Moving Upstream: The case for a more proactive approach to mental health in the workplace

Published February 15, 2022

A person is walking along a riverbank and notices a man dragging people from the water. The man brings each person to safety on the bank and resuscitates them, one at a time. He tells the passer-by he is a doctor and explains that he’s been so busy saving these people’s lives, he’s had no time to venture upstream to discover why so many are falling into the river in the first place.

This ‘upstream’ health parable is attributed to Irving Zola, a medical sociologist and disability rights campaigner in the 1980’s, to highlight how the vast majority of medical practice was reactive rather than proactive. Dr Brian Marien, co-founder and director of The Positive Group suggested that medicine has genuinely started to work upstream as well as downstream but the focus in mental health, psychiatry and psychology, is still predominantly downstream. Tuning in from his base in Scotland, Dr Marien gave the keynote address at our recent CEO Forum – entitled Leading Mentally Fit Workplaces – which we hosted in partnership with the Business Council of Australia.

It was a fascinating speech, filled with rich and insightful pieces of wisdom. But it was this notion of ‘moving upstream’ that caught participants’ attention the most. Could the time that organisations spend reacting to problems related to workplace mental health be better spent, as Dr Marien posited, on a more proactive, ‘upstream’ approach? And if so, what would that look like in practice?