Healthy Minds, Healthy Business: Strategies for Supporting Employee Mental Health
"What's it like working where you work?
‘Busy’ I expect you’d say. Everybody being asked to do more with less, reading your work email on a device at home, sleeping with your phone next to your bed in case there’s a call, working evenings and weekends just to do more work the next day, waking up in the night thinking about work, speaking on the phone before your family in the morning, snapping at your loved ones. Recognise any of these?
Sorry to be the bringer of bad news, but these are all early signs of stress.
You won’t be surprised to hear that most of these things are common, the new norm you might say.
According to the Health and Safety Executive (HSE), in 2020/21, an estimated 828,000 workers in the UK were affected by work-related stress, anxiety, or depression.
A study conducted by the mental health charity Mind found that 1 in 4 people in the UK experience a mental health problem each year. More than half of all of us will experience some kind of stress, anxiety, and depression during our working lives. As stated earlier, these conditions are very common and were responsible for 18.5 million days of work lost in the UK in 2022, a dramatic increase from 13 million in 2010. Absence from work because of mental health conditions (which includes stress, depression, anxiety and serious mental health problems) is the third single largest reason for absence from work in the UK for women, and the fifth largest for men. We should also recognise here that it is extremely likely many people who take time off for stress do not provide that as a reason (especially men), so the official statistics could easily be skewed, and the numbers are likely to be significantly higher.
It’s obvious therefore this is a substantial problem for all businesses, across all industries. And yet, we still seem to struggle to seriously deal with this issue in the workplace and truly focus on how we might best support people's mental health while at work.
Why is that?
Mental health is of course complex, but we can be sure of one thing, overall, people who have poor mental health do want to be at work, they just struggle to do that sometimes. Whether having to manage a mental illness or not, most employees want to be seen as top performers, they want the business to succeed and feel like they contribute to that success, but many struggle due to anxiety, depression, and other types of mental illness. Added to this, some may also be trying to manage side effects from prescribed medications which can range from drowsiness and unpredictable issues to hallucinations and even suicidal thoughts.
When people with poor mental health are at work, they may have difficulty concentrating, communicating, or juggling multiple tasks, and get frustrated sometimes with customers and colleagues, but they often won’t speak to their manager about it. The manager usually doesn't know how to have that conversation, and the employee doesn't know if the manager is going to support them or stigmatise them, or potentially even try to manage them out of the organisation. So, our employee who wants to be at work often isn’t aware of the support choices, can't have an open and honest conversation about it, perhaps feels stigma sometimes from the organisation (sometimes from themselves), and the problem just rumbles on until usually something drastic happens. As a result, many employees suffer in silence, don't take the time off they need, and if they do, they give a different reason for their absence.
One of the reasons for all of this is that we don't talk enough about mental health in our workplaces until we're past the breaking point. But why don’t we?
Of course, we're all supposed to be resilient these days, aren’t we? We're supposed to be tough, strong minded and successfully overcome the challenges that are thrown at us each day. It’s what our bosses want isn’t it? That’s probably true, but to have that resilience we all need a good work-life balance. Unfortunately, life isn't always a field of flowers that we skip through to and from work either. For most of us our personal lives contain a whole catalogue of problems covering anything from bills we can’t pay, health worries, anxieties over the kids (or parents), relationships, self-doubt, car problems, separation, bereavement and grief, to name just a few. But we soldier on don’t we, we were taught to go into work even when we shouldn't be there. Stiff upper lip and all that. Believe it or not, there is a name for that, it’s called presenteeism, and it costs the workplace many times more than simple absenteeism.
In case you haven’t heard the term, presenteeism is where employees come into work even though they are unwell or not functioning at their usual level. It happens when employees feel they have to work despite having physical or mental health issues, or when they're afraid of being penalised for taking time off. It can also happen when they feel like they're overloaded with work and can't afford to take the time off. Whilst it may seem like a good thing that employees are still showing up to work despite their problems, presenteeism can be extremely bad for businesses. When employees aren't functioning at their best, their productivity levels drop and mistakes are more likely to be made, leading to missed deadlines, poor-quality work and accidents.
As well as decreased productivity, presenteeism can also directly affect employee wellbeing. When employees come to work when they're unwell, they're more likely to get sicker and may need even more time off to recover. This can create a vicious cycle of absenteeism and presenteeism that's hard to break. Moreover, presenteeism can have a negative impact on overall employee morale and job satisfaction. If employees feel as if they have to come to work when they're unwell or not functioning at their best, they may feel undervalued or unsupported by their employer. This can often lead to lower job satisfaction and ultimately a costly higher staff turnover for the business.
So, how do we create a more supportive environment in our workplace where employees do feel encouraged to speak out honestly about how they are feeling and coping mentally?
Let’s first have a look at ourselves as managers.
As a manager, how would you respond to a new employee who starts your first meeting by saying, "Before we talk about my objectives, I should probably let you know I have anxiety attacks that send me running to the bathroom for 10 minutes at a time, and because of my depression I'll need extra sick days for when I can't get out of bed in the morning. Just so you know." What would you say, honestly (and just a hint, it definitely shouldn’t be, “Maybe we should give HR a call,")?
What if an employee comes to you as their manager and tells you they are struggling with stress, anxiety, or depression. What do you say (and again be honest with yourself)? Is your immediate go-to option to advise them to go and see HR or their doctor, as you’re not trained to deal with it?
So, our employee goes off to see their doctor and she says, “I'm going to sign you off for two weeks." It's the first NHS response, and it's well-meaning. Sometimes time off from work is a good thing, and seeing our doctor is a good thing, but it shouldn’t be the first place for that conversation. Our employee then leaves the surgery with a label, a diagnosis, possibly holding a packet of pills, and facing two weeks of daytime television. Will the situation truly be any better after those two weeks are up?
Unfortunately, we are too quick to disengage people. We need to be having these conversations in the workplace rather than disengaging quickly to move the ‘problem’ onto someone else.
So, what should leaders and managers do?
In the first place, we need to get over the idea that it's taboo for managers to talk about mental health with their employees in the workplace. Understanding that mental health is just as important to address as physical health is the first step that bosses need to take. If an employee comes to you with a broken leg, you wouldn't say, "Everything is fine, you’re OK, just get over it," would you?
We also need to appreciate most people will likely feel that disclosing a mental health problem is tantamount to admitting a vulnerability that could be perceived as a weakness, which in turn might prevent future promotions or even get you fired. So, to reassure employees that it’s safe to come forward with a mental health issue, it's essential that managers support and encourage a truly open and honest environment within their teams, as openness and honesty strengthens relationships and creates a higher level of trust. This highlights the importance of managers taking a step back from projects every now and then to openly connect with their employees on a more personal level. By providing a psychologically safe space and appreciating the struggles employees are going through, managers will be able to establish that higher level of trust.
The organisation itself also needs to support managers in better understanding stress and how to spot the potential symptoms of poor mental health among individuals. Training for managers in this area is woefully lacking in most businesses.
Some potential symptoms of stress to look out for in work colleagues could include:
Increased irritability or agitation.
Decreased productivity or work quality, difficulty concentrating or making decisions.
Difficulty managing workload or meeting deadlines.
Fatigue or low energy.
Instances of lateness, potentially due to sleep disturbances such as insomnia or oversleeping.
Physical symptoms, such as headaches or stomach problems.
Social withdrawal or isolation.
Changes in appetite or weight.
Managers should be aware that everyone experiences stress differently, and some people may show no obvious symptoms. However, if you notice any changes in behaviour or performance in your colleagues, it may be worth having a conversation with them to see how they're doing and if they need any support.
Managers also need to look out for appropriate opportunities to discuss any potential health issues. For example, our HR and occupational health policies on stress, anxiety, depression, or absence are frequently too long, full of jargon, and self-serving. The same goes for our absence procedures. When someone calls in sick on that first day, or you’re ticking the procedures box by having a quick ‘return to work’ interview, that’s a golden opportunity for a dialogue on mental health, don’t miss it.
When an employee comes forward with a personal issue they are facing, responding with "I feel that way sometimes," or "Someone in my family is dealing with that right now,” or even a simple, “I know how hard it can be," immediately makes the employee feel comfortable and creates a stronger, more personal connection.
Leaders and managers need to talk openly and often about mental health in the workplace. If we take time to do this, the positive language and conversation will cascade throughout the organisation. Remember, you don't make more people unwell by speaking about mental health, you give them the opportunity to seek help sooner.
Leaders and managers who talk about mental health universally gain respect. Managers need to be encouraged to talk about mental health in the workplace and be trained to spot the signs and symptoms, know what to say, know when to say it, know when to shut up, and know how to have a human conversation. If you're a manager, use this rule of thumb: be the manager you would like to have if you were experiencing stress, anxiety, or depression.
But it’s not just about leaders and managers doing the right thing is it? We are regularly reminded throughout the health and safety training we receive that we all have a duty of care to look out for ourselves and our colleagues, although in most instances this is focussed on physical safety and wellbeing. We often forget this duty of care should extend to our mental wellbeing also. When new employees join an organisation they receive training on how to lift a box, which is great, but why don't we talk to them about how to spot signs of stress, how to have a conversation with a struggling colleague, or to encourage them if they see a fraught colleague to say something, like, "how are you?" or simply, "can I get you a cup of tea?", or to encourage them to say something to a manager or a colleague if they feel they are struggling with their own mental wellbeing.
Many leaders have already begun this journey of transformation in making their organisation a truly caring one, and all credit goes to them, but if your organisation hasn’t yet, where can you start?
Firstly, we need to remember, this isn’t just a one-and-done conversation or a poster on the back of the toilet door, it's a truly cultural shift that will take time, potentially a lot of time. The good news though is that everyone can make it happen. It doesn’t necessarily require a big mental health campaign to kick it off in your organisation (although that isn’t a bad thing), perhaps all that is needed initially is a pot of tea, a tray of sandwiches, a packet of post-it notes, and some employees who have taken time off due to mental health concerns. They will give you all the information you need to get started.
Taking it to the next stage, in the UK you could partner with a NHS backed charity like Mindful Employer, or hire a consultant who will provide additional support and lots of experience. My own company has already established an excellent employee assistance programme which provides free personal telephone counselling to any employee who feels they need it. These are all great initiatives that will support your employees and contribute to a truly healthy and productive workplace, but whatever you choose to do, don’t treat these programmes as something to bolt on the side of your organisation and tick the box…job done. That won’t work alone. This programme needs to be fully integrated across the culture of the organisation, something everyone lives and breathes every day.
The most important thing is to listen to your people, write their concerns and ideas down, make changes where needed, and rinse and repeat on an ongoing basis. Remember, the Health and Safety Executive already expects employers to do this.
Who knows, in the future, we may see virtual reality software that trains managers in the best techniques, mindfulness meditation in meetings, little emojis that pop up on your screen asking how you are (heaven forbid), and psychotherapy through mobile devices. Undoubtedly these things are already being trialled right now, however, in reality it’s not always about making a significant financial investment in technology or consultancy support.
All we truly need to do is to make a commitment to:
Provide a safe space to talk about mental health in each of our workplaces.
Encourage human conversations.
Provide our managers and all employees with the necessary training and resources to spot the signs and symptoms of mental health issues, know what to say, when to say it, and when to listen.
As employers, all we need to do is give people permission to speak safely and be prepared to listen. It's a huge cultural shift for many of us, but it's one that we can all make.
Here are five top actions that an organisation can take to support a more open and honest culture around mental health in the workplace:
Encourage communication and transparency: It's important to encourage open communication between managers and employees, and to create an environment where employees feel comfortable openly discussing their mental health concerns. This can be achieved through regular briefings, team meetings, and one-on-one conversations.
Provide mental health training: Organisations should provide mental health training to all employees, including managers and supervisors, to help them recognise the signs of mental illness and know how to support employees who may be struggling.
Offer mental health support services: Companies can offer access to mental health support services, such as an Employee Assistance Program (EAP), to help employees who may be experiencing mental health issues. This can include counselling, therapy, and other resources.
Implement good mental health policies: It's important for organisations to have clear policies in place around mental health, including guidelines for managers on how to support employees who may be struggling, and policies around what mental health accommodations are available, such as flexible work arrangements.
Lead by example: Finally, organisations should lead by example and demonstrate their commitment to mental health by creating a culture that supports and prioritises employee wellbeing. This can include offering mental health days, encouraging work-life balance, and ensuring that managers are trained to recognise and respond to mental health issues.
There are several legal and ethical considerations around mental illness in the workplace that employers need to be aware of. Here are some key points to keep in mind:
Anti-discrimination laws: Under the Equality Act 2010, it is illegal for employers to discriminate against employees or job applicants based on their mental health status. Employers must ensure that their policies and practices do not disadvantage employees with mental health conditions.
Privacy and confidentiality: Employers have a legal obligation to protect the privacy and confidentiality of employees with mental health conditions. This includes ensuring that employee health information is kept confidential and only disclosed to those who need to know.
Reasonable adjustments: Employers have a duty to make reasonable adjustments to support employees with mental health conditions, such as providing flexible working arrangements or modifying job duties.
Duty of care: Employers have a duty of care to provide a safe and healthy work environment for all employees, including those with mental health conditions. This may include providing training and support to help employees manage their mental health and prevent harm to themselves or others.
Stigma and culture: Employers have an ethical responsibility to create a workplace culture that supports and prioritizes employee wellbeing. This includes reducing stigma around mental health, promoting an environment where employees feel comfortable discussing their mental health concerns, and providing access to mental health support and resources.
Source data: The UK government's Equality Act 2010 provides legal protections against discrimination for people with mental health conditions. The Health and Safety Executive (HSE) provides guidance on managing mental health in the workplace, which includes information on employers' legal obligations under UK legislation.