The invisible disease

When BT customer service manager Heidi Howarth was involved in a serious car crash in 1999, she couldn’t work, and was forced to spend a lot of time, unable to move, confined to the home.

Mental health issues are often hidden by sufferers

“Before the accident I’d been really active, so it was difficult for me to be doing nothing all day, every day,” she recalls. “I developed depression and agoraphobia, and was unable to return to work.”

Two years later, when she eventually went back to the office, she was lucky enough to have a good manager. “He recognised that I was experiencing a mental illness, and immediately referred me to a counsellor, who I saw the next working day,” says Howarth.

Over the next few months, BT paid for Howarth to undergo pre-cognitive behavioural counselling, and in 2002 she was fully able to return to work.

Mental ill-health is now the biggest single cause of sickness absence for UK organisations, according to Cary Cooper, professor of organisational psychology and health at Lancaster University. However, because mental health problems manifest themselves far less visibly than physical ailments, many senior managers tend to view this as a ‘soft’ issue, rather than something that can have a negative impact on the bottom line.

Sadly, enlightened employers such as BT are few and far between when it comes to recognising and dealing with mental health issues in the workplace. So how can HR begin to tackle this ‘invisible’ disease?

High price to pay

One of the key drivers to doing something about mental ill-health is cost. Recent figures from the Shaw Trust disability charity suggest that the total cost of mental ill-health to UK business is more than £9bn a year. This cost primarily comes from sickness absence, but mental ill-health can also affect productivity.

The ability to concentrate is vital for productivity, says Kevin Friery, clinical director at wellbeing specialist Right Corecare.

“With the emotional disturbance that accompanies mental health problems, employees feel less resilient, less able to manage the daily routine,” he says. “Their condition may mean they are sometimes unable to concentrate, to follow instructions, or to apply the normal logical framework to their daily life.”

It’s not just a small minority of people who suffer from these problems, either. Dave Joyce, national health, safety and environment officer at the Communication Workers Union, says mental health problems can affect anyone at any time, young or old.

“One in four of us will experience a mental health problem at some point in our lives,” he says. “If sufficient numbers of staff are affected by stress, the problem can become a serious organisational issue.”

Perhaps the greatest obstacle to tackling the problem is the stigma that is still attached to the issue of mental health. It is common for employees who are experiencing mental health problems to try to cover them up, or to convince themselves that they are suffering from a physical, rather than a mental, problem.

Equally, many managers are ill-equipped to recognise mental health problems. What’s more, since some mental health issues such as work-related stress are now covered by the Disability Discrimination Act (DDA), ignoring the signs could leave employers dealing with legal claims from staff.

Diagnosing the problem

Alison Loveday, head of employment at law firm Berg Legal, explains: “It is essential that employers recognise the first signs of anxiety and depression to prevent them becoming more serious. They should look out for an increase in unexplained absences or sick leave, poor timekeeping and under-performance, as well as constant tiredness and unusual displays of emotion.”

But the very nature of mental health problems makes them difficult to diagnose.

Clive Pinder, managing director of health and wellbeing consultancy Vielife, says: “Most organisations have no way of measuring stress until it is too late. They use trailing indicators, such as past behaviour, to identify mental health issues, by which time the negative impact of these issues has already manifested itself.”

Instead, he advises, HR needs to measure mental health issues proactively as part of an integrated health assessment programme.

Many employers now have a workplace counselling service that can help employees. But for some companies, the immediate reaction to discovering someone is suffering from a mental illness is to give them leave of absence. This is rarely the right approach to take, according to Leonie Nowland, head of return-to-work services at employee wellbeing consultancy ICAS.

“Too many people are signed off from work on endless sicknotes and left to suffer alone at home,” she says.

“We believe that work is a fundamental part of someone’s rehabilitation, and so focus on getting them back to work as soon as is practical.”

Preventative steps

HR should steer clear of trying to deliver treatment itself, Nowland adds, as sufferers need to be referred to appropriate specialists. But there are preventative steps that HR teams can take to ensure that the workplace does not cause mental illness.

The first is to look at job design and training. Louise Amos, HR consultant at software and services firm Northgate HR, says: “Employers can help prevent mental ill-health by changing work patterns, adjusting aspects of the role, taking away duties that cause problems, and ensuring employees receive the right training and support. The best way to discover a need for a job redesign or some additional training is to ask employees directly.”

The second is to improve the physical working environment. Marcus Roberts, head of policy at mental health charity Mind, says: “It’s very important that the physical environment of the workplace is pleasant. It shouldn’t be too cramped, stuffy or dark, for example. Making work environments pleasant is less expensive than coping with lower productivity and higher staff sickness and turnover.”

Handle mental health issues well, and your staff will respond with their loyalty. Three years after she returned to work, Howarth felt ready for a new challenge and won a promotion. She is full of praise for how BT helped her to recover.

“When it’s happening to you, you just think you’re being feeble and you should be able to cope,” she says.

Case study: BT

When it realised that it had about 500 people off sick every day with psychiatric problems, BT decided to act. It set up Work Fit – Positive Mentality, a health awareness programme drawn up in collaboration with the Communication Workers Union and Connect, together with the support of mental health charities, including Mind, and the Sainsbury Centre for Mental Health.

BT’s 104,000 employees are to be given information on how to combat mental ill-health. The programme will demonstrate how regular exercise, healthy eating, relaxation techniques and even the support of friends and family can help to ward off depression, stress and anxiety. It will also try to reduce the stigma of mental illness through education and promote the range of support services that the company provides.

BT hopes that by encouraging staff to adopt these small lifestyle changes, they will cope better with the pressures of modern living, and so work more creatively and productively.

The company’s chief medical officer, Dr Paul Litchfield, says: “BT takes pride in the way it supports people who develop mental illness, but we want to go beyond that and help them avoid ill health in the first place, so they can lead happier and more productive lives.”

Dealing with mental illness

Kevin Friery, clinical director at employee wellbeing specialist Right Corecare, offers tips on how to minimise the effects of mental ill-health:

  • Develop a mental health policy Accepting that mental ill-health is a serious issue is the first step towards improved employee wellbeing.

  • Perform a stress audit This will help you to gain valuable information on the issues affecting employee mental health and go on to remedy the situation.

  • Provide a counselling service Staff often find it difficult to admit to their employer that they have a problem. Counselling offers a confidential ear where employees can candidly discuss their concerns and receive help to overcome them.

  • Train managers This equips them with the skills needed to spot the signs of mental illness and to work out appropriate action to help the individual affected.

  • Improve physical health Mental health is inextricably linked to physical wellbeing. Promoting physical fitness can help employees to lower their stress levels.

  • Remove unnecessary stresses Long working hours, competitive behaviour and concerns about job security all lead to stress. Removing these worries allows staff to concentrate more fully on their work.

  • Offer a stress management course This will enable employees to learn techniques for coping with unavoidable stress, and will help to nip potential problems in the bud.
Mental health in the workplace

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