Mental Health in the Workplace Dr Paul Litchfield Chief Medical Officer BT Group plc Buffalo, NY- 08 October 2010
Mental health Mental health is more than the absence of mental disorders a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
Life is getting more pressured Greater pace More complexity Constant innovation More competition Increased isolation Less support Reduced certainty
Business is getting more pressured Investor / City perception Competition Customer awareness Technology / Innovation Regulation
Pressure v- Performance Performance Pressure
Prevalence of mental illness Mental illness: is common (approx. 1 in 4 of all adults) affects all age groups affects both genders affects all ethnic groups Therefore companies have to deal with mental illness whether it s work related (20%) or not (80%)
Impact of mental illness on companies ABSENTEEISM Typically 20% of total average spell 3 months Service disruption Replacement costs Retraining & rehabilitation PRESENTEEISM Reduced effectiveness & efficiency Impaired judgement Customer experience Impact on colleagues
Absenteeism Working days lost - UK Source: Confederation of British Industry - 2006
Impact of mental illness on companies Source: Sainsbury Centre for Mental Health - 2007
Business drivers for a mental health framework Legal compliance Cost management Diversity & creativity Social responsibility Corporate image and brand Enhancing performance through wellbeing
Business in the Community - Workwell Model http://www.bitc.org.uk/workplace/health_and_wellbeing/healthy_workplace_model/the_workwell_model.html
Creating a framework setting the mood music Company culture, values and inclusivity Educate on the basis of evidence dispel myths Concentrate on common mental health problems Provide practical tools for people and managers Keep mental health mainstream beware experts Address stigma through multi-channel communications Maintain a business focus at all times
Ensure alignment with business objectives The People Strategy Key Themes 1. Connected performance 2. Engaged people 3. Excellent leadership 4. Transformed skills 5. Healthy environment
Components of a framework Primary Engagement Promote Good Mental Health Secondary Intervention Support when Mental Health at Risk Tertiary Resolution Managing Mental Health Issues Shift in focus with maturity
BT Mental Health Toolkit Promoting good mental health Positive Mentality Management Competencies Managing Pressure Achieving the Balance Support when mental health at risk STREAM Health & Wellbeing Passport STRIDE Employee Assistance Management Managing mental health issues Open Minds Head First Employee Assistance Programme Mental Health First Aid Occupational Health Service
Example of a framework (Good Work Good Health: 2010)
Developing Personal Resilience Rational stop, reflect, choose evaluate, plan, remedy Connected personal meaning relationships home / work self awareness Physical Exercise Nutrition Sleep Mindful time breathing attuned to you http://www.resilient-organisation.org/
Developing Management Competencies Respectful and responsible: managing emotions and having integrity Integrity Managing Emotions Considerate Approach Managing and communicating existing and future work Proactive management Problem solving Empowering Reasoning/managing difficult situations Managing conflict Use of resources Taking responsibility Managing the individual within the team Personally accessible Sociable Empathetic engagement
Support when mental health is at risk Organisational hotspots Vulnerable individuals Identify Act Check STREAM: Stress Assessment and Management
STREAM process
Using STREAM results Individuals and line managers discuss stress-related issues
Using STREAM results Individuals and line managers discuss stress-related issues Senior managers departmental reports on stress profile
Using STREAM results Individuals and line managers discuss stress-related issues Senior managers departmental reports on stress profile BT Group stress-management control and benchmarking
Managing mental health issues Line support Keep in touch Specialist input Adjustment definition Rehabilitation plan Exit options
Preparing for return to work
Planning recuperative working
And then comes the Recession GDP Inflation Public Sector Finances Business Investment
Casualties of an economic downturn Work provides Personal worth Social interaction Life Structure Worklessness can lead to Increased anxiety & depression Hypertension Diabetes Heart Disease Stroke It s about more than just poverty
Most people do not lose their jobs Past focus solely on support for redundant People remaining subject to pressures Effects termed Layoff Survivor Sickness Companies rely on survivors to weather the crisis Companies need survivors to exploit the upturn The way restructuring is implemented is key Casualties and survivors need support
Recent evidence Kieselbach T (Ed). (2009). Health in Restructuring: Innovative approaches and policy recommendations. Bremen. http://www.ipg.uni-bremen.de/research/hires/hires_fr_090518_english.pdf McDaid D (Ed). (2008). Mental Health in Workplace Settings. Consensus paper. Luxembourg: European Communities. http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/consensus_workplace_en.pdf Graveling RA et al. (2008). A Review of Workplace Interventions that Promote Mental Wellbeing in the Workplace. Contract Research Report for the UK National Institute of Health and Clinical Excellence. http://www.nice.org.uk/nicemedia/pdf/mentalwellbeingworkfinalreport.pdf
Timeline for the people impact of restructuring Anticipation Phase Insecurity quantitative (job loss) & qualitative (job deterioration) Anxiety & Depression. Raised BP and cholesterol Heart Disease Men higher risk than women Execution Phase Increased work intensity workload and speed Anxiety & Burn Out. Fatigue, MSD and increased accident rates Middle managers higher risk female managers esp. vulnerable Consolidation Phase Guilt (why me survive?), Uncertainty (me next time?) & Role Ambiguity Depression. MSD and IHD. Disability pensions can double Asynchronous experience for different parts of workforce
Impact of restructuring on a business Sickness absence rates rise may be x 2 This compounds work intensity issues Presenteeism increases may be x 4 Organisational commitment & job satisfaction fall Relationships deteriorate Bullying & harassment Performance usually deteriorates (quality poor even if productivity up) Compliance falls & risk taking increases more accidents Employee turnover rises & remains high after upturn Voluntary leavers tend to have the most marketable skills Productivity rises in 1/3 of companies but falls in 1/3 Only 32% of companies reported a rise in profitability
Mitigating the adverse effects of restructuring Pay adequate attention to Perceived Justice Distributive Justice Selection Criteria ( needs & efficiency ) Procedural Justice Consistency Absence of Bias Accurate Information Interactional Justice Plus Clear, Early, Open and Personal Communication Sound change management Workforce psychology Communications strategy Middle manager engagement
Putting theory into action Company wide Improve people management competencies Address perceived justice issues Greater employee engagement Supportive communications Additional resources for managers Line of Business Analyse data by division & business unit Determine nature of issues and at risk groups Integrate with unit business priorities Construct plan from menu of interventions Deliver through business communication channels Measure impact and revise
Primum non nocerum (Hippocrates) Mental health is a business issue Managers need help to understand it Most interventions are low key and straightforward The economic cost of failure is considerable The human cost can be far higher
paul.litchfield@bt.com