking about a bullshit bravado that is in fact an indicator of a lack of resilience.
The science tells us that the building blocks of individual resilience are in wellbeing — exercise, eating, sleeping. So whilst the performance culture within organisations and self-appointed “coaches” talk about “choice architecture” and “living by design”, the power of basic things should never be overlooked in driving individual resilience. Likewise, resilience should never be viewed as a character trait — it is a running total that can be built up and taken from in equal measure.
Even more powerful is this concept of collective resilience. The idea is that, when an organisation is compassionate, observant and built around connection, it is infinitely more powerful than an organisation full of individually resilient people. Because the connection between people builds a collective resilience that looks after the weakest link in the chain, and recognises that, whilst individual resilience comes and goes, collective resilience doesn’t.
Psychological safety is hard…
There is an interesting concept in organisational development, called psychological safety. Psychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns or mistakes. Amy Edmonson made the concept popular in her much discussed Aritstotle Study with Google — which concluded that psychological safety is the key to their continued success and productivity.
When you think about innovation, creativity or any form of growth orientation, the ability to make mistakes is crucial. It’s no different in effective teams. Teams are at their most effective when people feel safe to venture ideas. Because ideas create more ideas.
Achieving this can essentially be at odds with the theories of traditional human resource management — tightly defined roles, a focus on measurement, incentives aligned to pre-set objectives. Sadly, philosophically, HR practices haven’t moved on much since the industrial revolution (the clue is in the “resources” bit) but the working world has. Whilst the physical working conditions are infinitely better, the mental working conditions aren’t — as we deal with blurring boundaries (smartphones are evil), complexity, fluidity and social pressure.
Psychological safety, more than any other aspect of Moai is something that really organisations have to do, not say. You can’t write a policy. You can’t kick off a project. You have to build it brick by brick. And you have to lead by example.
…belonging is harder
Underpinning Moai, the biggest founding idea is that belonging is the antidote to a whole range of personal and organisational challenges. Belonging means that people are ‘held in mind and met with mutual concern’. In psychology, Belonging is identified as a primal driver and absolutely hard-wired into every human being.
A lack of belonging (or “thwarted belonging”) is linked to a whole range of mental and physical health ills. One scientist’s research suggests that a lack of belonging is as bad for someone as smoking 15 cigarettes a day. If belonging was a drug, it would be the best funded drug on the planet.
One study of “Blue Zones” (places that have the highest proportion of centenaries) observed that the Okinawan people of Japan lived longer than anywhere. The key? Support groups of peers that Okinawans are born into, who make a cultural commitment to offer social and financial support from cradle to crave. They are called Moais.
In the workplace, it is equally as toxic or opportune. Belonging is the holy grail of culture. If people feel belonging, they are more productive, more engaged, happier, healthier. Moai is intended to be a modern belonging framework. A massive mission.
People need culture, not cults
At Class35, we are far from perfect when it comes to our culture. But we are getting better.
If I were to summarise the last year of discovery, learning and building Moai into one insight, it is that people need cultures not cults. The culture that people see is most usually not the culture that exists. Just as a brand is a collection of thoughts in the mind of a person, not the assets, logo, colours or fonts — culture is equally as nebulous, and in the eye of the beholder.
It isn’t about gathering around ‘values’ like a campfire. It isn’t about tokenistically talking about mental health, vulnerability and authenticity. These are no more indicative of cultures than mood videos are of brands.
It is about making a conscious choice to measure the conditions in which your team comes together, and making a commitment to slowly and deliberately build the cornerstones of effective teams — wellbeing, compassion, psychological safety and belonging. The same cornerstones of happy people.
If every organisation did this, the Department of Health reckons that 60% of the UK’s clinical burden would disappear.
The thing I love about Moai is that it is such a big idea, but grounded in such simple science. And I can’t wait to unveil it to the world with my good friend Dr Paddy.
For more information on Moai, and to enquire about piloting the platform, contact Paddy — patrick.davey@moaihealth.app.
