A recent report by the Organisation for Economic Co-operation and Development (OECD) has concluded that the UK is one of the worst performing countries for supporting the mental health of its workforce. Vicky Powell looks at the problem of mental ill health in the workplace and what employers can do to tackle it.

Cost of mental ill health

It is estimated that one in six workers in the UK experiences mental health difficulties, with depression, stress and anxiety the most common.

According to the OECD report, entitled Mental Health and Work — UK, mental ill health costs the UK £70 billion each year, amounting to about 4.5% of GDP, in lost productivity at work and benefits payments. When compared with seven other OECD countries, ie Austria, Belgium, Denmark, The Netherlands, Norway, Sweden and Switzerland, the UK’s costs are the highest. This high cost, the report says, is a direct consequence of the high prevalence of mental illness in the UK population.

Link between mental ill health and workplace factors

The report argues that there are close links between mental ill health and workplace factors. For example, people with a mental disorder report having:

  • less autonomy in their work

  • higher job insecurity

  • poorer job promotion prospects.

They are also more likely to report that their job has become more demanding over the past few years. Workers with a mental disorder more often report:

  • being overwhelmed by time pressures at work

  • having many job interruptions and disturbances

  • facing constant time pressures due to high workload

  • experiencing undesirable changes in their jobs.

It might be argued that workers with poor mental health are less likely to find high quality jobs, or they might perceive their working conditions to be of poorer quality. However, the OECD report cites extensive academic literature which indicates that various work stressors, such as workload, job insecurity and job strain, can actually cause depression and anxiety disorders.

Effect of mental ill health on the workplace

The mental ill health of workers has a number of repercussions on the workplace, according to the report. In particular, poor mental health impacts significantly on absence and performance. Perhaps not unsurprisingly, research suggests that workers with a severe mental disorder take more sick leave than people without mental health problems, thus affecting productivity. In addition, productivity levels at work are strongly impacted — 7 out of 10 workers with a moderate mental disorder report productivity reductions.

In one survey, workers experiencing mental health difficulties reported:

  • problems in making decisions

  • a greater likelihood of conflict with colleagues

  • difficulties learning new tasks.

Financially, the costs associated with sickness absence because of mental health problems are estimated in the UK to be as high as £8.4 billion and almost twice as much for productivity losses.

Workplace policies to address psychosocial risks

The figures above offer a strong financial incentive for employers to put in place workplace policies to address psychosocial risks and, in turn, protect performance and productivity.

There is no legislation in place in the UK specifically relating to work-related stress. However, under the Health and Safety at Work, etc Act 1974, employers have a legal duty to secure the physical and psychological health, safety and welfare of their employees while at work.

In addition, under the Management of Health and Safety at Work Regulations 1999 employers in the UK are required to carry out a suitable and sufficient assessment of significant health and safety risks, including the risk of stress-related ill health arising from work activities, and to take measures to control that risk.

The main approach to work-related stress has relied on the Management Standards for work-related stress produced by the Health and Safety Executive (HSE). The Management Standards identify six key areas of work design which, if not properly managed, are associated with poor health and wellbeing, lower productivity and increased sickness absence.

The six key areas are the:

  • demands made on employees

  • level of control over their work

  • support available

  • nature of relationships

  • roles within the organisation

  • way organisational change is managed and communicated in the organisation.

On average the use of more specialised expertise such as psychologists (rather than general health and safety experts and occupational health service doctors) is rare in the UK: only 1 in 10 UK employers can draw on such expertise, compared with 5060% of all employers, for example, in Sweden, Finland and Denmark. The report says that this infrequent availability of occupational psychologists in the UK reflects a situation in which most occupational health services still tend to give attention mainly to more traditional physical rather than psychosocial risks, despite the very high prevalence of the latter.

The report notes that employers are not obliged to provide training for their managers on how to manage colleagues with mental health problems. However, it argues that providing managers with training and skills to identify and respond to depression and anxiety is critical as they are particularly frequent but complex and difficult conditions to detect.

Good practice in UK companies

The report highlights several case studies of good practice in managing mental ill health in the workplace among UK companies.

For example, British Telecom (BT) has developed a three-tiered mental health framework as follows.

  1. Level one focuses on promoting employee wellbeing and preventing mental distress, such as through tips on the intranet and management training around softer skills.

  2. Level two is an initiative to identify distress and intervene early to prevent it from escalating, through an online stress risk assessment for employees and companion training for line managers about how to respond to people’s results.

  3. Level three includes a range of support and treatments for people experiencing mental health problems. Employees are also encouraged to work with their line manager to identify early warning signs and establish a plan of action for if they become distressed.

A new development at BT has been the launch of a cognitive behavioural therapy (CBT) service for staff experiencing mild-to-moderate mental health problems that do not need to be diagnosed by a doctor. Line managers can refer employees to occupational health, who can then decide whether CBT would be appropriate and, if so, what type. This has been used by around 200 people and satisfaction rates have been very high. BT has reported that its mental wellbeing strategy has led to a reduction of 30% in mental health-related sickness absence, and a return to work rate of 75% for people absent for more than six months.

Other examples of good practice include that of the audit and finance company, Deloitte, which has nine mental health champions who can be approached confidentially by all employees, outside of line management structures, if they have a mental health problem.

Similarly, after a workplace audit showed that EDF Energy was losing around £1.4 million in productivity each year as a result of mental ill health among its employees, the company started to offer psychological support in the form of CBT to employees. It also trained over 2000 managers to recognise psychological ill health among staff and to minimise its effects. This resulted in an improvement in productivity which saved the organisation approximately £228,000 per year, while job satisfaction rose from 36% to 68% ― a clear confirmation of the value of tackling mental ill health in the workplace.

The OECD report is available at: www.oecd.org.

Last reviewed 17 June 2014