Lighthouse

Need to know:

  • Although there is a lot of awareness around mental ill health, there is still a stigma attached to discussing it in the workplace.
  • Employers should promote initiatives that can help support mental wellbeing such as an employee assistance programme (EAP), occupational health, and mental health first aid training.
  • Creating open lines of communication between colleagues, line managers, and senior leaders will help to break the taboo of discussing mental health.

Addressing mental health in any setting is still very much a hush-hush subject and the workplace is no exception. Research published by Axa PPP Healthcare in March 2016 found that over a quarter (27%) of employers are more comfortable discussing a member of staff’s physical health than mental health, and nearly half (45%) of employers are wary about discussing mental health issues for fear of upsetting or offending employees.

For all the support measures and awareness campaigns now in place, not only within organisations but also wider society, why is it still a taboo to discuss an employee’s mental wellbeing with them?

People’s reticence to discuss mental health, or to admit it to themselves, is part of the issue, says Dr Mark Winwood, clinical director-psychological health at Axa PPP Healthcare. “It’s this stigma that people feel they will be seen as ‘being weak’ if they admit that they’re not coping,” he says.

“Stigma seems to be the major issue. That’s the stigma we hold within ourselves and the assumptions we make about the way that we feel we’ll be viewed by other people if they know we’re not feeling great. It’s also the stigma that society brings about by virtue of the way mental health problems are perhaps depicted in the news and on television. This is one of the major reasons that people won’t talk about how they feel psychologically in the workplace.”

Although there are adverts and campaigns, such as World Mental Health Day on 10 October, the stigma surrounding mental health discussion is still very much prevalent in the workplace, and can be exacerbated by the wider economy. Through periods of recession, or if unemployment figures rise, employees can be reluctant to mention that they are struggling to cope.

Matthew Judge, technical director at Jelf Employee Benefits, says: “A lot of it is fear, people just don’t know how to address that issue. It’s better than it was, and people do talk more openly about it, but there’s still a long way to go.”

Improvements in mental health support

Employers continue to see investment in the health and wellbeing of employees as important, and this includes offering services to address mental wellbeing, as well as physical health. Not only do employers view it as an important duty of care to look after the wellbeing of employees, but it also pays dividends in terms of improved absence statistics, increased employee motivation, and productivity.

Tim Routledge, founder and chief experience officer at Experience Insight, an organisation that uses research techniques from neuroscience, psychology and behavioural economics to understand people’s experiences and resilience to stress, says: “If [employees] feel happy in what they do, are resilient, and able to bounce back from setbacks and if things are going wrong, then they are more likely to have optimal wellbeing and deliver a better service [for customers]. It starts from an economic perspective but it’s all about looking after [employees].”

A few years ago there was a trend to remove psychiatric benefits from healthcare programmes, such as private medical insurance, because the instances of claims were low, says Jelf’s Judge. Now, however, although providers have not returned to providing unlimited cover, it is common for a provider to offer 28 days of psychiatric benefits, such as treatment from a mental health consultant or wellbeing therapist. Katharine Moxham, spokesperson for industry body Group Risk Development (Grid), says: “Forward-thinking employers are making the connection between health, wellbeing and productivity, and, of course, mental health is as key to this as good physical health.”

Many employers are not making best use of the added-value products that they have access to alongside group risk products, such as group income protection, which can include employee assistance programmes (EAPs), fast-track access to therapies such as cognitive behavioural therapy (CBT), and mental health first aid training for line managers. “It is important to really understand that these [services] are not just for use when people go off sick, they can support employers, HR managers, and staff every day,” says Moxham. “The preventative support can help employers to manage mental health conditions before they become a problem.”

Employer support

Employers can support all members of staff by making sure line managers, senior leaders and even colleagues are aware of both how symptoms of mental ill health can present themselves, and what help is available in the workplace. It is important that employers educate all employees about the symptoms, causes and support in order that everyone has a better understanding, says Austin Caffrey, organisational psychologist at health and wellbeing consultancy Feel Good Co.

“Pressure, in terms of demand for work or relationship difficulties, is one of the most common reasons for feeling anxious, [as well as] conflict in the workplace. These are things that can trigger or exacerbate problems,” says Caffrey. “One of the key things is to train people to be able to spot the signs and then give them the confidence to have a conversation.”

Individuals respond to pressure in different ways: some will flourish, others will not. Some employees will hide mental ill-health issues well, but their behaviour might change, for example, an employee might start coming into work late or their performance may worsen. They may become irritable or sad, while another might have a fixed grin. Any change may be indicative of mental ill health.

There cannot be a one-size-fits-all approach, so employers should ensure the workplace is open to conversation; line managers should ask each team member how they are, and how they are coping with their workloads, for example. If it then becomes apparent that an employee might need to speak with someone further, or require more professional support, benefits such as an EAP or other counselling services should be promoted. “Talking, promoting the EAP, promoting healthy behaviours, exercise, and technology switch-off times: these don’t have to cost a lot of money but all of these can really help people,” says Axa PPP Healthcare’s Winwood.

Although a stigma still surrounds mental ill health, workplaces have moved on their support significantly; continual encouragement of the ‘how are you?’ conversations and promotion of support services can only help to break the taboo further until discussing mental wellbeing becomes as commonplace as physical health.

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Wellcome Trust trains employees in mental health first aid

Mental health first aid training has helped the Wellcome Trust deal with a number of mental health issues presented by employees.

The medical research charity introduced a pilot mental health first aid training scheme with Mental Health First Aid for England in 2015, and fully launched in the beginning of 2016. Led by Natasha Gordon, project manager at Wellcome Trust, the scheme has created a network of employees that have been trained in how to recognise the signs and symptoms of mental health issues and how to provide help.

There are mental health check point posters all around Wellcome, which advertise the mental health first aiders across all divisions. “There’s been a number of broader reasons why people have been using the network, from bouts of depression, both cyclical or seasonal depression disorders, some work-related [issues] because that happens everywhere; stigma-related issues where incidents have happened or comments have been made and they feel upset by it; [and] bereavement,” explains Gordon. “Quite a broad range of issues have been coming forward, which is good in the way that people feel able to talk about those things with us.”

The organisation also advertises external sources of support. Gordon says: “Mental health problems can come up at the weekend and out of hours so there is external support [employees] can access.”

In addition, Wellcome provides an employee assistance programme (EAP), occupational health services, an on-site gym, and private medical insurance (PMI). In July, the organisation upgraded the mental health support available through its PMI scheme to give employees the opportunity to get a psychiatric referral as opposed to having to via their GP. Wellcome has also created a bespoke guide for managers to support them in having conversations with staff.

“I really want Wellcome to be seen as an organisation that is committed to supporting mental health,” says Gordon.

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Janssen takes a holistic approach to supporting employees’ mental wellbeing

As a healthcare organisation, Janssen is committed to helping its employees improve their mental and physical health.

The research-based pharmaceutical organisation, which is part of the the Johnson and Johnson group, takes a proactive approach to employee wellbeing. Charlie Hamlin, organisation effectiveness manager, says: “Prevention, and health and wellbeing, is very central to our business strategy. So it is not seen as separate but is very much integrated. Our global CEO [chief executive officer] wants us to be one of the healthiest [organisations] in the world and is very much prepared to invest in that aspiration.”

Janssen, which employs around 550 people in the UK, offers employees a number of initiatives to look after their wellbeing. In 2014, it introduced a two-day programme, Energy for Performance in Life, which looks at physical, emotional, mental, and spiritual aspects of life. The holistic programme talks about health and wellbeing in very positive terms.

“We recognise that the Energy for Performance in Life programme is a very useful tool to help us to encourage employees to take better control of their workload, to create a culture where it’s okay to say no, that legitimises being able to push back, to best manage their workload so that they can achieve a better work-life balance,” says Hamlin.

As part of its overall health and wellbeing approach, Janssen provides an employee assistance programme (EAP), free fruit for employees, an on-site gym, and has also participated in a global step challenge.

The organisation places a strong focus on performance and talent management. Hamlin says: “[It’s] about getting the right person in the right job at the right time, and being able to support them to progress. All of the things that are essential to effective human functioning are the foundations of mental wellbeing, and health and wellbeing generally.”

Janssen has taken part in The Sunday Times’ 100 Best companies to work for survey since 2012, but results in 2014 showed that, although it was in the top 20, it was almost at the bottom when it came to wellbeing, and highlighted a problem around work-life balance. Janssen worked with communications agency Like Minds to create a communications campaign that promoted the health and wellbeing initiatives available to employees in 2015.

“We’ve invested a lot of time, energy, and money in supporting the health and wellbeing of our employees and we do not have [a] highly sophisticated set of metrics to see what the payback has been on business, because we know it’s the right thing to do, not only from a business point of view but from an ethical point of view,” says Hamlin.

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Viewpoint: Mental health first aid training can guide employees to the right support

We all have mental health just as we have physical health, but it can seem more difficult to spot the signs of mental ill health.

The key thing to look out for when it comes to mental ill health are changes in an employee’s usual behaviour, such as unusual irritability or tearfulness, sudden loss of confidence or increased sickness absence. Noticing such changes is an important part of recognising when an employee might be experiencing a mental health issue and feeling confident to have a conversation with them about how they are feeling.

One simple step employers can take to help make their workplace more mentally healthy is to train staff in mental health first aid. This is the mental health equivalent of physical first aid training, and provides participants with the skills and confidence to recognise the signs and symptoms of common mental health issues and effectively guide a person towards the right support.

With World Mental Health Day taking place on 10 October, and the theme this year being ‘psychological and mental health first aid for all’, there is no better time for employers to commit to improving the mental wellbeing of their staff and introduce mental health first aid training to their workplace.

I strongly believe that all businesses should be measured by their social and environmental output and not just by profit. I think that if every [organisation] measured a triple bottom line, people, planet and profit, we would live in a much healthier and happier world.

Poppy Jaman is chief executive officer at Mental Health First Aid England

Poppy Jaman will discuss breaking the taboos around talking about mental health at work at Employee Benefits Live 2016 on 12 October.