Mental health at work

1
Mental health at work

• Jonathan Allan
• Disability Services Manager, Enable, Shropshire
  Council

2
Dame Carol Black

• There is a compelling case for organisations of
  all sectors and sizes to move beyond the
  traditional health and safety agenda to embed
  health and well-being at their heart and to
  create an empowering and rewarding work
  environment for all employees.

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Mental health problems

• Depression
• Anxiety and phobias
• Stress
• Bi polar disorder
• Schizophrenia

4
Prevalence

• 1 in 6 of the employed workforce have mental
  health issues at any one time
• 1 in 5 if you include drug and alcohol problems

5
Sickness absence

• On average workers take 7 days a year in sickness
  absence
• 40 of this is for mental health issues
• This represents 70 million days a year
• Largest single reason is work related sickness
• The longer a person is off sick the higher chance
  there is of multiple problems eg back pain and
  depression and long term mental health problems
  ie accessing secondary mental health care

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Presenteeism

• People who stay in work but under - perform due
  to ill health
• Losses in efficiency
• Fatigue, impaired attention, concentration, poor
  memory, can be worsened by medication
• Women, those under 35 years, and those with lower
  status jobs are more liable to have mental ill
  health
• Not acknowledged because of stigma etc

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Stigma in the workplace

• There is some sympathy in many workplaces
• Training, promotion, transfer can be affected
• More likely to be dismissed / made redundant
• People with stress and mental health problems
  conceal difficulties

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Stigma two examples

• Shaun really wanted to apply for a job as a
  community warden. He said I really wanted the
  job, but I decided not to apply. I knew I
  wouldnt get it. Having a mental health problem
  is worse than having a criminal record when it
  comes to getting a job.
• Mandy applied to train as a nurse, but because
  she is treated for depression the hospitals OH
  health nurse had to write to her consultant
  psychiatrist for a medical reference. Mandy said
  This was taking a while and I was told by the
  nurse I know its a nuisance, but we have to do
  this since that business with Beverley Allitt. I
  felt as if because I have a mental illness Im
  put into the same category as a murderer.
  Obviously I didnt say anything as I wanted to be
  passed as fit and thought if I challenged her it
  would be seen as part of my illness.

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Employer perceptions

• 60 of line managers underestimate the percentage
  of the workforce that experience mental ill
  health
• 75 of line managers are aware that they have
  managed at least one person with mental ill
  health
• In a survey only half of senior managers thought
  that anyone in their workforce had mental health
  problems
• Many employers have no policy on handling mental
  ill health
• Few line managers have confidence in GP
  assessments with regard to stress

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Disability Discrimination Act (DDA) general
duties on employers

• Equality of opportunity
• Eliminate discrimination and harassment
• Promote positive attitudes to disabled people
• Take steps to take account of disabled persons
  disabilities
• Supportive working environment

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Health and Safety - the legal requirements

• Strategic monitoring at board level
  absenteeism, staff turnover,poor
  performance,staff conflict
• HR, H S, OH managers best practice, risk
  assessments, mental health information, mental
  health advice
• Line managers monitoring individual
  absenteeism, risk assessments, reasonable
  adjustments
• Employees information to employer re health or
  risks

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Costs for employing organisations

• Best overview of cost data is in Mental health
  at work developing the business case by the
  Sainsbury Centre for Mental Health
• Total cost for all employers is 8.4 billion p.a.
• Total costs of sickness absence, presenteeism and
  staff turnover (recruitment) has been calculated
  at 25b a year to the UK economy
• 50k pa for a small company (50 employees)
• Other costs legal costs, costs to reputation

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Costs to the public purse

• 2.6 million people on sickness benefits
• Moving to work from IB saves taxpayers (net)
  3000 (based on low wage of 11250 pa)
• Lowering sickness leads to fewer GP
  consultations and use of secondary mental health
  care - 130m pa savings

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Returning to work

• Diane, company secretary to a multi-national
  business in the city, was due to be the first
  woman to be appointed to the companys board of
  directors when she had her first admission to
  hospital with mental health problem.
• Diane saidWhen I walked back into the office
  after three months in hospital it went totally
  quiet. Nobody knew what to say. My job had been
  shared out amongst a few other people and they
  made me redundant soon afterwards.

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Returning to work

• Work has a positive effect on health - self
  esteem, self identity, activity and purpose,
  income, status.
• Not working has a negative effect on all those
  areas. The longer a person is off sick the more
  difficult it is to return to work
• They are also less likely to return to work
• This is especially true for those whose ill
  health is connected to work
• Job retention offers potential huge savings to
  employers in lowering sickness rates, recruitment
  costs, legal and HR costs (eg employment
  tribunals)

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Return to work

• UK lagging behind other countries
• UK 1 in 6 return to work after a major injury
• USA 1 in 3
• Scandinavia 1 in 2
• Research is mainly around back pain

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Key guidance

• Shift (DH) Line managers resource a practical
  guide to managing and supporting people with
  mental health problems in the workplace
• HSE guidance
• Steve Boorman Interim Report on health and well
  being in the NHS
• Dame Carol Black Working for a healthier
  tomorrow health, work and well being
• Mental Health and Work Royal College of
  Psychiatrists 2007
• Sainsbury Centre for mental Health - numerous
  papers on mental health and employment
  summarising the research evidence

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Promoting Well Being

• Make information about mental health and well
  being available to workforce
• Positive approach that encourages good practice
  in mental health
• eg Good recruitment practices
• Sickness absence - positive monitoring
• Occupational health mental health support,
  counselling referrals, health screening, positive
  about mental health culture
• Support in returning to work

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Hows Your Business Feeling?

• Interactive self assessment and training
  resource to help managers and organisations
  create a mentally health workplace
• Created in Staffordshire as a tool for employers
  can be downloaded
• 14 questions - 10 on workplace and environment,
  4 on recruitment
• www.howsyourbusinessfeeling.org.uk

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Enable Supported Employment Service, Shropshire
Council

• MH Employment service
• DWP Workstep service
• Job retention service (IAPT) with Rethink
• Advice and information of employers on mh in the
  workplace

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Job retention services

• Early intervention service
• Preventative
• Establishing a dialogue between employee and
  employer
• Works with managers, HR and OH Case managers to
  navigate the system and facilitate communication
  between individual, employers, GPs, clinicians
• Honest broker role win / win solutions for all
• Quick route to clinical interventions

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Returning to work

• James said his employers allowed him to make a
  gradual return to work, starting back after a few
  months recovery with a reduced workload.
• James said My colleagues deserve great credit
  for having supported my recovery. I was rather
  dreading their reaction after being off work
  following a serious episode of bipolar disorder.
  I even doubted whether it made sense to continue
  in a high-powered job. But once I explained
  things to them they could see I was still the
  same old James and that there was nothing to be
  afraid of. Economically their decision has paid
  dividends as I have been one of the highest
  earners in the years since returning to work.