Workplace mental health: why the right foundations matter

Tracey Ward, Head of Business Development & Marketing at Generali UK Employee Benefits interviews Dr Julie Denning, Chartered Health Psychologist and Managing Director of Working To Wellbeing, Chair, Vocational Rehabilitation Association UK

 In March this year, the National Institute of Clinical Excellence (NICE) published its Mental wellbeing at work guidelines for HR and Line Managers. Designed to encourage employers of all sizes to think more strategically about the mental wellbeing support they provide to employees, bringing together good work, wellbeing initiatives and employee benefits. Do they help provide a workable framework for support? Or do the guidelines simply add an extra layer of complexity to an already complex issue?

To find out the answers to these questions, we spoke recently to our early intervention partner Working To Wellbeing, as part of a podcast. Here’s an excerpt from that podcast, to listen to the full 30-min episode, please click here.

Tracey: Tell us a bit about your background and expertise and why this is an area of interest for you.

Julie: We support people with long-term conditions to restore their function and quality of life, helping them get back to work, and helping all parties – employers and employees – recognise that work is good for you and should be considered a core part of the rehabilitation journey. A lot of what I do, as a health psychologist, is supporting people with the mental health component of their long-term condition. We also help employers with regards to support with return-to-work programmes, and we provide line manager training on everything from improving communication skills, to developing a Wellbeing Action Plan and understanding the Equality Act and reasonable adjustments.

Tracey: The NICE guidelines are extensive. Can you sum them up for us in a “if you know nothing else about the guidelines, know this” kind of way please.

Julie: Yes, of course. The guidelines focus on three tiers of mental wellbeing in the workplace. First, there’s the organisational tier and it’s this level that NICE says is often missing. This is about ensuring a strong basis – or strategy – is in place, encompassing values, culture and expressed in policies, procedures, line manager support and role modelling etc.

Then there’s the individual tier; having good line manager conversations, relationship building and ensuring wellbeing is out in the open. As part of that, identifying workplace stressors and making changes where necessary.

Finally, there’s the targeted intervention tier. This is for those at risk of developing mental ill health or who already have mental health difficulties. It’s about putting in place suitable workplace adjustments to support people to stay in work. It might involve developing an individual Wellbeing Action Plan to achieve this. This is a shared document of needs, developed by a manager in partnership with the individual. It helps the manager understand an individual’s needs, how to identify when they’re having difficulties and what support to provide in such circumstances.

The targeted intervention tier may also include the provision of clinical support, such as Cognitive Behavioural Therapy (CBT), or stress management interventions.

The key takeaway here is that you need all three tiers, otherwise you risk a wobbly house. If you want a strong house, you need strong foundations.

Tracey: Why do you think the guidelines have come about now?

Julie: Interestingly, this is their second iteration. The first iteration came out in 2016. They’ve been revised to include much more focus on the line manager role. But there are other guidelines from NICE, which I also urge people to read, such as Workplace Health: Management Practices.

The Covid-19 pandemic has fast-forwarded issues that were already growing, such as reducing stigma around mental health. The social isolation caused by the pandemic and the various lockdowns represents one reason for that. Also, supporting people in new ways of working currently presents a challenge for many employers. Added to all this is the fact that public services are creaking under the volume of need. There were long waiting lists for Improving Access to Psychological Therapies (IAPT) pre-pandemic and now they’re really under pressure.

Another factor is that ‘work’ doesn’t form part of health conversations as a rule. In 2019, Public Health England spoke comprehensively about this. However, during the pandemic, we’ve started hearing employers talk about work and health in the same conversation, because they’ve had people off work with Covid-19 and then Long Covid.

In the world of Vocational Rehabilitation, we see work as part of the rehabilitation journey so it’s great that employers are now having these conversations.

They need to be aware that good work is good for health. And great organisations will be stepping up to that.