Last reviewed 13 May 2016

Mental health and wellbeing is a major issue for British businesses. Julie Prezat of System Concepts advises on how to support those with mental health conditions to stay in work.

The latest estimates from the Labour Force Survey show that 9.9 million working days were lost to work-related stress, anxiety and depression in 2014/15. On average, nearly a month (23 days) were lost in each case. In the same period, according to the Health and Safety Executive (HSE), stress accounted for 35% of all work-related ill health cases, and 43% of all working days lost due to ill health.

The Labour Force Survey shows that stress is more prevalent in public service industries, such as education, health and social care, and public administration. The main work factors causing work-related stress are workload pressures such as tight deadlines, too much responsibility and a lack of managerial support. The survey also shows that females were more likely to experience work-related stress than males.

The most common mental health conditions in Britain are depression and anxiety, with the Mental Health Foundation pointing out that 9% of people meet the criteria for diagnosis. Other recognised disorders include phobias, panic attacks and obsessive-compulsive disorder (OCD). There are also more severe disorders such as schizophrenia and bipolar disorder.

However, despite the high sickness absence rates in Britain, mental health conditions do not need to stop people from working. The right support and the right job can enable people experiencing mental health conditions to stay in work.

Overcoming stigma

According to the mental health anti-stigma campaign Time to Change, 9 out of 10 people with mental health conditions experience stigma and discrimination. Discrimination often comes from fear, ignorance or hostility. Time to Change suggests that people with mental health conditions have the highest “want to work” rate of any disability group but the lowest in work rate. They state that one-third report having been dismissed or forced to resign from their job, and 70% have been put off applying for jobs, fearing unfair treatment.

The National Attitudes to Mental Illness survey conducted annually on behalf of Time to Change by market research organisation TNS, suggests that 48% of people feel uncomfortable talking to their employer about their mental health problems. However, the same survey indicates that people are becoming more tolerant and understanding of people with mental health issues and that since 2009, people are less likely to discriminate against people with mental health conditions.

Certain mental health conditions may be considered as a disability under the terms of the Equality Act 2010. This protects employees from discrimination and requires organisations to make reasonable adjustments to ensure people are not treated unfairly because of their disability.

However, tackling mental health at work should not just be about compliance. Organisations that take a proactive approach to managing mental health can see a number of benefits. A healthy, engaged and resilient workforce is likely to be more productive, perform to a higher standard and be more efficient. The organisation can also benefit from enhanced employee recruitment and retention, and profitability.

Making reasonable adjustments to enable an employee to do their job is likely to be less expensive than the cost of recruiting and developing a new employee. And positive mental wellbeing arrangements can also benefit local communities and more broadly, the country as a whole with less people requiring support from the state and avoiding progression to “worklessness”.

Fair recruitment processes

It is generally unlawful for an employer to ask any job applicant about their health or disability until the applicant has been offered a job. This is to ensure that disabled applicants are not rejected before interview. It gives the applicant the opportunity to have their suitability, skills and experience for the work to be considered by the employer.

There are only certain circumstances where an employer can ask health-related questions before they make a job offer. These may be in order to:

  • establish whether the applicant can take part in an assessment to determine their suitability for the job

  • determine whether reasonable adjustments are required to enable a disabled applicant to participate in an assessment during the recruitment process

  • find out whether an applicant will be able to perform a function that is intrinsic to the job

  • monitor diversity among job applicants

  • support “positive action” in employment for disabled people

  • determine if there is a specific requirement for the person performing the role to be disabled.

It is only when an offer of employment is made that an employer can ask questions relating to health or disability. For example, the employer may ask whether the applicant would need reasonable adjustments to enable them to do the job. Employers must avoid rejecting an applicant solely because the person has a disability. For example, if an employer shortlists two candidates, one of whom has a mental health condition, it is unlawful for the employer to rule out that candidate on the grounds of their disability.

Early warning signs

There are a number of early warning signs that can indicate whether an employee is experiencing a mental health condition. Encouraging open communication in the workplace is an effective way of encouraging employees to be open about their problems. However, observing changes in people’s behaviours can also indicate a problem. Early warning signs can include:

  • increases in unexplained absences or sick leave

  • poor performance

  • poor timekeeping

  • withdrawal from social interaction

  • poor judgment/indecision

  • constant tiredness or low energy

  • unusual displays of emotion, such as frequent irritability.

Making reasonable adjustments

Employers have a duty to make reasonable adjustments at every stage of employment, including recruitment, induction, training and return to work. In many cases, simple and cost-effective adjustments can make a big difference. Adjustments such as a simple change in practice or a reduction in workload can enable an employee with a mental health condition to stay in work and be productive. Other adjustments can include changes to the working environment, support with workload and support from colleagues.

The employee with the mental health condition should be central to discussions on reasonable adjustments. This enables the employer to understand and meet their specific needs. Advice and guidance from other professionals, such as the employee’s GP, health and safety and occupational health professionals, or HR, ensures that different options are considered.

Return to work

Effective absence management and a structured return to work can enable people with mental health conditions to return to work quickly. Employers should agree what contact they will have with the employee while they are absent from work. The employer should also consult the fit note issued by the employee’s GP to understand the effects that the mental health condition may have on the employee and what adjustments may be required.

The return to work should be structured and reasonable adjustments made. For example, a phased return to work with reduced hours may be necessary for a period of time. Employers should also consider the possible side effects of any medication that the employee is taking and how this may affect them and others at work. A tailored adjustment agreement may be helpful to document reasonable adjustments and provide a reference point for future discussions.

Mind, the mental health charity suggests that one in four people in the UK will experience a mental health problem each year. It is crucial that employers play a part in supporting job retention and return to work for people experiencing such conditions.

Managing mental health at work properly means equipping organisations with the tools to “do the right thing”. Responsible employers will be able to support current and potential employees throughout recruitment, employment, sickness absence and return to work.