Last reviewed 2 November 2016
The profile of mental health issues has risen substantially in the past 18 months: from education to sport, there has been an increased focus on the prevalence of such problems and their impact. Steve Vale, HR Consultant, investigates what is on the horizon for mental health issues in the workplace.
Mental health in the workplace has been an issue whose prominence has waxed and waned over the years. There was a strong focus on workplace stress at the end of the 1990s, with issues around the employer duty of care under health and safety at work legislation, to those employees (such as social workers) who were most at risk. More recently there has been an increasing interest in, and focus on, health and wellbeing in the workplace.
It is not surprising, therefore, that in the current climate the issue of mental health in the workplace is again becoming prominent, with recent survey data on the prevalence of such problems, and a new report offering recommendations for action.
Highlighting the problems
The results of a survey from Capita Employee Benefits, published in October 2016, showed that more than a third of employees (36%) said that a colleague had complained about stress but had not received employer support. Only a third (33%) of the 3000 workers surveyed said they would feel comfortable talking to their employer if they had a mental health problem and more than half (56%) of workers surveyed said they would not feel comfortable talking to colleagues about taking time off work following mental ill health.
These findings were backed up by comments from the CIPD, which said: “Our key findings about stress in the workplace suggest workload and management style are some of the key causes of work related stress, but there are also non-work factors such as lifestyle, relationships and family issues. We don't lose ourselves walking through the door, and offering to support people with stress is not just about physically being in the office." It drew attention to the fact that, despite the rise in awareness and concern around stress and mental illness, many businesses are failing to support robust mental health at work — a survey from the Institute of Directors found that only 13% of businesses have created plans to support good mental health — despite 95% saying it was important for the performance of their business.
To mark World Mental Health Day on 10 October, the World Health Organization (WHO) issued a reminder to employers of their responsibility to support the wellbeing of employees with “invisible” disabilities, such as depression, anxiety, dyslexia and dyspraxia. The WHO also reminded employers of their duties under the Equality Act 2010, which protects employees with long-term health conditions against discrimination because of their disability. Mental health conditions and other invisible conditions can amount to disabilities provided they have an impact on normal daily life, eg depression can be a disability if it has lasted or is likely to last 12 months or more or if it is likely to recur. Dyslexia has similarly been held to amount to a disability. The Equality Act’s requires employers to make reasonable adjustments for people with disabilities.
Stress remains a major issue
In its 11th biennial survey of health and safety representatives, the TUC reported that stress was identified as a top-five workplace hazard by 70%, and is still the most common concern in all sizes of workplaces and in every region/country of the UK.
2016 saw a higher proportion of respondents cite it as one of their top five concerns than in any previous TUC safety representatives’ survey. Concern over stress remained higher in the public sector than the private sector, but it has become more widespread in both sectors. In particular concern about stress is especially prevalent — and rising — in central government (with 93% citing it as a top-five concern), education (89%) and health services (82%).
The results were as follows.
While stress is the most widespread concern in both public and private sectors, it is more frequently cited as a top-five concern in the public sector (78% of representatives citing it) than in the private sector (63%).
Overwork is another concern that is more widespread in the public sector, with 46% citing it in their top five hazards compared with 33% in the private sector.
The public sector uniformly has higher rates of concern than the private sector over “psycho-social hazards” — including stress but also bullying/harassment and violence and threats.
In local government, concern over stress, bullying/harassment and violence have all increased considerably compared with 2014 — the sharpest rise was in the proportion of representatives citing violence in their top five list of concerns — up from 26% in 2014 to 47% in 2016.
Stress is the most common concern in all sizes of workplace, with around three quarters citing it as the major concern in organisations with over 200 employees.
There was a remarkable uniformity in the main five concerns of representatives in each UK region/country, with stress the most widespread concern everywhere.
The Mental Health at Work Report 2016
The above report, produced by Business in the Community in October 2016, covers the 2016 National Employee Mental Wellbeing Survey findings.
The report is based on a survey (the main survey) of 3036 full and part-time employees in the UK representative of gender, age, industry sector, region and business size, excluding sole traders and those working alone, drawn from a YouGov panel of over 600,000 people. In addition, it highlights data drawn from a parallel public open survey of 16,246 responses and explores mental health and wellbeing in the workplace with a focus on the role of the line manager.
The headline findings from the survey are as follows.
Widespread poor mental health
A majority of employees have been affected by symptoms of poor mental health. 77% of employees covered by the main survey said they had experienced symptoms of poor mental health at some point in their lives, and 29% had been diagnosed with a mental health condition (mainly depression or anxiety). 62% of employees attributed their symptoms of poor mental health to work or said that work was a contributing factor.
More than 10% of those surveyed described their current state of mental health as poor or very poor.
There is a clear disconnect between employees’ experience in the workplace and what those running the organisation believe is taking place. 60% of board members and senior managers believed their organisation supports people with mental health issues. Despite this, only 11% of employees in the main survey reported that they had discussed a recent mental health problem with their line manager, and half of employees said they would not discuss mental health with their line manager.
Only 57% of line managers reported that senior management had been supportive or quite supportive when they made changes to support an employee; 63% felt that they are obliged to sometimes put corporate interests before the wellbeing of colleagues; and 29% said that they faced situations where they have to put the interests of the organisation above the wellbeing of their team members frequently, or even every day.
As a result, only just over half of employees believed their manager is genuinely concerned about their wellbeing and overall perceptions of how well organisations support those with mental health problems are not encouraging: only 11% of those surveyed thought that their organisation dealt with mental health issues very well.
Lack of line manager training
Line managers are being required to respond to something they know little about. Although 76% of line managers believed that employee wellbeing is their responsibility, only 22% had received some form of training on mental health at work. One third felt that they lacked the confidence to recognise the symptoms of a mental health issue.
The default responses to employees experiencing symptoms of poor mental health appear to be arranging time off or a job move, which do not necessarily align with what the employee wants or what good practice would dictate.
Culture of silence
A pervasive culture of silence remains entrenched across workplaces. Employees appear to be uncomfortable talking about mental health at work and more than a third (35%) of employees covered by the main survey had not approached anyone for support on the most recent occasion they experienced poor mental health. Only 25% of employees had approached someone at work for support (rising to 26% when including those who had contacted an Employee Assistance Programme).
Despite believing that colleagues care about each other’s wellbeing (77% felt that their colleagues were very or fairly considerate), 86% said that they would think twice before offering to help a colleague whose mental health they were concerned about. Only 14% felt that nothing would stop them from approaching someone if they were concerned.
The threat of employees facing disciplinary action when experiencing mental ill health is very real. Results showed that 9% of employees who experienced symptoms of poor mental health also experienced disciplinary action, up to and including dismissal.
There are big differences between women and men in relation to workplace mental health. Women were more likely than men to talk about mental health with their line manager. Male managers are less confident than female managers in responding to poor mental health, yet are less enthusiastic about mental health training. In the case of a staff member with depression, 68% of female managers said that they would feel confident responding, compared to 58% of male managers.
The experience of mental health at work greatly differs between generations. Younger workers (18–29 years old) were more likely to experience symptoms of poor mental health but felt less confident about discussing it with their manager. They were also less trusting in their employer’s commitment to mental health and wellbeing. Older employees talked more freely about mental health and were more likely to feel that their employer is concerned with mental health and wellbeing.
More detailed findings
More detailed findings from the main survey show the following.
The most common symptoms of poor mental health in which work was a factor were:
psychological symptoms (eg depression, anxiety, panic attacks): 42%
behavioural symptoms (eg changes to appetite, irritability, procrastination, mood swings): 39%
physical symptoms (eg raised blood pressure, muscle tension, sweating, dizziness, headaches or migraines): 36%.
Generally, the survey showed that employees and managers were happier to talk about issues such as age and physical health than about mental health issues, although the survey distinguished between “mental health issues” and “stress” and showed that there was a greater willingness to talk about stress.
By the same token, stress was the symptom which managers felt most confident in responding to (77%). It appeared that more complex conditions might be less likely to be spotted. Experiences such as panic attacks, depression and mood swings are less familiar to managers and up to two-fifths of them feel not very or not at all confident in responding.
More than half (56%) of employees said no action was taken when they last experienced symptoms of poor mental health; only 7% were offered help with their workload and just 4% of employees were allowed time to work from home. A total of 7% of employees who disclosed symptoms of poor mental health were referred to some form of counselling and 5% said they were told where to get help or advice.
Access to workplace services and facilities, including Employee Assistance Programmes (EAPs), which are designed to help employees deal with personal problems that might adversely impact their work performance, health and wellbeing, is still limited: 37% of employees reported not having access to such facilities or services.
Conclusions from the survey
The report summarises the main conclusions from the survey as follows.
Employers need to recognise the scale of poor mental health in work, and take significant steps to reduce the risk of their workplace being a contributor to poor mental health.
Employers have a duty of care to their employees to respond to mental ill health just as they would to a physical illness, such as cancer, diabetes or back pain.
Organisations should equip their managers with the tools, support and organisational culture they need to do their job well, which must include managing employees with mental health issues.
There is a disconnect between the stated aims of employers regarding workplace mental health and wellbeing and the experience of employees with symptoms of poor mental health.
Workplaces should be environments in which employees feel comfortable disclosing their current state of mental health. Employees need support at an early stage and line managers should agree and implement a personalised plan that works best for employees.
Better signposting to support mechanisms such as EAPs is vital.
It makes good business sense to foster a culture of openness that supports employees with a mental health issue to work and stay in work. Whilst progress is being made with greater organisational awareness of the need to support better mental health at work, significant and potentially damaging disconnects exist that demand an urgent response from business.
Recommendations on the way forward
The report recommends actions on a number of fronts and at all levels within organisations.
Make a public commitment to tackle the culture of silence that surrounds mental health, and seek to embed wellbeing into organisational culture.
Take simple, positive actions to build a culture that champions good mental health — in this context Business in the Community and Public Health England’s Mental Health Toolkit for Employers is recommended.
Send a clear message of parity of esteem between mental and physical health to normalise conversations around mental health.
Appoint a mental health champion on to their senior team, with a remit to drive better mental health and encourage all leaders to act as role models, actively challenging myths and stigma both proactively and reactively.
Ensure skills based learning is made available to leadership and management teams to develop awareness, confidence and capability in managing mental health.
Be provided with basic mental health literacy so they can spot the signs when they or a colleague may need help.
Know where to go for guidance and be equipped with the confidence to start a conversation about mental health with colleagues they are concerned about. (In this context, Business in the Community’s Listen Up: Let’s Talk Mental Health is recommended as a practical guide for all employees on how to start a conversation with someone they are concerned about and how to talk about their own mental health.)
To address the disconnect between the aims of employers and the experiences of their employees, organisations need to:
acknowledge that a gap may exist between their leadership’s perception of support for employee mental health, and reality of employees’ experience, and take action to identify the gaps, with a commitment to resolving them
gather employee feedback using a range of informal and formal mechanisms to understand where gaps exist, including annual surveys, focus groups, and various employee forums
identify and remove any specific organisational barriers that restrict line managers from effectively managing and supporting individuals experiencing a mental health issue
identify the issues in the workplace that may be impacting on employee mental wellbeing and use this knowledge to inform changes to approach, policy, and organisational design.
To support line managers and address their needs, organisations need to:
train as many line managers as possible in first aid training in mental health and invest in improving their mental health literacy
regularly communicate to line managers the support they can draw on when supporting colleagues, and encourage them to seek support as needed, when managing a colleague with mental health concerns, eg from HR or other specialists, or their own line managers
ensure managers are supported to manage their own wellbeing, via their own managers and appropriate resources and training
ensure line managers understand what steps they can, or need to, take in order to agree reasonable adjustments with someone who is experiencing mental health issues
introduce the concept of “everyday wellbeing” as a core part of all 1–2–1 and/or personal development conversations, to help to normalise conversations around mental wellbeing between staff and their managers.
To tackle the culture of silence around mental health, organisations should:
instil an understanding in every employee that everyone has a state of mental health as they do physical health, and use awareness campaigns regularly to communicate this message, such as Time to Talk Day, Mental Health Awareness Week and World Mental Health Day
appoint volunteer wellbeing champions to be ambassadors, who can lead by example, raise awareness and share information to promote positive messaging about mental health
work with change-makers, including key leaders, HR and other specialists, and wellbeing champions, to equip them with the confidence and knowledge to promote an open climate where discussion of mental health becomes normalised.
To provide clear support to employees, organisations need to
provide them with a clear wellbeing offering, starting at induction, and reinforced on a regular basis, including resources to support employee resilience and mental wellbeing
include employees in discussions to develop flexible, bespoke solutions to their mental health support needs, ie making reasonable adjustments and implementing Wellness Action Plans
ensure that reasonable adjustments are made whenever possible to enable people to remain in work and take a phased approach to employees returning to work after a period of ill health
ensure every employee has access to (and knows where to find) appropriate support to stay well and to help manage mental ill health, reinforcing this information regularly
clearly outline the role that HR, health and safety and any additional specialist support functions can play in supporting all employees, so that employees feel they have a safe space to discuss mental health.
Those reading The Mental Health at Work Report 2016 may feel daunted by the extent of the issues it highlights, and the range of recommended actions. There appears to be a need for managers to improve their effectiveness at constructive interventions, as well as seeking to improve understanding and good practice across the whole organisation. It also underlines the importance of seeking to build and develop resilience within the workforce, enabling employees to better manage and cope with the complexities and changing nature of their working and personal lives.
Remote Working: A Practical Safety Guide for Businesses (2019), Glide Group
Employee Insight Report, Capita Employee Benefits
Mental Health at Work Report 2016, Business in the Community