How to measure the effectiveness of mental health strategies

mental health interventions

Need to know

  • Data such as absence, turnover, productivity and benefits usage can give an indication of employee mental health and wellbeing, which can be used to measure the effectiveness of any interventions.
  • Employers should offer as much choice as possible around mental health interventions but also consider different approaches for groups such as line managers or those in potentially traumatic situations.
  • Reporting of mental health-related absence may initially increase because a more open and supportive culture will give employees greater confidence around disclosure.

Over 15 million working days were lost in 2016 due to mental health issues, according to research published by the Office for National Statistics (ONS) in March 2017. But, while most employers are keen to find ways to address this, difficulties determining which interventions are effective can put many employers off.

It is not surprising. With mental health influenced by a broad range of factors, it is not easy to determine whether an improvement is due to an intervention or something completely different such as a promotion, a change in management or even a new relationship. Mike Shaw, managing director at Validium, says: “Measuring the return on investment for a mental health strategy is difficult. Although much of the data around efficacy is anecdotal, there are plenty of elements that can be measured to produce a financial figure.”

Cause and effect
It is sensible to start with a baseline from which to measure progress. For mental health, there are a variety of different measures that can be considered. Helen Smith, group commercial director at Benenden, explains: “Look at staff surveys to see how employees feel about health and wellbeing initiatives and the workplace generally. An employer can also measure data such as sickness absence, turnover and productivity. When employees feel supported, absence falls, and retention and productivity increases.”

Other employee benefits can also give employers a good snapshot of the workforce’s mental health and wellbeing. This could include obvious measures such as private medical insurance (PMI) and group income protection claims data or the number of calls to an employee assistance programme (EAP) but also details around gym and canteen usage.

While these measures can shift following the introduction of a new strategy, the data might not always show an improvement, especially in the first year or so. Charles Alberts, senior consultant at Aon Employee Benefits, says: “Intuition says that EAP usage and mental health related absence and PMI claims will go down but I’d argue the opposite. Concerns about disclosing mental health problems in the workplace mean there is chronic under-reporting, with employees masking it behind common health problems such as coughs, colds and stomach upsets.”

Fine-tuning the strategy
Directing spend to the most effective interventions will help an employer achieve the highest return on investment (ROI) on its mental health strategy. Looking at usage data and employee feedback will determine which are the most popular and, therefore, likely to deliver the best returns.

It can also be sensible to consider different approaches for some employee groups. Factors such as life and career stages, ethnicity and gender can all influence which interventions work best. Wolfgang Seidl, head of health management consulting at Mercer Health and Benefits, says: “It may be a bit of a generalisation but women do tend to seek help sooner than men. With one employer we addressed this by putting the EAP number into the mainly male workforce’s overalls and on the back of the tax disc in the [organisation’s] vehicles. This helped to increase usage and improve mental health.”

Some employees can also benefit from tailored support. This could include mental health resilience training for employees dealing with potentially traumatic incidents, and awareness training for line managers to help them identify and support colleagues who might be struggling.

It is also important to give employees as much choice as possible over mental health interventions. “It’s a very personal thing,” says Alberts. “If an employer can offer a range of interventions that’s great but if this isn’t feasible, educating employees on what’s available through taster or lunch-and-learn sessions can also be effective.”

Other employee benefits can help here too. For instance, some health cash plans include a wellbeing benefit, giving employees a pot of money that can be spent on treatments as diverse as reiki, sports massage and cognitive behavioural therapy.

Putting a figure on it
As well as finding the strategy that works best for employees, an employer may also want to translate this into a monetary figure. This can help to win support for future investment into mental health interventions.

Several strategies can be used here. For instance, where an employer offers PMI or a health trust, it could use changes in medical inflation to determine a figure, says Seidl. “Medical inflation is typically 9-10% in the UK so if [employers] can show [their] interventions have reduced this, [they] can calculate the savings,” he explains.

The UK Employee Assistance Professionals Association (EAPA) is also looking to take on some of this number crunching with the introduction of an online calculator in March 2018. In return for details such as headcount and the cost of the EAP, it will calculate a value to the employer. Paul Roberts, executive board member of the EAPA, explains: “It’s designed to give an immediate figure based on the organisation’s size. If the employer’s prepared to input more details such as the demographics of the workforce, it will further refine the calculation and provide information such as the potential improvement if promotional activity was increased. Over time, we’ll also be able to produce benchmarks so organisations can compare their own performance against their peers.”

But, while calculating the financial benefit to the business of different initiatives can win support from the finance director, more employers are taking a softer approach to their mental health strategies. As Smith says: “Many organisations are moving away from a culture where everything has a monetary value and instead are seeing the benefits of looking after their employees. It can be a leap of faith but organisations that put the health and wellbeing of their employees first, do reap the benefits.”