Managing for mental health

Bob Grove, Senior Policy Adviser, Mental Health Europe, outlines how mental health can impact a workplace and why it’s important to ensure your workers are mentally healthy

The costs to employers and to national economies associated with mental ill health in the workplace are huge. However, when figures of hundreds of billions of euros are quoted then the numbers are often too large to be meaningful. A few years ago in a landmark paper 1 the Sainsbury Centre for Mental Health in London looked at all the available evidence on the costs to employers and how they could be broken down into cost headings (ie sickness absence, staff turnover etc.) The paper also looked at the average cost per employee per year. They calculated that on average mental ill health cost every employer in the UK an average of around £1000 per employee per year. This is a significant sum, but what caught the eye most was the fact that, even using very conservative estimates, the greater part of the cost was in lost productivity from people who were not off sick but functioning below their best while remaining in work. This was characterised as presenteeism and the finding produced a raft of papers looking at how these hidden costs could be reduced2.

Creating a mentally healthy workplace

The more hopeful finding in this paper was that using relatively simple interventions around one third of these costs could be prevented. The key to success was board level recognition of the problem and leadership from a senior level which involves the whole organisation promoting positive mental health and learning how to manage mental ill health without losing valuable employees. Employers can be sceptical of gimmicky programmes that offer to improve productivity and reduce sickness absence by increasing employee wellbeing. And yet leading economists from the London School of Economics have shown a cost/benefit ratio of 1:8 from even a simple programme which encourages employees to look after their own mental health and that of their fellow workers (3).

There are many ways of doing this but what they all have in common is that mental health is no longer a taboo subject at work and caring about it becomes a topic of conversation and a focus for shared activity – a walk, a shared lunch, a talk on how to look after your own mental health when under pressure – all raising awareness and subtly making the link between good all round health and performance. With the launch of its Each of Us campaign, Mental Health Europe hopes to raise awareness about mental health in the workplace, specifically by developing a training on mental health for managers and employees.

Managing mental ill health

When an employee starts to show signs of mental distress it is often colleagues or managers who are the first to spot it. Uncharacteristic behaviour or visible distress does not mean that a person has a mental illness but if it lasts a couple of weeks it may be an indication that they have a problem for which they need help. The trigger for this may not be associated with work and in fact according to surveys most mental ill health which is visible at work is due to events or circumstances outside the workplace. However it must be managed – and the most important thing is not to ignore it or pretend not to have noticed until it gets much more serious. We are all vulnerable to being knocked off course by things that happen in our lives and the response of managers, colleagues and friends is vitally important for two reasons. Firstly the person experiencing the distress may feel they are letting people down or that admitting “weakness” is shameful. If they are to get help to get their working and personal lives back on track then openness and acceptance by those we see every day is very important. Secondly employers are in a good position to signpost the individual to sources of help or even provide professional counselling support if it is a sufficiently large organisation.

Managers at all levels can be trained to initiate conversations and respond quickly and positively to an employee who is not performing for reasons of mental distress (4). If someone does need to go off sick, managers can also be trained to keep in touch and to reassure the individual that work is still interested in them and that they are expected to get better. This is vitally important because belief in ultimate recovery can be a self-fulfilling prophecy. Given the right support the overwhelming majority of people will recover completely and return to full productivity without any special interventions.

More serious or longer term mental health problems can often be managed by making small, maybe temporary, adjustments to working schedules or other adaptations at work. Not only will the person be able to resume a full working life but for the employer long periods of reduced productivity often followed by long absences and maybe job loss can in most cases be avoided – to the great benefit of the bottom line!

Making an organisational commitment to mental health

Becoming a mentally healthy workplace where people are helped rather than stigmatised is not something that can be achieved by lecturing individuals on how to behave differently. It requires commitment right across the organisation and must be championed at board level. Many major companies now find ways of measuring the mental health and wellbeing of their workforces and most importantly the results are reported at least annually to the directors. Even better senior executives – often those who have experienced mental ill health themselves or in their families – now participate visibly in the drive to make the culture of the organisation one that values positive mental health and is supportive where there is mental distress. It may be that a mentally healthy workplace does not in itself produce a good business, but a good business will always benefit from a mentally healthy and cohesive workforce where people look out for each other.

1 Mental health at work: developing the business case (2007) Sainsbury Centre for Mental Health (now the Centre for Mental Health) London

2 Managing Presenteeism (2011) Centre for Mental Health London

3 Mental health promotion and mental illness prevention – the economic case. (2011) Knapp, M., McDaid, D. & Parsonage, M. Eds. London. Department of Health

4 Responding to mental distress at work. (2010) Lockett, H. & Grove, B. Occupational Health [at Work], 7 3 (20-23).

Bob Grove

Senior Policy Advisor

Mental Health Europe


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