***HIGHLY COMMENDED - HR & MANAGEMENT - BUSINESS BOOK AWARDS 2021*** Provides guidance for both employers and staff on promoting positive mental health and supporting those experiencing mental ill health in the workplace The importance of good Mental Health and Wellbeing in the Workplace is a subject of increased public awareness and governmental attention. The Department of Health advises that one in four people will experience a mental health issue at some point in their lives. Although a number of recent developments and initiatives have raised the profile of this crucial issue, employers are experiencing challenges in promoting the mental health and wellbeing of their employees. Mental Health & Wellbeing in the Workplace contains expert guidance for improving mental health and supporting those experiencing mental ill health. This comprehensive book addresses the range of issues surrounding mental health and wellbeing in work environments - providing all involved with informative and practical assistance. Authors Gill Hasson and Donna Butler examine changing workplace environment for improved wellbeing, shifting employer and employee attitudes on mental health, possible solutions to current and future challenges and more. Detailed, real-world case studies illustrate a variety of associated concerns from both employer and employee perspectives. This important guide: * Explains why understanding mental health important and its impact on businesses and employees * Discusses why and how to promote mental health in the workplace and the importance of having an effective 'wellbeing strategy' * Provides guidance on managing staff experiencing mental ill health * Addresses dealing with employee stress and anxiety * Features resources for further support if experiencing mental health issues Mental Health & Wellbeing in the Workplace is a valuable resource for those in the workplace wanting to look after their physical and mental wellbeing, and those looking for guidance in managing staff with mental health issues.
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1 Understanding Mental Health and Wellbeing
Defining Mental Health and Wellbeing
Dimensions of Wellbeing; Social and Spiritual
Physical and Mental Health and Wellbeing
Wellbeing is Subjective
Who Experiences Mental Ill-health and What Are the Causes?
Defining Mental Ill-health
Recognizing and Understanding Specific Mental Health Problems
Life Changes and the Impact on Mental Health and Wellbeing
Grief and Mental Health
2 Is Work Good for Your Mental Health and Wellbeing?
The Health and Safety Executive's Management Standards
Review of the Health of Britain's Working Age Population
Thriving at Work Review
Work and Stress
Investing in Employee Wellbeing and a Mentally Healthy Workplace
3 How to Be a Good Place to Work
Take Staff Wellbeing Seriously – From the Top
Promote a Culture of Openness Around Wellbeing and Mental Health
Inform Staff, Listen to Staff, and Involve Them with Decision-making
Encourage a Healthy Work–Life Balance
Provide Opportunities for Learning and Development
Establish and Promote Positive Working Relationships and Social Activities
Provide a Good Physical Work Environment
4 How to Look After Your Wellbeing at Work
Establish and Maintain a Good Work–Life Balance
Take a Proper Lunch Break
Take a Holiday
Manage Stressful Busy Periods at Work
Know Your Limits. Be Assertive; Say No!
Be Assertive About What You Want
Get Help with Your Work
Build Positive Relationships with Others
Dealing with Bullying and Harassment
Wellness Action Plans
Break up Sitting Time; Get Moving
Make the Best of a Bad Job; Make Your Job Work for You
5 Manage Your Mental Health at Work
1. Proactive Planning: Identifying What You Can Do to Avoid Episodes of Ill-health
2. Maintenance: Identifying What Will Help You Stay Well
3. Risk Management and Crisis Planning
6 Supporting Staff Experiencing Mental Health Problems
Addressing the Stigma of Mental Ill-health
Talking About Mental Ill-health
Planning to Help Prevent a Deterioration in Mental Health
How Should I Approach the Meeting with the Member of Staff?
Wellness Action Plans
Supporting Staff Through Ill-health and Back to Work
Being Supportive When an Employee is Off Sick
Preparing for an Employee's Return to Work
Reasonable Adjustments and the Access to Work Scheme
Building Resilience to Maintain Mental Health
Risk and Crisis Management
Websites, Books, and Resources
Health and Mental Health Organizations
Work and Employment Advisory Organizations
Mental Health Training
Therapy (see pages 209–213 for more information about therapy)
Books by Gill Hasson
Ebooks by Gill Hasson
Find Out About Therapy
The Health, Employee, Learning and Psychotherapy Service at Brighton and Sussex University Hospitals NHS Trust
In-House Counselling and Psychotherapy Services
About the Authors
End User License Agreement
Table of Contents
“I welcome this practical resource that clearly helps to provide authoritative advice on this key subject. Mental health and wellbeing are important, and too often ignored, it is great to see clear explanation and practical advice in this comprehensive text.”
Dr Steven Boorman CBE, Director of Employee Health
“This book is a valuable resource in helping us meet the challenge of recognising mental health issues in the workplace. As a society, we're gradually chipping away at the stigma that still exists, and through Gill and Donna's work on this book and the work pioneered at Brighton and Sussex University Hospitals, we can continue to change attitudes and promote genuine wellbeing at work.”
Dame Marianne Griffiths, Chief Executive of Western Sussex Hospitals NHS Foundation Trust
“This is a valuable resource, especially for employers, managers and employees but also for all concerned about mental health at work. It tackles some of the most important challenges in today's workplace, and makes good use of recent evidence.”
Professor Dame Carol Black, Expert Advisor on Health and Work to the Department of Health and Public Health England
Mental Health and Wellbeing in the Workplace is a must-have book for both employees and employers.
Beautifully written, easy to follow and packed with vital knowledge and practical strategies. This is not an opinion-based book. Its' evidence based, referencing fascinating studies because the expert authors have really done their homework and brought this together with their wealth of actual experience on the subject. With the ever-growing crisis of stress related illness in the workplace and mental health problems in society at large, these experts have given readers a true gift in knowing how to properly support self- care and for employers, the caring of others.
Dr Margot Sunderland, D.Psych - Director and Founder of The Institute for Arts in Therapy and Education
This edition first published 2020
© 2020 Gill Hasson & Donna Butler.
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, United Kingdom
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Library of Congress Cataloging-in-Publication Data is Available:
Names: Hasson, Gill, author. | Butler, Donna (Donna Margaret), author.
Title: Mental health and wellbeing in the workplace : a practical guide for employers and employees / Gill Hasson, Donna Butler.
Description: Chichester, West Sussex : Wiley-Capstone, 2020. | Includes bibliographical references and index.
Identifiers: LCCN 2020004334 (print) | LCCN 2020004335 (ebook) | ISBN 9780857088284 (paperback) | ISBN 9780857088307 (adobe pdf) | ISBN 9780857088291 (epub)
Subjects: LCSH: Psychology, Industrial—Great Britain. | Employees—Mental health—Great Britain. | Quality of work life—Great Britain. | Employee health promotion—Great Britain. | Personnel management—Great Britain. | Work—Psychological aspects. | Work environment—Psychological aspects.
Classification: LCC HF5548.8 .H353 2020 (print) | LCC HF5548.8 (ebook) | DDC 158.7—dc23
LC record available at https://lccn.loc.gov/2020004334
LC ebook record available at https://lccn.loc.gov/2020004335
Cover Design: Wiley
Cover Image: © Elaine Barker/Shutterstock
To our sons Jake and Tom who brought us together.
Adults in employment spend a large proportion of their time at work, so our jobs and workplaces can have a big impact on our physical and mental health and wellbeing. There is clear evidence that good work improves health and wellbeing across people's lives, both in terms of quality of life and economically. This entails working in an environment that is safe, as well as having a sense of security, autonomy, control, good line management and good communication.
However, for some people, work can also be a cause of stress and anxiety and alongside life's challenges, people's circumstances and experiences can further compound problems, which can lead to experiencing common mental health problems. This puts further strain on individuals and those they care for and about.
There is a growing emphasis amongst politicians, academics, trade unions, mental health organisations, employers large and small and workers on promoting good mental health and preventing mental ill health. This is important, as one in four adults experiences at least one mental health problem in any given year, and early signs of poor mental health, including feeling anxious, stressed, having low mood or trouble sleeping, can affect everyone. And in 2018, 17.5million working days were lost in the UK due to stress, depression, anxiety and serious mental health problem-related sickness absence. This costs UK employers an estimated £8 billion per year in lost productivity.
Supporting good mental health is about having a whole workplace approach as part of overall health and wellbeing, preventing problems, and intervening early and providing effective support and care to those experiencing mental illnesses. It is also about working in a way that encourages and supports good practice amongst managers and staff alike, and having a compassionate environment that values everyone.
At Public Health England, we have established better mental health as one of our ten priorities in our 2020-2025 strategy. Our aim is to ensure that mental health has parity with physical health, modelling the role that organisations can play as employers whilst embedding good mental health across our own work. We are also supporting the NHS on the mental health components of their Long Term Plan, including suicide prevention and new models of care to improve the health and wellbeing of people with severe mental illness.
This book provides resources to empower employers and their staff to plan ahead for the near and long-term future, on everything to do with promoting good mental health in the workplace. It highlights a variety of practical steps that can be taken intertwined with stories and case studies. The themes that run throughout are the importance of open, supportive communication and of training and education for employers, management and staff.
Wellbeing and good mental health are not only good for the individual and their ability to thrive and enjoy their work, but it is also vital for the prosperity and productivity of their organisation, a veritable win:win for everyone.
Chief Executive of Public Health England
How we spend our days is, of course, how we spend our lives.
For many of us, a large part of our days is spent at work; it's reckoned that we will spend 3507 days at work over a lifetime. The average person spends a quarter of their adult life at work. Work can give us a sense of purpose, structure, and satisfaction while also providing the means to finance daily life. It can also cause stress.
In fact, mental health and wellbeing at work is one of the most important issues facing all of us. Global organizations, national organizations, small organizations, trade unions, politicians, mental health organizations, employers, and, of course, employees, their families and friends are all becoming increasingly concerned about mental health and wellbeing in the workplace.
Managing mental health and wellbeing at work starts with understanding what mental health and wellbeing are. In Chapter 1 we explain this. We also explain what mental ill-health is and we describe the signs and symptoms of some common mental illnesses. Our mental health and wellbeing can change not just from day to day, month to month, and year to year, but at key stages and changes in our lives; you'll also read in Chapter 1 how some key life stages can adversely impact on our mental health and wellbeing.
In Chapter 2 we look at the impact that work can have on our mental health and wellbeing. We ask the question ‘Is work good for you?’ The answer is yes. And no. The research consistently reflects what we all already know: people are suffering at work; they're finding the increasing demands of work pressure untenable.
Issues such as a poor working environment, unrealistic deadlines, poor communication, poor interpersonal relationships, too much responsibility, and a lack of management support can significantly impact on the wellbeing of people at work. People get stressed. Especially if they're also dealing with difficulties and problems outside of work. People get stressed when they feel overwhelmed or unable to cope as a result of pressures and demands that are unmanageable; when they feel they have little control over a situation.
It doesn't have to be this way! In recent years, there's been plenty of interest and research telling us how to turn things around. In 2017, for example, an independent review – Thriving at Work – led by mental health campaigner Lord Dennis Stevenson and Paul Farmer, chief executive at Mind and chair of the NHS Mental Health Taskforce. Thriving at Work sets out a framework of core standards that all UK employers, it suggests – no matter what their size or the industry in which they operate – can implement to address workplace wellbeing and mental health.
In Chapter 3 we explain how organizations and managers at all levels can implement some of the recommendations made in the Thriving at Work review. You'll read how to assess, improve, and maintain wellbeing in the workplace. In other words, how to be a good place to work.
Of course, it's not all down to organizations and their leaders to up their game. There's a lot that individual employees can do to develop their own wellbeing and resilience. Chapter 4 has a wealth of practical advice and suggestions that can help individuals to, amongst other things, have a healthy work–life balance, manage stress at work, create positive relationships with colleagues, and look after their physical health at work.
However, although there's plenty that each of us can do to develop and maintain our wellbeing, we're not invincible. For one reason or another, any of us can experience a mental illness. In Chapter 5 we look at how best to manage at work if you have been or are currently unwell. We explain the importance of identifying what could trigger a downturn, what you can do to help yourself to be well, and what to do in a crisis. Throughout this chapter and the previous one, we emphasize the importance of not needing to do any of this – looking after your mental health and wellbeing – on your own. There is help and support out there.
In the last chapter – Chapter 6 – we write about how managers can help and support employees with mental health problems. There's a lot to take into account, but if you are a manager, do be reassured that no one is expecting you to know all the answers, or to know as much as a trained mental health professional. But having some knowledge, understanding, and training in mental health will help you know when and how far you can help, when to ask for support, and when to refer someone to other agencies.
Employers that genuinely promote and value wellbeing and good mental health and support people – whatever their culture, beliefs, and abilities – with mental health problems are more likely to create conditions that allow for everyone to give of their best, to be committed to their organization's goals and values, to be motivated to contribute to organizational success, to feel valued and supported, and to have a positive sense of their own wellbeing.
The World Health Organization (WHO) defines mental health as: ‘A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community’.
Our mental health affects the way we experience the world; how we think, feel, and behave towards ourselves and others. WHO defines mental health as a ‘state of well-being’ and just as physical health is intrinsic to wellbeing, so is mental health.
The mental health organization ‘Mind’ suggests that if you have good mental wellbeing you are able to:
feel relatively confident in yourself and have positive self-esteem
feel and express a range of emotions
build and maintain good relationships with others
feel engaged with the world around you
live and work productively
deal with the stresses of daily life
adapt and manage in times of change and uncertainty.
Both Mind and the World Health Organization's definition of mental health refer to a person's wellbeing. But is wellbeing the same as wellness?
When you think about wellness, think prevention and health. When you think about well-being, think happiness.
Susie Ellis. Chair of the Global Wellbeing Institute
Certainly, happiness is important, but there is more to wellbeing than the positive feelings that come with happiness. Both WHO and Mind recognize that wellbeing involves not just happiness, but crucially, the ability to manage difficulties, problems, and challenges; the ‘normal stresses’.
In 2012, Cardiff Metropolitan University Professors Rachel Dodge and Annette P. Daly et al. published their report The Challenge of Defining Wellbeing. Having reviewed and analyzed past attempts by other researchers to define wellbeing, they concluded that ‘it would be appropriate for a definition of wellbeing to centre on a state of equilibrium or balance that can be affected by life events or challenges’. Consequently they define wellbeing as: ‘the balance point between an individual's resource pool and the challenges faced’.
In other words, wellbeing occurs when a person is able to enjoy life and has the resources to draw on to manage life's ups and downs without feeling overly stressed. Therefore, an important component of wellbeing is resilience; the ability to cope with, as well as bounce back and recover from, difficulties and challenges.
There is no health without mental health.
World Health Organization
One of the key aspects of mental wellbeing is our social wellbeing; the ability to build and maintain good relationships with others. Social wellbeing is the extent to which you feel a sense of belonging and social inclusion. The UK Faculty of Public Health suggests that social wellbeing is ‘the basis for social equality and the antidote to issues such as racism, stigma, violence and crime’ and that it is dependent on, amongst other things, ‘the norm with regard to interpersonal relationships in a group, community or society, including respect for others and their needs, compassion and empathy, and authentic interaction’.
Another feature of wellbeing – just as important as social, mental, and emotional wellbeing, but not so widely acknowledged – is spiritual wellbeing. Spirituality refers to a sense of being connected to something bigger and more everlasting than yourself.
Spiritual wellbeing means the ability to experience and integrate meaning and purpose in life through a person's connectedness with self, others, art, music, literature, nature, or a power greater than oneself.
Spiritual wellbeing is about our inner life and its relationship with the wider world . . . Spiritual wellbeing does not just reflect religious belief although for people of a religious faith it is obviously a central feature.
Dr Ritika Srivastava
Distinctions are often made between mind and body but when it comes to mental health and wellbeing and physical health and wellbeing, we can't think of them as separate entities. Poor physical health can lead to a person developing mental health problems. And poor mental health can have a negative impact on our physical health and wellbeing.
A physical health problem can impact on our cognitive and emotional abilities; adversely affecting our daily lives, our work, and our relationships. Conversely, if our mental health is suffering as a result of, for example, stress, depression, or anxiety, we are less likely to eat and sleep well and may be less physically active which, in turn, can impact our immune system and so our ability to resist infections and illness can be depleted.
Just as when we neglect and ignore our physical health we can become physically unwell, it's also the case that if we ignore or suppress difficult feelings we can become physically unwell.
When we are exposed to stressful experiences or trauma, we can, without realizing it, banish the experience to the unconscious; it's too much to deal with and it's pushed down to the basement of our minds. Eventually – sometimes years later – the stressful/traumatic experience can present as a mental health problem, for example an anxiety disorder. But a stressful or traumatic experience can also manifest itself as a physical disorder.
One evening, Catrice was reversing her car into into the garage, when she heard a scream. She had reversed the car over her partner, Julie. Unknown to Catrice, Julie was sitting on the floor at the back of the garage, fixing her bike. Horrified and shocked, Catrice called an ambulance and Julie was taken to hospital. Although she had sustained serious injuries, they were not life threatening and in time, Julie recovered. However, a week after Julie's admission to hospital, Catrice developed a weakness in her lower limbs. Eventually she found that she was unable to stand; each time she tried, her legs gave way from underneath her.
Following weeks of tests, x-rays, physiotherapy assessments, and orthopaedic referral, Catrice's GP, believing that she was experiencing a ‘somatic response’ – a physical response to an emotional trauma – referred her to a psychotherapist.
Catrice had blocked the feelings – the trauma, stress, and guilt – she experienced as a result of Julie's suffering but those blocked feelings had manifested themselves as physical symptoms. With support from a psychotherapist, Catrice recovered; she was able to forgive herself for the pain and suffering Julie had been through as a result of her actions.
People with mental health problems are more likely to develop physical health problems and vice versa. Furthermore, people with mental health problems can present to their GP or employer complaining of physical symptoms that have no physical cause. This can sometimes lead to missed or delayed detection of the underlying mental health problem. The interaction between physical and mental health is complex and it is often difficult to determine the direction of causal relationships.
Professor Dame Carol Black
In the same way that the repression of stressful experiences can become a physical problem, physical health can impact on our mental health.
Psoriasis – an auto-immune condition affecting a person's skin – is an example of a condition which can impact on mental as well as physical wellbeing. A 2010 study published in the journal Archives of Dermatology found that those living with psoriasis are a third more likely than people without the disease to be depressed or anxious. The physical and psychological impacts can be cyclically linked: the condition can cause emotional distress which can trigger a psoriasis flare and, as a result, cause further distress.
A myriad of factors influence health and well-being, though many are familiar only to those who experience them.
Professor Dame Carol Black
Although there are key aspects to wellbeing – physical, mental and emotional, social and spiritual – wellbeing is subjective; each and every one of us has our own individual thoughts and beliefs about what makes for wellbeing. Our thoughts, ideas, beliefs, and experiences are framed in a narrative – we each have our own story – our own explanation or account of our wellbeing and what may or may not influence it.
For example, one person's account of their experience of depression and anxiety – how they feel, how they manage, and the extent of the impact on their wellbeing – will be different from someone else's experience and account. In another example, a person who is physically unwell or has a physical disability may feel that they have good levels of wellbeing despite illness or disability. Conversely, someone who is perceived as being well and ‘able bodied’ may believe and feel that they are not experiencing wellbeing to any great extent.
And, when it comes to traumatic experiences, professor of psychiatry at the University of North Carolina, Stephen Porges, suggests that the focus cannot be on the event, but on the individual reaction or response. ‘Much of our society defines trauma by the event when the real critical issue is the individual's reaction. By not accepting that, we end up saying: “If I can survive this and do well, why can't you?” So we start blaming the survivors again.’ Porges says that whatever the size or the intensity of the traumatic event ‘when a person has a reaction or response to trauma, the body interprets the traumatic event as a life threat’.
‘One in four’ is widely cited as the number of people who suffer from a mental health problem. The Health Survey for England found in 2014 that one in four people reported having been diagnosed with at least one mental illness at some point in their lives. A further 18% said they'd experienced an illness but hadn't been diagnosed.
As with so much of what it means to be human, our levels of mental health and wellbeing are a result of both genetic (nature) and environmental factors (nurture).
Although no specific genes for depression have been identified, research has shown that if you have a close family member with depression, you are more likely to experience depression yourself. While this might be caused by our biology, (nature) this link could also be because we usually learn behaviour and ways of coping from the people around us as we grow up. (Nurture)
Many factors can contribute to the onset of a mental illness. These include prenatal stress, adverse childhood experiences (ACE), including childhood neglect, abuse, and trauma; stress; bereavement; relationship breakdown; physical and sexual abuse; experiencing stigma or discrimination; unemployment; social isolation and loneliness; poverty, debt, homelessness or poor housing; physical illness or disability.
Mental ill-health can affect anyone, regardless of gender, age, race, ethnicity, religion, geography, sexual orientation, or other aspects of cultural background or identity. But some people are more vulnerable than others.
For example, 7.7 million adults aged 55+ say they have experienced depression and 7.3 million have suffered with anxiety, according to 2017 YouGov research for the charity Age UK. For people over 55, the death of loved ones, their own ill-health, and financial worries are the most common triggers for mental health problems.
In their 2016 report Mental Health Problems in People with Learning Disabilities, The National Institute for Health and Care Excellence (NICE) state that mental health problems in people with learning disabilities are more common than in the general population, with a point prevalence of about 30%.
People from a Black, Asian, and minority ethnic (BAME) background are, according to the UK Mental Health Foundation, generally at higher risk of mental ill-health. They also report that Post Traumatic Stress Disorder (PTSD) is more common in women of black ethnic origin.
The Mental Health Foundation report that evidence suggests people identifying as LGBT are at higher risk of experiencing poor mental health such as depression, suicidal thoughts, self-harm, and alcohol and substance misuse – compared to heterosexual people, due to a range of factors, including discrimination, isolation, and homophobia.
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