With mental health issues costing businesses an estimated £35bn each year, Nick Martindale looks at the need for a culture of understanding
For many years, employers have placed an emphasis on the importance of ensuring employees are physically healthy, driven largely by a need to reduce staff absence and increase productivity. But mental health has, until relatively recently, often been the poor relation.
The issue, though, has a huge impact on employees, and the businesses for which they work. According to Mind's 2017/18 Workplace Wellbeing Index, 66% of employees have experienced a mental health problem and 48% have done so in their current role. A 2018 study by the Health and Safety Executive suggests 15.4 million working days are lost due to work-related stress, depression or anxiety each year; an increase from 12.5 million working days the previous year. The Centre for Mental Health estimates the issue costs employers an estimated £35bn a year, equating to almost £1,300 for every employee.
There are signs that organisations are now starting to understand the scale of the problem; according to Punter Southall's Employee Wellbeing Research 2018 study, in partnership with the Reward & Employee Benefits Association (REBA), although just 16% of UK employers currently have a defined mental health strategy, 37% plan to introduce one in the next 12 months, and a further 26% intend to do so by 2020.
There are a number of ways in which employers can actively improve the mental health of their employees, and help those who do suffer from stress, depression or anxiety, but the fundamental requirement is to change the company culture so it is acceptable for people to talk about the topic. Getting buy-in from senior management is vital, says City Mental Health Alliance chief executive Poppy Jaman.
"Business leaders set the tone for how an organisation approaches mental health and wellbeing, so it's important that leaders have an understanding of it, and are skilled in talking about it," she says. "Sharing stories about mental health experiences - good and bad - can also create a culture of openness, thereby encouraging people in need to seek help without worrying about how it may affect their career progression."
In 2018, Bupa became the first company in the UK to provide mental health first aid training to its entire executive team, while at Deloitte over 500 partners and directors became mental health first aiders, she adds.
Line managers are key
Line managers are also an essential component in tackling the stigma around mental health. "Ensure line managers receive training to equip them with the skills and confidence to discuss mental health with their teams and provide support when required," advises Aon head of health management Charles Alberts. "Line managers are also key to creating working conditions that are conducive to positive mental health, ensuring workloads are manageable, their teams feel supported, and any changes taking place are clearly and openly communicated." But Aon's own Benefits and Trends Survey 2019 suggests only 41% of organisations currently train managers in this area.
Dr Sally Wilson is a senior research fellow at the Institute for Employment Studies. She highlights the practical role line managers can have in spotting the signs of mental distress. "If someone is showing the signs of being low or unproductive then it's the line manager who is most likely to notice that," she says. "You can't expect them to do everything but you can equip them with the soft skills to talk about this openly with their direct reports and understand how to refer things to occupational health or when to take things up with HR."
But often line managers do not know what to do when people confide in them, says Punter Southall Health & Protection chief commercial officer John Dean. "The line manager may either not know where to go or direct the employee to a counselling service, as this is the only service they are aware of," he says. "However, there may be other more relevant services available in the company that would offer more tailored support to help the employee get better quicker. They just don't know about them." Creating a ‘pathway to mental health document' that details all the support services available and how to access them is a simple way of overcoming this, he adds.
Yet there can be times when people are reluctant to approach line managers, and sometimes could even be a contributory factor in any work-related stress. Here, trained mental health champions can help bridge the gap between employer and employee, says Willis Towers Watson (WTW) wellbeing lead Mike Blake. "These should be trained in mental health first aid, which teaches people how to spot the signs and symptoms of mental ill-health and provide help on a first aid basis," he says.
"As well as acting as a confidante and directing employees to sources of support, such as internal counselling or EAPs, mental health champions can seek feedback from staff on how to improve mental health at work, advise organisations on specific areas of need or concern, and carry out activities and workshops that encourage healthy behaviours."
There are also a number of practical measures organisations can take to help individuals manage their own mental health.
"The most effective step an employer can take is to give employees tools and resources to be able to help themselves, while making sure there's a system in place to support them further if they need," says Thomsons Online Benefits consulting director Jack Curzon. "Workplace wellness programmes that incorporate mental health workshops and seminars to better help employees cope with issues like stress are a worthwhile starting point."
Setting time aside
Beam Consultancy clinical lead Keir Harding advocates setting aside a time in the week for people to think, and process any difficulties they may be facing. "If you haven't got that people don't talk about it and just cope in whatever way they find most useful," he warns. "That might be not doing some of the more difficult aspects of the work or even not turning up for work. A put-up-and-shut-up attitude might mean that things get done today but that will lead to resentment, burnout and a feeling that they cannot talk about the real issues in their organisation. Eventually people will just shut down."
There are already examples of organisations looking to create time dedicated to wellness. Three UK, for instance, has implemented Wellbeing Wednesdays, says West Berkshire Wellbeing project manager Catherine Greaves. "No meetings are booked between 12pm and 2pm on Wednesdays and, instead, employees are encouraged to use that time for activities that promote their wellbeing, such as exercising or reading a book to unwind." It also offers three paid days per year which staff can take off work to do something important to them, with many choosing to spend this time with family or volunteer for a good cause.
Other options include setting up lunchtime support groups, encouraging flexible working or signposting options for external help, says Simplyhealth director of corporate Pam Whelan. "Many organisations have developed their own campaigns, using employees willing to tell their story and pave the way for changing mindsets and challenging taboos," she says. "Just by increasing awareness and making mental health conversations ‘normal', companies can make major strides in reducing stigma and create a positive environment for staff to feel comfortable opening up about challenges they may be experiencing."
The right benefit mix
The right mix of benefits and support services is also vital if businesses are to confront the challenge of mental health. Employee assistance programmes (EAPs), which can be bought separately or accessed through other policies including cash plans, are an obvious means for employers to direct staff who need additional support to. "EAPs are the most common employee benefit according to the Aon Benefits and Trends Survey 2019, which is not surprising given the wide scope and the excellent value they deliver," says Aon's Alberts. "Most private medical insurance policies now offer direct access to a mental health clinical assessment and triage to the most appropriate treatment. Bypassing the GP enables faster access to the most appropriate treatment."
Group income protection policies also include access to EAPs, as well as other therapies and early intervention services, points out Legal & General Group Protection benefits and governance director Vanessa Sallows. "Early intervention services can give employees with mental ill-health much needed support, whether this is an immediate referral for psychological intervention, such as cognitive behavioural therapy, or advice on how the individual can help themselves by taking more exercise, maintaining a routine or having a healthy diet," she says.
It's also possible to provide workplace counselling to staff as a standalone service, says WTW's Blake. "Services can be delivered to employees face-to-face or by telephone and will usually be a short-term treatment, typically up to eight one-hour sessions focusing on a specific therapeutic approach such as cognitive behavioural therapy (CBT), cognitive analytic therapy or person-centred counselling," he says.
Management information can play a part too, by enabling employees to analyse data from staff surveys, health insurers or EAP usage to identify if there are any underlying issues within the business which would warrant particular treatment. "An employer reviewing their health plan usage may notice an increase in the use of physiotherapy, with corresponding spikes in calls to the GP service regarding stress headaches and the EAP service for workplace stress," says Simplyhealth's Whelan. "An astute HR manager may be able to match that back to a recent upgrade in office furniture which could prompt a re-evaluation of the furniture purchase, a comprehensive programme of work station assessments or simply the distribution of guidance on how to adjust chairs for optimum positioning."
However organisations decide to act on mental health, doing nothing is not likely to be a viable option for much longer. Blake points out that younger generations entering the workplace are more likely both to suffer from stress and mental health issues and be likely to report it.
"Keeping a fresh approach will help to keep these time-strapped generations' attention and keep them engaged," he says. "Consider the latest app developments in this area, such as behavioural therapy chatbots. Taking this future-proofing approach to mental wellbeing will benefit businesses, by creating a resilient workforce, who feel comfortable seeking help earlier, which will ultimately drive down incidents of presenteeism, absenteeism and staff turnover."
Good to talk: How Search Laboratory tackled mental health
Renae Shaw, head of HR at Leeds-based digital marketing agency Search Laboratory, made it her mission to get the topic of mental health on the firm's agenda just over two years ago.
"With any company initiative we need to make sure we have buy-in at the right level so I spoke with the board about the financial and the moral reasons for looking at this," she says. "I'm very lucky in that I have a board of directors that really got it, so that bit was very easy."
The next step was to set up a company wellbeing week, based around National Stress Awareness Day in November, and the business ran a number of free sessions where staff could discuss their physical and mental health with experts. "We had various other activities throughout the week to raise awareness, and we had the strapline of ‘Say Something'," she says. "We wanted people to know they could talk about any issues and that we would listen."
That first wellbeing week was followed by a number of other initiatives, including putting all the management team through mental health first aid training. "We also asked for volunteers from the staff to go through that training and had an overwhelming response," says Shaw. "So far 50% of our headcount have now had mental health first aid training."
The business, which employs 140 people in the UK and 15 in New York, has also focused on how to prevent staff becoming unwell in the first place. "We have a quarterly audit where managers look for anything that could contribute to people not being in a good place, for example if there's any significant change on the horizon," she adds. "We're also focusing on the measures that help us feel well such as having a sense of purpose, engagement and learning."
Search Laboratory also offers a number of other benefits designed to help people cope with stress and stay healthy, including mindfulness sessions, free gym membership and how-to health seminars, as well as offering free face-to-face private counselling through an employee assistance programme.
The response from employees to the greater emphasis on mental health has been extremely positive, says Shaw. "People are much more open now about saying why they have been off work," she says. "This isn't a new topic but they're more honest now and are asking for help sooner."
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