Why a disjointed approach to mental health at work is failing to deliver

Research shows just one in ten employees feel able to disclose a mental health issue to their manager

As the mental health of the workforce continues to deteriorate, the focus must shift from disconnected tactical solutions to joined-up strategic solutions, says Dr Wolfgang Seidl.

One of the most sobering facts to emerge from the 2017 Mental Health at Work Report, released by Business in the Community (BITC) and sponsored by Mercer, is the worrying disconnect between how leaders think employees’ health is being supported and how it’s actually being supported.

According to the study, 61% of CEOs and managing directors believe that employees’ mental health is being looked after, compared with just 40% of non-managers. The result is that three out of every five employees say they experienced a mental health issue in the last year due to work, or where work was a related factor, while 31% have been formally diagnosed with a mental health issue.

Despite this, just one in 10 employees (11%) felt able to disclose a mental health issue to their manager, with mental health remaining one of the most difficult topics to discuss at work. Those surveyed said they felt more comfortable talking about seven other equality and social issues, including race, age, physical health and religious belief.

Eight Dimensions of Wellbeing

  1. Physical – I take good physical care of my body
  2. Emotional – I can express and manage my feelings
  3. Spiritual – There is meaning and purpose to my life
  4. Social – I enjoy regular positive interactions with others
  5. Financial – I can manage my income to good effect
  6. Intellectual – I have opportunities to learn and stretch myself
  7. Environmental – I have positive thoughts about the world around me
  8. Occupational – I have goals I’m enjoying striving to achieve

Source: Mercer in association with Oliver Wyman

Most worrying of all, 15% of respondents said that after they had disclosed a mental health issue, they were subjected to disciplinary procedures, demotion or dismissal. So it’s perhaps unsurprising that employers lose £2.4bn a year replacing staff affected by mental health issues.

The need for joined-up strategies

A major issue with creating a healthy workplace is that few managers know what to say or do with someone who discloses a mental health issue. If you have a back problem, the chances are your manager will have a clearly defined care pathway, featuring a physical assessment, recommended adjustments and support to put these into practice while you recover.

But if you admit to struggling with extreme anxiety or feelings of low self-worth, the chances are your manager will not have a clue what to do with you. They might attempt to brush away your concerns or think they should be able to tell you about what they did at a time when they felt like you.

But suppose in reality your manager had never experienced a similar problem? What use is a standalone mindfulness seminar or one-off mental health day to someone who can’t come into work because they’ve developed a crippling anxiety disorder?

If this year’s research teaches us anything, it’s that record investment in disjointed, tactical wellbeing initiatives are failing to deliver. Strategic mental health pathways must be created and used to normalise people’s experience of recovering from and managing mental health issues, in much the same way that physical assessments and workplace adjustments have normalised people’s experience of, and willingness to seek help with, musculoskeletal issues.

Proactive elements

Such mental health pathways should include proactive elements, such as training managers to spot the early warning signs of stressed employees and resilience training to educate people how to sustain good mental health. There should also be reactive elements, such as a triage model for ensuring employees in need of further support are given clinically appropriate referrals into relevant treatment options.

The design of these pathways must be based upon the continuous analysis of organisational data, including the insights generated by analysing how people are currently using existing health services, such as medical plans, employee assistance programmes (EAPs), group income protection and occupational health or existing rehabilitation programmes.

This is important because if you only look at your EAP data you might conclude everyone has a mental health issue, whereas if you only look at your medical plans most people might appear to have a back, joint and muscle problem. Only by looking at all the data can you form a clear picture of how the health of your workforce is being impacted.

Fortunately, managers don’t need to be mental health professionals, or even to have experienced what someone’s going through to support them effectively. They only need to be able to direct them towards the appropriate pathway, such as the trained professionals at the end of an EAP, occupational health (OH), HR department or even a charity helpline.

Normalising mental health

Another big trend of late has been to identify role models who have suffered poor mental health in the workplace. If you haven’t got a leadership figure who can talk about their breakdown, you might be feeling that your wellbeing strategy is missing a trick.

But what if your CEO has never had a breakdown? Although it was hoped such a direct focus on mental health would encourage more people to get help sooner and, indeed, has contributed to a more positive discussion, this unfortunately hasn’t worked to improve the overall figures mentioned above. Instead, treating physical and mental health in isolation has led to disjointed policies that put too much pressure on people to talk about their mental health in isolation.

To progress, we need to accept that people naturally feel more comfortable talking about their energy levels and the concept of feeling flat or lethargic, than they do about their mental health directly, yet these symptoms are often part of a depression and can be a good way to aid the conversation.

At the same time, we need to stop trying to divide humans into two halves, their physical and mental components, and start creating biopsychosocial policies that look at their health as a whole.

In total, there are eight dimensions of wellbeing (see box), all of which are linked to and impacted by our mental health.

For example, if someone is struggling to manage their income, their financial health will not be what it should be and they will understandably be feeling stressed. Similarly, if loud traffic is keeping someone awake at night, their environmental health will be diminished, causing them to crave carbohydrates and eat unhealthily because they feel tired.

Affected individuals might not yet have any physical or mental health issues, and may even consider themselves to be healthy, but by using the dimensions of wellbeing to create people-shaped policies, employers have an opportunity to help people prevent future problems and flourish.

Creating a culture of health

Another reason the focus on disjointed mental health initiatives isn’t working is that mental health cannot be treated in isolation – not least because the way managers treat people has a direct impact on their wellbeing.

Each year, Britain’s Healthiest Workplace surveys thousands of employees to better understand the health risks facing employees and how these risks are impacting upon other factors such as job and life satisfaction, work engagement and productivity.

As well as identifying the healthiest workplaces each year, the survey also benchmarks all participating employers against six Health and Safety Executive (HSE) Management Standards, which have been proven to affect the health of employees. By training new managers to live up to these standards, you can empower them to create a culture of health.

1. Demands People are given adequate and achievable work and their skills and abilities matched to job demands. Any concerns about their work environment are also addressed.

2. Control Individuals have some say over their workloads and deadlines. They are allowed to play to their strengths and feel able to manage their day in healthy ways.

3. Relationships People are allowed to have “water cooler conversations”, enjoy social spaces, are able to foster good workplace relationships to help and support each other.

4. Role It’s clear what’s expected of individuals: they understand their role and objectives, and don’t feel as though the goalposts are being changed.

5. Change Change and the need for change is effectively communicated. People understand the probable impact of any change to their job and the timetable for changes.

6. Support Managers understand their duty of care to others, make time to talk to people one-to-one and know how to direct them towards appropriate support whenever needed.

Destigmatisation of mental health is now sorely needed and an isolated focus on mental health has failed to deliver the desired results. Employers must now normalise mental health by creating people-shaped policies that look at all the dimensions of wellbeing, instead of just looking at physical or mental health in isolation.

Critical to success is educating managers about their role in creating a culture of health and normalising people’s experience of recovering from and managing mental health issues, by ensuring managers know how to direct individuals to use the available support services.

Only once people can see others being given help to deal with an issue impacting on their health will they too become motivated to seek the support that is still so clearly needed.

Dr Wolfgang Seidl is a partner and workplace health consulting leader at Mercer.

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