UK: Mental Health In The Workplace – A Holistic Solution

Last Updated: 1 June 2015
Article by Alison Garrow

Summary and implications

Mental health issues are having an increasingly significant and costly impact on the workplace. A 2015 Organisation for Economic Cooperation and Development (OECD)¹ report states that mental ill-health is responsible for 30 to 50 per cent of all long-term sickness and disability among the working population. 20 per cent of the working age population suffer from mental illness, and half of us will suffer a period of poor mental health at some time in our lives.

Mental health in the workplace cannot be ignored – the Centre for Mental Health² estimates the annual cost of mental ill-health to employers in the UK is £30bn.

Why should employers care about mental health issues?

  • They affect the bottom line: in days lost to sickness absence, reduced productivity, management time, staff turnover, costs of legal advice and increased insurance premiums.
  • They can be costly in other ways: having a poor reputation for dealing with mental health may have a negative impact on a company's brand – no employer wants the negative publicity associated with a disability discrimination case.
  • Employers have duties imposed on them by law to have regard to the health and safety of their employees and to make reasonable adjustments for employees who suffer from mental health issues that amount to a disability.

The solution: Moving from an adversarial world to a collaborative one

When mental health issues arise in the workplace, they often end in an adversarial situation. In this briefing, we consider how employers could move towards a collaborative approach, using "fitness" for work as the touchstone for a joined up strategy for the employee – with the goal of retaining talent, building a reputation as an "employer of choice" and saving costs.

Many employers recognise the interplay between mental health and work and have committed to embracing a more positive culture in respect of mental health issues – there are over 1,000 employer signatories to the NHS's Mindful Employer Charter, and a significant number of employers have signed the "Time to Change" programme masterminded by mental health charities Mind and Rethink Mental Illness.

There has been a trend among employers to tackle mental health issues through resilience and well-being programmes. Many employers provide access to counselling and an advisory helpline for employees. These are good and useful initiatives, but they do not address the stigma of mental ill-health or how to ensure those who suffer from it are integrated in the workplace. In particular, resilience and well-being programmes do not address when, how and who should intervene with employees with mental health issues.

We have been working closely with centre (a specialist consultancy with expertise in mental health, fitness for work and organisation dynamics). We have identified three areas which focus on education, the early identification of and early action on mental health issues in the workplace:

  1. Policy audit and reform – put in place a mental health policy that directly addresses how mental health issues should be tackled in the workplace and consider how mental health issues can be incorporated in other policies.
  2. Educating and training management/HR – on mental health at work and its legal and organisational implications.
  3. A case-by-case approach for dealing with employees with mental health issues – bringing together the medical, management and legal perspectives.

Have a mental health policy

One of the first steps that a business should take is to develop a mental health policy – this is an important step to help remove the stigma of mental health issues in the workplace.

A mental health policy will in part be determined by the culture of the organisation or the culture that the business wants to promote. A policy may include the following:

  • A commitment to promoting and monitoring mental health.
  • A foundation for creating a "safe environment" removing the stigma and fear of discrimination.
  • Direction to the access to and scope for training on mental health issues (both legal and clinical).
  • An outline of the support for managers and employees.
  • Provision for monitoring and evaluation.
  • Appointment of "Mental Health Champions".
  • The interplay with other policies (such as bereavement, maternity leave and performance policies).

Educating and training management/HR

If a joined-up collaborative approach is to succeed, managers and HR need to be properly trained to enable them to spot and tackle mental health issues early on. Very often managers shy away from dealing with an employee whose behaviour has a negative impact on others in the office and/or on productivity because he or she is unsure of how to raise it with the employee. Receiving training will enable early intervention – increasing the probability of a successful outcome.

Finally, mental health training should seek to reassure managers that they are not being expected to address these issues as "lone rangers" – the business will support them in managing an employee with mental ill-health and will likely seek external advice from a clinical perspective and legal perspective to design a co-ordinated and effective approach to the situation.

Case-by-case approach

One of the keys to the successful handling of a mental health issue with an employee is early intervention. Too often, the employee's manager puts his or her head in the sand and indulges in wishful thinking that the problem will solve itself. Sadly, this is rarely the case. If the issue is picked up and addressed early (through HR or management identifying a problem or self referral), the impact on other colleagues should be lessened and a successful outcome is more likely.

This early action should take the form of seeking both clinical psychological and legal advice. The brief should determine if there is a fitness for work issue or if support/adjustment/time off should be provided. A clear evaluation will enable the business to work through the "diagnosed" problem with regular review and necessary adjustments by management and HR.

Legal advice should be tailored to ensure the employer is fulfilling its legal duties in its response to the situation and appropriately discharging its duty of care. If the situation develops such that the employee leaves the business, legal advice will address how to manage this sensitively and how to avoid giving the employee a claim for disability discrimination or unfair dismissal.

As every individual is different, and mental health issues can take an uncertain path, there will be no "one size fits all" approach. It will often be the case that early intervention enables an employee to keep working and continue to be a productive member of the team. However, there will be situations where the employee is not fit for work and a period of absence or indeed an exit from the business may be the best solution. By working with the employee to support them in their mental ill-health, an amicable departure should be possible and an employer should no longer find itself paying out vast sums in settlement as it will have discharged its legal obligations towards the employee.

If you are interested in finding out more about our work on mental health and our partnership with centre, please contact Richard Brown or Tracey Marsden.


1 OECD (2015) Fit Mind, Fit Job: from Evidence to Practice in Mental Health and Work, OECD Publishing, Paris, 2015

2 Promoting positive mental health at work, Acas, September 2014

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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