Mental Health in the Workplace

PUBLICATION

Mental Health in the Workplace

Insights for what’s ahead

Mental health is a growing human capital issue, generated by rising social awareness and the desire by companies to further diversity and inclusivity through their well-being programs. Worldwide statistics suggest anywhere between one-quarter and one-third of people will experience mental ill health requiring medical intervention at some point in their lives.
The COVID-19 pandemic has caused a profound and likely lasting shift in awareness of the need for employers to address mental health issues in their workforces. The rapid move to remote working has also highlighted the close connection between mental health, quality of leadership, and the design of work, especially in a digital context that can foster an “always on” culture leading to overwork and burnout. Businesses that recognize the need to address mental health issues in a holistic context can lead the way—but they also have to accept that nurturing more healthy work and workplaces will likely require significant change and investment in work design and working processes.
Although mental health is integrated into corporate well-being strategies, the complexities and special needs related to responding effectively to mental ill health in the workplace make it likely that companies will launch dedicated mental health strategies led by specialist managers. This separation from well-being programs may also enable more accurate measurement of the impact and ROI of mental health initiatives.
While workplace stress and burnout was the main focus for corporate interventions in the past, the prevalence of episodic mental ill health in the workforce covering anxiety, depression, mood swing disorders, and even psychosis will require more complex and sensitively applied strategies. The need for early disclosure and intervention will require company-wide culture change brought about by greater mental health awareness, supported and led by senior corporate leaders.
The role of line managers and supervisors in spotting the early signs of mental distress in the employees under their care will become a critical part of a company’s ability to respond effectively, requiring specialist training to build the skills and confidence to engage in conversations about workers’ concerns and needs.

Introduction

The ability and willingness of the organization to respond sensitively and effectively to the well-being and mental health of their employees has become an integral part of their brand and culture, impacting on their reputation for social responsibility and their ability to attract and retain the right talent. Measurable increases in well-being will also lead to higher performance and effective employee relations, contributing to a cohesive and productive corporate culture as well as significant cost savings caused by alleviating the expense of long-term mental health problems through early and sensitive intervention.

The return on investment for mental health programs is considerable. Unilever, for example, has calculated a return of €10 for every €1 spent on well-being initiatives. The company calculated the ROI of its well-being spend through a scorecard for senior leader engagement and a return-on-investment measure.(1) A study of Canadian businesses(2) found that the median yearly ROI on mental health programs was CA$1.62 among the seven companies that provided at least three years’ worth of data. Companies whose programs had been in place for three or more years had a median yearly ROI of CA$2.18. Programs are therefore more likely to deliver great returns as they mature.

Conversely, ignoring poor mental health poses considerable risk for organizations. A consensus paper published in 2020, Mental Health in the Workplace in Europe, highlighted data that calculate that each case of stress-related ill health leads to an average of 30.9 working days lost and that roughly a fifth of all sick leave is due to long-term mental illness. In addition, the report quoted research that suggests:

A reduction in physical and psychological health through the experience of stress can cause suboptimal performance that may lead to accidents and to other quality problems and reduced productivity, thereby augmenting operational risks;
Even minor levels of depression lead to associated productivity losses;
Where there is a loss of highly skilled workers due to poor mental health, additional recruitment and training costs may be incurred by the employer;
Sickness absence may also lead to an increased workload and potential risk for work-related stress in remaining team members;
In addition to absenteeism, businesses have to contend with presenteeism—poor performance due to being unwell while at work;
While the cost of presenteeism is difficult to measure, some studies suggest that its impact may be as much as five times greater than the cost of absenteeism alone.

With these findings in mind, this report will examine why mental health has become such an important business issue, highlight the good practice pioneered by companies tackling the challenge, and point to sources of information, advice, and support.

Why is mental health becoming such an important human capital issue?

The prevalence of mental health problems in societies around the world has always made mental health a critical social and workplace issue, and this is still the case today.

Estimates by the European Network for Workplace Health Promotion(4) suggest that a quarter of European citizens will experience a mental health problem in their lifetime, and approximately 10 percent of long-term health problems can be linked to mental and emotional disorders. Similarly, results from the 6th European Working Condition Survey found that 1 in 4 European workers reported that work has a negative impact on their mental (and physical) health.(5)

However, in addition to these long-standing statistics, a variety of factors have combined to make it a strategic human capital priority in recent years. Firstly, evidence exists that suggests millennials are experiencing greater mental health problems than previous generations. A study of over 41,641 college students in the US, Canada, and the UK published last year in the journal Psychological Bulletin by researchers from Bath and York St John Universities in Britain, for example, found that they feel overburdened with a perfectionist streak unknown to their parents or grandparents. Striving to reach impossible standards, they are experiencing anxiety, depression, an eating disorder, and even thoughts of suicide.(6)

Secondly, in an age where well-being has become a key commercial goal, workers increasingly expect their organizations to provide appropriate support. It has become part of the growing expectation of a sustainable and socially responsible business.

Unilever discovered this when rolling out the benefits of its well-being program. “Employee engagement is through the roof,” Chief HR Officer Leena Nair said recently. “Pride in Unilever is in the high 90s. Every measure has increased significantly because people think we’ve really taken care of their well-being in this COVID crisis…People really see Unilever is putting their well-being first and that has a huge role to play in how engaged they are and how willing they are to go the extra mile.”(7)

The reference to COVID-19 is pertinent. By far the most recent and pressing reason why well-being and mental health has shot to the top of the corporate agenda has been the impact and legacy of the crisis created by the virus. The grief, anxiety, and stress accompanying the onset of the virus, coupled with the psychological challenges of working from home in often unsuitable domestic circumstances, has catapulted mental health to a new high of corporate concern.(8)

Leena Nair at Unilever also found that 35 percent of employees surveyed by the company recently said COVID-19 had affected their health, well-being, and the way they think about life. “COVID should convince us, if nothing else, of the importance of staff well-being,” she concludes.(9)

How are companies responding?

Companies at the cutting edge of this issue, mainly from North America, Australasia, and the UK, have developed a variety of interventions to support an effective mental health policy.

These include:

Equitable recruitment and promotion policies in line with antidiscrimination legislation;
Mental health awareness education, supported by the use of mental “first aiders,” trained to engage in confidential and sensitive conversations about workers’ concerns and needs
Training for line managers and supervisors in how to spot the early signs of mental distress among employees in their care and how to respond appropriately;
Policies and procedures for how line managers and supervisors can work effectively with specialist HR personnel and/or occupational health experts;
The use of “reasonable adjustments” to working conditions that will help employees adjust to the challenges imposed by poor mental health, particularly when recovering from episodic mental health attacks, including temporary or permanent use of flexible working hours and reduced performance targets, access to private working space, and regular work breaks.

The greatest challenge faced by companies seeking to implement these policies is to create a culture where employees feel safe enough to disclose their conditions at a point early enough for these interventions to prove effective. Like any culture change initiative, this requires the active participation of senior management and appropriate measures and milestones of success, coupled with a strict and sensitive assurance of confidentiality.

These policies also need to be assimilated into existing talent management strategies to ensure that the company does not inadvertently write off or discriminate between the quarter and third of managers earmarked for fast-track development who may develop symptoms of a temporary or long-term mental health condition. Existing policies designed to cope with workplace stress and burnout may also need to be upgraded and expanded.

Mental health policies in practice

Centrica

“We are all unique and diverse in our own distinct ways and, at Centrica, this is exactly why we’re committed to placing diversity and well-being at the top of our agenda. Everyone has physical health all the time and mental health is no difference—it doesn’t come or go—it’s with us all the time. Holistic well-being remains at the heart of our messaging, a key part of which includes raising awareness and normalizing mental health in the workplace.”

With this message to the Centrica workforce, the company’s Director of Global Health and Well-being, Claire Rowan, launched a series of initiatives to place good mental health at the top of the company’s well-being agenda.

Centrica is a British multinational energy and services company, based in Berkshire in the United Kingdom. Its principal activity is the supply of electricity to consumers in the UK and Ireland. It also provides energy services to businesses worldwide.

At the time of the announcement above, in early 2018, the company was in the early phases of launching its Mental Health First Aid (MHFA) Network, with the aim of having 200 mental health first aiders (MHFAs) in place by the end of the year, trained and ready to support their colleagues in confidential conversations about mental health. By the end of 2018, the company had surpassed that aim with around 300 MHFAs in place globally.

Claire Rowan comments: “I truly believe there is no one-size-fits-all solution and we have seen an increase in requests for MHFA training and mental health awareness training. As such, we have developed several resources to make sure employees know what support is available to them. These include e-learning modules for employees and managers; a one-page document outlining all the existing support available; and a very simple sticker displaying contact details for 24/7 mental health support.”

In addition, mental health awareness training for line managers is being delivered to give them the opportunity to build their confidence in having mental health-related conversations in the workplace. As Rowan continues: “We shouldn’t, and can’t, underestimate the importance of managers feeling confident and able to talk openly about mental health with their teams, especially as we encourage individuals to take responsibility for their own well-being.”

All these initiatives are supported by a host of global activities and news articles centered around Mental Health Awareness Week and designed to support continuing conversations around mental health. “Of all things in the well-being space, this is one of the key areas that appears to resonate among our population at all levels and we will persist in pushing on the door that most definitely remains open,” Rowan concludes.

This foundation of well-grounded mental health policies served the company well during the 2020-21 COVID-19 crisis. A senior team leader described in the middle of 2020 how Centrica is using its digital capability to reach out to employees working from home:

“My team used Yammer (an online app) to create a thriving online community of more than 5,000 daily users to support people while they work from home. I am impressed by the initiative and creativity of everyone who has worked with speed to support our people when they’ve needed it most.

“The team has been spreading the word about how to use our digital tools in ways we’ve not done before—virtual coffee break, book clubs, online beers, and even team yoga. The use of digital technology will keep people connected and supported during these very worrying times.”

In another online post, Chief Technology Officer Luke Robertson described how the company is using digital technology to promote psychological safety among the workforce.

“As a technology team, we wanted to support the campaign for workplace culture change by Mental Health First Aid England, known as My Whole Self. The results are clear: people are empowered to bring their whole self to work, experience improved well-being and, as a result, drive better outcomes. It’s a very challenging time across the world right now, but it is vital that we stay connected, build trust within our teams, and for everyone to feel comfortable to be themselves.”

Finally, and most importantly, Centrica has realized that, to truly embed the culture of openness about mental health, the initiative must be led from the top. In October 2020, the company’s CEO, Chris O’ Shea, posted a very moving article about his feelings when his brother Carl took his own life 15 years before. The post was titled “Talking about mental health—a reality for everyone, everywhere.”(10)

NatWest Group

This extract from NatWest’s 2019 Annual Report shows how seriously this UK Banking Group takes its policy of Well-being and Mental Health. It has a dedicated well-being team and a well-being implementation committee, which meets on a monthly basis.

“One of our core priorities is building a healthy culture. We have clear goals to reinforce our cultural priorities each year, which form part of our leadership team’s objectives. We gather feedback from our listening strategy, which includes a biannual colleague opinion survey, a Colleague Advisory Panel that connects colleagues directly with our Board, and ‘Workplace,’ our social media platform.

“We also track metrics and key performance indicators and feedback from regulators and industry bodies, including the Banking Standards Board’s (BSB) annual assessment of culture in the UK banking sector, where we have continued to make good progress, with improvement in all nine BSB categories. Having ongoing discussions and engagement with a number of employee representatives, such as trade unions and work councils, is vital, and we regularly discuss developments and updates on the progress of strategic plans.”

NatWest Group has set in place a series of interventions to promote better mental health in the company, including many initiatives highlighted in the list above.

Early in the Policy’s development, the Group introduced mental health awareness training for managers. “We have done this for some time, and it is proving hugely valuable,” says Fiona McAslan, NatWest Group’s Well-being Lead for Colleague Experience and HR Transformation. “Because people had not been talking about mental health historically, it has given them a safe environment to understand what we mean about mental health and ask questions they haven’t had the opportunity to pose before.”

More recently, the Group has supported this measure by introducing a team of well-being champions. “Emerging research in this area suggests that Mental Health First Aiders on their own are not making enough of a difference in organization, compared with broader champions,” McAslan explains. “With this in mind, we introduced our Well-being Champion Programme in 2020 and we now have around 1,200 champions globally, actively engaged across all jurisdictions and business areas. We are planning to put them all through MHFA training this year, along with other champion curriculum topics.”

To further support managers in responding effectively to the mental health needs of employees in their care, the Group has also launched a virtual training module. Ninety-two percent of the Group’s line managers, 9,597 people, had completed this training by February 2021.

Where can organizations get information and support?

Companies wishing to seek out sources of information, advice, and support can turn to a rich variety of organizations. These include:

International and national mental health associations: These bodies act as a focal point for multidisciplinary professionals, original research, local action groups, and general information related to mental health issues. Examples include the World Federation for Mental Health, an international multidisciplinary advocacy and education organization, founded in 1948 in collaboration with the UN and based in New York and Geneva; and Mental Health Europe, the largest independent network representing mental health service users, professionals, and service providers, with 73 member organizations in 30 different countries. In the UK, the National Association for Mental Health (MIND) in London and the Scottish Association for Mental Health in Glasgow both provide information and advice for employers.
National HR professional institutes: With mental health becoming a key HR issue, most national HR professional institutes publish research and/or guidance for employers. The European Association for People Management has details of member organizations throughout the continent.
Trade unions: For similar reasons, trade unions issue guidelines for their local representatives outlining the latest research and information about workplace mental health issues, as well as how to negotiate reasonable adaptations to workplace conditions to help members adapt to the constraints of mental ill health. Many of these guidelines are published online. Two good examples are the guidelines issues by the British trade unions GMB and UCU.
Local charities and self-help groups. These are useful sources of expertise based on members’ lived experience of mental illness. Many collaborate with employers in their locality to help design and/or staff mental health awareness programs for employees, supervisors, and line managers.
The Conference Board. In the past year, the Human Capital website at The Conference Board has posted regular blogs and op-eds on mental health issues as well as details of webcasts featuring mental health experts and representatives from pioneering member companies (see Related Resources).

References:

(1) Mental Health and Well-Being in the Workplace: What Works and Why it Makes Business Sense, Amanda Popiela, The Conference Board, May 2017.

(2) The ROI in Workplace Mental Health Programs: Good for People, Good for Business - a blueprint for workplace mental health programs, Deloitte Insights, 2019.

(3) Mental Health in the Workplace in Europe accessed at https://ec.europa.eu/health/sites/health/files/mental_health/docs/compass_2017workplace_en.pdf

(4) European Network for Workplace Health Promotion, https://www.enwhp.org

(5) 6^th European Working Condition Survey, accessed 03 March 2021: https://op.europa.eu/en/publication-detail/-/publication/b4f8d4a5-b540-11e7-837e-01aa75ed71a1/language-en

(6) Thomas Curran and Andrew Hill, “Perfectionism Is Increasing Over Time: A Meta-Analysis of Birth Cohort Differences from 1989 to 2016,” Psychological Bulletin 145, no. 4 (2019): 410–429. https://www.apa.org/pubs/journals/releases/bul-bul0000138.pdf

(7) Ashleigh Webber, “Why, for Unilever, Well-Being has to Start with Local Culture Change,” Occupational Health and Well-being, Personnel Today, December 4, 2020.

(8) Royal Society for Public Health, accessed 03 March 2021. https://www.rsph.org.uk/about-us/news/survey-reveals-the-mental-and-physical-health-impacts-of-home-working-during-covid-19.html

(9) Webber, “Why, for Unilever, Well-Being Has to Start with Local Culture Change.”

(10) Chris O’ Shea. October 2020. “Talking about mental health—a reality for everyone, everywhere”. Accessed: 03 March 2021. https://www.linkedin.com/pulse/talking-mental-health-reality-everyone-everywhere-chris-o-shea/?articleId=6720269364114817024

(11) GMB Union. “GMB Union Guide to Mental Health”. Accessed 03.March 2021. https://www.gmb.org.uk/sites/default/files/HS_mentalhealth.pdf

Useful links

World Federation for Mental Health
www.wfmh.global info@wfmh.global

Mental Health Europe
www.mhe-sme.org info@mhe-sme.org

National Association for Mental Health (MIND)
www.mind.org.uk info@mind.org.uk

Scottish Association for Mental Health
www.samh.org.uk

European Association for People Management
www.eapm.org eapmsecretary@eapm.org

GMB Guidelines
www.gmb.org.uk/sites/default/files/HS_mentalhealth.pdf

UCU Guidelines
www.ucu.org.uk