TOC for Mental Health - c.ymcdn.com · TOC for Mental Health Presented By: Ami Uga, Mental Health...

1© 2014 TOCICO. All rights reserved.

TOCICO 2014 Conference

TOC for Mental Health

Presented By: Ami Uga, Mental Health CounselorViable Vision Expert Goldratt Consulting Japan

Yuji Kishira, Partner Goldratt Consulting JapanDate: June 2014



Acknowledgement

I truly thank Dr. Fukumoto, Ms. Akabane, Professor Itohisa, my family and GC members for supporting me in coming up with this presentation



About Ami Uga

-Master of Arts in Counseling Psychology from New York University

-Interned at Bellevue Hospital Center counseling clients at the Rehabilitation Department

-Researched on Quality of Life at Columbia University Presbyterian Hospital for pediatric orthopedic medical practitioners

Returning to Japan, worked at a counseling center taking in individual clients, andlater moved onto being the International director of a non-profit high schoolcounseling agency. However, Ami met Theory of Constraints, joined GoldrattConsulting Japan to bring holistic optimization in the area of mental health in Japan.



Reality of Mental illness in Japan

441,000 1,000,000• People with mood disorders increased from

441,000 people in 1999 to approximately a million people in 2011*1

65.1%

74.8%

• More than 65.1% of working people feel they are in severe stress and feel anxious at their workplace.*2

• 74.8% of companies have at least one employee that is taking more than a month of break from work*2

• The cause of suicides were specified for 15,867people out of 32,845 people who committed suicide in 2009. The main cause is said to be mood disorders, and at least 9,477people have committed due to depression and/or stress from workplace.*3

*1data from Ministry of Health, Labour and Welfare*2data from “Depression in Workplaces” by Aera Mook Aera Life*3data from “Overview of Suicides” published by Metropolitan Police Department

> 9,477 / year



Clients stop coming to counseling

A new diagnosis called “modern-type” depression comes up

Clients get break from work, but they are fine in non-work

environment

Clients feel pressured to go back to work and gets

more stressed

Clients are sent to counseling offices to “get

better”

Clients feel ashamed

to be labeled as “mental”

Other people from client’s department get mentally

stressed

The boss gets blamed for the

situation

Clients return to counseling

offices!

Clients need to take a break from work to

focus on treatment

Counselors get blamed for client not getting better

soonerCounselors get

stressed!!

UDEs of Mental Health Professionals




A new diagnosis called “modern-type” depression comes up

Clients get break from work, but they are fine in non-work

environment

Clients feel pressured to go back to work and gets

more stressed

Clients are sent to counseling offices to “get

better”

Clients feel ashamed

to be labeled as “mental”


stressed

The boss gets blamed for the

situation

Clients return to counseling

offices!

Clients need to take a break from work to

focus on treatment

Counselors get blamed for client not getting better

soonerCounselors get

stressed!!

UDEs of Mental Health Professionals



THE Dilemma of Mental health professionals

Live joyfully

A

Focus on treating clients with mental

illnesses

D

Focus on preventive education for mental

health issues

D’

Get the clients who have mental illnesses healthy as quickly as

possible

B

Create an environment that will prevent mental illness

C



AssumptionCause of mental

illness resides in the person himself

A: Live joyfully


Focus on preventive measures for mental

health issues


illness

Get the clients who got into mental

illness healthy as quickly as possible

Current Reality

Client needs to take a break from work to focus on treatment

AssumptionThe stress is caused

by the company

The workload increases for others

in the company


stressed

AssumptionNon-professionals

cannot deal with mental health issues

The client feels

stressed

The client feels pressured to return to work and gets more

stressed


The boss/surrounding gets blamed for the situation

Counselors get blamed for clients not getting better

sooner

Counselors gets stressed

AssumptionCounselors are

expected to diagnose the client

A new diagnosis called “modern-type” depression is created(depressed only

at work)

Clients get break from work, but they are fine in non-work environment

AssumptionIt is the counselor’s responsibility to get

the clients better

The client feels The client feels ashamed to be

labeled as “mental”

AssumptionPeople do not want to be a trouble to

others

Clients are sent to counseling offices to

be “made better”

Clients return to counseling offices



Counselor’s Office

What counselors face



Common Actions Taken in Organizations

Have a questionnaire to examine the mental toughness of employees

Provide mental healthcare education (Work-Life-Balance Program) Send the employee to counseling office Allow the employee to take a break from work

Reality Tells

Many industries and government, also mental health counselors have been putting in a lot of effort. However, there have been no tangible improvement, moreover, the situation is getting worse and worse, and now it is to the extent that mental illness is perceived as a societal problem…

There must be a fundamental erroneous assumption



What Mental Health Professionals Seek

Clients and surroundings are

living harmoniously

Clients and surroundings are

living harmoniously

Clients know how to deal with their

own issues

Clients know how to deal with their

own issuesClients are

working joyfullyClients are

working joyfully

Clients do not need to come to counseling office

repeatedly


repeatedly

Counselors are thanked

Counselors are thanked

Counselors love their work


There is no need for a new “diagnosis”

for depression

There is no need for a new “diagnosis”

for depression

There is no need to label people as

“mental”

There is no need to label people as

“mental”

Clients and their bosses are

communicating well


communicating well

BUT HOW? We have been doing our best!!



Why TOC?

Written by Dr. Goldratt in the cover page of the Japanese version of The Choice regarding What is TOC



The Assumption

p

AssumptionCause of mental illness

resides in the person himself

Everyone to be joyful in their organization

A


possible

B


illnesses

D


health issues

D’Create an environment

that will prevent mental illness

C



The Engines of Disharmony

Dear friend,

I promised a short document that will outline the essence of my proposal, so here it is.

Every manager, especially a top manager of a large engineering based company, is well

aware of the impact of increasing the motivation, initiative, synchronization, willingness to

collaborate and communication among his people. All those “soft” issues are actually the

hardest, most important ingredients that determine the capabilities of the company.

Unfortunately, the prevailing approach to improving these issues revolves around dealing

directly with the people. Let’s take motivation as an example. As long as we think that the

way to increase a person’s motivation is to talk with him, don’t we actually assume that the

cause for his lack of sufficient motivation resides with the person himself?

-Dr. Eli Goldratt

Blaming others will not solve the issue!



Words from Win-win-win Public WorksEffects of TOC implementation

There must be a

reason why

Employees’ motivations went up and workplace became cheerful and energetic in the midst of national wide scandal. There was no mental health professionals involved.



New Assumption

Live joyfully

A


possible

B


illnesses

D


health issues



C

p

AssumptionCause of mental illness

resides in the person himself

AssumptionThe cause of mental illness

resides in the engines of disharmony of the organization



Injection

Live joyfully

A


possible

B


illnesses

D


health issues



C

Injection

Solve the engines of

disharmony

TOC utilizes the tools to dissolve the engines of disharmony



2. What kind of actions do you feel pressured to usually take to solve this UDE?

3. On the other hand, what kind of actions do you think you should take to solve this UDE?

4. What is the common objective of D and D’?

6. By doing D’, what needs are you trying meet for A?

A:Objective

B: Needs

C: Needs D’: Wants (Action)

D: Wants (Action)

UDE:

The Evaporating CloudSimple 6 questions to evaporate mental stress

1. What makes you feel stressed?

5. By doing D, what needs are you trying meet for A?



UDE: Tension between company wanting employee to work at Takamatsu office and employee wanting to work Osaka office closer to home

Case Study: Employee who did not want to go to work

Employee to work full time and live

happily

A

move closer to Takamatsu office with

the family

D: Company’s Wants

work at a branch office that is closer to the

parent’s house

D’: Client’s Wants

stay at the workplace that he is accustomed

to

B: Company’s Needs

stay closer to the family

C: Client’s Needs



Case Study continued:What was revealed through the process

Simple truthIt is not realistic for the employee to work in the same way as he was working before the

stroke • Full time employment=at least 8 hours a day• Being a full time employee required multiple

relocations• Continuing the same type of job whether in the

Takamatsu office or at the Osaka branch was impossible with a paralysis

• Having the partial paralysis meant needing more family support



Case Study continued:Injection

Employee to work full time and live

happily

A

stay at the workplace that he is accustomed

to

B: Company’s Needs

move closer to the Takamatsu office with

the family

D: Company’s Wants

work at a branch office that is closer to the

parent’s house

D’: Client’s Wants

stay closer to the family

C: Client’s Needs

Injection

Work as part time

employee at a branch closer

to home



Case Study continued:Insight from the user, Mr. Henmi

What he used to think: Sharing problem will cause trouble to others and thus should not be shared, but should be solved on your own (by the person himself), because we assumed that the problem resided in the person himself.

But, when we assume that the problem resides in the unresolved conflict, we can work together to find win-win-win solution. Win for employee, win for workplace and win for counselor.



What Professionals can Do

Counselor’s Office

Office/ Home

Mental health counselors teach people how to resolve dilemmas



Professional’s Voice

Dr. Masakatsu FukumotoIndustrial Physician

Director, Shinbashi Baranoen Geriatric Health Services Facilities



A: Living joyfully


Focus on preventive measures for mental

health issues


illnessGet the clients who

got into mental illness healthy as

quickly as possible

Future Reality of Mental Health

Clients and surroundings are living

harmoniously

Clients and surroundings are living

harmoniously

Clients know how to deal with their own

issues

Clients know how to deal with their own

issues

Clients are working joyfully

Clients are working joyfully

Counselors are thankedCounselors are thanked



There is no need for a new “diagnosis” for

depression

There is no need for a new “diagnosis” for

depression

There is no need to label people as “mental”

There is no need to label people as “mental”


communicating well


communicating well

InjectionSolve the engines of

disharmony


repeatedly


repeatedly

Counseling offices are not needed

In organizations

Counseling offices are not needed

In organizations

AssumptionThe cause of mental illness

resides in the engines of disharmony of the organization



New Set of Paradigm

Current paradigm New paradigm

The cause of illness resides in the person himself (blaming oneself)

The cause of mental illness resides unresolved conflict

There must be someone causing the stress (blaming others)

Unsolved conflict causes stress to the individual and to organizations

It is better to increase counseling offices

There are no need to increase counseling offices, but instead it is better to increase people who can

dissolve dilemmas with evaporating cloud

Blaming others is not the solution. People are good



It’s Monday!



Thank You!

We have autonomy, mastery and purposeTo bring WA by making TOC main way in Japan and in the world

Science paper – one case with logicWill appreciate if you validate it



About Yuji KishiraHopefully not outer space being

As an author, speaker and change management leader, Yuji Kishira has been supporting holistic management transformation in various industries and government organizations. Some of his implementations are actively being picked in the mass media. One of his works, “Win-Win-Win public work reform” was adopted by the Ministry of Land, Infrastructure, Transport and Tourism as well as by many prefectural, city Governments all over the Japan. As a director of Goldratt Consulting, he is involved in various big companies implementing holistic change initiatives to become ever-flouring companies. His special interest in the change initiatives is people’s harmony – WA in Japanese. Inspired by it, he has been rediscovering Japanese implicit best practices and making them into a practical explicit body of knowledge.

Yuji’s various books are best and long sellers throughout Japan and he has a regular article in Asahi News Paper, one of the most respected national newspapers with 8 million in circulation.

Born in 1959, Yuji Kishira lives in Kyoto with his wife, Mayuko, author of children picture books. His spare-time interests include Japanese painting and music (as a vocalist of hard rock band)

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