As work slowly returns to something resembling normality post-pandemic, occupational health will have an important role to play in encouraging employers to be taking an holistic approach to health and wellbeing, argues Marc Holl. This will need to include recognising the connections, in both directions, between mental and physical health.
In 2018/19, mental health and musculoskeletal disorders accounted for the most workplace sick days; 12.8 million and 6.9 million respectively, highlighting the importance and need for robust wellbeing policies in the workplace.
About the author
Marc Holl is professional head of physiotherapy and clinical development lead at Nuffield Health
Research has shown emotional and physical wellbeing are closely interlinked, so having the happiest, healthiest employees means taking a holistic approach and nurturing both to ensure total employee wellbeing.
In this article, I am going to discuss how businesses can work with occupational health practitioners to support and enhance staff physical activity levels, work habits and emotional wellbeing to prevent chronic physical and emotional pain and long-term disorders.
The links between physical and mental health
The relationship between physical and emotional health is a complex one. Firstly, there are physical connections between what the mind is thinking and how the brain controls bodily functions.
For example, the brain is connected to our endocrine system, which can influence emotional health through the hormones it releases into our body.
Secondly, there’s evidence to show the more physically active you are, the more an individual’s emotional wellbeing improves. The relationship between ‘mind and body’ is reciprocal, so if one is neglected, it can have negative repercussions on the other.
Impact of poor emotional wellbeing on physical health
A troubled brain can impact physical health by sending negative signals to sensitive parts of the body like the gut, so a person’s stomach or intestinal distress can be the cause or the product of anxiety and stress.
Stress and anxiety can also create short-term physical symptoms like constipation, poor appetite and lethargy. Temporary psychosomatic symptoms can also occur, like heart palpitations, memory problems and headaches.
More serious, long-term mental health conditions like depression can have harmful physical consequences too.
Research shows nearly half of depressed adults are obese and the disease can increase the risks of heart disease, strokes, cancer and diabetes.
Research also suggests this may be because mental illnesses like depression affect the immune system and that associative habits like a poor diet or lack of exercise may create conditions for other serious physical illnesses to occur.
How does physical inactivity affect mental health?
A study involving 1.2 million candidates recently confirmed the more physically active you are, the higher the increase in mental wellbeing. People who exercised had 1.5 fewer “bad days” a month than non-exercisers.
It’s also important to consider the mental health of those who aren’t physically able to move or struggle with regular movement. An estimated 17.8 million people in the UK live with a musculoskeletal condition (MSDs) and these often go hand in hand with poor mental health, with pain and discomfort being linked to increased stress and anxiety.
It is also widely reported that poor mental health can lead to presenteeism, but productivity in the workplace can also suffer if employers ignore the mental health implications of physical conditions too. In fact, it’s estimated the total cost of lost workplace productivity attributable to MSDs could be as high as 2%.
But why does exercise have such a positive impact on our emotional wellbeing? Research suggests a lot of mental ill-health is characterised by a cognitive inflexibility that keeps us repeating unhelpful behaviours and restricts our ability to process new information.
However, regular exercise increases the volume of certain brain regions – in particular, the hippocampus – which increases the brain’s ability to process new information and separate new memories from old ones.
This process creates more “space” in the brain, helping individuals to subconsciously process and manage negative behaviours and habits caused by stress and anxiety.
Role of OH in promoting an holistic approach to wellbeing
I’m concerned some businesses are developing siloed approaches to physical and mental wellbeing. But the overlap is enormous.
For example, a recent BBC article described a young woman who experienced extreme physical symptoms of stress but had not realised poor mental health was the root cause of her suffering.
Occupational health practitioners play a vital role in helping businesses educate employees and implement multi-faceted approaches, which are needed to help staff connect the dots between physical and mental health.
Advising businesses to offer health initiatives such as personalised health assessments, education seminars and nutritional services is essential.
While they might seem like unnecessary extras, they play an important role in creating a culture of health and wellbeing where employees are empowered to take care of themselves.
Encouraging self-care is just one piece of the puzzle though. Occupational health practitioners should work closely with employers, so health promotion programmes are designed, executed and assessed to achieve the best possible results.
It is important strong bonds are formed between both businesses and third-party health professionals. The more the experts in their field fully understand the working patterns and the needs of employees, the better equipped they’ll be to create a tailored prevention strategy for individuals, as part of a wider workforce wellbeing programme.
Importance of demonstrating ROI
Health experts (including OH of course) should work closely with HR to suggest the best approaches and metrics to demonstrate positive return on investment (ROI).
Combined efforts are required to fully understand the impact wellbeing interventions have on conventional metrics like absence rates, to prevent businesses from rolling out ineffective blanket policies.
Occupational health practitioners will also be able to highlight some of the less obvious, indirect benefits, like higher retention rates and cost-savings due to fewer recruitment demands.
An effective workplace treatment plan combines physical offerings such as private health assessments, on-site or subsidised gym memberships with emotional wellbeing support.
Some businesses might consider bringing health professionals in-house, making time off to visit the doctor a thing of the past. Plus, the presence of an emotional wellbeing therapist in the workplace communicates clearly that conversations about mental health are welcome and expected.
Combining these with offerings such as employee assistance programmes (EAPs) may also be something to consider as a permanent investment. EAPs (as OH practitioners know of course) offer direct, confidential contact with experts who can support individuals with areas causing emotional distress, from family issues to work-related problems, addiction and mental illness.
In addition, occupational health practitioners are needed to make sure any workplace risk assessments specifically address stress. They can ensure policies have mental health perspectives, as well as the standard health and safety regulations, and those with health conditions and disabilities are not discriminated against.
Logistical support should be put in place for those who struggle to get around with ease. Managers should arrange for any meetings to be held in accessible locations for those with limited mobility and physical adaptations be integrated into the workplace, including orthopaedic chairs, footrests, hand rests and shelves at a lower height.
Finally, it is our responsibility to make businesses aware that technology is now available, which can make the identification of risk factors and early diagnosis of MSDs and mental ill health a quicker and simpler process.
For example, our “Personalised Assessment for Tailored Health” (PATH) tool uses an AI algorithm to recommend relevant steps that need to be taken to manage health risks with the support of clinical experts.
References
Working days lost in Great Britain, Health and Safety Executive, https://www.hse.gov.uk/statistics/dayslost.htm
“Are obesity and depression related?”, Healthline, https://www.healthline.com/health/depression/obesity-and-depression
Zdanowicz N et al (2017). “Depression and Immunity: a Psychosomatic Unit”. Psychiatria Danubina, (Suppl 3), pp. 274-278, https://www.ncbi.nlm.nih.gov/pubmed/28953777
Bonnet F et al (2005). “Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease”. Atherosclerosis vol 178, issue 2, pp. 339-344, https://www.sciencedirect.com/science/article/abs/pii/S002191500400468X
‘Regular exercise “best for mental health”,’ BBC August 2018, https://www.bbc.co.uk/news/health-45116607
‘Do you get healthier as you get older?’, Financial Times, January 2017, https://ig.ft.com/special-reports/health-work/2018/
‘Mental health presenteeism on the rise’, Personnel Today, October 2018, https://www.personneltoday.com/hr/world-mental-health-day-presenteeism-on-the-rise/
‘Exercise increases brain size, new research finds’, Science Daily, November 2017, https://www.sciencedaily.com/releases/2017/11/171113195024.htm
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‘Burnout: “Sick and tired of feeling sick and tired”,’ BBC January 2020, https://www.bbc.co.uk/news/technology-50604035
Path, Nuffield Health, https://www.nuffieldhealth.com/corporate-wellbeing/path
