How to have fierce mental health conversations at work

I Don't Want To Change

What do you think of when you hear the word fierce? Fierce can sound savage and aggressive, but in Roget’s Thesaurus, it reveals the following synonyms: robust, intense, powerful, passionate, eager, unbridled, and untamed.

I’m really fortunate to have a mentor who is a very successful CEO of an 8000-employee organisation. When we recently met, he told me that he had just read Susan Scott’s book ‘FIERCE CONVERSATIONS: Achieving Success at Work & Life, One Conversation at a Time”. He was so impressed, that he read the whole book in one sitting on a plane trip from London to Sydney. He kindly gave me a copy which I eagerly consumed.

Why had it impressed him so much and why did he think it was relevant to me?

There is no doubt that our workplaces are becoming more volatile and uncertain. This requires leadership that thrives on change and can inspire trust and confidence in their teams.

This trust and confidence is built one conversation at a time. Change fails when teams can’t have robust discussions about legitimate and perceived fears, and the elephant in the room.

Scott describes fierce conversations as one in which we come out from behind ourselves and make it real. Fierce conversations have four objectives:

  1. Interrogate reality
  2. Provoke learning
  3. Tackle our toughest challenges
  4. Enrich relationships


Importantly, Scott highlights that many of these discussions occur in meetings, but she recommends not calling them meetings, but conversations. She provides a 6-point guide for conversations, as outlined below. She recommends this is written before the meeting and that attendees are given it to read at the start of the meeting.

Organisational mental health issue guide

  1. Identify the most pressing issue

How do we inspire our leaders to build mentally healthy and supportive teams in a cost-effective manner?

  1. Clarify the issue

Rising work stress has been identified as a top 6 megatrend to impact productivity in the next 20 years. According the PWC research it is already the largest cause of lost productivity in Australia, due to absenteeism and presenteeism. 91% of employees are dissatisfied with how their employer is addressing this issue.

  1. Determine the current impact

How is this issue impacting our organisation?

Total cost and impact are probably unknown. At a minimum, I would recommend finding out the cost of workers compensation premiums, absenteeism (UK government research indicates mental health account for 40% of absenteeism), and stress claims.

*A more complete list of elements to estimate of the total impact of mental ill-health is below.


  1. Determine the future implications

If nothing changes what is likely to happen?

As highlighted by CSIRO research it is a top 6 employer risk for next 20 years.

  1. Examine your personal contribution to the issue

What is my contribution to this issue? How have I contributed to the problem?

  1. Describe the ideal outcome

When this issue is resolved, what difference will that make?

When this issue is resolved, what results will others enjoy?

When this issue is resolved, what results will I enjoy?

When I imagine this resolution, what are my emotions?

Whom should I invite?

Don’t just invite people with fancy titles. Whose perspective would be useful? Who is standing at the juncture where things happen? Who is standing downstream and is impacted by the outcome? Who will implement whatever is decided? Invite those at the customer interface? As this will require resources and executive team focus – which Divisional Director will you invite? If you don’t have an executive sponsor, it is questionable whether you should begin this quest.

In our experience, having a Divisional Director as a sponsor, is a critical success factor.

How do I call the conversation to order?

Thank you for coming. We have a decision to make to address one of the greatest employee risks facing the organisation for the next 20 years according to CSIRO research. My goal is to make the best possible decision for the organisation, so I need access to all the relevant data and information. Every person at this table is here because they have a valuable perspective.

How do I encourage honesty when many are reluctant to speak up?

No matter how sincere you are, those who have had a lousy experience with honesty in the past will be reluctant to push back on your ideas, and anyone else’s for that matter. Based on what has happened in the past, who could blame them? So, see who goes first. Some brave soul – let’s call her Sophie – will venture a comment. What happens next will tell a tale. It is essential that you say something like:

“Thanks, Sophie. Please say more about that.”

This is often all it takes. Watch your facial expression and body language, and bite your tongue if Sophie says something you disagree with. Instead of jumping back in to build your own case, invite her to keep talking. Invite her to share her thinking behind the idea. Delete ‘but’ from your vocabulary and replace it with ‘and’. When Sophie finishes say:

“That was helpful. It took courage to say some of those things you said. Thank you for your candour.’

Psychological safety is fragile but essential for solving complex problems. Tread carefully.

What should be the desired outcome of the conversation?

  • To recognize the scale of the risk to your organisation if nothing is done.
  • To gain commitment that it is a priority for the leadership team.
  • To complete a company audit based on a checklist.
  • Based on that checklist prepare a project plan to be presented to the executive team.

Would a checklist be helpful?

We have created a checklist, to think through some of the elements of having a successful plan to build a mentally healthy checklist.

Below you will see, how Kevin Figueiredo, GM, Group Safety, Health and Wellbeing of Woolworths self – assessed their current situation. He kindly gave me permission to share this.

Woolworths Self Assessment



Interestingly, Kevin rated each of the elements on a 5-point scale – where 1 was just a concept and 5 meant it was embedded. I think this is a really great addition.


Good luck in your quest.

*The full impact and cost of mental health at work

Some examples of internal data that you may be able to access to estimate the cost include the following:

  • Absenteeism rates and costs
  • Presenteeism estimates
  • Employee turnover rates vs industry norms
  • Workers’ compensation premiums, claims, and trends
  • Bullying and sexual harassment reports and claims
  • Stress claims
  • WHS risk assessments and meeting minutes
  • Accidents and injury rates
  • Lost time to injuries
  • Employee assistance provider contacts and trends
  • Peer support program use and trends
  • Exit interview data
  • Measurements of workplace productivity
  • Self-reported substance abuse
  • Drug/alcohol related incidents
  • Employee performance review feedback
  • Employee engagement survey results
Share this great article

Other news

Download Speaker kit

Download iCare

Download The Care Crew Credo Poster

Download 7 Ritual Form

Book Graeme


Sub heading here


Share This

Select your desired option below to share a direct link to this page

Reach out