Blue Light Programme Blueprint Pack: Part One The Case For .

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Blue LightProgrammeBlueprint Pack:Part OneThe case for supportWhy emergency servicesneed to take care of their staffand how they can do itfor better mental health

Why emergency services need to take care of their staff and how they can do it 3ContentsThe Blue Light Programme – background and context.5The bigger picture – mental health in the workplace. 6Presenteeism .6The costs of a sick but present workforce .8The blue light picture –mental health in the emergency services. 9The culture.9The causes. 10The costs to the emergency services. 11The impact of the Blue Light Programme –evidence of why it works. 13Tackling mental health stigma . 13Blue Light Champions. 14Training line managers. 16Our information . 19Keeping the workplace mentally healthy . 19Blue Light Mental Health Networks.20Our recommendations. 22Making better mental health happen – next steps. 23

4 The case for supportCredit: West Midlands Police

Why emergency services need to take care of their staff and how they can do it 5The Blue Light Programme background and contextWhen Mind launched the Blue LightProgramme in March 2015, we did soin the knowledge that 87.5% of bluelight personnel had experienced stressand poor mental health while workingfor blue light services. Emergencyservices personnel were also twice aslikely to identify problems at work asthe main cause of their mental healthproblems, compared with the generalworkforce population1.It takes a long time to changea culture. For a long time theperception from police officers, andprobably from the public as well, hasbeen that the police are somehowdifferent, somehow invincible, andthey shouldn’t experience mentalhealth problems – that they shouldbe stronger than that. And that’s totalrubbish. We are human beings, andwe have mental health problems thesame as everyone else.Becky Davies, police officerOur independent research also highlighted thehigh levels of stigma associated with mentalhealth problems within emergency services.Almost three-quarters (71%) of emergencyservices personnel told us that theirorganisation did not encourage them to talkabout mental health, and nearly half (44%)thought their colleagues would be treated lessfavourably if they disclosed a mental healthproblem at work2.The Blue Light Programme set out to changethis by delivering a range of interventions thataimed to:tackle mental health stigma and discriminationboost workplace wellbeingbuild resilienceincrease access to mental health informationimprove pathways to mental health support.Emergency services have made great stridesin improving the way they support staff whoexperience mental health problems. But thereis still a long way to go, and many of theinterventions delivered as part of the Blue LightProgramme still need to be fully embedded intothe day-to-day work of police, fire, ambulanceand search and rescue services.

6 The case for supportThe bigger picture mental health in the workplaceEvery organisation in the UnitedKingdom is affected by mental healthproblems in the workforce. At any onetime, one worker in six will experiencedepression, anxiety or problemsrelating to stress.The total cost to employers of mental healthproblems among their staff is estimated at 34.9 billion each year3. Across the UK,mental ill health is the leading cause ofsickness absence, costing an average of 1,300 per employee per year. ThroughMind’s research, it was also found that 95%of employees in the general workforce callingin sick with stress gave a different reason fortheir absence4.In 2015 to 2016, 11.7 million working dayswere lost due to stress, depression or anxietyand, on average in the same year, more daysper individual case were lost due to stress,depression or anxiety than for musculoskeletaldisorders5. A further 3.1 billion annually isspent to replace staff who leave their job dueto mental ill health6.PresenteeismPresenteeism is where an employee ispresent at work but under-productive due topoor mental health and emotional wellbeing.There may be many different reasons forpresenteeism at different organisations – suchas punitive sickness or absence policies, fearof impact on promotion, and concern aboutjob security.The Centre for Mental Health calculated thatpresenteeism costs the UK economy 21.2billion annually, compared with absenteeism –where an employee is not present at work –which costs the UK economy 10.6 billion7.Presenteeism is often more prevalent inorganisations that have a negative culturearound mental health. This can mean thatemployees who face mental health problemsfear being labelled or discriminated against,which in turn becomes a barrier to earlydetection, support and intervention.It can also prompt staff to go to work whenthey may not be well enough, which can bemore detrimental for their mental health in thelong run.

Why emergency services need to take care of their staff and how they can do it 7A 12-hour shift is a long time for anyone, butwhen you’re struggling with your mentalhealth, those 12 hours can seem like aneternity. That’s how each shift as a custodysergeant felt for me. So much so that Ihad to break each one up into 12 one-hourblocks, with my aim being to not make anymistakes and not let anyone get hurt.At first this helped, but after a few weeks,an hour seemed too long, so I split my12-hour shift again into 24 half-hourblocks. My aim was the same – to make nomistakes and not let anyone get hurt.Several weeks later, half an hour was toomuch. I sat there, looking at the clock,knowing my only option was to split myshift into 48 15-minute blocks. My prioritieswithin each 15 minutes were simple – don’tmake any mistakes and don’t let anyone die.I was trying to survive.By now, my life was all about blocks of time.The time I spent at work, and the time Ispent in between, dreading my next shift. Iwas incredibly depressed, lonely, exhaustedand I could see no future, only darkness.Time for me was running out and I dread tothink what I might have done to myself if Ihadn’t realised, with the help of friends andfamily, that it was simply time for me to getsome help. I am so happy that’s what I did.Ed Simpson, former police custody sergeant

8 The case for supportThe costs of a sick but present workforceResearch shows that presenteeism is hugelycostly to employers, but all too often ignored.Managing it well not only saves money inboth the short and longer term, but alsocontributes to the development of an engaged,productive and mentally healthy workforce.In 2017, HR Zone8 undertook a piece ofresearch into absenteeism vs presenteeism.One of its key recommendations was that“organisations need to focus on reducingpunitive parts of absenteeism policies if theywant positive action on presenteeism”. A keycriterion of the Blue Light Time to Changepledge is that blue light services review theirpolicies and procedures. The pledge alsoprovides guidance to blue light services onimportant things to consider when reviewingand updating polices that may impact on staffmental health and wellbeing. This guidancesupports the reduction of punitive policies thathave a negative impact on staff.Credit: Gwasanaeth Tân ac AChub De Cymru /South Wales Fire and Rescue ServiceOur own research shows that presenteeism isa significant problem for blue light personnel,who are more likely than the generalworkforce population to experience mentalhealth problems, but less likely to take time offwork. Tackling presenteeism not only yieldsfinancial benefits in the short and long term,but will also positively affect staff turnover,productivity and engagement.Simple steps to improve the management ofmental health in the workplace – includingprevention and early indication of problems –could help UK employers to save more than30% of the costs related to sickness absencedue to mental ill health, presenteeism andstaff turnover, equating to at least 8 billionevery year9.You can find out more about building thebusiness case for mental health at work here.

Why emergency services need to take care of their staff and how they can do it 9The blue light picture mental health in theemergency servicesThe cultureBefore Mind launched the Blue LightProgramme, we carried out some initialresearch into the culture of mental health in theemergency services. The results told us that:87.5% of emergency services personnelhad experienced stress and poor mentalhealth while working for blue light servicesemergency services personnel were morelikely to experience mental health problems,but less likely than the general workforceto take time off work as a resultemergency services personnel were twiceas likely to identify problems at work asthe main cause of their mental healthproblems, compared with the generalworkforce population44% of personnel thought colleagues wouldbe treated less favourably if they disclosed amental health problem at work – regardlessof whether respondents had personalexperience of mental health problems or not71% of emergency services personnelthought their organisation did notencourage them to talk about mentalhealth, compared with 45% of the generalworkforce populationworrying about being fit to work couldmake existing problems worse, potentiallyleading to increased or longer periods ofstaff absence.You can access the full research findings here.In addition to Mind’s research, surveys carriedout by other organisations provide insightinto the prevalence of mental health problemswithin emergency services, including:Police Federation Welfare surveyUnison Ambulance stress survey.

10 The case for supportThe causesOur research also highlighted the causesof poor mental health within emergencyservices10. They included:excessive workload (56%)pressure from management (55%)organisational upheaval (52%)long hours (45%)exposure to traumatic incidents (42%).Importantly, organisational factors areconsidered bigger triggers of poor mentalhealth than exposure to traumatic incidents.All too often, we see blue light staff andvolunteers willingly exposing themselves totrauma without being aware of the ‘drip-drip’impact it is having on their mental health.Consequently, badly managed change, poorleadership and perceptions of unfair treatmentcan often trigger poor mental health.The research clearly shows that we mustavoid limiting our attention to crises or majorincident care, and while it is vital to providesupport to personnel who have been exposedto traumatic incidents, we also need to tackleall of the causes of mental health problems.Interventions need to provide long-termsolutions – not just short-term fixes.Whatever the causes of poor mental health,it’s essential that support is available foremergency services staff. Mind’s Blue LightProgramme is just one way of doing this,ensuring that dedicated workers are at theirbest and ready to carry out these incrediblydifficult – often life-saving – jobs, which wecan all take for granted.

Why emergency services need to take care of their staff and how they can do it 11The costs to the emergency servicesBased on the average cost per employeelost annually due to mental health-relatedabsence in the UK, a blue light service with250 employees could lose up to 325,000every year11.This figure does not include the costsassociated with staff turnover due to poormental health. Our research12 showed that63% of emergency services personnel haveconsidered resigning from their job or voluntaryrole due to stress or poor mental health. Thecosts associated with replacing staff can include:advertising coststime reviewing applicants and interviewingHR time spent processing, includingreferences and background checkstraining of new staff.Aside from the financial implications of highstaff turnover, blue light employers mustalso consider the quality of their workforce.Without the right support systems in place toidentify and address mental health risk factors,emergency services potentially face losinghighly skilled, experienced and passionate bluelight workers.There has been a lot of media coverageabout the impact of mental ill health onemergency services:In Kent Police, the number of sick daysofficers take due to mental illness has morethan doubled from 2010-11 to 2016-17. A totalof 8,896 days were missed due to poormental health in 2016-17 when the averagehead count was 3,780, compared with 3,714days in 2010-11 when it was 3,75813.A report by the Chief Fire OfficersAssociation found that 41,000 shifts eachyear are lost in England and Wales dueto firefighters experiencing mentalhealth problems14.Freedom of information requests submitted toNHS regional ambulance services revealedthat both the number of paramedics onstress-related leave and the amount of timetaken off sick had increased dramaticallyfrom 2012 to 2014. Paramedics in Englandtook a total of 41,243 days off in 2014 as aresult of stress-related illnesses – up 28%since 201215.For an average estimate of how much bluelight services can save by implementingmental health support activity, have a lookat the happiness at work calculator at www.happinessatworksurvey.com/business-case

12 The case for support

Why emergency services need to take care of their staff and how they can do it 13The impact of the BlueLight Programme to date evidence of why it worksAt the end of the first year of theBlue Light Programme, we evaluatedits impact by the different activitieswe delivered.Tackling mentalhealth stigmaStigmatising attitudes stop people with mentalhealth problems getting the help and supportthey need. The organisational culture of aworkplace can either motivate or discouragepeople from talking about mental health andaccessing support. Creating a culture thatnormalises mental health conversations notonly supports those who are experiencingmental health problems, but also createsopportunities for early intervention.A positive organisational culture aroundmental health can also support staff whoreturn to work after mental health-relatedabsences, and can foster positive teamdynamics and relationships.The Blue Light Programme includes a numberof anti-stigma activities that are designed tohelp tackle workplace stigma and addressorganisational culture around mental healthand wellbeing.We know that changing an organisationwide culture is never an easy task; norwill it produce immediate changes. But itis essential if the Blue Light Programme’sactivities and aims are to be successfullyembedded within services.We anticipate that, as an organisation’s culturechanges for the better, there may be an initialspike in sickness absence reported as beingrelated to mental health. This should not be acause for concern, but is instead a clear indicatorthat internal culture is beginning to shift andattitudes towards mental health are improving.After the first year of the Blue LightProgramme, 91% of pledge leads reportedthat the Blue Light Programme had a positiveimpact on the organisation, and 25% saidthat the mental health of the workforce wasnow better than the same time the previousyear. Two-thirds (66%) said they wouldrecommend it to other emergency serviceorganisations.However, it’s important to note that,comparatively, just 27% of employeesagreed that there has been a positive impacton the organisation and the findings suggestthat employees are still hesitant to speak outabout mental health.Anti-stigma activity included:signing the Blue Light Time to Change pledgehosting awareness-raising events internallyBlue Light Champions organising eventstraining line managers to encourage staff totalk about their mental health.You can find out more about our impactreducing stigma in the emergencyservices here.

14 The case for supportBlue Light ChampionsA Blue Light Champion is an employeeor volunteer in the emergencyservices who takes positive actionat work to raise awareness of andchallenge stigma around mentalhealth. Champions are a service’scornerstone to creating a mentallyhealthier workplace. In manyinstances, Blue Light Champions willbe the first port of call for someonewho is experiencing a mental healthproblem when they need support.Having Blue Light Champions of allranks throughout the service helpsto reinforce Blue Light Programmeactivity and its importance.We found after year one of the programmethat emergency services personnel weregenerally positive about the support availableimmediately following a highly traumaticincident, but reported that support to helpwith the ‘drip-drip’ effect of the pressureof their job was poor or non-existent.Having a Blue Light Champion at workto talk to or to approach for informalsupport can help to bridge this gap, andcan be a means for signposting to otherresources and forms of support.At the end of the first year of the Blue LightProgramme, Champions reported better mentalhealth and more had sought support fromformal sources, such as GPs. Championsalso reported feeling more empowered andconfident to share their experiences.Blue Light Champions – and their friendsand families – felt enthusiastic about theBlue Light Programme and its positiveimpact on their own mental health. Theywere, however, less positive about thesupport provided by their organisation.This could have been for a number ofreasons. But we know that, in order for BlueLight Champions to be able to successfullyfulfil their role, they must by supported andempowered by their organisation. The BlueLight Programme services toolkit outlinesthe model we believe will best supportand empower Champions, while makingsure the organisation is kept informed ofall the incredible work they are doing.Being a Blue Light Champion can have ahugely positive impact on emergency serviceworkers. To see how it makes a difference,watch one of our films that feature Champions.There are more than 1,700 Championsregistered across England and Wales, and 93Blue Light Champions who also act as BlueLight Peer Supporters. These are registeredBlue Light Champions who have also takenour peer supporter training, to empower themto share their personal lived experience inorder to support colleagues with their mentalwellbeing and signpost to appropriate services.You can find out more about the impactof the Blue Light Champion role in ouryear one evaluation findings here.

Why emergency services need to take care of their staff and how they can do it 15

16 The case for supportTraining line managersFrom our initial scoping research, it wasclear that, when it comes to talking

Blueprint Pack: Part One. The Blue Light Programme – background and context. 5 The bigger . had to break each one up into 12 one-hour blocks, with my aim being to not make any mistakes and not let anyone get hurt. At first this helped, but after a few weeks, an hour seemed too long, so I split my 12-hour shift again into 24 half-hour blocks. My aim was the same – to make no mistakes .

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