MANAGING MENTAL HEALTH IN THE WORKPLACE
MANAGINGMENTALHEALTHIN THEWORKPLACEMODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEWhat is mental health and why does it matter?Poor mental health is one of the biggest issues in the workplace today,causing over 70 million working days to be lost each year1. This includeseverything from the most commonly experienced symptoms of stressand anxiety, right through to more complex mental health conditions,such as depression, bipolar disorder and obsessive compulsive disorder.As well as having a huge impact on individual employees, poor mentalhealth has severe repercussions for employers – including increasedstaff turnover, sickness absence due to debilitating depression, burnoutand exhaustion, decreased motivation and lost productivity. Butwhile companies of all shapes and sizes increasingly understand theimportance of good mental health, many simply don’t feel confidenthandling and communicating these issues in the workplace.This module looks at how to encourage good mental health – bysafeguarding staff wellbeing, addressing problems before they becomesevere, and supporting staff when issues do emerge. This is not aboutbecoming an expert in mental health; it’s about spotting the signsthat something might be wrong. It will signpost the right support andresources, and offer suggestions for putting strategies in place tosupport good mental health. All this will help empower managers to dothe same.By the end of this module you will: Understand why good mental health matters in the workplace now the role that you and your managers can play in spotting andKhandling mental health issues at workB e aware of medium to long-term actions for improving mental health inthe workplace and how to build awareness of them.-2-MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEFast factsMENTAL HEALTH IN THE UK:The big pictureTODAY9 out of 10people with mental healthproblems experiencestigma and discriminationTHE GENDER DIVIDE37%At leastWomen arebetween 20 and40% more likelythan men todevelop a mentalhealth problemof men are feeling worriedor low. Yet their wives,partners, other relativesand friends may have noidea there’s a problem1 in 4people will experience some kind ofmental health problem each yearSince 1981, the proportion ofmale to female suicides hasincreased steadily withAnxiety and depression isthe most commonmental problem4 in 5THE COST TO UK BUSINESSES1 in 5people take a day offwork due to stress24%70 millionworking days are lost each year due tomental ill health, costing Britainannually 70-100bn.Presenteeism canArounddouble the cost. 1 in every 8 spentcosting the UKan estimated 8.1bnAROUND THE COUNTRYLess than half of employeessaid they would feel able to talkopenly with their line manager ifthey were suffering from stressThe UK has thefourth highest rateof antidepressantprescriptions inEurope atIn the last 6 years the number ofworking days lost to stress,depression and anxiety hasincreased bysuicidesbeing maleHalf of women with perinatalmental health problems are notidentified or treated50 mper yearA quarter of people considerresigning due to stressPrevalence of mentalillness in NorthernIreland is 25% higherthan in EnglandIn a survey of UK adults,56%Aberystwyth andCoventry wererated as havingthe least happyemployeeswould nothire someone withdepressionsaid theyeven if they were the bestcandidate for the jobIn Scotland, nearly 1 in 10adults had two or moresymptoms of depressionor anxiety in 2012/3The North East has thehighest suicide rate inEngland while Londonhad the lowestPeople in Liverpoolwere rated as the mostanxious with an anxietyscore of nearly 30%Wolverhampton werelowest at around 10%on long-term physical conditions is linkedto poor mental health and wellbeingSources: NHS Information Centre for Health and Social Care NICE Common mental health disorders Time to Change Mind The King’s Fund & Centre for Mental Health 2014 CMO annual report: public mental health Business in the Community 2014 Daniel Freeman – Oxford University Office for National Statistics NHS figures 2014 Conference Genie Health and Safety Executive CentreForum Atlas of Variation Scottish Health Survey 2013 Centre for Mental Health 2014, London Action Mental Health Northern Ireland Mind & Chartered Institute of Personnel Development 2011 London School of Economics & Political Sciences MODULE 7-3-
MANAGING MENTAL HEALTH IN THE WORKPLACEHOW TO PUT MENTAL HEALTHON THE AGENDAGood mental health should be a priority for any business, and implementingit needs to involve more than just the HR department. It’s vital to getbuy-in from senior leadership and make sure conversations about mentalhealth and wellbeing happen at board level.Make the business caseSenior leaders are understandably under increased pressure to cut costs andoptimise return on investment, and may not immediately understand the businessimpact of poor mental health. Be prepared to make the business case and havefigures to back this up – come prepared with figures on staff turnover and morale,and bring relevant feedback from exit interviews.Set targetsWe all work better if we have clear goals that we are working towards, andmental health in the workplace is no different. Identify the key drivers for mentalhealth, and the key indicators; figure out how to measure these and what levelthe company should achieve; and ensure these are an integral part of yourcompany’s performance targets.Choose your momentThink about the best times to start a conversation with the board and get theirbuy-in. There are some important dates throughout the year which can help to getthe conversation started, including the Mental Health Foundation’s Mental HealthAwareness Week in May and World Mental Health Day in October. However, don’tfeel you have to wait for one of these. There are also many internal milestonesthat can help to put mental health on the agenda like board meetings, staffsurveys, staff absence reports. Think about the times in the year when your businessis busiest and staff are under the most stress, so you can raise the issue ahead oftime.-4-MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEIdentify your board championIt helps to enlist a board member as your mental health champion – someonewho will raise the issue at the highest levels of the business. It may be they haveexperienced a mental health problem themselves, or they may simply bepassionate about looking after staff. They can also help to lead by example,encouraging more junior employees to think about their mental wellbeing at work.Break the tabooMental Health is still a taboo subject in the workplace. 67% of employees feelscared, embarrassed or unable to talk about mental health concerns withtheir employer2. To break this taboo and create an open and caring culture it’simportant to get your board on side and take a top down approach. If they arespeaking out on the issue, perhaps even drawing on their own experience, thenthis attitude will trickle down to managers and then staff.Expert viewChris O’Sullivan, Mental Health Foundation“Mental health is something we all have. Workplaces that challenge us, supportand develop our sense of purpose, and support us when things are hard can playa massive role in protecting and building our mental health. A mentally healthyworkplace can be built on the back of good basic line management relationships,clear HR policy and engagement of staff in decision making. Prevention is key we need to enable everyone to flourish, those in distress to access help quickly,and those who have recovered from mental health problems to stay well andenjoy successful careers”Take FiveWhen is your next opportunity to raise the issue of mental healthwith the board? Do you know when your next board meeting is? Isthere a busy period at work coming up?Good mental health is vital to business performance, becauseDid youknow?MODULE 7when staff feel happy and well cared for, they are moreengaged, more motivated and more loyal. As many as a thirdof employees would consider leaving their job if they didn’t feellooked after by their employer and a further 21% would be lessmotivated and productive3.-5-
MANAGING MENTAL HEALTH IN THE WORKPLACESTART WITH YOUR MANAGERSYour line managers are absolutely pivotal. They are usually the ones responsible fordealing with mental health in the workforce day to day, but many can lack theconfidence or experience to manage this alone.Training and support - Help your managers to help your people. Consider investingin training to help them recognise the early signs of a mental health conditionand put strategies in place to support staff that are affected. It’s also importantto follow up to make sure they have taken this training on board and understandhow to apply this day-to-day. Make it clear that they are not expected to becomeexperts in mental health or to handle problems alone – instead they are there toflag problems and signpost the support and resources available.Many third parties offer training for managers to helpthem recognise, understand and deal with theseissues. For example, Mental Health First Aid is a coursedeveloped by Mental Health First Aid England which teaches peoplehow to identify, understand and help a person who may be developinga mental health problem. In the same way as we learn physical firstaid, mental health first aid teaches you how to recognise those crucialwarning signs of mental ill health.For more information on Mental Health First Aid, visit their website.Starting conversations - Many managers can find it difficult to talk about mentalhealth issues with staff, often for fear of doing or saying the wrong thing. Talk toyour managers about how to get the conversation started.Every October for World Mental Health Day, Mental Health Foundationcoordinates ‘Tea and Talk’, an initiative designed to create conversationson mental health in communities and workplaces. A Tea and Talk sessionis a great way to start a conversation on your workplace about whatmental health means to the workforce, and what the organisation mightdo about it. Find out more here.For more tips on communication, see module 3:Communicating your wellbeing strategy.-6-MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEHAVE YOU SPOTTED THE SIGNS?There are many reasons why mental health has become such a huge issue in theworkplace today, but one factor is that many cases go unrecognised until theybecome severe. Whilst many employers are now primed to spot signs of physicalillness, mental health problems can be more difficult to identify. Here are somecommon signs that someone may be struggling with their mental health at work.EmotionalPlease tickYes / NoCognitiveYes / NoBehaviouralYes / NoPhysicalYes / NoBusinessYes / NoEmployees who are struggling with their mental healthmay seem irritable, sensitive to criticism, demonstrate anuncharacteristic loss of confidence or seem to lose their sense ofhumour.An employee may make more mistakes than usual, have problemsmaking decisions, or not be able to concentrate. Look out for anysudden and unexplained drop in performance at work.This could include things like arriving late, not taking lunchbreaks, taking unofficial time off, not joining in office banter, ornot hitting deadlines, becoming more introvert or extroverted,generally acting out of character.Employees who are stressed sometimes exhibit physicalsymptoms such as a constant cold, being tired at work, lookinglike they haven’t made an effort with their appearance, or rapidweight loss or gain.At a business level, look out for increased absence or staffturnover. Have you noticed employees working longer hours ora general drop in motivation or productivity levels?MODULE 7-7-
MANAGING MENTAL HEALTH IN THE WORKPLACEYes Spotting one or two of these symptoms does not always mean there is anunderlying mental health issue, but you should consider checking on youremployee’s wellbeing or picking up with their manager - especially if youknow they may be going through a difficult time inside or outside work.No If you haven’t experienced any of these, you’re doing a good job lookingafter the wellbeing of your staff at the moment. However, with mentalhealth problems on the rise think about how to safeguard this for thefuture.Expert viewJoy Reymond, Head of Vocational Rehabilitation Services, UnumAlthough understanding of mental health issues is growing,misconceptions still remain – especially in the workplace.Once thought of as something that happened to anunfortunate few, one in four people are now affected bymental health issues, and employers need to be able to spotthe signs. If not, problems may only come to light later onwhen more serious interventions are necessary.Addressing stigma and discrimination in the workplace is critical to ensuringthat people can come forward and seek help. National anti-stigmaprogrammes operate in England, Wales and Scotland. You can find resourcesand multimedia content from programmes local to you:Time to Change WalesTime to Change EnglandSee Me Scotland-8-MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEWHAT NEXT?Take TenAn effective mental health and wellbeing strategy considersprevention, intervention and protection. You can find someways businesses can tackle these three issues issues in thefollowing pages, but before you read on, have a think aboutyour own workplace. What do you already do to supportgood mental health, where can you improve this, and whatelse might you need to introduce?PreventionSafeguarding the mental health of your workforceHow do you already do this?How can this be improved?What else might you need to introduce?MODULE 7-9-
MANAGING MENTAL HEALTH IN THE WORKPLACEInterventionStepping in before problems become more seriousHow do you already do this?How can this be improved?What else might you need to introduce?ProtectionSupporting staff if they need time off, or need help returning to the workplaceHow do you already do this?How can this be improved?What else might you need to introduce?- 10 -MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEPreventionIt’s important to safeguard the mental health of your workforce by creating an open andcaring culture that makes staff feel supported and looked after. Here are some practicalways to do this:CultureCommunicationhaving a concrete policy reassuresemployees that their company caresabout their wellbeing. Create a culture of openness andawareness by encouraging people totalk about mental health.communal areas, and other internalcommunications to raise awareness ofmental health. Introduce discussion about mentalhealth at staff meetings – use themas opportunities to check in with staffabout how they are feeling or how theywould rate their stress levels and why. Conduct regular staff surveys to take atemperature check on wellbeing andfeedback results and progress to staff. Develop a Mental Health Policy – Use staff newsletters, posters inWorking practices Encourage staff to take regular breaksaway from their desks and get out ofthe office to reduce stress. Introduce a power-down hour, whereeveryone steps away from their email. Review job descriptions to makesure these set out clear and realisticexpectations of staff. If not, this might becontributing to, or even causing, mentaldistress amongst your employees. Think about how success is measuredand people are rewarded.Managers Train up management – if employeesknow their boss is clued up in mental.health matters, they may feel morecomfortable in coming forward todiscuss any problems they may have atwork, or even at home. Make sure line managers spendtime with staff and get to knowthem – this makes it easier to spotwhen they’re struggling or behavinguncharacteristically at work.Mental Health Foundation worked with Royal Mail Group to develop a suite of five short training videos on mentalhealth and wellbeing for staff. The company wanted a way to reach staff across the country with bite-sized,accessible but evidence based content that would support the wider ‘Feeling First Class’ work on mental wellbeingacross the company. Working with staff and experts, the film series has been viewed by over 7,000 managers.The films are available to view on You TubeFor more tips on building trust, see module 4: 5 ways to improve motivation and trustMODULE 7- 11 -
MANAGING MENTAL HEALTH IN THE WORKPLACEInterventionWhen problems do occur, taking simple steps to improve mental health can prevent themfrom developing into something more serious. Here are some practical ways to do this:Internal support Provide accessible guidance on how Outside helpto manage stress. Understand thatproblems with stress arise when thereis an imbalance between what isexpected of someone and their beliefsabout whether they can meet thosedemandsProvide guidance and support to helpemployees to become more resilientand more able to positively adapt tochange in the workplaceCreate a peer-to-peer support systemso people can talk with colleagues ofthe same level about their concernsConsider holding regular informal‘drop-in’ sessions with someone fromHR, or even a third party, to encouragepeople to talk through any issues theymay be experiencingProvide training and resources for linemanagers to empower them to spotthe signs of mental health. Make sureyou follow up with them to make surethey have taken this on board andunderstand how this applies to their ownrole .Working practices Allow flexible working andaccommodations for all staff to workfrom home – during a period of stressor worry, coming in to the office couldaggravate illness in certain cases. Givethem the option to work from homeif they need to be in more relaxedsurroundings. Check that you have an EmployeeAssistance Programme in place toprovide additional support for staffif they’re having difficulties inside oroutside the workplace – these can offera range of services from counsellingthrough to legal advice Seek the advice of your health partners.Your Employee Assistance Programmewill have plenty of resources availableto help your managers become morecomfortable with the issues relating tomental healthCommunication Make sure staff know what supportis available through your intranetor employee handbook and findopportunities throughout the year toremind people what is available andhow to access it Keep in touch with staff so they don’tdisengage from the workplace andthey understand you are available toprovide supportMany firms are creating peer-to-peer support networksto help staff talk through problems when they arise.When Deloitte partner John Binns went off sick withacute depression the company knew something had tobe done to protect the workforce. It has now introducedMental Health Champions throughout the business whoare on hand for support with advice and informal chats.Ernest & Young has introduced a similar mental healthbuddy system so that employees can discuss issues openlywith a peer before approaching a line manager.- 12 -MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEProtectionIn the most serious cases, staff may need professional support or an extended period oftime off work. Here are some ways you can support the recovery process:Benefits package Make sure your employee benefitsReturn to work planpackage provides support for mentalhealth. Income Protection, for example,provides a regular replacement incomeif an employee is unable to work due toillness for more than six months. It mayalso come with vocational rehabilitationservices to support them if they areable to return to work. Your IncomeProtection provider may also offertraining and education programmesdesigned to help managers addressmental health problems in theworkplace.Outside help Make use of Occupational Healthservices like the government’s Fit ToWork service and professional thirdparties and charities to address healthproblems and make any necessaryadjustments in the workplace. Develop a tailored and phased returnto work plan to help employees easeback into the workplace when they areready – this may mean starting them ona few hours a week and build their timeup slowly, or making adjustments to theirrole to reduce the pressure they areunder.Communication Hold consistent return to work interviews– these ensure the employee hasn’tcome back too early and can help youget to the root of a problem, as wellas being an effective tool of absencemanagement. Continue to check-in with employeesregularly – often support can dropoff once they are settled back in theworkplace, but it is important to havean ongoing, and meaningful dialogueto prevent problems from recurring.Helen was a senior medical underwriter with a small consultancy firm when depression made it difficult to cope atwork and left her no option but to take time off. Her employer had previously taken out Group Income Protectionand when their claim for Helen was accepted her case was referred to Unum’s rehabilitation services to see howthey could support her. A vocational rehabilitation consultant discussed a manageable return to work plan with Helenand her employer. She was also referred for some sessions of Cognitive Behavioural Therapy to help build up herresilience and develop coping strategies. With this support Helen gradually took control and increased her workinghours. She is now back working normally, socialising with friends, and has regained her confidence.MODULE 7- 13 -
MANAGING MENTAL HEALTH IN THE WORKPLACEFUTUREPROOFING YOURBUSINESS It’s important to take action on mental health now. The WorldHealth Organisation predicts that depression will be theworld’s most common illness by 2030 and suggests the globalburden of the condition will be greater than for illnesses suchas diabetes, heart disease and cancer.To tackle this and avoid the detrimental impact poor mentalhas on both employees and businesses, employers must takeaction to prevent mental health issues occurring, as well asproviding support when they do. The reward for getting thisright is a happier, healthier workforce, and a more successful,high-performing business.Expert viewJane Cattermole, Minding Your BusinessWe can’t ignore the fact that unreported, unmanaged stress increasesthe prevalence of mental health issues at all levels. UK workers arestruggling with increased workloads, relationships with managersand changes they have little or no control over. Stigma and lackof awareness prevent staff from speaking out and asking for help,or from receiving it in a timely fashion. It is now imperative that allorganisations, across all sectors take a pro-active approach tomanaging this.- 14 -MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEIN SUMMARYThink aboutOnce you’ve decided what medium to long-term actions youshould introduce in your workplace, you need to think abouthow you can implement them.Consider what you could do: Today (e.g. Look for signs of poor mental health in yourworkplace and think about any gaps in the support onoffer). Tomorrow (e.g. schedule meetings with managers to discusswhat training or support they need in handling mentalhealth issues). Next week (e.g. compile your insights to inform futuredecisions, identify new policies/policy changes that couldhave an impact on mental health in your organisation, andput this on the agenda for your next board meeting).If you don’t remember anything else, remember:Good mental health is vital to business performance,because when staff feel happy and well cared for,they are more engaged, more motivated and moreloyal.Line managers need ongoing training and support tohelp handle mental health issues day to day.An effective mental health strategy considersprevention, intervention and protection.Employee benefits are a good way to provide tangiblesupport for staff struggling with their mental health.MODULE 7- 15 -
MANAGING MENTAL HEALTH IN THE WORKPLACEDon’t forget to update your CPD record after completing this module!You can use all of the learning from this module to contribute to your CPD.Just download and complete our easy-to-use template and keep it with yourCPD records.Other modules in this series include:5 ways to improve workplace wellbeingTop tips to attract and retain the best peopleCommunicating your wellbeing strategy5 ways to improve motivation and trust10 ways to win over your Finance DirectorDeveloping an effective wellbeing strategyRead moreAll references and sources included in this modulecan be found here and are available inYour Ultimate Wellbeing Toolkit.References1 UK Chief Medical Officer, 20132 Time to Change, 20113 Time to Change, 2011- 16 -MODULE 7
MANAGING MENTAL HEALTH IN THE WORKPLACEUse this page to reflect Immediate actions yo on the following:u Things you could do could take.as ancommitment to workplac ongoinge goodmental health. Conversations you might hacolleague about workplac ve with ae goodmental health. The kind of things you woin the workplace to supp uld like to seeort goodmental health.Think aboutMODULE 7- 17 -
MANAGING MENTAL HEALTH IN THE WORKPLACEFurther readingProfessional ServicesBe Mindful Onlinehttp://bemindful.co.uk/ UK’s only evidence based online mindfulness course, supported by Mental HealthFoundationHow To Guides on Mental tal Facts on Mental Healthhttp://www.mentalhealth.org.uk/factsBlog: Benefits of Good Line workplaceBlog: First Class Mental Health – Royal Mail Group Case ass-mental-healthScottish Centre for Healthy Working kplace-health-promotion/mental-healthResources for aceFor tips on how to manage mental health issues at ips-embracing-mindful-workplace/Ideas for how to bring mindfulness into the radar/Understanding why it’s important for employers to understand mental healthhttp://www.unum.co.uk/stress-workA simple guide to stress at s-dare-to-take-the-stress-test-infographic/Take the stress test to get an idea of how this might be impacting your organisationResources to share with your s for stress awareness and management- 18 -MODULE 7
MANAGING MENTAL HEALTH IN THE How to manage mental health issues in the 01/23122-how-to-beat-blue-mondayGuidance on using Blue Monday in January for initiating conversations around mental healthThird party supportHealth and Safety Executive management standards for stress are highly regarded - http://www.hse.gov.uk/stress/standards/Health and Safety Executive also provides tools and support for managers - http://www.hse.gov.uk/stress/mcit.htmNICE are the gold standard for evidence in health and have produced guidance for employers on how topromote mental wellbeing at work.https://www.nice.org.uk/guidance/ph22Public Health England and the NHS promote the Workplace Wellbeing Charter http://www.wellbeingcharter.org.uk/index.phpTime to Change, companies can sign up for more help and guidancehttp://www.time-to-change.org.ukBusiness in the Community’s workplace guide http://www.bitc.org.uk/sites/default/files/booklet mh 0914 final version.pdfMIND, the mental health charity, have mental health at work l-health-at-work/As Fit for Work rolls out this will be especially helpful for smaller employers who don’t have occupationalhealth support - http://fitforwork.orgChapter ten of the 2013 Chief Medical Officer report has loads of statistics on mental health and work thatcan be helpful for building the business case with the board ds/attachment data/file/413196/CMO web doc.pdfMinding Your Business specialises in delivering services to those businesses who want to take apreventative, rather than reactive, approach to mental health issues in the workplace www.esrasurrey.co.uk/busines/Mental Health First Aid is an educational course which teaches people how to identify, understand andhelp a person who may be developing a mental health issue http://mhfaengland.org/Affinity Health at Work specialises in improving organisational performance through enhancing workplacehealth, wellbeing, engagement and leadership http://www.affinityhealthatwork.co.uk/MODULE 7- 19 -
MANAGING MENTAL HEALTH IN THE WORKPLACEUnum is an employee benefits provider with more than 40 years’ experience in the UK.Unum helps employers protect their workers by providing employee benefits. These help toprevent their workforce becoming ill, allow them to step in at the first sign of illness and providefinancial protection if they need it. As part of this, Unum now also offers workplace dental cover.The Mental Health Foundation is the UK’s charity for everyone’s mental health. Focused on gettingevidence based answers out to the public, employers and decision makers – our mission is tohelp people understand, protect and sustain their mental health. We have been at the forefrontof workplace mental health for over a decade, and offer a range of products, services andpartnership opportunities to employers.@mentalhealthmentalhealth.org.ukUnum are partnering with the Mental Health Foundation to tackle the stigma of mental health in theworkplace and call on business leaders to safeguard the mental health of their employees at everystage - from prevention, through
encouraging more junior employees to think about their mental wellbeing at work. Break the taboo Mental Health is still a taboo subject in the workplace. 67% of employees feel scared, embarrassed or unable to talk about mental health concerns with their employer2. To break this taboo and create an open and caring culture it’s
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̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
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Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. Crawford M., Marsh D. The driving force : food in human evolution and the future.
