An inevitable long-term impact of the pandemic has been an increase in mental health issues. Analysis from University College London (UCL) and the Office for National Statistics (ONS) has found that levels of anxiety, depression and psychological distress remain high in the UK population compared to pre-2020 levels.
For many, work has been part of the problem, due to increased demands, heightened isolation and a skewed work-life balance. The ONS’s Labour Force Survey reveals that work-related stress, anxiety and depression has increased significantly since 2019, while Business in the Community (BITC), a responsible business organisation, and private healthcare provider Bupa found that 41 per cent of employees experienced work-related mental health issues last year.
It therefore feels like a pertinent time for employers to invest in their staff’s mental health. There is not only a moral case for doing so – well-being support has clear links with higher productivity, lower employee turnover and increased financial returns, while poor mental health costs UK employers up to £45bn per year. For every £1 spent on mental health provisions, employers get back £5 in reduced absence, presenteeism and staff turnover.
Policy around mental health at work
Anxiety and depression are the most prevalent mental health conditions linked to work, says Emma Mamo, head of workplace well-being at mental health charity Mind. The biggest risk factors are the same as the protective factors (those which safeguard our mental health), dependent on which way the scale tips: whether someone feels valued, their workload, their relationship with their line manager, the pace and intensity of work, and the physical workplace environment.
While some of these factors can be hard to control, efforts need to be “systematically” integrated into a workplace, and continuous rather than tokenistic, says Mamo – for example, committing to ongoing line manager training rather than simply signposting to World Mental Health Day.
The government’s Thriving at Work 2017 review laid out recommendations on how employers should do this, focusing on six areas for long-term improvement. These were to develop a mental health strategy; improve awareness among employees; encourage open conversations; provide good working conditions; train people managers; and routinely monitor employee mental health.
In its response, the government did not go so far as to legislate the requirements but did “encourage” all businesses to take this approach. As one of the largest employers in the UK, the Civil Service also signed up to it. “Those are the broad areas of focus that any employer should be looking to realise,” says Mamo. “Employers can’t solve this overnight, nor should they try. They should have an ongoing dialogue with their staff, and monitor and respond to changes.”
The review’s recommendations were translated into a public-facing resource called the Mental Health at Work Commitment, which sits on Mind’s Mental Health at Work website. It features toolkits on instilling better mental health practices and encourages employers to “sign up” to the commitment, with more than 1,000 UK public and private sector organisations having done so.
The fact that workplace mental health provision is not backed by legislation makes it trickier to enforce but Mamo says that employers should be framing their approach inclusively, rather than legally. Mind has also lobbied government to clarify the definition of disability under the Equality Act 2010 to offer more workplace protections for those with mental health issues, but again, meeting these criteria should not be the defining factor for receiving support.
“Some people experiencing poor mental health may never meet the [Equality Act’s] definition,” she says. “It exists on a spectrum with people struggling at certain times. Employers shouldn’t offer reasonable adjustments because they must – they should offer it regardless. It’s not about legal compliance – it’s about being a supportive, progressive employer.”
How employers are investing in mental health
Unilever frames its mental health strategy around four areas: culture, leadership, prevention and support. This approach allows the multinational company to address mental health in a “logical order”, says Tim Munden, chief learning officer and global well-being lead at Unilever, and also preventatively rather than reactively. “There’s no point trying to encourage people to be open with their line manager if their line manager is not equipped to respond,” he says.
Culture and leadership include measures that help to create a better environment, such as signposting to resources internally, line manager training, and encouraging leaders to speak openly about their own mental health. Prevention and support include more proactive elements such as access to trained mindfulness coaches and mental health first-aiders, an employee assistance programme (EAP) offering free counselling, and external counselling covered by the Bupa employee health insurance scheme.
The company also monitors well-being via a bespoke tool called Team Energy Assessment, where staff submit their opinions on their team culture. Anonymised reports are created for line managers and the data correlated with employee surveys to give a clearer picture of people’s support needs and company culture.
Observation is a crucial part of care, says Mamo, whereas previously employers have viewed mental health as a problem to tackle. “Historically, employers have seen mental health as reactive, around sickness absence and supporting people once they are unwell,” she says. “This has now turned into ‘how do we keep our people well?’”
This requires company policy to be constantly updated, to ensure it accommodates changing mood and demographics. As an example, Unilever created bespoke toolkits to help those suffering from grief and post-traumatic stress disorder during the pandemic and decided to train more people under 30 as mental health champions after research showed that younger employees were experiencing high rates of stress and anxiety. “Big Four” accounting firm EY also updated its UK staff policy in response to Covid-19, by doubling paid special leave for anyone needing time off in an emergency, and extending full discretionary sick pay to all employees, regardless of length of service.
Similarly to Unilever, EY aims to create an open culture by giving employees a safe space to discuss issues through its staff-led mental health network, which acts as a “powerful forum to share experiences, insights and resources”, says Justine Campbell, managing partner for talent. It also offers EY Thrive, a digital platform with monthly webinars and information on mental health, a “fast-track” pathway to mental health services without the need for GP referral, and cognitive behavioural therapy (CBT) through its EAP.
What about small businesses?
Smaller and medium-sized enterprises (SMEs) have less money and time at their disposal so they should start with free tools, says Munden, such as Mind’s Mental Health at Work website, which has thousands of resources donated by businesses, charities and government. Additionally, they can focus on improving culture by championing openness.
“Encouraging leaders to speak about their own experiences – I’ve spoken about my own post-traumatic stress – helps create a sense of normality,” he says. “Using your own resources is a great place to start.”
Mamo adds that provision should be proportionate. “A small company’s mental health strategy might just be a two-page statement of intent, whereas a multinational will have budget for occupational health, an HR team and an EAP,” she says. “The important thing is that you have a clear approach that you articulate to your staff.” Additionally, SMEs can look to larger employers for advice in this area – Mind regularly connects corporate businesses with Deloitte, for example.
The business case for workplace well-being
Aside from increasing staff happiness, there is a strong business case for investing in mental health. Unilever has found clear links between better well-being and higher productivity. Many of their measures, such as leader talks, have helped to improve workplace “psychological safety” – the belief that you won’t be punished or humiliated for sharing ideas or concerns.
“That’s proven to be very powerful,” says Munden. “We’re noticing more and more that leaders who are vulnerable and willing to speak about their own struggles create greater followership and more psychological safety. They also role model [an] openness that helps people speak about their own mental health.” This is, in turn, linked with achievement – for instance, Unilever’s research has found that regular feedback from a line manager is linked to both higher psychological safety and work performance.
Investing in well-being also leads to greater motivation and company loyalty, adds Mamo, helping to reduce staff turnover. “When you recruit someone, you invest in building their knowledge and expertise,” she says. “If a workplace isn’t supportive, they leave, the company recruits someone else, they go through the same experience – it’s a revolving door.”
Integrated mental health support is increasingly becoming an employee expectation, so to attract the best talent, attitudes need to shift, Munden adds – Deloitte found that over a quarter of UK “millennials” took time off work due to stress and anxiety caused by the pandemic. “Generations coming into the workforce will not want to work in places that don’t create human environments,” he says.
Ultimately, investment in mental health means treating people as individuals rather than disposable resources; it creates empathy and encourages workplace inclusion more generally. “Yes, we care about mental health for performance and to attract talent,” says Munden, “but also because it’s the right thing to do. The simplest thing employers can do is treat people with respect and dignity.”
Image courtesy of Shutterstock / Deliris.
This article first appeared in our print supplement Healthcare: An uncertain future for the NHS, published on 22 October 2021.