This week is Mental Health Awareness Week which presents us with an opportune moment to remind ourselves of how employers can support employees who may have mental health issues and to generally ensure that the workplace supports a culture of openness.
This year’s theme for Mental Health Awareness Week is on “body image” which feels particularly pertinent, given that we are immersed in a culture where we are relentlessly faced with images of air-brushed, filtered, unattainable concepts of beauty, all of which is consumed and inevitably then has an impact on our mental wellbeing.
One of the illnesses that is borne of body image issues are eating disorders. These are a medical diagnosis based on your eating patterns, and tests on your weight, blood and BMI (body mass index). Common examples of eating disorders include anorexia – where a person tries to keep their weight as low as possible – and bulimia – where a person binge eats and then intentionally throws up. Whilst there is no specific cause, a person may be more vulnerable to a disorder if they experience trauma, difficulties at school or at home, or have certain traits such as being competitive or a perfectionist. Many people who have other physical or mental health problems, like depression, may also develop eating problems because they see it as a way of gaining control. For further information, see Mind’s resource on Understanding Eating Problems.
Statistics show that around 1.25 million people in the UK are suffering from an eating disorder. Often workplace stress exacerbates the problem. Of 600 people who were surveyed as part of Eating Disorders Awareness Week in 2016:
- 30% reported feeling stigmatised or discriminated against because of their eating disorder at work;
- more than 4 in 5 felt that their colleagues were not informed about eating disorders; and
- almost 2 in 5 described their employer’s impact on their recovery as ‘unhelpful’.
These figures clearly demonstrate employers can and should do more to alleviate body image issues in the workplace.
In support of this year’s Mental Health Awareness Week, we have set out below the issues that employers face around body image in the workplace and some tips on how to proactively manage these issues in the workplace.
Common issues that employers deal with concerning eating disorders are:
- 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 effect (i.e. more than 12 months) on their normal day to day activities. Whilst not all those with an eating disorder would be considered to have a disability, it is possible that someone with a severe eating disorder with substantial effects on their daily life is could be considered as having a disability. A person is also protected under the Equality Act 2010 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 (Managing Attendance and employee turnover) 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).
Some tips for employers on how to manage their employees’ eating disorders are:
- Educate managers. Managers should be given training and skills to identify and respond to eating disorders. As employees may also have other mental and physical health issues, there must sufficient education on these wider issues too, and how they can be interconnected. Training is essential as mental health conditions are complex and difficult to detect.
- Educate all employees. This will ensure that they can also express a concern and seek help for a colleague, rather than commenting on each other’s appearances or habits, making assumptions about their colleagues or excluding them. Learning about eating disorders is essential in de-stigmatising them and fostering a supportive environment.
- 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 (see the Management Standards and Indicator Tool).
- 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 employees to reach performance milestones.
- 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 so that they can attend appointments or attend to their health needs. Providing support can include buddy or mentoring systems; supporting someone to prioritise their work or simply increasing the frequency and quality of supervision.
- Early identification. Often the person suffering with an eating disorder will not tell a colleague about their illness. Managers should therefore be aware of any outward signs, such as changes in an employee’s weight and behaviour. This is important as it can ensure that an employee feels supported at work and may encourage sooner treatment. When talking to someone for the first time about a disorder, managers should be gentle and find safe ways of doing so, like referring to the eating problems in the third person.
- 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.
- Encourage employees to seek further treatment if necessary, such as talking to a doctor, going to therapy or being admitted to a specialist clinic.
- Use Occupational Health Services. Currently Only 10% of SMEs use these.
- 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 such as an eating disorder.
- Communicate your policies and outline support that is available if needed. Mental health issues, such as eating disorders, are often difficult to identify. This may encourage employees to talk about their condition and ask for help.
- Keep an eye out for the Health and Work Service. This service intends to provide a work focused biopsychosocial 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.
- Ensure that your workplace promotes and celebrates diversity and inclusiveness, for example in its recruitment and promotion processes and advertising campaigns by recognising non-Western beauty norms.
- If your business involves media, fashion, sport or food, be conscious of how those with body image issues may be impacted by the nature of the business and consider ways to promote a healthy body image.
- Ensure that your dress code is not discriminatory (see the ACAS guidance). For example, apply the code to both men and women equally (although they may have different requirements) and ensure that reasonable adjustments are made for disabled people or those practicing a religious faith.
This publication is a general summary of the law. It should not replace legal advice tailored to your specific circumstances.
© Farrer & Co LLP, May 2019