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
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
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.
Show a positive and enabling attitude to employees and job applicants with mental health issues. This will include positive statements in recruitment literature.
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.
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.
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.
Provide non-judgmental and proactive support to individual staff who experience mental health issues.
Ensure that all line managers have information and training about managing mental health in the workplace.