Mindful Employer: making a difference in mental health

People who have a mental health condition often have access to considerable support. The Mindful Employer initiative seeks to address the question: “Who supports their employer?” Richard Frost explains.

The Mindful Employer scheme was launched in October 2004 by Workways, a vocational rehabilitation service offered by the Devon Partnership NHS Trust. The aim of the initiative is to provide employers with easier access to information and support for employees with mental health conditions.

It has since spread across the UK and been launched independently in Australia and New Zealand.

The Mindful Employer evaluation

The evaluation can be downloaded from both the Mindful Employer and Workways websites.

Having allowed the initiative to become well established rather than attempt to assess its effectiveness too early, an evaluation has now been published. Supported by the Devon Partnership NHS Trust and Sheffield Hallam University, the evaluation provides practical suggestions and recommendations for employers to implement.

The increased prevalence of stress, anxiety, depression and other mental health conditions in the population has been increasingly recognised, together with their effect on the workplace and the need for employers to provide appropriate support for those affected.

For the purpose of this article, “mental health conditions”, “mental ill health” and similar phrases encompass common mental health problems (such as stress, anxiety and depression) as well as severe mental health issues (for example, psychosis and schizophrenia).

Increasing work stressors

Since the 2008/09 economic recession, there has been an increase in work stressors such as organisational change and restructuring, job insecurity, work intensity and inter-personal conflict, particularly among those working in the public sector (Chandola, 2010; Sinclair, 2011).

Employees also experience difficulties outside the workplace – for example, bereavement, financial problems, relationship breakdown or other issues. Such non-work-related stress, anxiety and depression causes more sickness absence than work-related issues (CBI, 2011).

Overall, one adult in six has a mental health condition at any given time (Department of Health, 2011) – and among adults of working age this is as high as one in three (Health, Work and Wellbeing, 2009).

There is an expectation that employers should offer support and evidence that more of them are taking positive action – particularly large and public-sector employers.

But there is also a continued reluctance among employees to disclose mental health conditions to their employer, and criticism of managers in their understanding of, and responses to disclosure of, mental health conditions (Collingwood, 2011; Sinclair 2011; the NHS Information Centre and Mental Health and Community, 2011; Young and Bhaumik, 2011a; Young and Bhaumik, 2011b). Key issues for employers are the tensions between running the business and supporting staff and problems in finding the right support to help employees experiencing mental ill health (Davidson, 2011; Sparham, Spicer and Chang, 2011).

Box 1: Recommendations for employers – statements

  • To make policies live by revisiting existing policies and considering ways in which they can be developed to enable practical, day-to-day differences for all staff throughout an organisation.
  • To increase confidence by investing in mental health awareness training for line managers and other relevant staff.
  • To develop knowledge by sharing good practice and remedial actions within and outside the organisation and with other employers.
  • To keep talking by developing staff support facilities and improving communication.
  • Recommendations for the development of the Mindful Employer initiative can be found in the evaluation report.

Evaluating effectiveness

The MSc-level qualitative evaluation of Mindful Employer focused on current practice and remedial actions by a group of employers that had submitted a two-year review of their commitment to Mindful Employer’s Charter for Employers.

The charter – a set of six aspirations for employers to work towards, rather than a target-driven or quality-standard approach – recognises that changing attitudes towards mental health conditions takes time. Some 1,000 employers of all sectors and sizes have signed the charter since the initiative began.

The evaluation revealed that employers demonstrate a degree of confidence in providing non-judgmental and proactive support, with 87.3% of signatories that had completed a review achieving at least three aspirations across most or the whole of their organisation – clear signs that employers are headed in the right direction.

Looking across all of the charter’s aspirations and the range of current practice and planned remedial actions, the evaluation showed that increasing the availability and provision of both information and training are recurring themes.

In times of economic stringency, training budgets are often the first to suffer – and yet equipping managers to provide support is vital for the wellbeing of staff and the running of the business.

The evaluation and related literature also demonstrated a need for increased awareness of legal responsibilities. Policies for dealing with mental health issues in the workplace are common in current practice.

It showed that clearer communication and the sharing of good practice are important, as this allows others to develop the skills and capacity to support managers and staff. As may be expected, small and medium-sized employers found it easier to achieve aspirations due, in part, to shorter lines of communication.

The evaluation found a wide range of current practice and a willingness to address the areas that needed improvement, together with practical remedial action.

Summarised in box 2 and shown more fully in the evaluation itself, these examples provide a quick guide for employers wanting to relate the aspirations of the charter to their business demands and staff-support requirements.

Areas of concern

The voluntary nature of the initiative and its somewhat counter-cultural approach is part of its success and popularity.

However, despite clear publicity and explanation that the charter is not a set of quality standards or an accreditation, other organisations do not always convey this message and the emphasis on “getting people to sign up” remains an area of concern. Such perceptions also exist among employees, who see the logo being displayed and grant it the same status as other accreditation-based symbols.

There is also concern that some employers carry similar misconceptions and complete their review accordingly. As a self-completed document, the reviews give limited justification behind the marked levels of achievement.

It may be helpful in future to request testimonies from employees as part of the review, as employee interviews conducted for the evaluation were valuable and raised different perspectives on the issue of perception. These ranged from full confidence in levels of achievement to applying a reasonable degree of caution.

The influence of target-focused workplaces and other forms of accreditation do play a role. Part of the purpose of the Mindful Employer scheme is to address the need for people to talk about mental health difficulties and to help overcome any stigma and discrimination.

The sample of employees consulted in the evaluation clearly showed this to be an area of significant importance, as one described: “I think if people were asked if we were a Mindful Employer, they would say we were in terms of what they think or feel they get. People feel like they can be themselves, and I think that’s really important at work because the way I grew up the last thing you were going to do was be yourself at work – that was far too dangerous! The idea that you can be yourself is very good. I think people feel that quite keenly and appreciate that there are forums for them to be open.”

The personal benefits are also well illustrated by another interviewee: “Part of why I love my job is I know that if I’m ill or something really big happens at home, I will get the support I need to manage it. I know I don’t even have to ask my manager because he trusts me to manage my time. We have a good relationship. He doesn’t have an issue with talking about things that are slightly outside the work remit – it’s accepted that it’s almost impossible to keep the two separate. I think it’s just a culture – having an open, understanding and non-judgmental culture is really key, because if you don’t have that, it doesn’t matter what your policies and procedures are.”

A distinctive approach

Despite no dedicated funding, Mindful Employer has established its place alongside other, much larger, employer-focused mental health initiatives. Its distinctive approach complements Government programmes and proposals, and offers a forum to provide employers with easier access to information and local support and a facility through which businesses and organisations can share good practice.

For those who are familiar with the issues of mental health and employment, the findings of the evaluation will not be a surprise. What this evaluation highlights is that a voluntary, long-term and non-target-driven approach is appropriate to this complex area. It also confirms that there are a variety of methods that such improvements can be implemented and achieved by employers in ways that enable both the running of the business and supporting their staff.

Richard Frost is lead vocational adviser at Workways. Tel: 01392 677050


Chandola T (2010). Stress at Work. London: The British Academy.

Collingwood S (2011). Attitudes to health and work amongst the working-age population. London: Department for Work and Pensions.

CBI (2011). Healthy returns? Absence and workplace health survey 2011. London: CBI/Pfizer.

Davidson J (2011). “A qualitative study exploring employers’ recruitment behaviour and decisions: small and medium enterprises”. London: Department for Work and Pensions.

Health, Work and Wellbeing (2009). “Working our way to better mental health: a framework for action”. London: Department for Work and Pensions and Department of Health.

Department of Health (2011). “No health without mental health”. London: Department of Health.

Sinclair A (2011). Absence management 2011. London: CIPD. 

Sparham I, Spicer N, Chang D (2011). Health, work and wellbeing: attitudes of GPs, line managers and the general public. London: Department for Work and Pensions.

The NHS Information Centre and Mental Health and Community (2011). Attitudes to mental illness – 2011 survey report. London: The NHS Information Centre for Health and Social Care. 

Young V, Bhaumik C (2011a). “Health and wellbeing at work: a survey of employees”. London: Department for Work and Pensions.

Young V, Bhaumik C (2011b). “Health and wellbeing at work: a survey of employers”. London: Department for Work and Pensions.

Box 2: Summary of current practice shown in sample of charter reviews – statements

Aspiration one

Show a positive and enabling attitude to employees and job applicants with mental health issues. This will include positive statements in recruitment literature.

  • One-to-one supervision and group/team support.
  • “Open door” policy by managers.
  • Use of Mindful Employer logo and disability symbol on letterhead paper, job advertisements, publicity, website and so on.
  • Use of customer/service-user experience in recruitment.
  • OH or other specialist support.

Aspiration two

Ensure that all staff involved in recruitment and selection are briefed on mental health issues and the Equality Act 2010 and have appropriate interview skills.

  • Information about the law in recruitment and selection materials.
  • Specific training about the law in this area.
  • Mental health awareness training.
  • Use of guidance for managers in recruiting staff with a mental health condition (such as the Mindful Employer Line managers’ resource).
  • Availability of HR expertise.

Aspiration three

Make it clear in any recruitment or occupational health check that people who have experienced mental health issues will not be discriminated against, and that disclosure of a mental health issue will enable both employee and employer to assess and provide the right level of support or adjustment.

  • Applying principles behind service delivery to own staff.
  • Clear statements about non-discrimination in relevant policies and any publicity.
  • Statements explaining that disclosure of health issues helps in providing adjustments and support, and health checks are not used as part of the shortlisting or interview process.
  • Advising applicants about employer support provision (for example, counselling) at recruitment stage.
  • Guaranteed interview for applicants with a health problem who can demonstrate meeting the minimum requirements for the post.

Aspiration four

Not make assumptions that a person with a mental health issue will be more vulnerable to workplace stress or take more time off than any other employee or job applicant.

  • Specifically addressing bias and negative assumptions through training, forums, policies and day-to-day practice.
  • Monitoring staff absence.
  • Having mental health first aiders on staff to assist when necessary.
  • Promotion of Mindful Employer commitment whenever possible.
  • Displaying posters in the workplace that help to challenge stigma and discriminatory attitudes.

Aspiration five

Provide non-judgmental and proactive support to individual staff who experience mental health issues.

  • Access to an employee assistance programme.
  • In-house mental health support.
  • Guides on reasonable adjustments for all managers and the majority of employees to access, with specific examples of mental health issues.
  • Counselling service.
  • Link with the local NHS mental health trusts to promote access to their employment support advisers for service users who are employees and who need this extra support.
  • Flexibility around time management and breaks.
  • Opportunities to take part in creative activities on-site for relaxation and wellbeing, such as yoga and so on.
  • Fostering an atmosphere of openness about health or ill health and wellbeing.
  • Support groups specifically for line managers.
  • Drop-in session with the occupational health nurse where confidential issues may be discussed.
  • Phased return provided for any employee returning after long-term illness.
  • Leaflets put out on information racks, with topics changed every month.

Aspiration six

Ensure that all line managers have information and training about managing mental health in the workplace.

  • Identify gaps in knowledge of particular staff members, teams and managers.
  • Seek help, advice and training from external organisations.
  • Mental health awareness training.
  • Having a “health week” event in the workplace to provide information and raise awareness.
  • Intranet pages giving information on managing staff and reasonable adjustments.
  • A more in-depth version of the above can be found in the evaluation report.
  • Improving employer support for staff with mental health conditions.

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