Need to know:
- Occupational health provisions have typically been seen as dealing with physical health and safety, but employers should understand and promote their role in supporting mental wellbeing.
- Having a codified approach to mental health can place it on the same footing as physical health and safety, which has knock-on effects for an organisation's culture.
- Occupational health must be used in conjunction with other benefits and initiatives focused on wellbeing, to create a holistic strategy.
Defined as the branch of medicine dealing with the prevention or treatment of job-related injuries or illnesses, occupational health has traditionally been seen as typically being reactive, and dealing largely with physical issues.
However, as employers and staff become increasingly aware of the effects of work on mental health, and vice versa, it is important to understand the evolving role of occupational health.
Physical impacts
Even considering the traditionally held assumption that occupational health focuses predominantly on physical health and related workplace adjustments, these do still have a role in supporting mental health, either directly or indirectly.
Evan Davidge, total reward and wellbeing consultant at The Wellbeing Leader, says: “Physical and mental health are inextricably linked. If someone is suffering from musculo-skeletal issues, it can have a material impact on their mental health, particularly if they cannot function properly in their role, have to take time off, or even face the possibility of a life-changing condition.”
In addition, physical health problems can be a symptom of mental health issues, says Kate Meads, company director at Kate Meads Associates (KMA), which works closely with occupational health practitioners to get employees back to work.
“We get an awful lot of referrals for people who either have physical diagnoses or injuries that are actually masking an underlying mental health issue, [as well as] people who have actually been signed off with work-related stress, anxiety or depression,” she says. “We try our utmost to keep people in the workplace; it’s about recognising that and taking a measured, planned approach.”
Approaching from the physical angle can also be a helpful gateway to understanding employees’ mental wellbeing, where many are still reluctant to discuss psychological issues openly.
“With any mental ill-health you often find there’s a manifestation of physical symptoms, and often people are more comfortable saying [that] to their managers or occupational health,” says Meads. “When you scratch the surface, the underlying issue or illness is related to mental ill-health.”
Changing perceptions
The assumption that occupational health only deals with physical ailments is more an issue of perception than an actual gap in capabilities. Existing occupational health support for mental wellbeing are much the same as for physical illness: assessing someone’s fitness to work due to stress or mental ill-health, recommending workplace or role adjustments to allow an individual to be productive, helping an individual return to work after a period of absence, or referring them on for clinical treatment.
Sally Wilson, senior research fellow at the Institute for Employment Studies (IES), says: “Occupational physicians have always supported mental as well as physical health. Employers are taking so many approaches to tackle [mental health], so one of the issues for occupational health professionals is, where do they fit in in the wider picture of what employers are doing?”
This will only become more important in the future, adds Davidge: “The whole essence of work is changing, occupational health will have to evolve to meet the new challenges of the workplace of tomorrow, and it will certainly have a critical role to play in developing appropriate wellbeing strategies to ensure people can continue to give their best.”
The evolution into fully rounded physical and mental health support is arguably something that lies at the feet of the employer, rather than the occupational health industry.
Gary Butterfield, co-founder and executive director at Juice, explains: “Occupational health has traditionally been seen as a really reactionary service. That’s true, it is there primarily for those that already have an issue, but [it also has] an invaluable contribution to make to an organisation, not just in supporting those that have an issue, but just as importantly being proactive and supporting the organisation in trying to avoid that problem in the first place. Good occupational health units will support organisations to do that.”
This evolution is a case of education and communication, says Wilson: “A lot of line managers don’t understand what occupational health is. It’s about educating employers, and educating line managers internally, about the support their occupational health providers can provide and in what circumstances it’s important to refer.
“Occupational health is seen as a last resort, rather than a first line of action, [and] adjustments are put in place when somebody is sufficiently unwell. There is a very strong argument for finding ways to get occupational health involved at an earlier stage.”
Therefore, employers should be sure to remind staff and line managers of the support systems already there, and promote occupational health as a key part within any wider approach to mental health support within the organisation.
A clinical approach
There are many methods of supporting staff mental wellbeing, from training mental health first aiders to have difficult conversations, to delivering meditation and mindfulness sessions.
While many of the arguably 'softer' approaches can provide a general culture of wellness, the more formal nature of occupational health is fundamental in creating change.
For example, adjustments to working hours or conditions, when recommended by an occupational health practitioner, place mental health concerns at the same level of importance as physical safety. This can then have a knock-on effect in helping staff feel supported, heard and more psychologically safe overall, says Butterfield.
“A big engagement piece and a big thing for employees is that sense of support,” he explains. “There’s a lot of value just in a member of staff feeling like the organisation cares and that they are supported, even if that person doesn’t engage in the services, that feeling of support is incredibly valuable for all aspects of wellbeing, in particular mental health.”
Holistic wellbeing
Ideally, then, an organisation’s approach to mental health will take both sides into account.
“Workplace wellbeing is very much a composite construct now, it’s moved away from the traditional form of occupational health,” says Davidge. “There is [still] a distinction between ‘health and safety’ and wellbeing, but it is very fuzzy. It requires a coordinated approach, not just focusing on [traditional] health and safety, but more holistically at some of the broader issues.”
