Mental health at work review calls for legal changes as thousands lose jobs

Paul Farmer:"Every employer in the UK has a responsibility to support employees with mental health problems and promote the mental wellbeing of their entire workforce."
Paul Farmer:"Every employer in the UK has a responsibility to support employees with mental health problems and promote the mental wellbeing of their entire workforce."

A high-level review of mental health at work has found that 300,000 people lose their jobs every year due to mental health problems, and calls for changes to the law to make employers’ management of mental health more transparent.

The independent review, which was commissioned by Prime Minister Theresa May in January and published today, found that employers lose up to £42 billion a year due to mental health issues, while the UK economy loses up to £99 billion.

Thriving at Work – the Stevenson/Farmer review of mental health and employers was led by Dennis Stevenson, a mental health campaigner, and Paul Farmer, chief executive of charity Mind.

The review calls on employers, regardless of size or industry, to adopt six mental health core standards covering mental health at work plans, mental health awareness for employees, line management responsibilities and routine monitoring of staff mental health.

The six recommended mental health core standards

  1. Produce, implement and communicate a mental health at work plan.
  2. Develop mental health awareness among employers.
  3. Encourage open conversations about mental health and provide support when employees are struggling.
  4. Provide employees with good working conditions.
  5. Promote effective people management.
  6. Routinely monitor employee mental health and wellbeing.

Public sector employers and private sector companies with more than 500 employees should adopt further enhanced standards, says the review.

The Government is urged to introduce a mental health online information portal to promote best practice.

The Prime Minister is asking NHS England and the civil service to implement the recommendations, according to the BBC, as well as considering the legislative changes suggested.

The review calls for changes to legislation and guidance, such as the Companies Act, to encourage employers to report on workplace mental health on their websites and other channels. The law on reasonable adjustments should be enhanced to protect employees with fluctuating mental health conditions.

The reviewers also suggest “statutory sick pay is made more flexible to better support people with mental health problems to take voluntary phased returns to work where appropriate”.

The public sector should lead the way, the report says, particularly the three biggest employers, the NHS, education and the civil service. The review recommends senior leaders in the public sector have a performance objective relating to ensuring the mental health of all employees, and that they are accountable for adopting mental health care to the enhanced standards.

Enhanced mental health standards for the public sector and larger employers

  • Increase transparency and accountability through internal and external reporting.
  • Demonstrate accountability.
  • Improve disclosure process.
  • Ensure the provision of tailored in-house mental health support and signposting to clinical help.

The Health and Safety Executive is urged to raise employer awareness of their duty to assess and manage work-related mental ill health.

Current government services offering practical support to mentally ill people returning to work including Access to Work, the Fit for Work Service and other NHS services, are found to be too fragmented. It is also recommended that health professionals be able to sign fit notes.

Other recommendations include additional support from the Government for small and medium enterprises and the use of digital technology as a means to support those working remotely or in the gig economy.

Industry efforts to support employers in understanding and comparing employee assistance programmes and occupational health services are encouraged, ideally through the development of standards and tools for online comparisons.

The review includes case studies of good practice and makes 40 recommendations for employers, Government and regulators. It draws on Department of Work and Pensions statistics and analysis by consultancy Deloitte.

Farmer said: “We found that in many workplaces, mental health is still a taboo subject and that opportunities are missed to prevent poor mental health and ensure employees who may be struggling get the support they need. In many instances employers simply don’t understand the crucial role they can play, or know where to go for advice and support.

“The human cost of failing to address mental health in the workplace is clear. Workplace mental health should be a priority for organisations across the UK. Every employer in the UK has a responsibility to support employees with mental health problems and promote the mental wellbeing of their entire workforce.”

Stevenson said: “In light of the demonstrable impact of poor workplace wellbeing on individuals, employers and the UK economy, we are calling on the Government to accept the recommendations in full, and to introduce the core standards in the public sector.

“We need the right leadership among employers in the public, private and voluntary sectors, and a mandate from policy-makers to deliver our ambitious but achievable plan.

“It’s time for every employer to recognise their responsibilities and effect change, so that the UK becomes a world leader in workplace wellbeing for all staff and in supporting people with mental health problems to thrive at work.”

Reaction to the Thriving at Work report

Rachel Suff, senior employment relations adviser at the CIPD, said: “This welcome review shows that the UK is facing a greater challenge than expected when it comes to mental health in the workplace. With one in six people at work affected by mental ill health, a commitment from the Government to address the issues head on and adopt the recommendations will be a clear signal to employers to do the same.”

Suff added:  “The success of this report will ultimately rest on the willingness of Government, employers and key stakeholders to work together in partnership to deliver long-term and sustainable change.”

Danny Mortimer, chief executive of NHS Employers, said: “The report rightly highlights the importance of proactive employment practice and of promoting mental health awareness in the workplace. Employers in the NHS will welcome the clear and evidence-based recommendations and standards, which reinforce the work we have been undertaking as the nation’s largest employers, but also challenge us to do much more.”

Nigel Wilson, insurance company Legal & General’s group CEO, backed the proposals: “This report is a call to arms for all employers – we strongly urge the government to accept Paul and Dennis’ recommendations.

“As a provider of insurance to other employers, and a big employer ourselves, we have been engaged with mental health issues for a long time, alongside great organisations like the City Mental Health Alliance and on our own behalf through our ‘Not a Red Card’ campaign.

“We now need to step up our ‘doing’ as well as our ‘thinking’, with continued de-stigmatisation, more transparency, better digital tools, encouraging ‘active listening’ by managers and more training for employees. Legal & General will now aspire to ‘enhanced’ status as described in the report and hope others will do the same.”

Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, said: “We welcome this report’s approach to prioritising the mental health of the workforce and keeping mental health high on the healthcare agenda.

“Key to alleviating some of the pressures we are currently seeing within the mental health sector is the support offered to individuals before they reach crisis. Empowering employees to look after their own mental health is a crucial step towards this.

“The evidence shows that improving employee mental health is both beneficial to the individual and good for business, paying dividends in terms of morale, retention and productivity.

“The NHS has made great progress in this area. For example, the South London and Maudsley NHS Foundation Trust has introduced several initiatives as part of its happier@work project.

“This programme includes workshops on mental health awareness; skills workshops for managers; and practical skills for peace of mind, managing wellbeing and stress awareness.

“The more support the Government offers to spread these types of initiatives, the better.”

James Malia, director of employee benefits at Sodexo Engage, said: “Today’s ‘Thriving at Work’ report makes some reasonable recommendations for employers on how to support their staff, but the truth is that more needs to be done and we should stop relying on just the government. Whilst we have come a long way in eliminating the taboo of mental health, talk must turn in to action.

“Promoting effective people management is simply not enough. Businesses need to invest in intensive training which give these managers the tools and understanding of how to recognise both good and poor mental health. Most of all, if it’s possible to have one or more mental health ambassadors in the workplace who have been through their own challenges, it will immediately encourage more employees to speak out.”

Louise Ward, communications and policy director at the British Safety Council, said: “Great progress has been made on addressing safety issues and reducing accidents and injuries in the workplace, but there is still significant work to be done on wellbeing and health, particularly mental health.”

Ward added: “We believe that employers will welcome the proposed core standards, and supporting guidance, as this will help to establish a benchmark for good practice. However, we are concerned about the ability of businesses, particularly SMEs, to resource the interventions required to achieve this benchmark. We also welcome suggestions that the Government should consider financial incentives to support this work.

“Employers are likely to require information and advice to support development of mental wellbeing programmes and it will be important to provide a mechanism to facilitate access to ‘quality assured’ tools and providers. The proposed single online portal would be welcomed, but would need to be properly resourced to ensure that it delivers effectively against expectations. It will also be important to ensure that good intentions do not result in an increase in ‘blue tape’ requirements that might put more pressure on businesses, particularly SMEs.

“The recommendations set out in the report will place significant demands on the already stretched NHS and public sector. We are concerned that additional resource will be required to meet these demands, and care will be required to mitigate the impact that workload increases could have on the mental wellbeing of staff employed in these areas.”

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