Viewpoint: Are you doing enough to support the mental health of your workforce?

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      Thriving at work1 – a major report on mental health and employers, commissioned by Prime Minister Theresa May – has highlighted the impact of mental ill health in the workplace. It’s called on employers to rise to the challenge of addressing one of the biggest issues affecting the performance and productivity of workers in the UK today.

      Its authors – mental health campaigner Lord Denis Stevenson and Paul Farmer, chief executive of Mind and chair of the NHS Mental Health Taskforce – show that poor mental health costs employers between £33bn and £42bn a year. This is in addition to an estimated £37bn to £52bn cost to the economy in lost output and £25bn cost to the government due to reduced tax intake, NHS treatment costs and ill-health related welfare payments.

      In March 2017 Deloitte released their paper, ‘Workplace mental health and wellbeing - at a tipping point?’2 where they highlighted the following five key implementation challenges for employers when considering their mental health strategy:

      1. Failure to see mental health and wellbeing as a priority
      2. Mental health and wellbeing policies are reactive and driven by staff events or experience
      3. Lack of insight around current performance
      4. Poor evidence base to measure return on investment of wellbeing strategies
      5. Lack of collective knowledge around best practice

      Both in Stevenson-Farmer’s Independent Review and in our experience we see hugely positive trends with employers increasing their focus on mental health. Many companies provide valuable services such as Employee Assistance Programmes, Occupational Health and wellbeing initiatives. Yet it’s time to take stock and critique our strategies to best support:

      • Employee awareness
      • Encourage higher utilisation of available support
      • Better integrate multiple services to support case management
      • Do more to prevent the onset of mental ill health and build resilience
      • Seek to provide a strategy which supports all stages of mental health
    • The company isn’t the only one that pays for poor mental health

      The human costs of poor mental health are also steep – not only are individuals with long-term mental health disorders much less likely to find work, an estimated 300,000 lose their jobs every year. The problem is growing – according to the UK Labour Force Survey, the number of sick days taken due to mental health problems increased from 13.0m days in 2010 to 15.8m days in 2016, accounting for nearly I in 8 of all work days lost to ill health3.

    • Making mental health support part of your daily DNA

      For more enlightened employers, awareness and understanding of the importance of employee mental health have grown to such an extent that managing it has become an essential part of their people management strategy. Regrettably, for others the picture is far from encouraging and the continuing stigma and prejudice associated with mental ill health do neither employers or employees living with mental health issues any favours.

      We know from our own research that over two thirds (69 per cent) of MDs, CEOs and business owners don’t believe that suffering from stress, anxiety or depression is a serious enough reason for employees to be absent from work4. No surprise then that, according to Business in the Community’s latest Mental health at work report, just 13% of employees felt able to disclose a mental health issue to their line manager. Alarmingly, of those who disclosed a mental health issue, 15% were subject to disciplinary procedures, demotion or dismissal5.

      Clearly, there is still a long way to go before we can claim with confidence that employers throughout the land are properly supporting mental health at work.

    • Managing mental health at work

      When it comes to managing mental health at work, it is important to remember that there’s much more to employee mental health than mental health issues or problems caused by work. Employees are affected by a multitude of pressures, both in their private lives and in their working lives. And, when these exceed their perceived ability to cope, it can lead to stress, anxiety or even depression.

      Thankfully, there are solutions. First and foremost, HR can play a leading role in challenging the stigma that continues to surround mental health at work. Buy-in and leadership from the top are critical. And, for their part, HR professionals can show their mettle by calling on their business’ leaders to visibly demonstrate their commitment to creating a positive, supportive workplace culture, where managers and staff are aware of and understand the importance of good mental health. Managers throughout the organisation also need to be trained and supported so they are confident and well equipped to have effective conversations with employees to help them to deal with their difficulties. Achieving such a workplace culture should help employees affected by mental ill health have the confidence to speak openly about their situation, or approach others with whom they recognise the symptoms.

    • Providing support is essential

      Supporting mental health in the workplace is an integral part of employers’ duty of care to their employees’ health and safety. Moreover, it can bring a significant commercial return. According to a study by Monitor Deloitte commissioned to support the Stevenson/Farmer review, the average return on investment of workplace mental health interventions is 4 to 16. A strong focus on wellbeing is key to building a mentally healthy workplace and the following guidance can help you and your organisation to achieve this.



      Workplace culture


      Building and maintaining a positive, supportive workplace culture needs to be led from the top, with business leaders and senior management demonstrating their awareness of and commitment to safeguarding employees’ mental health. Central to this is the promotion of a healthy work/life balance to lessen the likelihood of overwork and burn-out – for example, if bosses make a point of leaving work on time, others will follow their lead.

      Working well


      Employers can encourage a wellness culture in a number of ways. These can include flexible working, encouraging employees to take regular breaks (and all their holiday) and, if practicable, even having email ‘blackouts’ outside of working hours. HR is well placed to track employees’ uptake of holiday and can use the information to prompt line mangers to make sure their reports are taking enough time off to rest and recharge.

      Work/life balance


      A good work/life balance is essential for employee wellbeing. To avoid the pitfalls of overworking, try to encourage employees to work to their contracted hours. It is good policy to encourage and support employees to do their best when they’re at work but also to make the most of their own time, unhindered by workplace concerns, when they’re done for the day. It will help them to become more resilient and less likely to succumb to stress and fatigue.

      Diet and exercise


      While HR professionals may feel it’s not their place to counsel employees on lifestyle choices such as diet and exercise, these can have a significant impact on physical and mental health and, in turn, on performance and productivity. Indeed, poor physical health can adversely affect mood, self-esteem, energy levels and resilience. Even simple measures such as encouraging a healthy, balanced diet (which employers can facilitate by ensuring canteens, vending machines and food delivery services offer healthy choices) and regular exercise (through gym discounts and promoting lunch-time walking groups and sports such as five a side football) can pay dividends by improving employees’ physical and mental health.

    • Building resilience and delivering a robust mental health programme

      Confident, psychologically secure employees are an asset to any employer and, by taking the lead on introducing measures such as those described above, HR professionals can go a long way to ensuring their organisation successfully supports employee health and wellbeing.

      • The normalising of mental health helps build resilience. It can help your teams recognise the signs of mental health, assist in the development of coping strategies as well aid line managers to be responsive and act accordingly. We’re seeing organisations increasingly focus on prevention; seminars and webinars that bring external experts onsite to help drive interest and ensure the key messages resonate.
      • Don’t under estimate communication as part of your strategy, it is key to join the dots between health and available services for your employees. Give time within your annual programmes for mental health to get the same profile and attention as physical health. It helps demonstrate that all important commitment. It supports in the removal of barriers. When done well, it goes a long way to help drive awareness and utilisation in the most meaningful and impactful way.
      • Analyse your absence and management information. Assess if your benefits meet the demands of your workforce. Look to understand outcomes, to see if the right intervention is occurring at the right stage. Examples include ensuring your EAP service offers appropriate quality clinical support for emotional issues as well as expert guidance for practical issues. Access to the right expertise is important to help on a wide range of issues, from financial, home and mental health advice.
      • Support your people to stay at work or aid their return to work. There is a strong interrelationship between mental and physical health and all your benefits and services should combine to offer a whole systems approach which supports reasonable adjustments for physical and mental wellbeing.
      • Seek employee feedback with a combination of informal and formal approaches; this will help understand where your strategy has gaps in the eyes of your employees. Act on this feedback to reinforce your commitment to change.
      • Be ready – preparing for and looking after your people in times of crisis is complex and delicate. Build a robust strategy for how you’ll provide support when it comes to critical incident management.

      For further help and support on building your health and wellbeing strategy contact AXA PPP healthcare.

    • View our webinar, Creating a positive approach to mental health which can be found on our health and wellbeing webinar page in the Business Health Centre.

    • Footnotes and links

      1. Lord Dennis Stevenson and Paul Farmer (2017). Thriving at work: an independent review of mental health and employers. Department for Work and Pensions and Department of Health.
      2. Deloitte’s Workplace mental health and wellbeing at a tipping point
      3. Office for National Statistics (2017). Sickness absence in the labour market.
      4. Online survey of 1,000 senior business managers, MDs, CEOs and owners for AXA PPP healthcare undertaken February 2015 by market researcher One Poll.
      5. Business in the Community (2017). Mental health at work report.
      6. Elizabeth Hampson and Sara Siegel (2017). Mental health and employers: the case for investment. Supporting study for the independent review. Monitor Deloitte.
    • Dr Mark Winwood

      Viewpoint by Dr Mark Winwood, Clinical Director for Psychological Health for AXA PPP healthcare's Health Services division

      Mark holds Associate Fellowship and Chartership with the British Psychological Society, he is registered with the Health and Care Professions Council (HCPC) and is a chartered Scientist.

      Mark joined the medical services of AXA PPP healthcare in June 2008 and was previously Clinical Director for AXA PPP healthcare Employee Support for over 10 years.

      Prior to joining AXA Mark worked as a Senior Psychologist in the NHS and has many years of clinical experience and research expertise. He is an active member of the EAPA, BPS and BACP - Workplace. He maintains a private practice as a Psychologist in London.