The scale of the mental health challenge facing employers as ‘normality’ hopefully returns means occupational health needs to grab the reins and provide leadership to join up mental health support, argues Dr Tarun Gupta.
Anxiety levels about office returns, commuting or even the continuation of working from home are reportedly high as workplaces and society continue to open up. This is evidenced by the influx of seemingly new ‘conditions’ such as ‘Coronaphobia’ or ‘Covid-19 anxiety syndrome’.
The question is, how should organisations respond? The answer is, not in a knee-jerk – stick a plaster over it – kind of way.
Instead, employers need to take a long-term strategic view. This involves getting much better at equipping their people to take care of their own personal health and happiness needs while, at the same time, better managing and mitigating the underlying risk factors.
This is going to require boundaryless (in other words multidisciplinary and cross-organisational) collaboration – and occupational health (OH) has a key role to play.
On the one hand, it’s important not to medicalise perfectly normal responses to circumstances. In other words, over-medicalise normal anxiety related to the pandemic and reintegration back into daily life.
On the other, where such issues are leading to absence and presenteeism or maybe even contributing towards work-related stress (because, let’s face it, putting your finger on one stressor can often be difficult), there is an onus on employers to do something.
These issues are distinct from formal mental illness, such as clinical depression or generalised anxiety disorder, which require diagnosis and management in general practice and are not the focus of this article.
Existing issues, accelerated
To an extent, there is nothing new here of course. Stress and anxiety have long represented the top cause of work-related absence. The thing is these problems are exacerbated now.
They’re maybe even masked by working from home, furlough and shielding. The pre-pandemic approach of focusing more on treating the symptom (think the growth in mental health first aiders and mindfulness apps) as opposed to the underlying problem, clearly wasn’t working; as evidenced by latest Labour Force Survey results.
Depression or anxiety collectively represent the top reason for employee absence due to work-related ill health, accounting for 17.9 million working days lost in 2019/20.
The Health and Safety Executive (HSE) reports that this figure is statistically significantly higher than the previous period. Obviously, the pandemic is a contributory factor but it’s clearly not the cause; levels were already high pre-Covid-19.
The HSE’s management standards – against which all organisations should risk assess – are designed to cover the six areas of work that, if not properly managed, are associated with poor health, lower productivity and increased accident and sickness absence rates (including work-related stress).
To recap, these management standards are:
- demands (workload, work patterns and work environment);
- control (how much say someone has in how they do their work, including responsibility and deadlines);
- support (encouragement and resources from line managers and colleagues);
- relationships (dealing with unacceptable behaviour);
- role (whether people understand their role); and
- change (how change is communicated).
Time to get strategic
To take a long-term strategic focus to all this – in other words, to identify and treat the underlying problems – necessitates joined-up thinking across all the departments with an interest and responsibility.
This means all the ‘people’ departments: HR, OH, health and safety, reward and benefits. It also necessitates genuine partnership-working with relevant third-parties, such as employee benefit consultants and health and protection insurers.
Let’s provide an example of what this looks like in practice. Where OH or health and safety are carrying out HSE stress risk assessments and/or picking up day to day feedback from employees, results could be shared with HR in a way that enables HR to investigate underlying causes with the help of line managers. This might seem obvious but experience dictates that it’s not always happening in practice.
Where OH or health and safety are carrying out HSE stress risk assessments and/or picking up day to day feedback from employees, results could be shared with HR in a way that enables HR to investigate underlying causes with the help of line managers. This might seem obvious but experience dictates that it’s not always happening in practice.”
The data and findings may then be used to inform any necessary changes to HR policy and practice, as well as helping identify any line manager or other employee training needs.
On top of that, HR and OH will be informed to liaise more with employee benefit consultants and directly with their health and group income protection insurance partners. This can help with maximising existing benefits and services, such as from employee assistance programmes, ‘long Covid’ support programmes and personalised return-to-work pathways, as well as support with more general employee communication.
On this last point, this might involve designing a more tailored and human-centric approach, one that resonates or ‘connects’ with employees more effectively. This is necessary to help both equip people to make their own decisions on what’s good for their very personal health and happiness needs as well as to ensure the support services available are seen as relevant and, therefore, used and valued.
Old habits die hard
Boundaryless collaboration was seen to a certain extent during the pandemic crisis. But old behaviours, such as turf wars, might be creeping back as employees return to physical workplaces. Occupational health must therefore actively work against this. Old habits won’t carry us into the future of reinvention required for business in 2021 and beyond.
The good news, however, is that leaders by and large are finally on board with the need to own the wellbeing agenda.
The experience of the pandemic has led many leaders to recognise the need to turn wellbeing programmes from a bunch of initiatives into something altogether more strategic; more problem- and solution-focused, with data-driven decision-making at the heart. As the experts in work- and life-‘ability’, OH practitioners are well-placed to take a leading role here.
The government has already made it clear that it sees employers playing a crucial role in supporting mental health. If its (admittedly pre-pandemic) consultation paper Health is everyone’s business is anything to go by, it also sees occupational health playing a front and centre role in absence prevention.
Five steps to joined-up mental health support
Finally, what at a practical level should OH be advising employers to be doing in this context? This, naturally, will vary from employer to employer and will to an extent depend on sector, demographics and specific health, safety and wellbeing priorities. But here are five things that may be good to nudge or encourage employers to be doing to join up their mental health support.
- Review risk assessments regularly after initial implementation. This is especially the case if any changes occur in the business that could potentially increase the risk; for example, lone working and when there’s major business change.
- Talk to staff and monitor incident rates and control measures. This will also help to assess whether the measures in place are effective.
- Liaise regularly with HR to help with further investigations into root causes. This allows for appropriate interventions, whether changes to policy, practice, workload or training needs.
- Also liaise more widely with other ‘people’ departments and third parties. Alongside working with HR, work with reward and benefits, insurers and consultants to help make best use of the wellbeing, intervention and rehabilitation services to which the company already has access. This should include improving the communication of such services and wellbeing per se, equipping people to make their own informed choices about what’s best for them.
- Work in partnership with line managers, mental health first aiders and wellbeing champions. This should include sharing risk assessment outcomes with them, supporting them with having conversations, and signposting to help – even social prescribing – while being careful not to diagnose.