WorkLife

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Mental Health at Work – The Silent Sickness (Part 1)

In this article, Anna Gregory reviews some of the issues facing employers when dealing with mental health issues at work.

Many of you will be aware of the new Health and Work Service which the government intends to implement this year (Health and Work Service). Its main purpose is to ensure a faster and more effective return to work for employees on long-term sickness absence. Whilst we wait for further details on the delivery and implementation of this Service I thought that it might be helpful to look at one of the main causes of long-term sickness absence – poor mental health. This will be the first in a series of posts on this topic and provides a broad overview of the issues.

Poor mental health in the workplace is often misunderstood and mishandled by employers and employees; yet it comes at enormous cost to employers. There is a vast array of statistics which demonstrates this loss including:

  • One in four people in the UK will experience some kind of mental health problem in the course of a year and depression affects one in five adults in the UK (the Mental Health Foundation).
  • It is estimated that, per year, £8.4 billion is lost to sickness absence; £2.4 billion to staff turnover and £15.1 billion to reduced productivity (the Sainsbury Centre for Mental Health).  
  • The average employee in the UK takes seven days off sick each year of which 40 per cent are due to mental health problems. This adds up to 70 million lost working days a year, with one in seven directly caused by a person’s work or working conditions (the Sainsbury Centre for Mental Health).

A few adjustments and a better understanding of the nature and extent of mental health problems can significantly reduce sickness absence, increase staff engagement and productivity and reduce staff turnover, recruitment and costs. Dealing with employees with mental health problems throws up a number of legal issues for employers including:

  • The Health and Safety at Work Act (1974) requires employers to secure the physical and psychological health, safety and welfare of their employees while at work and the Management of Health and Safety at Work Regulations (1999) requires employers to carry out a suitable and sufficient assessment of significant health and safety risks and take measures to control them.
  • The Equality Act (2010) requires employers to make reasonable adjustments for people with disabilities; according to this Act a person is defined as disabled if they have a mental or physical impairment that has a substantial long term (i.e. more than 12 months) effect on their normal day to day activities. Therefore, someone with a mild form of depression may not be covered but someone with severe depression with substantial effects on their daily life is likely to be considered as disabled. A person is also protected under the Act if they have been affected in this way in the past but have been well for some time.
  • Long-term sickness absence may on its own in some (albeit fairly limited) circumstances bring a contract to an end through frustration and dismissal of an employee in these circumstances may not be unfair. However, as highlighted in the ACAS guidance (ManagingAttendance) employers should only dismiss an employee as a last resort when all alternatives have been exhausted (for example, reasonable adjustments, phased return to work, flexible hours and job design).

The following posts in this series will look at these areas in further detail. In the meantime, set out below are ten top tips on how employers can reduce stress and proactively manage poor mental health in the workplace:

  1. Measure the causes of work-related stress. The Health & Safety Executive has developed a comprehensive questionnaire for employees which enables employers to assess their current working conditions and reduce stress amongst their employees; the “Management Standards and Indicator Tool” can be accessed at Appendix 2 of the following document: Managing the causes of work related stress.  
  2. Review your policies. Some improvements to working conditions are both easy to implement and very effective at reducing work-related stress. Examples include extending additional paid or unpaid leave during a hospitalisation or other absence and allowing additional time for workers to reach performance milestones.
  3. Be flexible and provide support to employees. For example, take a flexible approach to employees’ start and finish times and to the arrangement of their annual leave. Providing support can include buddy or mentoring systems; supporting someone to prioritise their work or simply increasing the frequency and quality of supervision. 
  4. Early identification. Provide managers with training and skills to identify and respond to depression and anxiety. This is important as mental health conditions are complex and difficult to detect.
  5. Early intervention. Offer quick access to a holistic initial assessment and psychotherapy if required. Consider providing confidential counselling and other employee assistance programs. A study by Wang, P and others (2007, published in the Journal of the American Medical Association) showed that one off screening for stress and mental health symptoms followed by access to specialist telephone based advice by trained physicians reduced the productivity losses and employee turnover and resulted in a positive return on investment overall.
  6. Use Occupational Health Services. Currently Only 10% of SMEs use these.
  7. Make use of schemes such as the Access to Work Scheme (AWS). The AWS provides flexible grants to workers who have a disability, health or mental condition. Further details can be found here: Access to Work
  8. Communicate your policies and outline support that is available if needed. Mental health issues are often difficult to identify.  This may encourage employees to talk about their condition and ask for help.
  9. Educate employees about the effects of psychological risks on their health.
  10. Keep an eye out for the Health and Work Service. This Service intends to provide a work focused bio-psychosocial assessment to employees who have been off sick from around four weeks; it will also offer advice to employers, employees and GPs on issues preventing a sustained return to work and on how to prevent sickness absence occurring. As part of this Service the government also intends to introduce a tax exemption for employer expenditure on recommended medical treatment. Further details can be found at HMRC Tax Exemption

With thanks to Katie Rigg, Trainee at Farrer & Co, for contributing to this article.

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