The latest annual statistics, published by the Health and Safety Executive (HSE), indicate that in 2016/17 almost half of all working days lost due to ill-health were reported as being due to work-related stress, depression or anxiety. This estimate, based on figures from the Labour Force Survey (LFS), is further complemented by the Mental Health at Work Report 2016 produced by Business in the Community (BiC), which was based on the 2016 National Employee Mental Wellbeing Survey findings. They highlight the extent of mental health difficulties at work.
- A majority of employees have been affected by symptoms of poor mental health. 77% of employees covered by the main survey said they had experienced symptoms of poor mental health at some point in their lives.
- 62% of employees attributed their symptoms of poor mental health to work, or said that work was a contributing factor.
- More than 10% of those surveyed described their current state of mental health as poor, or very poor.
There will inevitably be some debate about the accuracy of such statistics, but the key concern is that there is a major disconnect between these figures and those reported by employers, who believe the problem is not so large, and that they are doing all they can to support people.
According to the Society of Occupational Medicine, mental ill-health affects one in six people at work in the UK. The World Health Organisation predicts that if we do not proactively address wellbeing, mental illness will be the leading cause of disability and absence in the workplace by 2030. So, employers need to give mental health the same level of importance and investment (time and resources) that that have placed on safety over the years.
In 2016, the main causes of work-related stress, depression or anxiety were said to be:
- workload pressures, including tight deadlines
- too much responsibility
- a lack of managerial support
Sickness absence is very costly in tangible financial terms, but also it usually means that when someone is off work that the workload burden then falls on others, so this can lead to a spreading negative ripple effect within the organisation.
The most common symptoms of poor mental health, in which work was a factor, were:
- psychological symptoms (e.g. depression, anxiety, panic attacks):
- behavioural symptoms (e.g. changes to appetite, irritability, procrastination, mood swings):
- physical symptoms (e.g. raised blood pressure, muscle tension, sweating, dizziness, headaches or migraines):
The BiC report summarises the main conclusions from the survey as follows:
- Employers need to recognise the scale of poor mental health in work, and take significant steps to reduce the risk of their workplace being a contributor to poor mental health.
- Employers have a duty of care to respond to mental ill-health just as they would to a physical illness, such as cancer, diabetes or back pain.
- Managers need to be equipped with the tools, support and the right organisational culture to do their job well, which includes managing employees with mental health issues.
- Workplaces should be environments in which employees feel comfortable disclosing their current state of mental health. Employees need support at an early stage, and Line Managers should agree and implement a personalised plan that works best for that employee.
- Better signposting to formal support mechanisms is vital. No one is expecting Line Managers to be mental health experts, but they need to know where to refer people for help, and what they can do by way of follow-up.
It makes good business sense to foster a culture of openness that supports employees with a mental health issue to remain working. The mental health charity Mind state: “Mental health is still the elephant in the room in most workplaces – employees are reluctant to raise the subject for fear of discrimination, while Managers often shy away from the subject for fear of making matters worse, or provoking legal consequences. This culture of silence means undetected mental health problems can spiral into a crisis, resulting in sickness absences.” It is certainly our observation that Managers worry far more about this type of sickness absence rather than when a more tangible physical illness is reported, and they usually “freeze” taking no action for a very long time when actually early contact with the employee is vital.
The same report recommends actions on a number of fronts, and at all levels within organisations that employers should do including:
- Seek to embed well-being into organisational culture. You will see that in our 2018 Handbook updates we now talk about physical health and mental well-being in several of our policies.
- Take simple, positive actions to build a culture that promotes good health
- Send a clear message of parity of esteem between mental and physical health to normalise conversations around mental health.
- Appoint a mental health champion from the senior team, with a remit to drive better mental health.
- Ensure skills based learning is made available to Management teams to develop awareness, confidence and capability to deal with mental health.
Additionally employees should:
- Be provided with basic mental health literacy, so they can spot the signs when they or a colleague may need help – see mental health first aid.
- Know where to go for guidance, and be equipped with the confidence to start a conversation about mental health with colleagues they are concerned about.
Introduce a Well-being Framework
So, how can employers embed well-being into the organisation? As always it has to be led by Senior Managers. Ideas include:
- Train all Managers and employees (just as we train employees on codes of business practice and safety) in enhancing workplace well-being. This will help to:
- dispel the myth that depression and other common conditions are weaknesses, instead recognise that these are just other forms of illnesses
- aid employees in recognising symptoms in themselves, and in others
- provide guidance on how to manage someone in a team who might become ill
- demonstrate how to reintegrate someone into work after illness; after all, it is well established that work is good for us, and can be key to the recovery of someone who has been ill
- How an organisation successfully communicates on matters of mental health is key to the successful implementation of a well-being strategy. Normalising mental illness by encouraging senior and influential people to share stories of their associations with conditions, such as depression and anxiety. This is the most powerful means of breaking the stigma and generating discussion.
- Introduce mental hygiene techniques your employees can learn. Just as many employees have a personal trainer in the gym, think about encouraging mental hygiene techniques, such as good sleep, food and exercise practices, how to develop resilience and assertiveness to reduce the affects of conflict at work, mindfulness techniques to help reduce stress etc.
Other Practical Steps
View health holistically as a combination of Mental and Physical Health
Employers need to accept that all employees have mental health, in the same way that they have physical health. Mental health can move up or down a spectrum from good to poor, depending on factors in and outside the workplace just as physical health can.
Review how you describe employees with Mental Health Issues
To change adverse perceptions of people with mental health conditions, Managers should describe people with mental health conditions in more positive terms. Rather than labelling them as mentally “disabled”, and focusing negatively on what we assume (wrongfully in many cases) they cannot do, Managers need to have open discussions about how to help to enable them early on, thus avoiding actually disabling them as soon as their mental health condition is found out.
Line Managers, and where possible all employees, should receive training, which should deal with outdated unhelpful definitions of weakness and strength. Mental health problems are very often the curse of the strong, not the weak. For instance, it is usually high achievers that are likely to suffer unexpected and severe mental health burnout.
Swift early access to Medical Intervention
It is also critical that Managers help employees with mental health conditions to access the medical services and the support that they need quickly and swiftly, as early medical intervention will help them return to work sooner. Managers need to be taught that with the right support, mentally ill employees can return to the same or better performance than previously.
Mental Health First Aid Training
Line Managers or employee volunteers who complete the course will have mental health first aider status and will be able to spot mental health problems, take action to prevent them from developing into something more serious and help colleagues to recover more quickly.
Many employees are promoted into management positions because of their technical skills and ability, but without training, they will not necessarily have the right people management and communication skills to be able to deal with mental health issues in an open and supportive manner, so this course really helps.
The two-day course developed by Mental Health First Aid England:
- Trains delegates to recognise the signs and symptoms of mental ill health.
- Educates on what are the good mental health hygiene factors and self care.
- Empowers delegates to provide help and support on a first aid basis though the power of building relationships that encourage people to talk about their problems and health.
- By asking the right questions, it helps them guide people with mental health problems towards the right support services.
- Covers a range of mental health problems, from stress through to more serious conditions such as depression and psychosis.
- Develops understanding of the stigma that exists around mental health.
Open and Supportive Culture of Communication
Employers should promote an open and supportive culture, where Line Managers have regular one to one catch ups with their staff, during which they check in on their mental health well-being (whether they are aware of a mental health condition or not), in the same way that they check in on work-related matters. It is important that employees feel able to be authentic and bring their ‘whole self’ to work, rather than pretending to be someone that they’re not, in order to conform and fit in. The stiff upper lip British attitude is not helpful in encouraging open conversations around mental health.
Address your Working Environment
Create an environment where individuals feel their work is meaningful, purposeful and they are treated with dignity. Creating a sense of purpose beyond profit and growth; encouraging a more respectful environment will go a long way to helping prevent mental illness in the workplace.
Back to Work
The way an employee is treated during their absence, and their initial return, has a major impact on their likelihood of returning to work. Once an employee has been off sick with mental health issues for four weeks or more, the chances of them returning to work are much slimmer, as they lose confidence and begin to feel alienated from the business. Keeping in touch in an appropriate manner is vitally important.
The Society of Occupational Medicine (SOM) has highlighted six key steps to support the return to work process following sickness absence due to mental ill-health.
For employers and employees, six steps have been identified as follows.
- Dealing with the initial absence.
- Developing knowledge and skills.
- Maintaining communication throughout the absence.
- Preparing for the return to work.
- The return to work conversation.
- Keeping healthy and productive at work.
The SOM points out that people often find it difficult to talk about mental ill-health, and sometimes do not recognise it in themselves. In severe cases of mental ill-health, an employee may feel numb and unable to ask questions, or ask for help. The guidance offers helpful tips regarding what to say, and what not to say, to the employee who is suffering from mental ill health.
Key actions for these steps are:
- If they do not contact you, contact them, focusing on recovery not return to work.
- Look after the rest of the team, and develop skills to have open constructive conversations with empathy.
- Not communicating makes things worse, so keep in contact regularly as it increases the chances of a successful return to work.
- Do not get people back too soon, but talk positively about how they can return, identifying possible adjustments so you can plan properly.
- Focus on having a good conversation not following procedures, and focussing on the future then prepare a plan.
- The employee may need long-term support, even if they only experience mental ill-health once. On-going review of the plan will give them the best chance of staying healthy and at work.
We recognise that there is a lot of information to absorb on this topic, and it may seem daunting. Even if you just act on a handful of our guidance, you will be making a good start. Our recommendations would be:
- Get Senior Management commitment to being supportive about mental health issues, and communicate that to all employees.
- See what you can do to reduce stress and anxiety within your team.
- Keep in regular contact with people who are off work due to ill-health.
- Consider training a couple of people in Mental Health First Aid.
- Educate your Managers in commitment to being supportive, and giving them the skills to put this into practice.
Our Consultants would be pleased to advise you on any element of the issues arising from this newsletter.