A study day held in September focused on the role of occupational health when dealing with employee mental health issues. Noel O’Reilly reports.
The challenge of supporting employees with mental health problems to return to, and stay in, work was the theme of the recent meeting of the Thames Valley group of OH nurses, where three of the speakers had experienced mental health problems themselves.
“The lessons coming from today are about support – and not just support from health professionals and GPs. Hopefully, it’s from your organisation, line managers and friends,” said Caroline Minshell, chair of the group, and health director for MESA, BP Exploration Operating Company.
“Managers need to work with OH practitioners in a much more proactive way,” said Neville Richardson, an expert on line-management training and practices. Richardson said that the current economic climate made this more important. “People are now desperate to keep their job and are taking more and more on.”
Role of occupational health in supporting return to work
He added that employers need to identify “presenteeism”, where employees come to work when they are unwell or unproductive, and they must do more to educate line managers to promote the recovery of people with mental health problems.
It is important to discuss mental health issues openly. “Having a health problem is isolating enough without people avoiding talking about it,” said Richardson. “It should be normal policy for managers to contact people off sick. Really it’s about getting rid of the stigma of mental health problems,” he added.
Derek Mowbray, psychologist at consultancy Organisation Health, said that mental health literacy should be incorporated into every health improvement programme, and that this is a role for OH.
Businesses need to focus on work organisation and social interactions. According to the Centre for Mental Health, UK businesses may be losing £2.4 billion per year in turnover costs due to mental health problems.
Richard Frost, lead vocational adviser at Workways, said that the traditional view among some employees that OH was working for the employer’s interests, as opposed to supporting the employee, was changing. “OH has moved from the stereotype of working for the company. Perceptions around OH have improved, and attitudes about employers too,” he said.
Frost advocated the Mindful Employers campaign approach, which is voluntary for employers and managers rather than based on standards or targets. He presented a case study of housing support organisation Secondstep, which signed the Mindful Employer Charter, introduced positive statements in recruitment advertisements about mental health and created a new role of “peer support assistant”. Job interviewers are trained in mental health awareness, and the firm has increased the amount of reasonable adjustments offered to support staff with health problems.
What organisations need to do
Ken Gray, chartered occupational psychologist at the Keil Centre, said that the Health and Safety Executive (HSE) Standards for Work-Related Stress, used by employers to manage mental health and stress at work, had advantages and disadvantages. He said that the standards are good for getting a conversation going with individuals, but managers that use the standards tend to “look for one specific cause and ignore others”.
“We could have spent a lot of time addressing a problem that wasn’t really there. You need to use some other tool [to address that].”
Christie Rainbird, OH adviser at Oxford Brookes University, said that employers should focus on policies and attendance management to support employees with mental health problems. “Vocational rehabilitation should take the lead. The focus should be on getting people back to work,” said Rainbird. She added that the organisational barriers to rehabilitation included:
- resistance from line managers;
- lack of skills in handling complex cases and vocational rehabilitation in HR function;
- delay in setting up vocational rehabilitation;
- suspicion or ignorance among unions, employers and GPs;
- difficulty getting caring professions to work together;
- lack of commitment in some organisations; and
- no commonly accepted model of rehabilitation.
The most difficult barriers presented by individuals were:
- lack of self-awareness and insight on part of the person suffering mental health problems;
- a lack of commitment to rehabilitation;
- secondary gain from being ill;
- personality disorders;
- politically inspired barriers to return to work;
- pre-occupation with illness; and
- GP not committed to supporting the plan for return to work.
Rainbird encouraged OH nurses to embrace case management of people with mental health problems but warned that “it takes up an enormous amount of time and energy”.
Workplace mental health resources
Time to Change: Campaign that began in 2007 targeting discrimination against people with mental health problems and improving public attitudes.
Eight steps to resilience at work: An approach to building and sustaining resilience against the threats to wellbeing and performance at work.
Five ways to wellbeing: A set of evidence-based public mental health messages aimed at improving the mental health and wellbeing of the whole population.
Mindful Employers: An employer-led initiative that aims to increase the awareness of mental health at work, including a website, line manager resources, events news and an employer’s charter. The initiative also includes local employer groups using the LinkedIn social network site, with members such as the Home Office, HSBC and Amnesty International.
Shift: An initiative to tackle stigma and discrimination on mental health issues in England. A line managers’ resource was launched last year.
HSE standards for work-related stress: Management standards that define the characteristics, or culture, of an organisation where the risks from work-related stress are being effectively managed and controlled.