Strategy | New standards for a unified, global, approach to mental wellbeing

New standards for a unified, global, approach to mental wellbeing

By Tracey Ward Head of Business Development & Marketing, Generali Employee Benefits UK

Trying to ensure a consistent strategic direction for mental health and wellbeing across a global organisation can be like trying to fit a square peg into a round hole.

When you are dealing with multiple countries, each with their own health and safety standards (adherence with which - not to mention interpretation of - can vary hugely too), a catch-all strategy is unlikely to fit. Consequently, organisations have traditionally approached employee mental wellbeing in a piecemeal manner. At the same time, issues such as work-related stress and burnout continue on an upward trajectory.

It is with this in mind that new proposals for the first global standards, giving organisations practical guidance on how to manage psychological health and wellbeing in the workplace – otherwise known as psychosocial risk – were recently published as part of a consultation document. The consultation for ISO 45003 Psychological Health and Safety at Work closed in October, with the final standard expected to be published in summer 2021.1

These standards aim to approach psychological wellbeing with a health and safety risk mindset, at the same time helping to better align personnel across health and safety, Human Resources (HR) and Occupational Health (OH). Or to simply get organisations to start thinking with a health and safety mindset where they don’t have specialist, trained workers to manage psychosocial health.

In short, the standards aim to put psychosocial risk on a par with physical health risks in organisations of all shapes and sizes, and on a consistent basis around the globe.

Jason van Schie, Founder and Managing Director at FlourishDx, a provider of digital mental health tools focused on illness prevention and wellbeing optimisation for global employers, applauds the ISO 45003 focus on systemic strategies to support employee mental health.

He says the approach recommends that businesses align psychological health and safety to policy and governance in the same way they are currently expected to do with physical health and safety. “It also focuses more on the design and management of work, as opposed to the current popular approach which is focused almost solely on making employees responsible for self-care and improving resilience.

“While many jurisdictions have their own standards on psychological health and safety – including the UK HSE Management Standards – for multinationals, ISO 45003 provides a single reference point whereby a unified approach can be deployed across global operations thus allowing multinationals to move away from geographically siloed human capital strategies.

“Psychological health and safety is not just about harm prevention, it also includes wellbeing promotion. This is also evident in the ISO 45003 draft standard. We see workplace mental health as a shared responsibility between employer and employee. Not all work stressors can be eliminated, so individuals also need to be encouraged to practise self-care and develop healthy ways to deal with stress.

“FlourishDx is not just about companies adopting standards or performing risk assessments. It also empowers individuals if they engage in the platform with education and skill development in order to keep themselves well and optimise their wellbeing.”

Alison Pay, Managing Director of Mental Health at Work, a provider of facilitated mental health training to organisations of all sizes, says that for those organisation looking to explore the business case around productivity and employee engagement and, as part of that, the cost of poor mental health, referring to supportive guidelines such as ISO 45003 should prove useful.

However, she adds that although it is important to recognise that psychosocial hazards exist, they will impact each of us in different ways at different times in our life.

Alison adds: “Guidelines such as ISO 45003 could be a helpful resource for workplaces beginning to consider a workplace mental health programme. However, there is a significant risk in approaching the subject of mental health in the same way as a traditional health and safety programme with the expectation of a set of standards or a checklist.

“Mental health can’t be generalised and therefore the response to it can’t be; it’s about people, not hazards per se, and a programme won’t be effective unless you have taken the time to get to know your colleagues or team members, so that you can recognise changes in their mental health and start a conversation about how you can support them in their work so they can manage their mental health, before this becomes an issue. This needs to happen within a culture of openness, honesty, signposting and support.”

Structure needed

It is probably safe to say that occupational health and safety management has thus far largely been dealt with superficially or simply ignored. It is also very disjointed across business departments. Plus, there’s little recognition of the fact that work and home life are not inseparable.

The pandemic has helped shine a light on all of this, heightening the need for a much more structured, focused and human-centric approach. Why? Because Covid-19 has exacerbated existing issues in terms of a huge amount of ‘solutions’ yet a worsening of mental wellbeing.

It is telling that the global mental wellness economy is now worth $120.8 billion, according to research just out.2 According to the Global Wellness Institute, It forms part of the wider global wellness economy, an industry that has grown by 6.4 percent annually from 2015 – 2017, nearly twice as fast as global economic growth.3

Growing problem

At the same time though, issues such as burnout and work-related stress are getting worse.

New research shows that online searches for the terms “burnout symptoms” have increased by 24% this year. This is leading to predictions of a January 2021 “burnout spike”.4

Burnout was added to the World Health Organisation (WHO) classification of diseases last year. It is not a medical condition as such – rather it is what can result where chronic work-related stress has not been successfully managed. According to Vanessa Latham, Employment Lawyer at BLM Law, speaking at a recent Generali UK webinar, claimants could argue that the signs of burnout were obvious to the employer, thereby triggering an obligation to the employer to prevent injury occurring.5

“It [burnout] has not hitherto been formally recognised as a condition in its own right, as opposed to an aspect of others,” adds Vanessa. “But I understand there is now a suggestion that the WHO classification of mental health diseases contained in ICD 10 is due to be replaced in January 2022 by ICD 11, which does introduce burnout as a separate classification.”

Meanwhile, research by the European Union Organisation for Safety and Health at Work has found that only 20% of European companies inform their employees on psychosocial risks or work-related stress, let alone take any meaningful action to tackle these.6

And a recent Business Continuity Institute (BCI) Horizon Scan Report found poor employee health has become the most frequent cause of disruption to businesses globally – overtaking cyber-attacks for the first time since 2014.7

Don’t delay

So, what can organisations do now to start to take more informed and integrated approach?

The goal of the FlourishDx software platform is to provide the tools to support organisations that wish to adopt the new standards. Jason explains that it was designed from the outset to enable organisations to take a systemic approach – as opposed to a piecemeal approach – to workplace mental health, therefore consistent with the goal of ISO 45003. It aims to help employers adopt a risk management approach for the prevent of psychological injuries, thereby aligning health and safety and HR functions and assisting them to work together towards positive mental health outcomes. It will also afford local language support (starting with French and Spanish) in the first half of 2021.

“The ‘work design’ survey within FlourishDx can be deployed at scale and results filtered to location and / or work group in order to identify potential psychosocial hazards and assess risk levels,” adds Jason. “The results also point to possible strategies that can be used to address identified hazards. Consultation with workers is a key part of ISO 45003 and FlourishDx makes this easy to achieve at global scale.”

In early 2021, the provider is also launching what it terms the ‘Flourish Factor’: an implementation support tool that can be used to measure progress.

“This feature will walk companies through a step by step approach to adopting ISO 45003, in line with relevant clauses within the standard, with assurance built in. The Flourish Factor score can be used by multinationals as a measure of the maturity of their psychological health and safety system and how well it has been adopted in different geographies and work groups.”

Support today

Meanwhile, Mental Health at Work designs and delivers customised programmes for organisations, through a blend of facilitated virtual workshops, supported by webinars and e-learning. This programme starts with an understanding of the organisation, including the challenges, expected outcomes and any existing activity around mental health including signposting and support.

Alison reports that they are increasingly seeing organisations roll out this approach globally, taking into account local culture, issues and legislation, but with centralised principles around the culture of openness about workplace mental health.

“The tailored programme that starts with raising mental health literacy and awareness, along with a recognition that everyone has mental health which moves along the continuum.

“We then introduce the skills to have an open conversation about mental health – this is set within the context of the role of a leader, asking a question and then making time to listen, without trying to solve or fix. This is a skill that can be learnt, but for most, it takes practice.

“We then work with an organisation to look at how we embed this approach in business as usual and what other support might be needed to keep momentum, including possibly creating a network of Mental Health Allies as expert listeners and ‘signposters’ supporting employees and managers in ensuring all conversations are proactive.”

Business recovery and ongoing sustainability rests on taking a proactive approach to employee wellbeing. In fact, 9 in 10 CEOs believe wellbeing initiatives are key to driving long-term changes to their business model.8

So, while the proposed standards will help bring much needed structure to many, it is worth looking now at how to better integrate existing professionals across the business to ensure a more co-ordinated approach to aspects such as employee benefits care pathways and utilisation, bringing much needed usage and value during the current troubled times.

Generali Employee Benefits (GEB) partners with FlourishDx to help optimise wellbeing for global employers: namely its pooling, captive and global underwriting clients. Mental Health at Work is a wellbeing investment matching partner of group risk provider Generali UK Employee Benefits. Generali provides funding support to clients with regard to Mental Health at Work’s services, where a specific need is identified.

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1 British Standards Institute, BS ISO 45003 Occupational health and safety management – Psychological health and safety at work: managing psychosocial risks – Guidelines [Accessed Nov 2020] 
2 Global Wellness Institute, Global Wellness Institute finds mental wellness is a $121 billion market, Nov 2020 
3 Global Wellness Institute, Wellness industry statistics and facts [accessed Nov 2020] 
4 HRreview, Experts predict January ‘burnout spike’ as cases of burnout increase, Oct 2020, 
5 Generali UK and BLM Law, Tackling work-related stress: How far should HR go? And what does Risk need to know? Sept 2020. To access the recording go to and contact [email protected] for the password.
6 European Agency for Health & Safety at Work, The Third European Survey of Enterprises on New and Emerging Risks (ESENER) 2019,!/en/survey/overview/2019 
7 Business continuity Institute, Horizon Scan Report 2020, 
8 PwC CEO Panel Survey 2020, August 2020 

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Generali UK provides Group Life Assurance, Group Income Protection - plus added-value wellbeing services - to the UK employees of multinational clients. Generali UK is also pioneering Wellbeing Investment Matching, helping clients fund discrete, tailored wellbeing initiatives where a need has been identified.

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