People affected by stress, anxiety or depression can get access to a lot of assistance. But who is there to support their line managers or colleagues in the complex and sometimes disturbing area of mental ill health? Is it occupational health (OH), human resources (HR) specialists, business directors, or business owners?
Designed and led by employers, web-based service Mindful Employer aims to increase awareness of mental ill health and provides information and support for employers in the recruitment and retention of staff.
Facilitated by WorkWays, a service of Devon Partnership NHS Trust, Mindful Employer was designed by a wide range of businesses and organisations and was launched in 2004 as a small, local service in the Exeter area. Such has been the interest, it has now spread across the UK and attracted support from the government, small, medium and large employers, and a range of national, regional and local supporting agencies. Employers continue to play a key role in the development of the initiative, notably through a Council of Reference made up of OH and HR specialists, business directors and managers.
Response
When a member of staff is experiencing mental ill health, a manager may struggle to know how to respond. They may lack confidence, may not understand what is wrong and, with many other competing demands, may not wish to deal with something they may perceive as weakness.
Mental ill health is often perceived as more difficult to deal with than physical health problems. After all, no-one would think twice about contacting someone who is off sick because of a broken leg, or giving colleagues an update on their progress. But mental ill health still carries stigma and prejudice.
The causes of mental ill health may not be work-related – indeed, work may be the ‘safe place’ where there is respite from these problems. But while the employee may benefit from being at work, they may not function well, which is often referred to as ‘presenteeism’. The manager still has a service to run or a business to deliver, so how do they balance the need to support an employee when other staff and the business need a high level of performance to meet objectives?
Mindful Employer: key principles By employers, for employers: The service is about increasing awareness of mental health, helping employers deliver their business, providing support networks and information, and making it healthier to talk about mental health. Good practices not great promises: The service is concerned with helping employers recruit and retain valued and talented members of staff. It is completely voluntary and supports employers to work towards putting its principles into practice in ways which are sensible, achievable and realistic. Adapted and adopted: Employers are the experts on their business. The service supports employers in adapting its principles within their own policies, structure and culture, adopting them for the longer-term benefit of staff. Safe people not scary places: 52% of people with a psychiatric history have concealed this fact from their employer for fear of losing their job. Mental ill health remains an area of fear and stigma for many. By being a mindful employer, organisations will demonstrate that they are willing to enable disclosure of mental ill health to take place without fear of rejection or prejudice.
Support
Employers do have a duty to react and respond. Line managers may have to consider which company policies to refer to (if there are any) and who they need to contact, which could include OH, HR, a union representative, or the employee’s GP. It may also be that within the organisation, no-one has relevant knowledge or experience, so gaining local support, such as through local NHS services or mental health charities, could be vital.
Employers can also get support from the OH-led Small Business Advice line (0800 0 77 88 44), NHS Plus, the Employers Forum on Disability, Acas, and the Health and Safety Executive. There is also guidance on mental health at work from the National Institute for Health and Clinical Excellence.
Mindful Employer provides employers with easier access to that information combined with local support. The website carries information about employing staff who experience mental ill health, and provides details of supporting agencies, many of which are shown on the UK regional and national pages, making identification and contact easier.
Employers can contact WorkWays in Exeter to discuss a specific case but, for example, a business in Newcastle will want to speak to supporting agencies in Newcastle.
Partnerships with local agencies have been developed and signposting to the right information and other local support are key parts of the initiative. In some places Local Employer Networks are also held to enable employers to meet each other, exchange ideas about good practice and provide vital peer support.
Changing attitudes and workplace culture doesn’t happen quickly, and the key principles of Mindful Employer (see box, above) are ones which employers can work towards and implement within the normal policies and practices of their company. However, employers should be aware that this is a long-term initiative, possibly taking years.
Competing priorities such as customer demands, targets, increasing profits, securing funding, implementing a reorganisation, gaining contracts and other commitments often mean that the mental wellbeing of staff is not high on the agenda. And yet the benefits of supporting staff are immense. Investing time and support, and recognising that retaining a valued, experienced and talented employee is cheaper than recruiting and training a new one, are important.
The voluntary approach taken by the initiative and its emphasis on not being a set of boxes to tick is counter to 21st century workplace culture to an extent, but this philosophy has been a significant factor in its success and national appeal. In a world full of targets and outcomes, it has brought a refreshing approach – after all, there is little point in a mental health initiative that induces stress.
OH physicians and advisers have a vital role to play in enabling employers to work towards improved practice. Early access to OH support – at week one of a mental health-related absence, for example (or better still, before any absence occurs) – is increasingly recognised as good practice. OH specialists are key in planning and supporting phased returns, assisting in task or stress management issues, arranging or signposting to other support, such as counselling, and also in supporting line managers who may lack confidence in knowing how best to respond.1
OH cannot work effectively in isolation, and can provide support and a consistent link between the GP, HR, management and the employee, and it is important that OH advice is passed through to line managers. For smaller employers, direct contact with the GP is more likely, although external OH consultants can provide similar central points of support.2
Employer charter
The service promotes a Charter for Employers who are Positive About Mental Health – a voluntary agreement which seeks to support employers in working within the spirit of its positive approach. It is not legally enforceable and does not negate the need for employers to get the right person with the right experience, qualifications and skills for the job. The charter takes into account that organisations of different sizes will have a range of priorities, policies and practices influencing the recruitment and retention of staff.
Support, training and assistance is available from WorkWays and other Mindful Employers to help in implementing and reviewing commitment to the charter. Each signatory undertakes a supportive review after two years and subsequently every three years. It is a self-assessment aimed at identifying good practice already in place, areas the employer wishes to improve, and the action they plan to take. There is no ‘pass mark’ – simply completing the review is sufficient to remain a signatory.
The charter is a set of aspirations rather than a set of standards, unlike Investors in People (IiP), the Disability Symbol, Chartermark and similar accreditations. Only a small number of signatories have had their charter revoked due to failure to respond to the request for a review.
Signatories
Combining data held at WorkWays and that provided by local support organisations that have a partnership agreement, it is estimated that about 2,500 employers regularly receive information about the service. Employers can be involved without signing the charter, but many use it as a tangible display of their commitment. By December 2009, 580 organisations had signed the charter since the initiative began in 2004, ranging from large organisations such as Nationwide Building Society, First Direct, HSBC Group and HM Revenue & Customs, to small enterprises of just two or three employees. About one-third of signatories are from the public sector.
The charter signatories employ nearly 900,000 members of staff throughout the UK. One hundred have now completed their first review. The biggest need identified by employers is mental health awareness training for line managers. Awareness training is available though WorkWays as part of the overall initiative.
The initiative supported Dame Carol Black, national director for health and work, on the Mental Health and Employment Strategy Steering Group, which developed Working Our Way to Better Mental Health: A framework for action.3
Impact
“It is vitally important that we work in partnership across sectors and disciplines to improve the health and wellbeing of our working-age population, and I think partnership-building has been central to the success of Mindful Employer,” said Black.4 The companion report, Work, Recovery & Inclusion5 also urges public sector organisations to lead by example in committing themselves to the initiative.
Cary Cooper CBE, professor of organisational psychology and health at Lancaster University, says: “Lack of mental wellbeing in the workplace is costing the UK £25.9bn per annum in terms of sickness absence, presenteeism and turnover, and an additional nearly £5bn in terms of incapacity benefits. It is not only economically costly, but also costly to the health and wellbeing of individuals and their families.
“Initiatives such as Mindful Employer energise employers to do something about the wellbeing of their employees, and this is of vital importance to the health of the nation.”4
“Company size really doesn’t matter – nor which industry or sector it is in,” says Simon Kemp of Swindon-based business, AudioMSG. “Encouraging an open and honest environment on mental health and wellbeing makes good business sense. There is growing concern about the impact of mental illness on businesses, and it’s important to realise that employers can make a difference by reducing unwanted costs associated with sickness absence at the same time. The charter is common sense, really.”
Public sector organisations also support the service. “Scarborough & North East Yorkshire Healthcare NHS Trust became a Mindful Employer in late December 2007 as the trust prides itself on being an equal opportunities employer and includes staff with mental health issues and wanted to participate in this excellent initiative,” says Helen Long, divisional HR manager. “Since then, in conjunction with the trust OH department, we have run awareness sessions for our managers which include a definition of mental health, signs and symptoms of both positive and poor wellbeing, and the impact of not handling the situation on the individual, other staff, and patients and early interventions. Becoming a Mindful Employer was the trust’s prompt to run these awareness sessions.”
Commitment
Changes throughout an organisation can also be stimulated by making a tangible commitment to the initiative as Second Step, a voluntary sector organisation in Bristol, demonstrate: “We employ more than 150 staff and provide a range of services to more than 550 people,” said Gill Pickford, head of quality services. “As a mental health organisation we signed up to the charter in August 2007, and have just been through our first review. We have found the standards in the charter fit very well with our aims and values. We have used the charter as a toolkit to check our employment practices and to help us promote good mental health at work. “Some of the changes we have made since signing up to the charter are:
- Including positive statements in all our recruitment literature.
- Introducing a new ‘peer support assistant’ post.
- Implemented an employee assistance programme for all employees and their families.
- Trained our HR department in mental health first aid
- Trained all interviewers in mental health awareness and the Disability Discrimination Act
- Increased the amount of reasonable adjustments made, and improved our expertise in this.
“On a practical level, the charter aims have certainly helped us drive forward some real improvements. The resources available, such as the Shift Line Managers Resource, have also been really useful in supporting us to continue to increase awareness about mental health at work.”
Mindful Employer seeks to complement OH to promote and maintain the wellbeing of the workforce. With the right support, people with mental health issues can and do stay in work. With the right support, employers can continue to deliver their business.
Richard Frost and Lynn Aggett are vocational advisers at WorkWays and lead on Mindful Employer.
Mindful Employer is a registered trademark of Devon Partnership NHS Trust. Visit the website www.mindfulemployer.net for more information, or contact the authors at [email protected]
References
- Grove, B. and Seymour, L., 2005. Workplace interventions for people with common mental health problems: Evidence review and recommendations. London: British Occupational Health Research Foundation.
- Frost, R. and Aggett, L., 2006. Working for Health. Devon Partnership NHS Trust.
- Health Work and Wellbeing, 2009. Working our way to better mental health: a framework for action. London: Dept for Work & Pensions; Dept of Health.
- Mindful Employer, 2009 [Online]. Available: www.mindfulemployer.net.
- HM Government, 2009. Work, Recovery & Inclusion: Employment support for people in contact with secondary care mental health services. London: HM Government.
- National Institute for Health and Clinical Excellence, 2009. Promoting mental wellbeing through productive and healthy working conditions: guidance for employers. London: National Institute for Health & Clinical Excellence.
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