Sickness absence: Open plan to tackle stress

If you read nothing else, read this . . .

• Stigmas associated with mental health problems can create a culture of silence, with staff afraid to talk about their health issues and employers scared to offer support in case they say the wrong thing.

• High-profile cases of mental health problems, for example, among sports professionals, help to remove the stigmas.

• Early intervention is essential, with absence possibly avoided altogether if the right support is made available.

• Employers should focus on the individual and what they can do at work, rather than the mental health problem.

The stigmas that exist around mental health problems need to be overcome by both employers and employees so that proper support can be given

Mental ill-health can set employers additional challenges in managing sickness absence. On one side, employees can be reluctant to tell their employer they are suffering from a mental health problem, while on the other, employers are unsure how to help and support them in the best way.

The stigmas associated with mental health are a major hurdle when dealing with it in the workplace. Amy Whitelock, senior policy and campaigns officer at Mind, says employers feel these stigmas can make it hard to identify the cause of sickness absence.

“Too often, it means that what could be a preventable mental health problem spirals into a serious condition and a long period of sickness absence,” she says. “There is fear on both sides. The employee is worried about what the employer will do, especially as there is evidence that some people with mental health problems have been managed out of their organisation, but the employer is also worried that it might add to the employee’s distress, say the wrong thing or make them more ill. This creates a huge disconnect where the problem is not talked about.”

She points to the experience of Deloitte as an example. When one of the firm’s partners returned to work after being off for a few months with depression, he said that if he had been made aware of the support the company offered, he would not have needed to take time off. This resulted in him spearheading the creation of mental health champions at Deloitte so employees could talk informally about any problems they might have.

Awareness days

Other employers are also looking at initiatives to help remove the stigmas of mental health issues. Sarah Perkins, UK healthy living manager at American Express, says it includes mental health in its awareness days. “Globally, we run awareness days around events such as World Mental Health Day, while in the UK the whole of the fourth quarter of 2011 is focused on the issue of resilience,” she says. “We will be looking at issues such as negative stress and how to combat it.”

Informa is also keen to raise awareness of mental health in the workplace. Thomas Humphris, head office HR and UK reward director, says he was sceptical when one of the firm’s physicians said he was going to run a series of workshops on managing stress. “I was interested to see how many people would attend, because they are saying publicly they cannot cope,” says Humphris. “But during the time it has been running, attendance has risen, suggesting the stigma is slowly disappearing and people are much more open about it.”

Such initiatives are helping to remove the stigmas, but there is also evidence of a generational shift, with younger people much more comfortable talking about it. Martin Todd, head of reward at Grant Thornton, thinks this has been helped by high-profile people talking about their mental health problems. “Some sports stars, for instance [cricketer] Marcus Trescothick, have talked about having depression and this means people can really relate to what they say,” he says. “Twenty years ago, you would not have seen this.”

Cultural change

This cultural change, and the initiatives employers are introducing, will help to create a more open workplace where staff feel they can talk about these issues, but employers also need to consider how to deal with absence related to mental ill-health.

Ann Dougan, marketing director at Cigna HealthCare Benefits, says early intervention is even more important with this type of absence. “Employers need to recognise mental health problems as quickly as possible, get a dialogue going with employees and explore the options for support,” she says. “Take a multi-disciplinary approach. Use resources from charities as well as an employee assistance programme and occupational health, but make sure it is deployed around the needs of the employee.”

As well as recognising the problem early, preferably even before the employee takes any time off, it is important to treat them as individuals. Whitelock says this is essential for mental health problems because two people with the same diagnosis can be affected in different ways. “Focus on the person, not the problem,” she adds. “Ask them how their condition affects them and their capability to do their job.”

Ksenia Zheltoukhova, researcher at the Work Foundation, says: “When someone is off with a mental health problem, employers need to encourage them to focus on what they are capable of doing. Rather than saying ‘I am off work with depression’, they should be encouraged to talk about what they can still do at work. It improves their self-esteem as well as their chances of returning to work.”

Open dialogue

Many employers shy away from contacting staff who are off with mental health problems for fear of causing extra stress, but it can be beneficial to maintain an open dialogue. If staff are suffering anxiety about their job, this can be exacerbated if the employer does not contact them, says Whitelock.

Adam Brooke, employee benefits manager at JP Morgan, says: “You need to make sure all your employee benefits are joined up. I have come across cases where, because there are caps on the treatment available on medical insurance, the employee has been left to their own devices and has not been able to get the help they needed. You need to be sure all providers are on board, for income protection as well as medical insurance, to ensure support is provided where necessary.”

Employers that are prepared to tackle mental health problems head-on should be prepared for a slightly odd reaction, says Whitelock. She points to an NHS trust that has done a lot of work to remove the stigma around mental health. “Rather than seeing a fall in sickness absence related to mental health, it actually saw a rise because employees felt more supported,” she says. “This was very positive for the trust as it found out the real reasons for absence and could put the right support in place.”

Read more from the sickness absence roundtable