Health and wellbeing: Employers must tackle mental health issues

If you read nothing else, read this …

  • Mental health problems are estimated to cost employers £26 billion a year in sickness absence, reduced productivity and turnover.
  • Mental health problems can range from the moderate – stress, anxiety and depression – to the more severe – schizophrenia, bipolar disorder and post-traumatic stress disorder.
  • Employers can help with the prevention and early identification of mental health issues by offering guidance to managers and staff in recognising the symptoms and signposting places for more advice and treatment.
  • Counselling and therapy services, such as employee assistance programmes and cognitive behavioural therapy services, can help staff with mental health problems.

Case study: BT connects staff with mental health awareness

BT developed a mental health framework for all its staff to address the growing awareness of mental health issues both within in the workplace and among the general population.

The framework operates on three levels: the first is around promoting good mental health and preventing ill health; the second is about identifying any early signs of distress and acting at an early stage to prevent it deteriorating into more significant mental health issues; and the third provides a suite of intervention services or treatment services to help people when they have developed a problem.

Against that framework, BT has developed a number of programmes and initiatives. These include an online self risk assessment tool that gives employees feedback on their level of stress, offers guidance and suggests actions they can take; mental first aid training for the company’s people managers; and a fully triaged, case-managed cognitive behavioural therapy (CBT) service that offers face-to-face counselling, guidance, self-help and computer-based therapy.

Dr Catherine Kilfedder, group health adviser at BT, says: “We continuously work to promote a culture of positive mental health in the organisation and use a variety of communication channels to do that.”

Mental health issues are a growing problem in the workplace and employers need to take positive action, says Tynan Barton

At any one time, one in six adults will be experiencing some form of mental ill health, and it is fast becoming the main reason staff go off sick, according to the Sainsbury Centre for Mental Health.

Mental health in the workplace is a growing issue, and with World Mental Health Day approaching on 10 October, the subject will be in the spotlight. Kevin Friery, clinical director at Right Corecare, says sufferers are under-represented in the workplace, despite many wanting to return to employment.

“Many employers have not had experience of working with people with that type of illness,” he says. “But the government will be pressing people to come off of incapacity benefits and sickness-related benefits, and into employment. Employers will be engaging more often with people with mental illness.”

Mental ill health varies widely, from mild and moderate disorders such as anxiety, depression, phobias and stress-related disorders, to more severe conditions such as schizophrenia, bipolar disorder, and post-traumatic stress disorder. These conditions affect a person’s ability to carry out their work, and can result in a drop in performance and productivity. In turn, this can lead to an inability to cope with work entirely.

Such conditions can last from a few days to a few months, or even longer in some cases. Early intervention is needed to avoid further harm to both the employee’s health and the workplace. Bob Kitchin, chief executive officer of Twining Enterprise, a charity that provides vocational support to people with mental health needs, says that as with all illnesses, prevention is better than cure, but early intervention and support are vital.

Early intervention essential

“There is evidence that if [employers] can intervene in those early weeks, typically before someone is at the six-week point of being signed off sick, then they have a much improved chance of getting people back to work successfully and sooner,” he says.

Although employees are primarily responsible for their own wellbeing, the amount of time they spend at work means employers have a certain duty of care. And for people suffering mental ill health, work can play an important role in their recovery. “Work does far more good for you than not, and it is far better than being out of work,” says Kitchin. “There are strong links between unemployment and depression, and unemployment and increased suicide risk. Being in work needs to be part of people’s recovery and healthcare treatment.”

Failure to address mental ill health can have financial and non-financial implications for employers. As well as lost productivity, sickness absence can increase costs through temporary cover, overtime, recruitment advertising and training. Non-financial implications include low morale among staff. Declan White, group protection marketing manager at Friends Provident, says: “This can impact on the reputation of an employer if it does not have policies and practices that address mental health in the workplace.”

In addressing mental ill health among staff, employers must consider both preventative and treatment measures.
Giving staff guidance on the recognition and acceptance of mental health issues can aid prevention by helping them to recognise when a colleague needs help. Sally Wilson, research fellow at the Institute for Employment Studies, says: “It is important for employers, line managers and HR managers to be aware of mental health issues because they are ‘invisible’ compared with physical health conditions: you cannot see them. Employers cannot really deal with a mental health issue until it has been recognised and sometimes employees are not going to tell their employer they have a problem.”

Dr Jenny Leeser, assistant medical director at Bupa Health and Wellbeing and a consultant occupational physician, favours prevention. “Encourage a healthy lifestyle and promote exercise, which has been shown to be effective in mild depression,” she says.

Cost-effective support

Mental health policies and practices do not have to cost a lot, and there are cost-effective ways for employers to support staff during their absence and on their return to work. Friends Provident’s White says: “Employers could look at workloads and deadlines to make sure they are realistic and fair. They could also look at the hours staff work and maybe offer flexible working.”

Employers can also offer medical treatment, advice and counselling, and ensure staff are talking to the right people and engaging the right services. This could involve the occupational health department, a confidential employee assistance programme (EAP), or simply talking to their GP. Stress and anxiety can also be brought into the workplace because of personal debt, so financial advice may also help. “It is useful if employers have an EAP that covers that sort of advice as well,” says Bupa’s Leeser. “People who have a lot of debt do not perform well at work because they are too worried.”

Employers should also check which services are provided under their group income protection (GIP) plan, says White. Although a period of sickness may fall within the deferred period before a GIP policy pays out, staff can use other services provided by risk insurers, such as EAPs and counselling, he says. “We have a psychiatric nurse who can speak to people suffering from stress, anxiety or depression, and talk through the causes and how we can help with rehabilitation, or work with the employer to maybe improve conditions to help overcome those issues.”

Some policies may offer other treatments, such as cognitive behavioural therapy to understand the cause of stress or depression.

Employers need to recognise what their responsibilities are and how they can support staff with appropriate benefits, advice and training. Kitchin suggests a two-pronged approach. “Employers need to make an effort to reach out and look for information and training. Equally, the NHS and other organisations need to reach out to employers to let them know what is available.”

Mental health statistics

Mental health problems are estimated to cost employers £26 billion a year in sickness absence, reduced productivity and staff turnover, according to the Sainsbury Centre for Mental Health – equivalent to over £1,000 for every employee in the UK.

In the CBI/Pfizer On the path to recovery: Absence and workplace health survey 2010, 50% of employers cited non-work-related mental health issues, such as anxiety and depression as among the top factors leading to long-term absence.

The Department of Health’s Attitudes to mental illness 2010 research, published in March, found 25% of British adults work with, or have worked with someone with a mental health problem.

Axa’s Money sickness syndrome report, published in July 2010, found 90% of adults suffer physical and mental stress over financial matters. Symptoms include anxiety, depression, sleeplessness and a loss of sense of humour.

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Figures from Medicash, published in August, found men are four times more likely than women to phone in sick due to work-related stress. Also, 31% of women and 24% of men often feel stressed.

Read more from the health and wellbeing supplement