Improving wellbeing at work

diary and clock

A food manufacturer in Kent has cut the length of sickness absence attributed to mental health problems by tailoring an employee wellbeing programme to the needs of workers, many of whom were migrants whose first language was not English. Tristi Brownett reports.

During the past decade there has been a concerted shift of attention to workplace wellbeing strategies. Initially, the focus was specifically on stress but recently there has been a wider recognition of the psychosocial aspects that influence positive physical and mental health and wellbeing.

Blue-chip organisations and large corporates had, to some extent, a reputation for leading the way; however, more recently Government has taken the mantle with a slew of policies, directives and papers, all of which recognise the critical nature of work and wellbeing on the economic success of the country.

Failure to address workplace psychosocial factors has been shown to reduce workplace performance (van den Heuvel et al, 2009). A weak psychosocial environment has been shown to: influence the perception of poor health (Sparks et al, 2001; Labriola et al, 2006); increase the experience of pain; induce delayed recovery from musculoskeletal conditions such as back problems (Waddell and Burton, 2000; Lund et al, 2005); and elicit negative coping strategies such as drinking excessive alcohol (Head et al, 2004) or over-eating (European Commission: DGE, 2000). Therefore, workplace wellbeing interventions are increasingly focusing on strategies that give attention to the role of “good work”, employee engagement and the psychosocial environment (Bevan, 2012).

What is “wellbeing”?

The word “wellbeing” is used liberally in our daily lives and has been coupled to the notion of health, having first been mentioned in the preamble to the constitution of the World Health Organisation (1947). Most people know what it is when they are experiencing “wellbeing” or feel it being affected, yet it defies a singular description.

Common terms used to define wellbeing originated in ancient Greece, with “hedonic” wellbeing being derived from pleasure and “eudiamonic” being recently appropriated to reflect aspects of positive mental health in terms of flourishing and thriving. By this, it is meant that individuals have a sense of purpose, feel that their life is well lived as a result of fulfilling their potential, or have a sensation of autonomy, or control (Jeffrey et al, 2014).

Wellbeing at work is recognised as something that is experienced, influenced by internal cultural and organisational factors and by personal internal resources such as emotional state and resilience (Biggio and Cortese, 2013). Being required to establish a workplace wellbeing programme can be an overwhelming task for a lone practitioner.

As an example, this article describes the approach adopted at a food-manufacturing site in South-East England.

To bring about meaning and relevance for all employees, a partnership approach was sought. Partnership is a deeper relationship than consultation. While both approaches establish the health wants and needs of the community, partnership approaches seek to empower and create power from the bottom up (Scriven, 2010). These community approaches are deemed essential in public health interventions. The process can at times be uncomfortable for participants to be involved in democratic decision making, and being accountable for those decisions (Burns et al, 2004).

Overcoming staff suspicion to win engagement

The OH practitioner had attempted to engage employees in conversations about their health and wellbeing to drive demand. However, initially the employees were suspicious or cynical about the organisation’s motives in wanting to adopt a wellbeing strategy. Formal and informal conversations, at all levels of the organisation, eventually suggested that enough of the workforce were encouraged that the OH service was sincere about working with employees to influence change.

A site wellbeing survey was carried out. It was a pivotal moment in that it was the first time that any written document was offered in a range of languages and to all staff, regardless of grade or shift. The process gave employees the opportunity to respond anonymously. The response rate was 14%, yet deemed highly successful by management that had previously reported that voluntary engagement with any initiative on site was extremely low.

The results of the survey showed consistency with the worksite factors known to have an impact on mental wellbeing (Health and Safety (HSE), 2007). Furthermore, the survey indicated that employees’ wants and needs were based on fundamental human needs (eg availability of hot food and drinks, ability to communicate with each other) and were entirely achievable.

Further examples of employees’ wants and needs included opportunities to have a career structure, to learn the English language, and have maths and English lessons, have a more comfortable rest environment, comfortable footwear and a range of health-promoting opportunities.

Results also identified that employees wanted a wide range of advice and support, more consistent management and explicit procedural justice. The results were shared with everyone and an integrated business strategy was written and agreed, highlighting the steps to address the survey findings.

As employees’ needs were diverse, the strategy to bring about wellbeing could no longer be wholly owned or facilitated by OH. Coincidentally at this stage, boardroom and managerial conversations suggested that organisational change was inevitable, to shift towards lean manufacturing and improve profitability. The wellbeing initiative was at risk of being derailed before it had begun.

OH took a leadership role in showing that the whole organisation, especially managers, could be facilitators of the transformation. Gopee and Galloway (2009) highlight that transformational leadership focuses on the merging goals, desires and values of leaders and followers in a common goal. The leader does not necessarily need to be in a position of authority.

A series of conversations with OH persuaded senior management that the business aspirations could be achieved while including a wellbeing agenda. The HR function supported this argument, focusing on non-attendance at work and poor performance due to health reasons.

Managers were also interested in how wellbeing could be combined with an engagement agenda (Terhani et al, 2007). The role of good employee communication in engaging employees was recognised. The wellbeing survey and informal conversations with OH had highlighted that a large percentage of the workforce didn’t speak English exclusively, if at all.

A small budget was provided to address this through translation services to ensure that more information was available in other languages, and that training was delivered in an appropriate language. A site translator role was designed; much like a first-aider role, in that translators were taken from the existing pool of staff, who were given an additional payment and permission for time off work to deal with urgent translation requirements.

An employee assistance programme (EAP) was implemented for all staff. Also, the services of a local charity were commissioned to provide specific help and advice to migrants. Together with the translation services, this appeared to enhance the overall sense of trust that was lacking beforehand. The utilisation rates of these services in the first year were high, as was voluntary employee involvement in a range of discussion forums.

A three-year OH wellbeing plan was written, signalling an intention to respond to the health needs of staff. In year one the focus was on mental health, in year two it was musculoskeletal issues and in the third year, lifestyle and health.

Conversations took place with key departments about the importance of responding to the staff survey, with support from the HR and training departments. Around 30 initiatives were carried forward as part of the site’s wellbeing strategy, which addressed stated needs and the notions of good work through personal development, values and culture.

Successfully launching the employee wellbeing programme

The wellbeing strategy was launched with a wellbeing day, funded from savings in the stationery budget. Staff were invited to take part in a wide range of activities including health checks, team games, a climbing wall, motorbike and bicycle maintenance, keepfit taster sessions from a local gym, hair and beauty makeovers via the local college and wellbeing presentations from the EAP provider. Providing hot food and an extended lunch break made the wellbeing day a positive talking point, and staff representatives reported that the occasion further secured employee confidence in the changes in the organisation.

The training department together with a local college of further education obtained a government grant to run maths and English lessons on site. A baseline was taken of each employee’s abilities and among the English-speaking staff it was established that the average reading age on site was nine, with a very high rate of dyslexia also present.

Consequently, weekly one-to-one lessons commenced and a number of staff quickly attained a formal qualification equivalent to GCSE level. The lessons continued, as demand for the classes remained high. HR initiated a quarterly “celebrate success” tea, where staff graduating from the programme or similar could be formally recognised for their efforts.

Prior to the implementation of the OH wellbeing plan, managers had admitted they did not feel equipped to deal with the behaviour of mentally unwell, distressed or agitated staff. An analysis of sickness absence data, OH records and management referrals revealed that common mental health problems such as stress, anxiety and depression were complicated by some employees’ personal lives. Psychiatric disorders such as schizophrenia, psychosis and bipolar disorder appeared to be exacerbated by limited access to healthcare.

The reasons for this were varied but included: being isolated from family; lack of fluency in the English language; and lack of understanding of how to access local GPs or accident and emergency departments. OH arranged mental health first-aid training for managers, developed ongoing relationships with the local mental health services, GPs and nurse practitioners and made referrals to EAP counsellors in the event of crisis or potential suicide, with support from external translation services where necessary.

The mental health first-aid training for managers was an accredited programme by Mental Health First Aid England and, although attendance was voluntary, most managers (including members of the executive) completed one or two modules. Around 75% completed the whole programme. Coupled with revised sickness absence policies and additional training for managers, the mental health training increased the confidence of managers in supporting employees.

Recognition and reward

Union and staff representatives reported that attitudes to mental health had changed. Academic evaluation of the three-year wellbeing programme at the midway point showed that one of the most successful, measurable outcomes of the programme was its impact on mental health. Although the overall sickness absence rate remained broadly unchanged, mental health absence improved, with the total length of each episode being reduced by half on average.

The academic evaluation highlighted a shortfall in the programme. Although employees indicated that they had a sense of improved workplace wellbeing, they were not able to attribute this to a specific cause or activity. The review highlighted that while the strategy was well embedded to some extent, communication of it had not been successful and this affected access to specific initiatives.

The evaluation findings can be explained using a four-stage organisational change model (Nutbeam, 2006). This model demonstrates how organisational influences affect the effectiveness and speed at which change is seen. The programme of activities in the strategy had been implemented without explaining the individual benefits and overall purpose, and stakeholders were not given the relevant information. Middle managers who acted as gatekeepers to enable staff to attend specific activities during the working day may not have understood the business imperative.

It is critical to appraise a programme during its life cycle so adjustments can be made. The programme leaders recognised the need to improve communications, boost branding of the programme and engage middle managers with the strategy. However, the programme was successful in reducing the length of absence due to mental health problems. This data helped make a business case for increased funding for the second year’s focus, which was musculoskeletal health.

The wellbeing strategy and programme of activities played a part in the manufacturing site winning several prestigious industry awards. The business discovered that having a healthy and engaged workforce improved staff retention. Furthermore, contact from the local job centre indicated that job seekers were actively pursuing the company as an employer of choice. The OH service was invited to present the wellbeing strategy at the Kent Healthy Business Awards launch (part of the Workplace Wellbeing Charter) as an exemplar for other local organisations.

In conclusion, when addressing the subject of workplace wellbeing, OH and HR practitioners should seek to engage deeply with employees to ensure the strategy is well tailored to their needs, find ways to show management that it works and don’t forget to use good communication.

References

Bevan S (2012) “Good Work, High Performance and Productivity“. The work Foundation May 12

Biggio G, and Cortese CG (2013). “Well-being in the workplace through interaction between individual characteristics and organizational context“. International Journal of Qualitative Studies in Health and Well-being. 8: 1748-2623)

European Commission: DGE (2000) “Guidance on work‐related stress: Spice of life or kiss of death?” Luxembourg: Office for the Publications of the European Communities.

Gopee N, Galloway J (2009). “Leadership and management in healthcare”. London: Sage.

Head J, Kivimaki M, Martikainen P, Vahtera J, Ferrie JE, Marmot MG (2006). “Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II study“. Journal of Epidemiology & Community Health, 60(1); pp.55-61.

Health and Safety Executive (2007). “Managing the causes of work-related stress: A step-by-step approach using the management standards“. HSG 218. London: Crown.

Jeffrey K, Mahony S, Micaelson J, Abdallah S (2014). “Well-being at work: a review of the literature“. New Economics Foundation.

Labriola M, Lund T, Burr H (2006). “Prospective study of physical and psychosocial risk factors for sickness absence“. Occupational Medicine; 56; pp.269-274.

Lund T, Labriola M, Bang Christensen K, Bültmann U, Villadsen E (2006). “Physical work environment risk factors for long term sickness absence: prospective findings among a cohort of 5357 employees in Denmark“. British Medical Journal 25; 332(7539): pp.449-452.

Nutbeam D (2006). “Using theory to guide changing communities and organizations”. In Davies M, McDowell W, Health Promotion Theory. Berkshire: Open University press. Chapter 4.

Scriven A (2010). “Working with communities”. In Promoting Health a Pactical Guide. 6th Edition London: Balliere Tindall Elsevier Chapter 15.

Sparks K, Faragher B, Cooper CL (2001). “Well‐being and occupational health in the 21st century workplace“. Journal of Occupational and Organizational Psychology, 74(4); pp.489-509.

Terhani N, Humpage S, Willmott B, Haslam I (2007). “Change agenda: what’s happening with well-being at work?” London: CIPD. May 2007.

van den Heuvel SG, Geuskens GA, Hooftman WE, Koppes LLJ, van den Bossche SNJ (2009). “Productivity loss at work; health related and work related factors”. Journal of Occupational Rehabilitation (2010); 20; pp.331‐339.

Waddell G, Burton AK (2000). “Occupational health guidelines for the management of low back pain at work: evidence review“. Occupational Medicine; 55(2); pp.124-135, 2001.

World Health Organisation (1947). “Preamble to the Constitution of the World Health Organisation” as adopted by the International Health Conference, New York, 19-­22 June 1946.

About Tristi Brownett

Tristi Brownett RN, Dip (HE), BSc (Hons), SCPHN (OH), PG Cert, MSc, FRSPH, FRSA is a lecturer at the School of Public Health, Midwifery and Social Work at Canterbury Christ Church University.
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