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By Tracey Ward, Head of Business Development and Marketing at Generali UK Employee Benefits
There’s so much well-meaning advice, guidelines, frameworks, support and services out there when it comes to mental health in the workplace, you could be forgiven for thinking “where on earth do I start?” or, perhaps more appropriately, “How do I evolve all of this in a way that is more strategic?”
In September, the World Health Organisation delivered a new set of guidelines on mental health at work. This comes in the same year that the National Institute for Health and Care Excellence published its mental wellbeing at work guidelines. And of course, there was the introduction last year of the global ISO45003 psychological health and safety guidelines.
To help provide some simplification and guidance – with a focus on prevention, early intervention and long-term management (or improving functionality) – we recently brought together a brilliant line-up of experts as part of Generali UK’s series of wellbeing focused webinars.* Here are some highlights from that discussion.
Prevention
Daniela Masters, Head of Global Health and Wellbeing Programmes at GEB Network: Mental health has been a major focus at the multinational clients I’ve been working with over the last couple of years at least. Mental health is explicitly excluded from private medical insurance in the group environment, but many companies are looking to close coverage gaps. This has included investing in additional services to support mental health or even working with their local insurers to find support through the other insurance lines of business, such as life, disability or income protection insurance. With public health services becoming ever more stretched, these services have become more important than ever. But, the question, is where to even start. So, let’s start with prevention. Where do we see organisations starting and what data are they using?
Dr Julie Denning, Chartered Health Psychologist and Managing Director of Working To Wellbeing and Chair of the Vocational Rehabilitation Association: Employers need to take a more data-driven approach to find out what their specific needs are and then match the support accordingly. So, things like engagement surveys are a good starting point to get a feeling for the culture. Then investigate other data sources such as absence; why people are going off sick.
Daniela: Jason, you’re working in the area of psychosocial risk management. Can you tell us from your perspective where employers have started to invest in their organisations in this regard, or at least where they’ve investigated it?
Jason van Schie, a Psychologist and Co-Founder of People Diagnostix, the company behind FlourishDx: I’m glad you chose that phrasing, because I don’t see a lot of companies investing in psychosocial risk management; perhaps only those at the bleeding edge that are starting to do things like adopting ISO45003 and aligning that to their Occupational Health & Safety management systems. A lot of companies are only just starting to investigate it.
The more guideline types that you referenced by the WHO and others that help put it out there that psychosocial risk management should be part of a holistic approach to prevent harm to employees, the more that organisations will become interested in this area.
When we’re talking about things like burnout, we’re increasingly realising that it’s not because people are lacking resilience that they’re burning out, it’s due to unsustainable work. So, we need to look at things like workload. We need to look at meaning and purpose at work. And at supervisor support. All these things that we know make any job good.
Early intervention
Daniela: Do you see much of a change in organisations supporting employee mental health since the Covid-19 pandemic?
Kay Needle, early intervention and rehabilitation expert at General UK Employee Benefits: One of the things we’re not really seeing employers do is make line manager KPIs, management KPIs. There’s not currently any performance indicator for line managers to engage with this kind of training; to be proactively managing absences within their team; or things we already know can be preventative – things in a remote working space.
One of the changes we’re seeing coming out of the pandemic is that it’s becoming increasingly difficult to see a GP. We are seeing more and more things like prescriptions for minor illnesses being pushed out to pharmacies. Fit notes are now being issued by pharmacies and physiotherapists, rather than GPs.
We’ve always had this issue that employees who struggle to talk about their mental health might tell us instead about a physical issue as the reason why they’re struggling. For example, back pain. So, in the past, they might have gone to their GP with back pain looking to be signed off work. Their GP might ask probing questions around whether they were stressed around work or if there was anything else going on in addition to the back pain. Now they’re being signed off by their physiotherapist for the back pain and no-one’s asking those probing questions. So, it’s going to be easier to mask a mental health issue.
Daniela: Jason, when it comes to signposting, a lot of organisations will invest in mental health first aiders when it comes to first point of contact. Where does this sit in your idea of mental health risk management?
Jason: There’s a lot of wasted investment in mental health first aid. It’s seen as a bit of a panacea for everything; putting out a group of trained peers as the frontline of mental health support in a workplace. The problem with these programmes is that aside from the initial training, there’s not a lot of strategy behind it. So, really for these programmes to be effective, we need to think about leaders supporting that and helping to signpost to peer supporters. There needs to be ongoing evaluation as to whether peer supporters feel confident and competent in having conversations with their colleagues.
There also needs to be systems in place to ensure we’re preventing vicarious trauma to the peer supporters who are in this frontline role. It’s basic risk management – when you bring in a control, like peer supporters in this instance, you’ve got to be aware that the control could be another risk.
It’s not that all this can’t be overcome. It’s just that companies aren’t thinking about this. And that’s why we decided to launch a new feature in FlourishDx around peer supporters, which is designed to capture data on how they’re being used. It’s similar to EAP data, but also asking peer supporters whether they feel competent and confident to have these discussions, and allowing peer supporters to opt out of conversations on different topics that they might not be comfortable with. It’s about putting in place those systemic risk controls to prevent harm to the peer supporters.
There’s a whole load of other areas that you should be thinking about as part of your holistic risk management strategy; that’s (mental health first aiders) one out of 10. Most people aren’t touching risk management and I think that’s where you get the best bang for your buck.
Long-term management
Daniela: Julie and Kay can you comment on what employers can do where lived experience with mental health is concerned?
Kay: As insurers we’re focused on getting people back to work. And also on preventing them from going off work in the first place. But one of the things that we’re not yet good at accepting is the concept of chronic mental ill health and the fact that some people will struggle with their mental health throughout the course of their careers, just like some people will have a long-term physical health condition.
Although therapy has an important role in helping with maintenance and management, it isn’t necessarily a cure for all mental health conditions. Therefore, signposting people back into therapy repeatedly might help them make adjustments but it’s not going to help them to thrive at work, to do good work, and also to reap the benefits of work for their own mental wellbeing.
One of the key things in that relationship with Occupational Health is to first understand how to onboard someone with a long-term mental ill health condition, making sure there’s an open and inclusive culture so that the person feels able to share that information early on. Then making sure line managers are empowered to know how to respond to that information. This includes engaging with that employee and putting in place suitable risk assessments, as Jason has explained, and understanding what risks we, as a business, pose to this employee and how can we mitigate those risks. There are so many tools and resources available, such as wellness recovery action plans.
Julie: Wellbeing Action Plans are great as part of that. It’s a live document that’s used on an ongoing basis to support someone with a long-term condition. It encourages regular check-ins to find out how things are going and what signs and symptoms colleagues and line managers need to be aware of.
*To receive a link to the recording of the webinar ‘Taking a 360° approach to mental health’, please email [email protected]
Disclaimer:
All information contained herein represents the views and opinions of the author as at the date of writing and is provided for general information only. Nothing herein constitutes or is intended to constitute financial or other form of advice and no individual should rely upon the information provided in making a specific investment decision without first seeking independent professional advice.
