Stress4 Mental Health and HEALTH POLICIES 01. Proactive Health Policy 02. Internal Health Relationships 03. Health Surveillance and Screening 04. Mental Health and Stress 05. Getting People Back to Productive Work 06. Employee Wellness and Engagement
1 Mental Health and Stress Contents Contents Why stress and mental ill-health are different problems for an organisation.....3 Take action to improve your organisation s strategy..........5 Use the resources available to help your line managers engage with this topic.. 7 Help your employees become more resilient to stress................9 Case studies from learning organisations.. 11 Further Information..............13 Notes.....................14
www.rssb.co.uk 2 About the Proactive Health Policies booklet series Management of employee health and wellbeing is an important challenge for all organisations. Becoming proactive in health management can assist corporate responsibility, reduce company costs, increase productivity and, most importantly, improve people s lives. This nest of six health policy booklets is designed to support organisations in becoming proactive in health management. They are a starting point to help the different disciplines involved engage with a similar set of ideas. These ideas will enable a flow of information and understanding that can push the health agenda forward. They highlight: Key focus areas Important concepts Good practice Useful tools and links Booklet 4 - Mental Health and Stress Mental health and stress have been identified as key contributors to ill-health effects on the workingage population, which represents a substantial cost to the industry some of which is hidden in reduced productivity. The management of mental wellbeing is complicated by stigma and discrimination in the workplace. The government has responded with a national strategy for mental health and work 1. This document aims to provide the context and case for improving mental health and managing stress in the workplace, and outlines management approaches that organisations can use to provide benefit to both employer and employee.
3 Mental Health and Stress Why stress and mental ill-health are different problems for an organisation Confusion between stress and mental ill-health can lead to organisational inactivity. Managing stress can prevent mental ill-health and resultant absences. The Health and Safety Executive (HSE) defines stress as the adverse reaction people have to excessive pressures or other types of demand placed on them at work. However, stress is not an illness but a state that can be good as well as bad; the pressures and demands that cause stress can have a positive effect, although excessive and prolonged stress could lead to mental and physical illness. The most common presentations of mental ill-health are anxiety and depression, which may be the result of issues such as a difficult life event such as bereavement or problems at work. Many organisations see mental ill-health and stress as a Pandora s box that should not be opened, for fear of all the stress cases that may be identified. However, managers should work towards viewing stress and mental ill-health differently, the default positions for stress should not be time off work, nor turning a blind eye. Stress in life is unavoidable, but needs to be managed and controlled, to prevent the excessive and prolonged exposure that will lead to mental ill-health problems. While there is a lack of data relating specifically to the rail industry, stress is considered as being one of the industry s major work-related ill-health issues. Across the wider transport and communications sector, the 2010 TUC biennial survey of safety representatives showed stress as the most frequently identified ill-health hazard at 59% 2. Stress was also identified in RSSB research on the management of health needs (2005), as the second biggest health problem of concern to the rail industry 3. These findings are in agreement with the 2012 Chartered Institute for Personnel and Development (CIPD) report that put stress as the single major cause for absenteeism 4. Since stress is acknowledged as an issue in all organisations, the question must be how can organisations control stress levels?
www.rssb.co.uk 4 The medical profession itself has difficulty with a lack of distinction between non-specific psychological symptoms and diagnosable mental illness; it is a debate over the provision of more healthcare, set against concerns about over-medicalisation. And so it is not surprising that many organisations have failed to act decisively on this issue. However, there is strong evidence that work is generally good for mental health and the benefits usually outweigh the risks 5. Opitmum Stress = Positive wellbeing Boredem Performance Unhappiness Anxiety The Pressure performance curve. The target for organisations is a balance between too much and too little pressure
5 Mental Health and Stress Take action to improve your organisation s strategy Taking action to improve organisational conditions and controls is a big step, but support and guidance are readily available. There are a number of reasons why employers should take steps to make adjustments for people with mental health conditions. There are legal requirements, which are defined in the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. But there are also more positive reasons, such as making your organisation a responsible and engaging place of work. There is much that an employer can do to improve the management of mental wellbeing in the workplace. A proactive organisation could be defined as one that recognises that work is on the whole very good for mental health 6 in terms of getting employees back to work, and who actively promotes productive and healthy working conditions 7 to prevent workrelated ill-health problems. NICE provides recommendations to employers on how they can promote mental wellbeing through productive and healthy working conditions, key points 8 include: Provide a strategic and coordinated approach to promoting employees mental wellbeing. Integrate the promotion of mental wellbeing within all policy and practices concerned with managing people. Create an awareness and understanding of mental wellbeing and reduce the potential for discrimination and stigma related to mental health problems. Adopt a structured approach to assessing opportunities for promoting employees mental wellbeing and managing risks. Provide the opportunity for flexible working, where practical, and promote a supporting culture. Strengthen the role of line managers in promoting the mental wellbeing of employees through supportive leadership style and management practices.
www.rssb.co.uk 6 NICE recommends the use of frameworks to promote and protect employee mental wellbeing, for example: HSEs Management standards for work-related stress 9. This focuses on changes to the organisation and job rather than the individual. It identifies the six main sources of stress as being: Demands in the workplace, such as workload The control an employee has in the way they work The support they are given Working relationships A person s role within an organisation Organisational change Against each of these risk areas, the HSE management standards highlight good practice. Your organisation could put together plans to make managers aware of these standards and how to use them. Photo: Network Rail Is your organisation onto the right track to manage health?
7 Mental Health and Stress Use the resources available to help your line managers engage with this topic The NICE, NHS and CIPD guides will assist your line managers to understand and promote the mental wellbeing of their staff. The Equality Act (2010) outlines an employer s duty to make reasonable adjustments for people with disabilities, in order to ensure that they have the same access to everything that involves gaining or keeping employment as a non-disabled person. From a business perspective, making a few small adjustments to enable a member of staff to continue doing their job is far less expensive than the costs of recruiting and training a new employee. The NHS guide below provides a good resource to help with these adjustments: http://www.nhshealthatwork.co.uk/images/ library/files/government%20policy/ Mental_Health_Adjustments_Guidance_ May_2012.pdf The Shift Line managers resource 10 offers a guide to line managers about engaging with people experiencing mental health problems. It covers many of the issues line managers have about talking to their team members about stressful and mental health issues such as: Identifying early signs of distress Using ordinary management procedures to identify problems and needs Understanding patterns of absence Things to consider when an employee appears or says that they are stressed Talking at an early stage Engaging with someone who is reluctant to talk about their mental health Managing an employee who becomes tearful and upset Managing the rest of the team Communicating with colleagues
www.rssb.co.uk 8 Line managers can find useful suggestions for talking about stressful situations with their team members in this document: http://www.hse.gov.uk/stress/pdfs/ manage-mental-health.pdf There s no one right way to talk about mental health - everybody s different. But what s important is to try. Far better to talk and occasionally say the wrong thing than to ignore the problem and hope it will go away. Carrie Thomas, mental health trainer Further useful resources for line managers can be found on the MIND website: http://www.mind.org.uk/media/43719/ EMPLOYERS_guide.pdf and another about taking stock of mental health in your market place which gives guidance to line managers: http://www.clearkit.co.uk/ public/cms/80/87/101/921/resource_2_take_stock_of_mh_in_ your_workplace_final.pdf?realname=zjpyu1.pdf
9 Mental Health and Stress Help your employees become more resilient to stress Guides to build resilience within your employees as part of your mental health strategy are waiting to be used. The HSE stress management standards can help an organisation to positively affect the mental health of its employees. In addition to the HSE resource, organisations may also offer their employees help to make them more resilient to pressures at work. CIPD recommends an employee-centred approach 11 where individuals are provided with education and support to help them deal with the problems they face in the workplace. Business in the Community have developed an Emotional Resilience Toolkit 12 which provides a practical guide to promoting the resilience of individuals and teams in the organisation. This includes a 12-step model for developing an initiative to build emotional resilience as part of a health and wellbeing programme. The steps are listed below; and you can find full details and a business case and best practice recommendations, by downloading the toolkit at, http://www.bitc.org.uk/ourresources/report/emotional-resilience. 1. Identify perceived health and wellbeing issues and programme vision 2. Know the business environment 3. Create the project team 4. Evaluate current resources 5. Create/review the core framework 6. Undertake a needs analysis and establish KPIs 7. Clarify initial objectives 8. Develop the year s programme 9. Find the right business partners 10. Communicating the programme 11. Launching the programme 12. Evaluation and on-going programme management
www.rssb.co.uk 10 Transport for London Learning to be resilient to stress Transport for London (TfL) started their stress reduction group in 2004. Its aim is to teach employees life skills to deal with difficult times and build a long lasting resilience to stress. The group is facilitated by skilled experienced counsellors and uses different behavioural techniques to help employees understand and manage stressful situations more effectively. Each group contains six to twelve employees who attend a two-hour session every week for six weeks. Follow up sessions are available for any employee who requests additional support at a later stage. The effects of stress were monitored before and after the group began. After three years, the numbers of working days lost for employees who went on the course came down from over 3,000 per year to around 1,000. This saving of 2000 days represents a cost saving to the business of approximately 400,000. Source: ORR health case studies Transport for London are already seeing the benefits of their work in this area Employee guidance on managing stress Network Rail have produced stress guidance for line managers on mental health using the MIND document called: Emotional Health, http://www.mind.org.uk/media/43719/employers_ guide.pdf East Midland s OH provides face-to-face toolbox talks lasting two hours, to promote awareness of psychological and MSD in workplace. TfL have produced a managing stress-employee guide. Rail organisations are starting to act to improve performance within this area.
11 Mental Health and Stress Case studies from learning organisations Many organisations have decided to act to manage mental health and stress rather than believe it is beyond them to make a positive difference. Case Study BT - strategy for mental health The mental health strategy consists of three phases: Reducing stress at source through workplace and job design Identifying early signs of stress and supporting individuals to address work pressures that cause stress Helping people suffering from stress to cope and recover The strategy has resulted in initiatives that promote good health, prevent illhealth, identify those at risk and provide early intervention. Over the past four to five years, the sickness absence rate due to mental health problems has fallen by 30% despite pressured market conditions and BT now gets almost 80% of people who have been off for more than six months with mental illness back into their own jobs, compared with 20% nationally. http://www.hse.gov.uk/involvement/ casestudies/btgroup.htm Many of the largest UK and global organisations are engaging with the mental ill-health stress issue. They are finding business benefits for their organisations and improving the working lives of many employees.
www.rssb.co.uk 12 Case Study Hertfordshire Wellbeing programme for schools The Hertfordshire s Grid for Learning web page provides guidance for school on managing stress, which includes: Stress management and wellbeing guidance for schools. Model HR policies for stress and wellbeing. Information on the Wellbeing programme which works with schools to create a healthy and positive working environment. Stress management toolkit which includes a stress survey form, stress risk assessment and action plan and guidance on how to complete a risk assessment. General guidance on mental health and HSE standards. Information on a third party employee assistance programme for schools at a small cost per employee per annum. This covers areas of work-life balance, managing stress, handling conflicts and help individuals to improve their skills and confidence and deal with personal areas such as buying a house, managing money etc. http://www.thegrid.org.uk/info/ healthandsafety/stress.shtml The longer organisations like Hertfordshire s Grid for Learning tackle mental health issues, the stronger their solutions become. Leaving these issues unresolved will just hide the problems.
13 Mental Health and Stress Further Information Promoting mental wellbeing through productive and healthy working conditions: guidance for employers, PH 22, NICE, 2009 http://guidance.nice.org.uk/ph22/guidance/pdf/english Government national strategy on mental health: https://www.gov.uk/government/publications/the-mental-health-strategy-for-england HSE Management standards for work-related stress, HSE, 2008: http://www.hse.gov.uk/stress/standards/index.htm and a guide for employers on making the Mangement Standards work: How to tackle work-related stress http://www.hse.gov. uk/pubns/indg430.pdf Sainsbury Centre for Mental Health identifies key components of effective work-based programme: http://www.centreformentalhealth.org.uk/index.aspx BITC Emotional Resilience Toolkit: http://www.bitc.org.uk/resources/publications/ emotional_resilience.html Mindful employer Line Manger s Resource A practical guide to supporting staff with a mental health condition, Mindful Employer, 2011 (an update to www.shift.org.uk which provides SHIFT Line Manager s Resource: for practical guidance on managing and supporting people with mental health problems in the workplace): http://www.hse.gov.uk/stress/pdfs/manage-mental-health.pdf The Work Foundation provides reports and event relating to resilience: http://www.theworkfoundation.com/research/workforce-effectiveness/health-wellbeing/ Resilience Vocational rehabilitation: what is it, who can deliver it, and who pays?, Sainsbury Centre for Mental Health, 2008: http://www.centreformentalhealth.org.uk/pdfs/vocational_rehab_what_who_paper.pdf Foresight Mental Capital and Wellbeing Project, final project report, The Government Office for Science, 2008 Sets out its suggestions for employers on promoting good mental wellbeing and the enhancement of mental capital: http://www.bis.gov.uk/assets/biscore/corporate/migratedd/ec_group/116-08-fo_b New Economic Foundation Five ways to wellbeing, A five-a-day programme of social and Five Steps a Day personal activities that can improve mental well-being. The five steps are Connect with people; Be active; Be curious; Learn; Give http://www.neweconomics.org/projects/five-ways-well-being
www.rssb.co.uk 14 IOSH provides an occupational toolkit for stress with training material, preventative action, early action and interventions, referrals and rehabilitation and further information. NHS Choices provides information on understanding and managing stress, anxiety and depression: http://www.nhs.uk/pages/homepage.aspx Notes 1 Working our way to better mental health: a framework for action, Department of Work and Pensions and Department of Health 2009 2 ORR overview of work related ill-health in the GB rail industry in 2010, ORR, 2011 3 RSSB research project T389 Management of Health Needs Report 1: The current position across the rail sector, 2005. 4 CIPD Absence Management Annual Survey Report 2012 5 Is work good for your health and wellbeing? Waddell & Burton 2006). 6 Vocational rehabilitation: what is it, who can deliver it, and who pays?, Sainsbury Centre for Mental Health, 2008 7 Promoting mental at work: guidance for employers, PH 22, NICE, 2009 8 Promoting mental wellbeing at work: guidance for employers, PH 22, NICE, 2009 9 HSE Management standards for work-related stress, HSE, 2008 http://www.hse.gov.uk/stress/standards/index.htm 10 Shift the Department of Health s programme to reduce the stigma and discrimination directed towards people with mental health problems http://www.hse.gov.uk/stress/pdfs/ manage-mental-health.pdf 11 http://www.cipd.co.uk/hr-resources/factsheets/stress-mental-health-at-work.aspx 12 Emotional resilience toolkit Healthy people = healthy profits, BITC, 2009
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