The first signs that a person's mental wellbeing is taking a hit of some sort can easily come at work. How their employer responds and the decisions they make about managing them can make all the difference for them, their family and their future. Read our guide to improving outcomes and making a difference for your employees and your business as a whole.
As an employer or HR manager you are very much in the front line when it comes to mental ill health issues. Not least because you might well be the first person to notice that someone is not their usual self.
It's fair to say that dealing with employees with mental health issues is a challenging area of people management. Mental ill health takes many different forms and the signs are not always easy to distinguish, even for medical professionals. But it's one that occurs all too often and taking steps to educate yourself and your staff can yield very positive results for all concerned.
Undoubtedly however, the first step to managing situations involving the mental health of your employees is to gain awareness and understanding of the issue for individuals and in the community at large. Let's start with some stats from leading national bodies:
Mental illness costs employers between £33-42 billion a year. (Thriving at Work, Independent government review 2017)
The annual cost to the UK’s economy as a whole amounts to a staggering £74-99 billion per annum. (Thriving at Work, 2017).
300,000 people with a long-term mental health problem fall out of employment every year. (Thriving at Work, 2017).
Approximately 1 in 4 people in the UK will experience a mental health problem each year (NHS).
Nearly 7% of the population living in private housing surveyed for an NHS study had attempted suicide at least once in their lifetime.
The Organisation for Economic Co-operation and Development (OECD) estimates that over 15 million working days per year are lost to depression,stress and anxiety
Those are pretty appalling figures by anyone's standards. Even if you only have a small workforce there is a strong likelihood that someone who works for you will be affected if this hasn't happened already.
For the vast majority of people, their employment is a huge factor in their life (not least because it is their source of income) and how you manage that situation when it arises can have a major impact on a sufferer's ability to recover and minimise the negative impact on their life.
Equipping yourself to manage and support a troubled individual through a mental health crisis positively is not just good HR management practice and good humanity, it can mean that they are able to continue in their job which is clearly a win for you as well as them.
The human argument for being proactive about mental health awareness and support in your workplace as an employer is very compelling. However, there are some fundamental business reasons for caring too:
- Employee motivation
- Greater staff retention rates
- Reduced absenteeism
- Increased competitiveness
Knowing how to go about it however, is another matter.
Understand your responsibilities
As an employer you have a legally enshrined duty of care towards your employees which extends not just to how you treat them but how others treat them while they are at work.
In 2017 the government commissioned an independent review of mental health and employers by Lord Dennis Stevenson and Mind CEO Paul Farmer.
As well as examining the costs to businesses and the economy that mental ill health creates, the review, entitled Thriving at Work, also laid out what employers can do to better support all employees, including those with mental health problems to remain in and thrive through work.
Its key recommendation is that all employers, regardless of how big they are or what industry they are in, should adopt 6 “mental health core standards” as a basic foundation for their approach to improving their support for employees who suffer from mental illnesses and creating conditions that minimise work related situations that trigger or worsen them:
Produce, implement and communicate a mental health at work plan.
Develop mental health awareness among employees.
Encourage open conversations about mental health and the support available when employees are struggling.
Provide employees with good working conditions and ensure they have a healthy work life balance and opportunities for development.
Promote effective people management through line managers and supervisors.
Routinely monitor employee mental health and wellbeing.
Implementing positive mental health policies on the lines of the Thriving at Work recommendations not only allows your business to reap the benefits of improved productivity and avoid the negative consequences of mental ill health among your staff, it also provides a bedrock for your legal compliance with the Equality Act (2010) and the Protection from Harassment Act (1997) your obligations under the Health and Safety at Work Act 1974 and Management of Health Safety at Work Regulations 1999.
Recognising Mental Ill Health
Let’s be clear what we are talking about when we are discussing mental ill-health.
Conditions you may encounter as an employer or manager can include anything from an addiction, an eating disorder, a personality disorder, self-harm, obsessive compulsive disorder, anxiety, depression, PTSD, bipolar conditions, schizophrenia or psychosis, through to dementia conditions or mental ill-health caused by physical trauma.
Let’s not beat about the bush. People die of these things, whether by their own hand or because their inability to control some aspect of their behaviour leads them to a tragic outcome. Mental illnesses defined as severe or enduring are linked to premature mortality rates of up to 15-20 years.
Mental health problems can be triggered by events or life conditions – anything from a bereavement to a heavy workload.
What one person breezes through with a jaunty determination to maintain a sense of humour in the face of adversity, can floor another person who is no less smart, serious and responsible. And here’s the twist: your colleague with pleasant disposition and seemingly come-what-may fortitude could easily be harbouring suicidal thoughts or 6 months down the line find some life event impossible to cope with and succumb to a disastrous breakdown.
Mental health conditions are also defined by 3 categories according to their duration:
Where a person suffers from the condition for a period of time but recovers after treatment.
The condition comes and goes.
The person suffers from the condition constantly but is able to control it through medication, therapy, self-help and/or practical support.
It's important to remember that it isn’t always life events that “cause” a mental illness. Some mental ill health conditions are physical in origin. It’s not really your job to diagnose or decide (and please don’t try, that’s what doctors are for).
Managing Employees with mental health conditions
As an owner/manager, an employer, a line manager or HR professional you could find yourself called upon to deal with an individual with a mental ill health issue in a myriad of different scenarios. You may be perfectly comfortable and highly experienced at dealing with issues arising from a staff member’s physical illness, and in theory a mental health issue should not be much different.
In theory that is, except that the interpersonal aspects that may arise when someone is experiencing some kind of mental health issue can really muddy the waters.
Whether it’s a case of a stressed or depressed employee’s worsening performance, the behaviour of a person with addiction or alcohol problems impacting the business, or someone having a full-blown crisis, you need to be prepared and informed.
ACAS have some excellent resources on their website which will help you understand your role as a manager, recognise an employee’s mental ill health, provide meaningful and practical support to enable them to continue working and to support and manage their colleagues who may be impacted by the situation in a variety of ways: See their guide Managing staff experiencing mental ill health
“People who have or have had a mental illness are working effectively at all levels of seniority, in all sorts of different organisations.”Mental Health First Aid - MHFA England: The Line Manager's Resource
We shouldn’t be surprised that people who are experiencing absolute misery or are in some way overwhelmed by what is going on in their head may not be the easiest folk to deal with.
Isolation, alienation, fear and inner turmoil – whether rational and justified or not – can easily lead to conflict with others. When you find yourself dealing with conflict amongst employees, have a think about whether someone’s behaviour and reactions in a given situation, especially if they seem out of character. could be a symptom of a deeper underlying problem.
A quiet, respectful and confidential chat to ask that person how they are feeling in general (and actually listen to their answer) could help them open up, and then you are in a position to do more to help before things get out of hand.
In general, put this principle in your top pocket and take it out often: your staff should know that if something is troubling them then it's OK to talk about it. Any expert on mental health you can find will tell you that the need to hide their state of mind because of embarrassment or fear of censure or finger-pointing is downright harmful for vulnerable individuals.
A culture of openness about mental health at your workplace, even if it just amounts to a poster and a few leaflets about the place can be a valuable signal to someone fighting down inner turmoil and persuade them to get help and not try to stifle the problem.
But in terms of HR practice, there are three types of scenario where bullying and harassment and mental health combine to create a storm you need to navigate as an employer with a good awareness of the employment law implications.
A situation where an employee is suffering from a deterioration of their mental health because of bullying and harassment at work.
An employee is being bullied or harassed by other members of the team, or even customers, as a result of their mental ill health condition.
The sufferer himself or herself is behaving inappropriately toward colleagues or others they come in contact with through their work as a consequence of their mental ill health.
If you have already laid down good, clear guidelines on the standards of behaviour in your employee handbook you will be in a much better position to deal with situations that arise.
Old-fashioned (or immature) mentalities that stigmatise mental illness still exist, there’s no point denying it. You may not be able to tell employees what to think but you certainly can require them to behave decently and professionally towards one another.
In all these circumstances it is vital that you understand how and where you must ensure your business's compliance with Employment legislation and act accordingly. It's in rocky situations like this that you might want to call in help from us at Tiger HR.
In the event that a situation involving an employee suffering from a mental ill health condition results in a claim against your business and the matter goes to an employment tribunal, your best defence will be your ability to demonstrate that you took reasonable care to prevent and/or mitigate any negative consequences for them under the Equality Act (2010).
Your Employee's Handbook and your subsequent adherence to any disciplinary procedures that became necessary, either for the individual or other employees who may have treated them inappropriately, will be key factors in this.
You will also need to show that you implemented reasonable adjustments to accommodate their needs at work.
A stellar example of an employer working to help and support an employee who was suffering from Alzheimer's Disease was recently in the news.
Thanks to excellent management by Sainsbury's both locally and at corporate level, Mrs Yvonne Salomon was enabled to continue in employment at the store for 2 years following her Alzheimer's diagnosis and 6 months after an Occupational Health assessment which delivered the devastating news that the condition was advancing so rapidly that she was, in effect, unemployable.
Her son Doron, tweeted his heartfelt gratitude to them saying:
"A few of the things Sainsbury's have done:
...offered regular retraining; changed her hours; had regular welfare meetings with her and my dad; ensured her colleagues were aware of her condition so they were able to help her; and even created a role that didn't exist so that there was something in-store she could do despite the fact her job title has never changed from 'picker'."
You can read the full story here. There is a lot to celebrate and emulate.
But even if you are not a large and wealthy employer like Sainsbury's there is still plenty of opportunity to be creative, honourable and compassionate by putting in place reasonable adjustments to help and support a suffering staff member and enable them to remain in work.
The Department of Health provides comprehensive, downloadable guidelines here:
This article from the Royal College of Psychiatrists has a substantial list of examples of reasonable adjustments made by employers to accommodate, protect and support employees suffering from mental ill-health:
Even quite small adjustments that cost nothing and barely touch everyone else's routine can mean a world of difference to a person weathering out a mental health crisis and help them avoid becoming one of the 300k people who fall out of employment in the UK each year.
Training & Resources
If you are looking to improve your organisation's support for employees with mental health conditions you could do a lot worse than to start with MHFA (Mental Health First Aid) England. Their website is a mine of useful resources, from posters through to full guides for line managers that can be downloaded free of charge.
You can download their excellent Workplace Wellbeing Toolkit, packed with highly comprehensive resources which will guide you through building a whole organisation approach to Mental Health. The Line Managers’ Resource is particularly valuable if you want to improve your own effectiveness in dealing with mental health issues, including severe crises. There is good advice on taking care of yourself if you are feeling the strain of dealing with an upsetting situation too.
They also provide an excellent range of training courses and conduct campaigns to raise awareness and improve mental health support for individuals and organisations.
ACAS is also an excellent source of clear advice and guidance on mental health issues for employers and HR teams. Find their mental health pages here.
The UK's leading Mental Health charity Mind also provides invaluable training and resources. Explore Mind's courses.
Rethink is another leading charity with excellent resources, advice and support. Bookmark Rethink's factsheets in case you need them.
NHS Employers also provide extensive advice, guidance and resources for businesses on all issues of health and wellbeing at work including mental health. (How lucky we are to have them!)
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