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Mental illness in the workplace: The hidden epidemic

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Mental healthWith 50% of all sickness and absence attributed to stress every year, at an estimated cost of £4bn to UK employers, isn’t it about time that employers stopped burying their heads in the sand? Verity Gough explores how HR can play its role in dealing with this last taboo.


When it comes to mental health issues in the workplace, the statistics reveal a worrying trend. According to recent figures, mental illness is the second biggest category of occupational ill health after muscular-skeletal problems, and with nearly three employees in 10 having a mental health problem in any year it’s certainly an issue that employers cannot afford to ignore.

The Iceberg Effect

Mental health issues can affect anyone at anytime, and with added pressure from financial woes, now is a particularly stressful time for employers and employees, and this is when things can start to go awry. “People who are extremely concerned and stressed are not going to be concentrating on their work and will be looking to personal survival as much as anything,” says Professor Derek Mowbray, a chartered psychologist and director of business consultancy, Organisational Health.

“When people are ill what happens is something we refer to as the Iceberg Effect,” remarks Mowbray. “That is to say, people who are suffering from all sorts of conditions, adverse events at work, bullying, harassment, a whole series of things where they feel negative about the organisation they are in, but they haven’t got to the point when it is so unbearable that they become sick.

“We tend to forget that executive board members, directors, even the chairman also suffer and to even greater degrees than employees in this climate, and they are least likely to admit they need help.”

Derek Mowbray, Organisational Health

“So you have a huge amount of negativity taking place which in itself is hugely expensive because staff aren’t concentrating on their work, they are not engaged in the activity of the organisation, they don’t make any effort as they are not concentrating and therefore they don’t look out for the interest of the company, and that can be massively expensive.”

But if defining mental illness can have doctors dumbfounded, how is HR meant to spot the signs? “You can reduce it in essence to a very simple question,” says Mark Lomas, national equality and diversity manager at The Shaw Trust, a national charity which supports disabled and disadvantaged people into employment and provides consultancy services for organisations wishing to implement or update their own equality and diversity policies.

“Ask yourself: ‘What has changed?’ So if someone is very sociable at work but over the last few weeks or months they have stopped interacting with people socially, then that is a marked change in behaviour. Perhaps they are a stellar performer and all of a sudden their performance really isn’t there. It’s noticing those changes in behaviour and having a sensitively-handled conversation early on about it.”

The key, says Mowbray, is to break the silence surrounding stress and mental health issues, and to do this, employers need to encourage an environment of mutual trust and openness by encouraging staff to discuss issues without fear of humiliation or comeback, something that can often be harder than it sounds.

“It is quite difficult for many people, particularly those in senior positions, to be open about stress. We tend to forget that executive board members, directors, even the chairman also suffer and to even greater degrees than employees in this climate, as they have the responsibility for everyone else as well as the survival of the organisation, and they are least likely to admit they need help.”

“Ask yourself: ‘What has changed?’ It’s noticing those changes in behaviour and having a sensitively-handled conversation early on about it.”

Mark Lomas, The Shaw Trust

This was witnessed at the start of the year when German billionaire Adolf Merckle committed suicide following huge losses suffered by his business empire during the financial crisis. According to newspaper reports, the desperate situation of his companies caused by the financial crisis, coupled with the economic uncertainty and a feeling of powerlessness caused him to end his own life.

This, it has to be said, is an extreme case but it serves to illustrate just how severe workplace stress can be. If managers are trained to spot the signs of mental illness before it takes hold, there will hopefully be minimal upset caused to both the employee and business.

Prevention is better than cure

While there are many different catalysts for mental illness, a positive working environment and appropriate support has been seen to have a significant impact on reducing stress-related sickness absence and improving long-term outcomes for employees experiencing mental illness.

However, while many organisations have Employee Assistance Programmes (EAPs) in place to help managers react to problems by referring troubled employees to the relevant person, the evidence of the impact of these is ambiguous.

“Psychologically they are useful to have but what we’re really interested in doing is ensuring that managers really engage their staff and talk through everything that is effecting the organisation and creating a sense of trust and commitment between themselves and their staff. This is what HR should be fostering now,” says Mowbray.

“They should be training managers in how to engage with their staff so they become aware of how they are coping on a day-by-day or hour-by-hour basis. If they can do that they stand a better chance of preventing things from going off the rails.”

Yet while this sounds a simple enough exercise, one of the main obstacles has been the stereotype of a mentally ill person portrayed by the media. Lomas believes that the negative image of mental illness is one of the main reasons it remains a taboo in the workplace.

“The press has promoted an idea of mental health as very worst case scenario, someone who is schizophrenic or has psychotic episodes,” he explains. “People generally aren’t aware of the breadth of the mental health spectrum and the fact that a person’s personality and life experiences impact where they sit on that spectrum.”

Understanding this can not only help employers spot what might be a mental health issue more easily, but also what they can do in terms of preventing it. For example, within Lomas’ own organisation, a robust Equality and Diversity (E & D) programme which puts the onus on the line managers has been developed.

“We put them through a specific course on mental health – how to manage it, how to spot the early warning signs, how to handle those conversations, what to expect when someone is grieving. It is about understanding how you engage with the workforce, particularly on that line manager level – if you can get that right, you can go a long way to resolving the issues.”

HR’s role

If the managers are at the frontline dealing with mental illness, then HR is the support system. “HR is really the big monitor of all of this,” reflects Mowbray. “If HR staff are in touch with what’s going on, they will be able to spot the manager that is going off task, give support and get them back on track managing their staff effectively. The role of HR is really having a watching brief and to intervene when they see things going off and to give the necessary support at that time.”


Spotting the signs

  • An increase in unexplained absences or sick leave

  • Poor performance

  • Poor time-keeping

  • Increased use of alcohol, drugs, tobacco or caffeine

  • Frequent headaches and backaches

  • Withdrawal from social contact

  • Poor judgement/indecision

  • Constant tiredness or low energy

  • Unusual displays of emotion e.g., frequent irritability or tearfulness
  • Source: tacklementalhealth.org

    In addition, adds Lomas, HR should ensure line managers are aware of the resources and help available and implementing training and awareness schemes across the organisation. “We have a mandatory equality and diversity training and mental health awareness training which has a 70% pass / fail mechanism and if you don’t pass that, you don’t get through your probation period,” he says.

    “Our E & D competencies are built into our appraisal framework as well, so you have to demonstrate to a staff member that you are aware where all the diversity and equality information is and who to go to, while managers have responsibility for identifying particularly E & D issues and providing communication, understanding and taking the strategic view of how that impacts on business.”

    The Shaw Trust also has a code of conduct that has specifically set-out standards with regards to bullying and harassment, backed up with a robust policy framework which includes a mental health policy detailing the support available to staff members if they have a mental health issue. “This includes their responsibilities in terms of working with the company in order to resolve things to their satisfaction and it outlines quite clearly what the organisation’s responsibility is to that staff member,” explains Lomas.

    But what about non-work-related stress? Mowbray believes that employers still have a duty of care for their staff whether their illness is work-related or not. “I take a pretty straight forward view that both encroach on each other – it’s virtually impossible to disentangle them. Stress at home encroaches on work and vice-versa and the employee who suffers, however it is caused, has a responsibility to seek help while the employer also has a responsibility to support the employee.”

    Nurturing an environment of trust and support appears to be key to tackling this ‘hidden epidemic’. Preventing stress at work by giving managers the tools and information to respond to issues will not only save the company in terms of staff and money, but could save lives.

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