A mental health charity has recently launched a campaign in an effort to improve support for those suffering from mental ill health in the workplace. Nic Paton reports.
One thing we have seen a lot of during the recession and downturn is research - some of it robust, some of it less so - that makes the link between the difficult economic and job climate and its possible effect on the mental health of the workforce.
In the May 2011 issue of Occupational Health magazine for example: research from health insurer Aviva suggested that 30% of employers felt mental health issues were contributing significantly to their workplace-related absence; a study from thinktank The Young Foundation concluded that working at night potentially exposed staff to greater risk of poor mental health (among other health issues); and according to figures obtained by the BBC, worries over money and job security are fuelling a rise in depression in England.
Even though the validity of this latter piece of research was later questioned by the Guardian's Ben Goldacre, what is clear is that employers and health professionals are becoming increasingly concerned about the spread and cost, both to businesses and individuals, of mental ill health in the workplace.
What Mind is calling for
- Employers to encourage open and supportive work environments, where employees can discuss mental health without fear of discrimination.
- Employers to ensure that protecting mental health is embedded in change management, in order to manage extra pressure on remaining staff.
- Employers to treat mental health problems with the same importance as physical health problems.
- Businesses of all sizes to make supporting staff wellbeing a corporate priority.
- Businesses to report on the wellbeing of their staff at board level.
- Businesses to introduce workplace mental health policies that promote wellbeing for all staff, tackle work-related mental health problems and support staff who may be experiencing mental distress.
One organisation that has been making a lot of noise about workplace-related mental ill health in the past few months is the charity Mind, which has argued that conditions such as anxiety, depression and unmanageable stress are now affecting one British worker in six each year, at a cost to businesses of up to £26 billion. In April, its Time to Change campaign argued that two workers out of three were scared to tell colleagues about their mental health problems, with many workers with mental illnesses reporting negative experiences when it came to talking about it. In March, Mind teamed up with the Federation of Small Businesses to publish guidance to help small firms manage mental health and wellbeing in the workplace and support their staff.
The charity is also running a major five-year campaign under the banner Taking Care of Business - Mental Health at Work, which is designed to highlight mental ill health in the workplace and what employers can do to manage it better and support employees.
Its latest piece of work for this campaign was unveiled in May and makes salutary reading, even for health professionals such as occupational health nurses and physicians who will inevitably be well up to speed on mental ill health as an issue and concern. The study, which was carried out by research company Populus and sampled 2,000 people, found that:
- work was the most stressful thing in people's lives at the moment, with 41% saying that they felt stressed or very stressed by their jobs;
- two respondents out of three said that management was putting them under more pressure as a result of the economic downturn, with more than half saying morale was low and 48% being "too scared" to take time off for illnesses. One in five feared that mentioning stress to their boss would put them first in line for redundancy;
- in the public sector - one of the key customers for occupational health support and provision - things are potentially even worse, argued Mind. Nearly three-quarters (72%) of workers said that staff morale was low, 68% said they were working under more pressure and eight out of 10 said they were "more stressed than ever";
- in total, the sample found that 41% agreed stress was a "taboo" topic, with seven out of 10 saying their boss would not help them to cope with the problem, one in four fearing they would be perceived as less capable than other colleagues if they admitted to stress and, of those who had disclosed a mental health problem to their bosses, one in five having been subsequently sacked or forced out of their jobs;
- more than a quarter (28%) of those polled felt "stressed" by the threat of redundancy. For public sector workers, this rose to 41%. More than a quarter (28%) also felt stressed by "unrealistic" targets; and
- a total of 37% of the poll sample said that they felt stressed by excessive workload, with a similar percentage (36%) saying much the same about poor management.
Cause for concern
The reasons for all this work-related stress are complex and, of course, may not necessarily be "work related" in a technical sense, in that home, personal and financial issues will all commonly intermingle when it comes to mental health and wellbeing. But, as Mind is also arguing, when those pressures are compounded by poor management or a poor working environment, its consequences become very much a workplace issue.
Even though none of this will be "news" as such for OH professionals, it is important to keep pushing the message and keep the pressure on employers that this is not an issue that can be ignored, even in the current difficult climate, argues Mind chief executive Paul Farmer.
Mind's top five tips
- If you are a manager, ask your staff how they are. Schedule in regular catch-up meetings to discuss how staff are managing and progressing.
- Promote an open, supportive environment. Staff should be able to speak up when something is wrong, and know that they will be listened to and supported.
- Make sure staff have time and space to relax. Provide a staff room or a space they can go to for a break.
- Make sure roles and responsibilities are clear. Give employees some control over planning their workload.
- Make sure staff feel valued for their work. Knowing your work is appreciated does wonders for morale.
"To be honest, for occupational health practitioners quite a lot of what we're saying will not be new. People who are OH specialists will already know this because they see its impact on the workplace on a daily basis - the impact that poor mental health has on the workforce," he explains.
"But what we hope, nevertheless, is that a campaign like this builds to create some momentum around this when it comes to tackling this as an issue.
"OH practitioners are on the front line of this, but, quite often, what they see and are dealing with is not necessarily reflected in organisational practices. So what we are hoping is that this research might act as a rallying cry for organisations, led by OH practitioners, to begin to put mental health at the top of their agenda," says Farmer.
"What we need to get people to recognise is that they need to begin to own the business case around this, to see why it needs to be given the priority that it does."
In the current environment, where many organisations are going through challenging times, it is even more important that employers (using occupational health expertise) invest in and prioritise mental health, Farmer suggests.
As part of its research, Mind has proposed five tips for a mentally healthy workplace (see box above), which, says Farmer, could be a good starting point for OH practitioners when it comes to effecting practical change across their organisations on this issue.
"If OH nurses and managers were able to promote those five top tips across the piece that would be very helpful. Quite often this is an area in which OH ends up having to arbitrate on behalf of managers. So they have an opportunity to be encouraging managers to become more proactive as well as encouraging staff to be more open and create a more supportive environment," he adds.
"There has to be a proper balance, with people being given proper roles and responsibilities, ownership and being valued. It is not new, but it is not happening. It is about reminding and encouraging people to implement good practice. And the message for businesses is that poor mental health, which can lead to greater sickness absence and reduced productivity, is bad for business as well as being something that it is right to tackle as a duty of care issue."
The Government's Healthy lives, healthy people public health White Paper, published in December 2010, highlighted the high costs attached to mental ill health and stress in terms of absence. Nevertheless, the Government, both in terms of policy-making and as one of the country's largest employers, could be doing more to set an example, argues Farmer.
"The Boorman review, for example, features mental health quite highly. But there are also some real opportunities to take initiatives such as 'Access to Work' and make them as available as possible, to make them less bureaucratic," he says.
"We also need to make it easier for people to disclose mental health in an appropriate way, especially in terms of their relationship to their employer. We need more tools to help employees and employers with this and more wellness and recovery action plans," he adds.
Case study 1 - call centre
In an area notorious for stress and mental ill health - call centres - one firm trying to set a good example is London-based Listen UK, a fundraiser that works exclusively for charities and employs between 200 and 260 people.
“We have to acknowledge that this sort of work can be stressful from time to time. People can be unpleasant to you when you are ringing them up so, rather than forcing you to stay at your desk and simply take another call, we do try to ensure people can, if they want, take time to speak to a manager. That is not a problem for us,” explains director Tony Charalambides.
“We have a very strong promote-from-within policy and a very comfortable working environment. It is all open plan, there is lots of natural light and there is a circular, pod-like layout. We offer flexible working hours, and try to manage people as flexibly as we can. People have the flexibility to change their shifts and the way they work.
“We provide free coffee and tea and have a breakout area for people to sit down and relax in. [With] shift work, it is important to let people take breaks whenever they want. It is simply about treating people like adults and not being ultra-disciplined,” he adds.
While the company does not directly access OH services, its focus on mental health has meant it has a much better absence and recruitment and retention rate than average for the sector, as well as a better “turn up” rate for workers in a sector where people simply not turning up for shifts can be a real problem.
“People know the people they are working with. We also have a much better rate of shifts that have been booked being honoured than many of our rivals, around 90%. And of the remaining 10% we are normally notified in advance around 7% of the time. Within the rest of the industry, in a normal call centre, the no-show rate is more like 20% to 25%,” adds Charalambides.
Case study 2 - consultancy firm
When it comes to making the business case for intervening to improve mental and physical health, you couldn’t probably come up with a better example of something that will make senior management sit up and take notice than a strategy that will reduce the total direct and indirect cost of health per employee by more than £500 per year and deliver £700,000 net savings per year after all your investments in health provision have been taken into account.
That is exactly what consultancy firm Aon Hewitt, which employs around 1,700 staff in the UK, has achieved since launching a wholesale review of its absence management (including absence for mental ill health) back in 2006.
Key initiatives included:
- a health audit that discovered widespread under-reporting of absence (which as a result rose initially from 4.37 days per employee to 6.2 days and is now at 3.8);
- the development of a tool to collect and analyse data more effectively;
- the launch of a branded internal health management strategy under the banner “Be Healthy with Hewitt”;
- outsourcing of reporting to a confidential day one absence recording service;
- the development of key absence “triggers” for further intervention;
- the creation of a psychological rehabilitation service, separate to the occupational health service, into which employees can be referred if they are off for 10 days or more because of stress or mental ill health;
- better promotion and use of employee assistance programme services, which were being used by only 2% to 4% of staff; and
- a reduction in income-protection claims from around three a year to, since 2006, not a single one.
“We calculated that we were spending £2,850 per employee per annum on health. Now it’s £2,300. It’s figures like that, when you pull them together, can really engage leadership at board level,” says associate James Kendrick.
“When you show them these are the sorts of savings that can be made, then it is much easier to get them to commit to extra investment in other areas of the business associated with health.
“And, of course, it is also the right thing to be doing by your employees and helps to make you more of an employer of choice,” he adds.
XpertHR finds out whether or not employers are equipped to manage mental ill health.
XpertHR also provides an employee wellbeing policy that can help to maintain the mental health and wellbeing of staff.