1 April 2014 Advice, Community

Mental health in the workplace

Focus is increasing on businesses’ responsibility for their employees’ mental wellbeing. This year the government published an action plan on the issue and the OECD released a report highlighting the extent of the problem in the UK. Dame Carol Black, adviser on work and health at the Department of Health, suggests what action employers should take

Q. Why should employers worry about the issue of mental health in their workplaces?
A. Mental ill health costs the UK £70bn every year, accounts for 52 per cent of the loss in employment and productivity and 47 per cent of healthcare costs. 

Employers who don’t care will have staff not performing as well as they could, as well as a lot of absence. Caring for people’s resilience or positive mental health is important if you want to meet your bottom-line productivity and quality of product.

Q. Are employers to blame for some of the problems?
A. Core managerial behaviour contributes hugely to mental ill health. That’s not to say it’s the managers’ fault – they are promoted for their technical skills, but they aren’t given training in how to work with people and how to be sensitive to the knowledge that people perhaps are not themselves. Good management and good leadership will reduce those big numbers.

Q. What proportion of businesses have a clear mental health policy or some sort of training in place?
A. Increasingly, large companies with global reach are starting to put something in place. There are very good examples of it in GSK, BT, EDF Energy and BP. EDF has a very good online resource programme that an employee can go through at home. Some companies are experimenting with online cognitive behavioural therapy. Some also extend help to employees’ families.

It becomes more difficult if you’re a medium sized or small company. But being reasonable with people, respecting them, listening to them and giving them a sense of autonomy doesn’t have to cost much.

If you have some resources, I would spend it on line-manager training. ACAS does some fantastic courses, for example, as does Mindful Employer. And Mental Health First Aid trains employees to look out for each other, which is very powerful – if you’ve got a mental health problem you may be more comfortable talking to a colleague to start with.

People often forget that physical activity also helps your mental health. A walking group at lunchtime doesn’t cost money. You can encourage people to bicycle if that’s appropriate. But I think it is the mindset and the company culture that starts you on this road, with some pretty good rewards.

Q. Much of what employers do now is voluntary, should there be more coercion for them to help? 
A. You can’t easily mandate wellbeing but I would mandate training line managers. To give an example, the NHS has a whole range of training programmes available to their line managers, including one that covers this whole area; but voluntary uptake is only 19 per cent.

Q. Is the government helping? 
A. One of the big things it’s doing is the ongoing campaign about the stigma of mental health – it’s still a huge problem in certain companies. It’s also put more money into Improving Access to Psychological Therapies (IAPT), which it started three years ago.

I think that this needs to work alongside employment advice. IAPT may help you feel less depressed, anxious or stressed, but if that stress caused you to leave work temporarily then it would be much more effective if there were an employment adviser to make sure there was nothing wrong at work – there’s no point sending you back into the same situation.

Q. Is enough being done to avoid job loss because of mental health issues?
A. The ideal would be to try and make adaptations at work to make their job better, or offer an alternative job, but medium and smaller sized companies in particular may not be able to do that. If that’s the case it is better to know sooner rather than later because once someone has been out of work for 12 weeks the chances of them going back to their job is less than 20 per cent.

Employers should do everything in their power to help people because those who have severe mental health problems are usually incredibly loyal and capable if they have an employer who can be accommodating. They will give 110 per cent when they are able to.

Q. What more can employers do to help people back into work?
A. If somebody were off sick then a good company would keep in touch – that’s the first fundamental. And that should be the manager, rather than farming it out or giving it to HR, as doing it well increases the chances of people coming back.

Companies should also try very hard to make adjustments, perhaps when people come back. People might not be able to work five days a week, they might need a graduated return to work, some ongoing cognitive behavioural therapy for a while or support from employee-assistance programme providers. 

The most difficult thing is that when you go back to work after a knee replacement everybody knows how to talk to you; if you go back after a mental health problem, a good manager will have tried to ensure that colleagues understand the situation and can be supportive.

Q. How do you think we can make more progress on issue of mental health in the workplace?
A. We need to get real support for the health and wellbeing agenda from organisations like the CBI and Federation for Small Businesses, the Chambers of Commerce. 

The government listens to them. This has been difficult as the issue has been portrayed as something soft and fluffy, a matter of social responsibility. But there are good examples of companies that have saved money or have better quality or better products by getting this right.

Q. How should a company start to set up a help scheme?
A. Look for good examples of companies the same size. Ask your employees what they want – you need a good survey and potentially some focus groups. Look to the places that you’re likely to find good advice because you need to do it in steps; you can’t do this all in one fell swoop. 

I’m in the process of this for my own organisation, Newnham College, Cambridge. I asked ACAS and our local council how they could help. I’ve contacted Mental Health First Aid and Mindful Employer. It’s taught me a huge amount about where I should prioritise the resources we have.