Thriving at Work: the Stevenson/Farmer review of mental health and employers Thriving at work: the Stevenson / Farmer review of mental health and employers PDF 5 0 An independent review into how employers can better support all employees' mental health, including recommended core standards.
About 300,000 people with a long-term mental health problem lose their jobs each year, a review commissioned by Theresa May has found.
The Thriving at Work report, published on Thursday, puts the annual cost to the UK economy of poor mental health at up to £99bn, of which about £42bn is borne by employers.
The authors – the Mind chief executive, Paul Farmer, and the mental health campaigner and a former HBOS chair, Dennis Stevenson – said they were shocked to find the number of people forced to stop work as a result of mental health problems was 50% higher than for those with physical health conditions.
Farmer said the evidence suggested it is still a taboo subject in many workplaces. “The picture is that there are very significant numbers of people in work with mental health problems but there are significant numbers who are not,” he said.
“We think that the reasons for that are a combination of a lack of support, lack of understanding within some workplaces and a lack of speedy access to mental health services. Sometimes in organisations people feel themselves excluded as a result of their mental health issues and sometimes people don’t necessarily spot that somebody is struggling.”
Farmer and Stevenson said that the challenge was bigger than they had envisaged when instructed by the prime minister, but that with action dramatic changes could be achieved over the next 10 years. They said they hoped that the number of people with long-term mental health problems who lose their jobs could be reduced to the same level as those with physical conditions.
They found that about 15% of people at work have symptoms of an existing mental health condition, which they said illustrates the fact that given the right support they can thrive in employment.
Farmer described the economic case as overwhelming and the authors link current failures to the UK’s relatively poor productivity. An analysis by Deloitte examining existing workplace interventions identified potential to generate a return to business of between £1.50 and £9 for every £1 invested.
Among examples of good practice highlighted by the report are the mental health first aid courses at Thames Water and, at Aviva, the promotion of e-learning modules to help identify and self-identify when people need support.
Farmer and Stevenson said they want all employers to commit to six core standards around mental health, including having a plan in place, increasing awareness among employees, stipulating line management responsibilities and routinely monitoring staff’s mental health and wellbeing. “What we feel is really important is that organisations take responsibility for the mental health of their staff,” said Farmer.
“As the stigma around mental health begins to shift, I think the area of mental health in the workplace is becoming much more visible. Employers are recognising that this is an issue, but they don’t know what to do. That’s why we’ve recommended these core standards.”
Highlighting further benefits for companies, he said that some young people were now asking employers about their mental health policies in the same way they might have asked about their green credentials a decade ago.
“The most progressive organisations in this area are already being quite open in terms of their internal reporting and what they put on their website in terms of how they support their staff,” he said.
Large employers are expected to go further and the report calls on the government and public sector to lead by example. It says the government should also ensure that the NHS provides high quality mental health services, quick and convenient to fit around employment, and consider enhancing protections for employees with mental health conditions in the Equality Act 2010.
The report makes 40 recommendations and Stevenson urged the government to accept them all. “We need the right leadership among employers in the public, private and voluntary sectors, and a mandate from policy-makers to deliver our ambitious but achievable plan,” he said.
Stephen Martin, director general of the Institute of Directors, welcomed the review which he said shows “mental health is not just a moral issue, but a business one too. Business leaders must put themselves at the frontier of addressing these challenges.”
Case study: ‘I was using work in a quite self-destructive way’
Andrew Omerod, 35, from London, operations director at GrantTree, says he has experienced both sides of the coin when it comes to mental health problems at work. “When I was working for my previous employer, I was using work in quite a self-destructive way. Overworking is a way of acting out the pain you’re experiencing that you don’t know how to express. It’s also a way of escaping it in the short term – but it’s harmful in the long term.
“It was work that led to me having a breakdown. I’d been living with depression a very long time already; work happened to be the way it was expressed. I had to take time off, about a year.
“The thing that was disappointing for me more than anything else was that when I was ready to go to work my employer became quite disruptive. They basically said: ‘You can come back to us but rather than reporting directly to the MD [managing director] you’re going to have to report to someone else who we’ve promoted in your absence.’ So we agreed that I would leave.
“The experience at GrantTree has been very different. I am very passionate about my job, I get caught up in it and here I have colleagues who say to me: ‘You seem to be staying late and taking on quite a lot of stuff, is that sustainable?’ [They are] people who recognise I can fall into this kind of behaviour.”
One in four people in the UK will have a mental health problem at some point. While mental health problems are common, most are mild, tend to be short-term and are normally successfully treated, with medication, by a GP.
Mental health is about how we think, feel and behave. Anxiety and depression are the most common mental health problems. They are often a reaction to a difficult life event, such as bereavement, but can also be caused by work-related issues.
This guidance talks generally about work-related stress but where such stress is prolonged it can lead to both physical and psychological damage, including anxiety and depression.
Work can also aggravate pre-existing conditions, and problems at work can bring on symptoms or make their effects worse.
Whether work is causing the health issue or aggravating it, employers have a legal responsibility to help their employees. Work-related mental health issues must to be assessed to measure the levels of risk to staff. Where a risk is identified, steps must be taken to remove it or reduce it as far as reasonably practicable.
Some employees will have a pre-existing physical or mental health condition when recruited or may develop one caused by factors that are not work-related factors.
Their employers may have further legal requirements, to make reasonable adjustments under equalities legislation. Information about employing people with a disability can be found on GOV.UK or from the Equality and Human Rights Commission in England, Scotland and Wales.
There is advice for line managers to help them support their employees with mental health conditions.
The Stevenson Farmer ‘Thriving at Work’ review
In 2017, the government commissioned Lord Stevenson and Paul Farmer (Chief Executive of Mind) to independently review the role employers can play to better support individuals with mental health conditions in the workplace.
The ‘Thriving at Work’ report sets out a framework of actions – called ‘Core Standards’ – that the reviewers recommend employers of all sizes can and should put in place. The core standards have been designed to help employers improve the mental health of their workplace and enable individuals with mental health conditions to thrive.
By taking action on work-related stress, either through using the HSE Management Standards or an equivalent approach, employers will meet parts of the core standards framework, as they will:
- form part of a mental health at work plan
- promote communications and open conversations, by raising awareness and reducing stigma
- provide a mechanism for monitoring actions and outcomes
How mental ill health and work-related stress can go together
Work-related stress and mental health problems often go together and the symptoms can be very similar.
Work-related stress can aggravate an existing mental health problem, making it more difficult to control. If work-related stress reaches a point where it has triggered an existing mental health problem, it becomes hard to separate one from the other.
Common mental health problems and stress can exist independently – people can experience work-related stress and physical changes such as high blood pressure, without having anxiety, depression or other mental health problems. They can also have anxiety and depression without experiencing stress. The key differences between them are their cause(s) and the way(s) they are treated.
Stress is a reaction to events or experiences in someone’s home life, work life or a combination of both. Common mental health problems can have a single cause outside work, for example bereavement, divorce, postnatal depression, a medical condition or a family history of the problem. But people can have these sorts of problems with no obvious causes.
As an employer, you can help manage and prevent stress by improving conditions at work. But you also have a role in making adjustments and helping someone manage a mental health problem at work.
Mental ill health, stress and the Management Standards
Although stress can lead to physical and mental health conditions and can aggravate existing conditions, the good news is that it can be tackled. By taking action to remove or reduce stressors, you can prevent people becoming ill and avoid those with an existing condition becoming less able to control their illness.
HSE’s Management Standards approach to tackling work-related stress establishes a framework to help employers tackle work-related stress and, as a result, also reduce the incidence and negative impact of mental ill health.
The Management Standards approach can help employers put processes in place for properly managing work-related stress. By covering six key areas of work design you will be taking steps that will minimise pressure, manage potential stressors and limit the negative impact that the work could have on your employees.