Employee Benefits Wellbeing Supplement 2005 – Stressed out

With fewer than 10% of companies having a policy to tackle stress, it’s little wonder the condition is proving to be a blight on British industry as organisational apathy continues to subject staff to serious health risks, says Sam Barrett

Case Study: London Underground

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Stress is the disease of the 21st century. Along with related mental health problems, such as anxiety and depression, it results in more than 12.8 million lost working days a year, according to the Health & Safety Executive (HSE). And with up to five million employees saying that their work makes them feel very or extremely stressed, it has a significant effect on productivity, costing the UK around 10% of its gross national product.

Although stress is such a major cause of absence and reduced productivity, only a small number of employers have taken any steps to combat it. Fewer than 10% of organisations have an official policy to tackle it, according to a report from mental charity Mind called Stress and mental health in the workplace. Tony Urwin, clinical and business development manager at Bupa Psychological Services, explains: "It’s essential that employers do take steps to tackle stress in the workplace. Stress is an initial response to a situation that can be beneficial, but, over time, if someone is exposed to more stressful situations than they can cope with it can lead to serious mental and physical health problems."

Taking a common sense approach to workplace stress is generally seen as the best way to prevent it becoming a major issue and there are a number of steps employers can take. Dr Mike O’Donnell, chief medical officer at UnumProvident, says: "Openly recognising that employees can become stressed is important. There’s much less stigma attached to stress now and if you give employees and line managers the right tools to deal with these problems you can deal with it more effectively."

When an employee calls in sick with stress it is this first conversation that can be the most important, but the line manager taking the call may feel awkward if not properly prepared. "Rehearsing what you would say to an employee suffering from stress with someone in human resources, for instance, can be very useful in these situations," explains O’Donnell. Including a stress policy within the absence policy can help to ensure that correct procedures are followed. It also promotes the organisation’s stance on the issue.

The stress policy may in fact be different to the absence policy. As the issues that result in stress can become magnified with time, it’s sensible to require an absent employee to make contact on the first day to talk about what’s causing them to be away. Dr Trevor Smith, consultant occupational physician at the PMI Health Group, says: "If work-related factors are thought to be playing a part in any illness, it is important to look to address them, so that the illness is not perpetuated or does not recur."

Employers may find assistance in identifying where potential problems lie and what steps need to be taken from the HSE’s Management Standards for Stress. Introducing an employee assistance programme (EAP) may also help to identify potential problems in the workplace. Employees and their families can be given access through an EAP to confidential counselling for stress through a telephone helpline. The same service can also be used to give counselling for personal problems such as bereavement and debt, which can result in stress.

Many such services will provide employers with an anonymous report detailing the type of calls received by a helpline, which can then help organisations to pinpoint any potential problems in the workplace, for example bullying or restructuring. But O’Donnell says that employers should investigate the counselling philosophy behind an EAP before committing to a particular one. "Ask the provider about counsellor training and how they’d deal with someone finding it difficult in the workplace.

An EAP should empower an employee but some counsellors won’t focus on work as a benefit to mental health," he explains. If employers have gone to the trouble of sourcing an EAP provider, they should also promote the service. Nick Homer, product marketing manager for income protection at Norwich Union, says: "Don’t just stick it in the terms and conditions in the employee handbook, promote it regularly and prominently to your employees." Poster and intranet campaigns can also help to raise awareness of the existence of an EAP.

But even with the most robust frontline stress management tools, employees can find themselves unable to cope. In these instances, expert support can be extremely useful. "Involving an occupational health professional at an early stage can help to manage the medical aspects of the absence. They will be able to ensure optimum treatment and identify any short or long term adjustments that might assist in successfully returning the employee to work," says Smith. Employers may also find it worthwhile to provide private medical treatment or counselling in a bid to help tackle stress and to get employees back to work.

Bupa’s Urwin explains that the cost of providing this can often be a lot less than the amount the organisation stands to lose in terms of lost productivity. Employers may find that their income protection insurers are also able to help employees to return to work. Stress and mental health problems account for between a quarter and a third of their claims and so many insurers have considerable experience of helping employees suffering in this way back into the workplace. "We try to speak to claimants as soon as possible, ideally before they’ve even become claimants. The longer someone is away from work the harder it becomes to get them back into the workplace and, even if they didn’t have a psychological problem when they were first absent, it’s very likely that they will after six months," explains Norwich Union’s Homer. Employees may even be able to return to work on a more gradual basis without losing the support of income protection. "Proportionate benefit means that some income protection benefit will still be paid if the employee returns to work on a part-time basis or to a lower-paid job," says Homer. O’Donnell adds that an alternative source of support and advice can also come from charities and recommends Mind’s resource pack for employers entitled Managing for mental health.

This guide provides advice on everything from creating a healthy workplace to support groups that can help with employees suffering from mental illness. Even where an employee’s absence has extended into weeks and months it is important to stay in touch so that they continue to feel part of the organisation.

O’Donnell suggests sending them company newsletters, inviting them in for informal meetings and encouraging colleagues to contact them regularly. "These steps make it much easier for them when they do come back to work." Even where an employee has returned to work, they must continue to receive support from the organisation. As O’Donnell concludes – work can be part of the solution as much as it can be part of the problem.


What do employers use to combat workplace stress?

Policies on bullying/harassment 81%

Flexible working/work-life balance policies 80%

Counselling/employee assistance programmes 79%

Workshops/training for managers 52%

Workshops/training for employees 32%

Media (such as brochures and videos) 17%

Massages 12%

Job swapping/matching 9%

Other 2%

Case Study: London Underground

Stress is the number one cause of absence at London Underground but the organisation has introduced a stress plan to help change this. Alison Dunn, head of treatment services at London Underground, explains: "In 2002, we employed a stress consultant, Emerald Turner, to look at the ways we could improve how we dealt with stress in the workplace." One of the consultant’s recommendations was to conduct more rigorous risk assessments so potential problems could be identified and the appropriate steps taken to mitigate them.

"It was also clear that managers wanted more support to deal with employees suffering from stress. Many weren’t sure what they should say to stressed employees and worried that they could make situations worse," explains Dunn To assist, a manager’s toolkit was put together, which includes guidance on how to recognise the signs of stress, role-plays, additional resources and a relaxation CD. Turner also recommended improving employees’ resilience to stress. "To do this we introduced a stress reduction programme last summer. This won’t stop the stress but will help employees deal with it," says Dunn.

Employees are provided with a guide to dealing with stress and for those who have symptoms of stress a series of six two-hour workshops has been introduced. "The course starts by helping [employees] manage their symptoms, for example, with relaxation techniques. Then we will work with them to understand what caused the problem. Finally, we will look at possible lifestyle changes they could make, liaising with their managers where necessary," explains Dunn Although it is still early days, the results are already encouraging. Sickness absence was 79% lower in the six months after the stress reduction programme was introduced by the organisation.

Mental wellbeing and the law

Employees’ mental health is safeguarded by a number of different laws. The Health and Safety at Work Act 1974 includes a duty for employers to look after employees’ mental and physical health and safety, while the Management of Health and Safety at Work Regulations 1992 requires employers to undertake mental health risk assessments for their employees.

But, the extension of the Disability Discrimination Act (DDA) this December, means that employers will now need to be even more vigilant. Jane Byford, partner in employment and pensions at legal firm Martineau Johnson, explains: "In the past, for a successful personal injury claim an employee would need to demonstrate they had a clinically well recognised mental illness, that it had been caused by work and that it was foreseeable. "But for a successful claim under the DDA, the requirements are much less stringent.

I expect we’ll see a lot more claims." Critically, an employee no longer needs to be suffering from a clinically well-recognised mental illness. Byford believes that stress will be enough to warrant a claim. The mental illness or impairment needn’t be caused by work either but the employer could be found negligent if it doesn’t make reasonable adjustments to accommodate the employee.

Mary Sutton, a partner with solicitors Davies Lavery, says: "What is reasonable will depend on the employer. For example, a large employer will be able to accommodate more changes than a smaller one. "There are no hard and fast rules about what an employer will need to do but it could mean changing the hours an employee works, allowing them to work from home or moving them into a different role within the organisation."