Counting on U: Supporting the Mental Health of SME Owners

The strong relationships formed with relevant industry partners are a key innovation of the Deakin Business School (DBS) Counting on U (CoU) training program. Participants include two mental health groups, a state-based occupational health and safety authority, Australia’s largest funder of health and medical research, an Australian government specialist small-business group, and four respected accounting and bookkeeping bodies. DBS has worked with these stakeholders to co-create the CoU training program, to secure 3.15 million AUD (1.96 million USD) in funding, and to recruit over 4,200 business advisors to enroll in the program.

Call to Action

CoU is a continuing professional development (CPD) program developed in response to the disproportionate levels of poor mental health experienced by small- and medium-sized enterprise (SME) owners, as well as the lack of evidence-based pathways for reaching such a large and disparate population with critical mental health support.

Compared to salaried employees, SME owner-managers are particularly vulnerable to experiencing high levels of depression, anxiety, and other mental health conditions. Despite a recent study indicating that SME owner-managers are 25 percent more likely to report suicidal thoughts and 67 percent more likely to attempt suicide, other research found that only 10 percent of SME owners reported accessing professional help for mental health issues.

A particularly common source of stress experienced by SME owner-managers is financial pressures, such as limited cash flow and creditor pressure. These stressors are especially debilitating for owner-managers not only because of the associated feelings of failure and shame but also because ongoing financial pressures constrain owners’ ability to address other adverse psychosocial conditions, like long work hours and a lack of support, which can further undermine their well-being.

Collectively, business advisors, like public accountants and bookkeepers, represent one of the few groups that have regular contact with large numbers of SME owners. They are well-placed to help mitigate financial pressures, identify early signs of mental health conditions, and encourage owners and managers to seek help when appropriate. However, many advisors find it difficult to work with distressed clients, largely because their pre-employment and CPD training doesn’t equip them with the necessary mental health knowledge and skills.

Innovation Description

CoU is composed of four innovative program features: its approach to reaching SME owners, its training content, its delivery, and its learning transfer.

It is the first work-based mental health literacy program designed to draw on accountants, bookkeepers, and other business advisors to reach often isolated and vulnerable SME owners with timely mental health support.

A unique feature of the CoU training is the integration of prevention-oriented client relationship-building training (RBT) with treatment-focused mental health first aid (MHFA). This comprehensive approach prepares business advisors to build more supportive relationships with their owner-clients and then leverage these relationships to develop well-informed technical advice to mitigate owners’ financial distress. Finally, it empowers advisors who do see signs of depression, anxiety, and other mental health conditions to encourage owners to seek help.

The training was designed to help business advisors overcome common barriers to accessing and completing CPD programs. This included offering the program over a 21-month period and giving participants ample opportunity to finish the training. Further, the program provides training free of charge, delivers it solely online, and enables participants to receive CPD points for completion.

To help these professionals transfer the learning gained from CoU into everyday practice, they undertake follow-up “booster sessions” one and three months after training. These sessions were designed for advisors to work with their peers to identify and address barriers to learning transfer.

Innovation Impact

DBS evaluated the overall impact of the CoU training program with a randomized control trial. The CoU team compared the outcomes of undertaking CoU, which combines RBT and MHFA training, with the outcomes of completing MHFA alone. The results revealed that, compared to MHFA-only training, the CoU program resulted in stronger advisor-client relationships, reduced owner-client financial distress, improved mental health among owner-clients with low mental health at baseline, and increased advisors’ confidence in applying MHFA.

Pre- and post-training results also showed that CoU led to significant improvements for business and finance professionals in a variety of MHFA outcomes. There was a 59 percent increase in knowledge of common mental health conditions, a 42 percent decrease in stigma regarding mental health problems, a 50 percent increase in discussions with owner-clients about suicidal thoughts, a 31 percent increase in providing information about local mental health services, and a 100 percent decrease in business and finance professionals who felt MHFA was not part of their role.

These results underscore the business, educational, and societal benefits that can be gained from these professionals participating in the CoU training program and applying the knowledge to support the financial and emotional well-being of their SME owner-clients. As a result of these findings, together with the over 4,200 CoU participants, we have an in-principle agreement from participating accounting and bookkeeping bodies to make CoU a permanent component of their CPD offerings.

Likewise, the DBS team has close connections with the coordinators of undergraduate and postgraduate accounting courses at Australian-based universities, and the school plans to work with them to add RBT and MHFA training to their courses.

Reference Links

• “Counting on U in 90 Seconds,” YouTube video
• “Counting on U: Mental Health Training Program,” YouTube video
• “Counting on U Research Hub: Our Research Activities,” DBS website