If you read nothing else, read this….

  • Mental health problems can be a major financial drain on an employer, leading to increased absence, presenteeism and health insurance costs, as well as risking litigation and reputational damage.
  • Training can help line managers identify the early signs of a mental health problem and signpost the employee to further support.
  • Initiatives such as mental health months and mental health champions can help remove the stigmas around it and make it easier for employees to ask for help if they are not coping.

Changing this is essential, says Dr Wolfgang Seidl, workplace health consulting leader, UK and Europe at Mercer. “Mental health problems can be very costly to a business,” he explains. “As well as increased levels of absence, presenteeism and staff turnover, an organisation can suffer reduced productivity, higher claims on its group income protection and [private] medical insurance plans, and expensive legal claims.”

To illustrate just how costly it can be, research conducted by the Centre for Mental Health in 2010 put figures of £8.4bn on the annual cost of absenteeism, resulting from ill mental health and £15.1bn on the cost of presenteeism.

Employers’ responsibilities

Employers also have a legal responsibility to look after their employees’ mental health and wellbeing. Katherine Maxwell, partner and head of employment at Moore Blatch, says: “Employers have a duty of care to employees to provide a safe place of work in terms of both their mental and physical health.”

As well as providing this safe environment, if an employee tells their employer they are feeling under pressure, or it is obvious they’re showing signs of stress – for instance, working longer hours or behaving differently – the employer is expected to take steps to address this. Failure to do so and an employee could potentially resign and sue for constructive dismissal.

While most employers would want to support their staff, the culture of some workplaces can make this difficult. “Employees can be scared to say they’re struggling in case it affects their career prospects,” adds Maxwell. “Creating an open culture, where they feel able to come forward, is smart business practice.”

Early identification

One of the most effective elements of an organisation’s mental health strategy is line manager training. This teaches managers how to identify the early signs of mental health problems and talk empathetically to employees. Andrew Kinder, chair of the UK Employee Assistance Professionals Association, says: “It’s not about turning them into counsellors. But if they can get in early and signpost the employee to the support available, it will make a big difference.”

This support can include a variety of tools, including employee assistance programmes (EAPs), which can provide advice and information to employees for personal problems such as relationship breakdowns and debt, as well as work-related stress; private medical insurance, which includes psychiatric cover but may also offer a psychological pathway to provide further support such as counselling; and group income protection, which can deliver vocational rehabilitation where someone is likely to be off long term.

As well as external support services, an employer may also want to consider making adjustments to an employee’s work to help them cope. Anne Payne, executive director of Validium, explains: “The line manager may be able to make some simple changes, such as reducing an employee’s workload or the number of meetings they attend, but it can also be useful for the employer to have flexible-working options, such as part-time or compressed hours, because this can help to reduce some of the pressure on the employee.”

Changing culture

Employers can also take more proactive steps to safeguard their employees’ mental wellbeing. This could include resilience training, which can teach employees how to recognise when they are in a stressful situation and provide them with the tools to cope or ask for help.

Mark Witte, principal at Aon Employee Benefits, recommends going further. “All sorts of factors feed into an individual’s mental health and wellbeing, so it’s sensible to take a holistic approach, taking into account factors such as sleep, exercise and diet,” he says. “These all support an employee’s mental wellbeing and make it easier to turn to their employer for help if they have a problem.”

As well as giving employees the tools to look after themselves, employers can also take additional steps to normalise mental health and put it on a par with physical health. This could include running mental health weeks or months, or recruiting employees as mental health champions.

These champions, who can come from all levels of the workplace, can be very effective. “If someone’s happy to talk about their experience and the things they do to enable them to cope, it can really encourage other employees to come forward if they have a mental health problem,” Payne explains.

Seidl also recommends that employers should be creative with their approach, recommending strategies such as encouraging employees to get together to let off steam, and exploring initiatives such as the psychology of happiness and mindfulness training. “There are so many things [employers] can do that are really positive,” he says. “These will support employees’ mental health and wellbeing, but will also engage them and potentially lead to improvements in workplace performance.”

Case Study: Royal College of Nursing addresses high levels of mental health-related absence

The Royal College of Nursing (RCN) employs around 900 people to represent and support its 420,000 members. While it aims to be an employee health role model, it also has its own business drivers for addressing mental health in the workplace.

Peter Cocco, deputy director of human resources and organisational development, says: “In 2013/14, we found that 7.7% of our employees, equivalent to 67 members of staff, had suffered stress, anxiety and depression, and that 18% of all sickness, some 1,216 days, was related to mental health. The health and wellbeing of our employees is our primary concern, but it was also concerning to see how much mental health problems were costing the business.”

To address this, it worked with its employee assistance programme (EAP) provider, Validium, to implement a range of initiatives to support employees. These included manager training; a mental health month as part of its health and wellbeing calendar; 10 flexible-working options to support work-life balance; and a package of training for employees, including resilience training and mindfulness sessions.

Special steps were also taken to support its frontline employees. “As pressures increase on the NHS, our employees are having to deal with more calls from stressed and anxious members,” says Cocco. “This can seriously affect them, so we introduced support mechanisms for these employees in particular.”

Although it is too early to determine whether these programmes have helped to reduce absence, Cocco is pleased with the results. “We’ll keep evolving the programme to address new issues and keep it fresh, but we’ve already received a lot of positive feedback from managers and employees,” he says.

BOX: Statistics

  • One in six workers is dealing with a mental health problem at any time (Mind).

  • One in five people take a day off work due to stress, and one in 10 have resigned as a result of stress (Mind).

  • 43% of organisations saw an increase in reported mental health problems (Chartered Institute of Personnel and Development Absence Management annual survey report 2014).

  • 50% of employees have never been asked about stress, depression or anxiety in a one-to-one with their manager (Bupa).

  • 80% of business leaders claim they have effective measures in place to tackle mental health issues, but only 32% of employees with a mental health condition agree (Bupa).

  • 28% of people in the UK have consulted a counsellor or psychotherapist, with women (32%) and people aged between 35 and 44 (38%) most likely to have done this (British Association for Counselling and Psychotherapy, 2014 Attitudes survey, July 2014).

Viewpoint: An open culture is key to supporting staff

Under the Equality Act (2010), if any employee discloses a disability, including a mental health problem, an employer has a duty to make reasonable adjustments to working practices to support that member of staff. For a mental health problem to be considered a disability, the impairment must have substantial adverse and long-term effects on a person’s ability to carry out normal day-to-day activities.


Adjustments should be made on a case-by-case basis and can be as simple as offering some more one-to-one support when someone is struggling. Flexible working hours, phased return, reduced hours and buddy systems are all potential solutions to a supportive work place environment for all staff.

Employers also have a general duty of care to all of their employees under health and safety legislation. This includes assessing and mitigating the risk of stress-related ill health arising from work activities.

However, we want employers to see supporting their staff as not only a legal obligation, but one part of being a responsible employer that values the contribution of each and every member of staff.

Employers need to create an open culture where staff feel able to speak about their mental health and any issues they are facing. Staff need to be reassured that if they do open up, they will be met with support, rather than facing stigma or discrimination. Starting a conversation about mental health does not have to be difficult, it can be as simple as asking someone how they are doing. Having a mental health problem does not necessarily lead to problems with performance, so try not to make assumptions about an employee’s mental health and private lives and how these might impact on their ability to do their job.

If someone does open up, an employer should ensure that it keeps anything they say confidential. If they would rather not talk about it, an employer must respect this decision. Confidential support such as employee assistance programmes (EAPs) can be useful for staff who do not feel comfortable talking to their employer about their mental health. A well-supported member of staff experiencing a mental health problem can carry out their role to a high standard.

Emma Mamo is head of workplace wellbeing at Mind