Mental health and work

3 November 2017

Lord Dennis Stevenson and Paul Farmer recently published an independent review of mental health and employers. Our Chief Executive, Paul Jenkins responds:

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The word landmark is overused but I think was appropriate for Paul Farmer and Dennis Stevenson’s report last week “Thriving at Work” on the steps which need to be taken.  It was a compelling call to action which highlighted the clear moral and economic case for improving mental health at work.  If implemented, it would not only address the immediate challenges implicit in 300,000 people with mental health problems leaving work each year it would also be symbolic of a fundamental shift in attitudes towards mental health in our society.

In the ten years or so I have worked in the field of mental health I have been aware of the importance work has in transforming perceptions of mental health.  It is already one of the areas where, in those ten years, significant change has taken place.  In 2007 you could count the organisations who took workplace mental health seriously on the figures of one hand.  There is now recognition of the issue, if not action, across the economy, but there is still a lot more to do.

My first exposure to mental health at work came before I joined the sector.  At a time of organisational change, two of my team with historic, but at the time undisclosed, mental health problems became unwell and had extended periods of absence from work.  As their line manager it was a tremendously unsettling experience and one which I had no training on how to deal with.  Luckily, with positive help from HR, both returned to work and have continued successfully with their careers.  It could have been different.

In line with many of the recommendations in the Farmer/Stevenson review there are, in my view, a number of critical issues which need to be grasped if we are to create genuinely mental health friendly workplaces and realise the personal and economic benefits associated with that.

The first relates to mindset.  By that I mean that organisations and their leaders genuinely value the contribution of employees who may have had or who may develop mental health problems.  It is a mindset that believes that, a history of mental health problems, does not devalue the skills and competences that those people bring to the job.  Indeed, that in some cases, the experience may add something additional in terms of commitment and insights.  As with physical health issues support and reasonable adjustments can be enacted which help people affected to continue to carry out their role.  

The second covers organisational commitment to develop a strategy to support workplace mental health, to invest in the identified interventions and to monitor performance.  As in other areas of change this agenda needs time round the board table if it is to be taken seriously and prioritised over other issues which can easily soak up management time.  An organisational strategy needs to be specific to the organisation and, while some generic interventions are appropriate, there needs to be analysis of the specifics of the organisational context.  The presentation of mental health stressors and the level of problems vary between organisations.  The four fold variation in the costs of mental health problems between different sectors was one of the fascinating facts from the Farmer/Stevenson report.

Above all strategies must mark long term commitment to this issue.  At its heart this is a question of a cultural change, and as any of us in senior positions of management are aware, cultures don’t change without perseverance and sustained commitment over a period of time.  There is a strong message here for the NHS, amongst others, whose work on staff wellbeing and resilience has tended to be piecemeal and inconsistent.

The third focuses on the crucial role of line managers in supporting staff who have or may develop mental health problems.  Their skills and competency in helping keep someone well or managing a situation when someone becomes unwell is often the biggest single factor in determining a successful outcome for an individual experiencing mental health problems. 

Line manager training in mental health crucial but this must go beyond Mental Health First Aid, excellent starting point though that is.  I would argue strongly that we need to build in a psychologically informed focus on wellbeing into a much range of management training, in particular in areas such as performance management and change management which are so often create potent stressors which can impact on the development of mental health problems.

Disclosure is an important factor in enabling line managers to carry out their role.  As I know from my own experience situations are so much harder to deal with when the first conversation about mental health is when someone becomes unwell.  Organisations can help, in both formal and informal ways, to encourage employees to disclose issues but it is also easy to understand, given years of stigma and discrimination, why people don’t.   Initiatives such as BT’s mental health passport which allow a standard format for individuals to document, in discussion with their line manager, the nature of their issues, early warning signs of developing problems and the best strategies for supporting them are a very helpful way of normalising the issue.

My final point is that an agenda mental health at work cannot sit in isolation from a wider debate about the quality of working experience.  While, on the whole, I accept the argument that work is good for one’s mental health, there are times when it is not.  A lack of work/life balance, constant and badly handled change, bullying and harassment, lack of value or appreciation of employee’s contributions, lack of autonomy in people’s roles are all casual factors for poor mental health.  As a Chief Executive I know all too well that it is impossible to shelter an organisation from all the pressures of the external environment but leaders can not absolve themselves of thinking of what the impact of that environment are on the people who work for our organisations.  The debate must be both about how we create resilience in the workplace but also how we create workplaces which require less resilience.

At an annual cost to our economy in terms of lost output of as much as £99 billion and thousands of ruined lives this is not an issue we can ignore.  

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