Mental health service users' experiencesof stress in the workplace

All names have been changed to ensureanonymity in four examples, two in theprivate sector and two in the public sector, ofsituations where organisational and individualstress prevention, management andinterventions differ dramatically.

● Emma was completing a Master's degree andworking at a restaurant where she was undera great deal of stress. The conditionsexacerbated her depression and affected herability to perform her job and studyeffectively. Now in a new job, the supportand flexibility offered to her by theorganisation and the personal techniques sheuses enable her to reach her potential andstay healthy.

● Hannah was working for a pensionsconsultancy when she experienced stressburnout. She has been deeply affected bythe experience and believes theorganisation expected too much fromemployees while failing them in a numberof ways. A number of organisational andindividual circumstances lead to herreaching 'breaking point'.

● Kelly had a very positive experience in thevoluntary sector. The organisation had acomprehensive mental health policy andoffered flexible working hours. Equallyimportant was the support she receivedfrom colleagues. She believes the red tapein the public sector often preventsemployers from being supportive toemployees with mental health problems.

● Joanne worked in a public relations rolewhere she was expected to completeimportant tasks, in public, without anytraining or adequate support, even thoughshe had declared her diagnosis of manicdepression. The stress triggered hercondition and eventually led to her forcedresignation. The inhumane treatment shereceived from the organisation, before andafter her employment was terminated, hasaffected her working life ever since.

The full report provides more detail aboutthese service users' experiences. It alsopresents case studies of public and privatesector organisations making effectiveinterventions to prevent and manage stress.

Conclusion

On basis of this research, Mind concludes thatwhile workplace stress is a huge occupationalhealth problem, it is manageable. Moreover, itis clear that employers cannot afford to ignoreit any longer.

We urge understanding and openness to issuesof mental health in the workplace. Equallyimportant, we show that it makes bettereconomic sense for organisations to supportcurrent employees than to have to recruit andtrain new ones, who, if the proper systems arenot in place, will become stressed themselves.

Order Stress and mental health in theworkplace from Mind Publications at £5.00plus 50p postage and packing. Call 0844 4484448 or 020 8519 2122 ext 306, emailpublications@mind.org.uk or visit Mind'sonline shop at www.mind.org.uk/osb

Summary v6 29/4/05 19:57 Page 1

Mind 15-19 Broadway London E15 4BQ T: 020 8519 2122 F: 020 8522 1725 w: www.mind.org.uk Registered charity number 219830Registered in England number 424348

For details of your nearest local Mindassociation and of local services, contactMind's helpline, MindinfoLine on 0845 7660163, Monday to Friday 9.15am to 5.15pm.Speech impaired or deaf enquirers cancontact us on the same number (if you areusing BT Text direct, add the prefix 18001).For interpretation, MindinfoLine has accessto 100 languages via Language Line.

For employees with mental health problems

● Searching for and applying for jobs canbe stressful experiences in themselves, soit is important to recognise and preparefor this.

● Relationships with colleagues are acrucial factor in the experience of stressat work for employees with mentalhealth problems. Therefore, it isimportant to develop supportiverelationships and friendships at work.

● Workplace stress can create mentalhealth problems, or act as a trigger forexisting mental health problems whichmay otherwise have been successfullymanaged. This highlights the importanceof recognising and guarding againstfactors in the workplace that may causestress, or of negotiating adjustments toyour working practices, in reference tothe DDA if necessary.

● You can play a key role in preventingpersonal stress by developing awarenessof the causes and symptoms of your stressand developing personal coping skills.

Summary of key messages For employers

There are a number of key actions thatemployers can take in order to encourage a mentally healthy workplace:

● Demonstrate and encourage awareness,understanding and openness in relationto the issues of stress and mental healthin the workplace.

● Adopt and adhere to formal policies onstress and mental health in the workplaceand commit to addressing both issues.

● Allow employees to make reasonableadjustments, for example, flexi-time,working from home or quiet rooms tohelp them to manage mental healthproblems and work related stress issues.

● Offer resources or procedures to helpmanage stress at work and generallyimprove mental wellbeing, for example,stress awareness training, access tocounselling or stress busting initiatives.

Web: www.robertsoncooper.com

Summary v6 29/4/05 19:57 Page 2

Stress and mental healthin the workplaceExecutive summary

Mind week report, May 2005

Summary v6 29/4/05 19:57 Page 3

Background

In January 2005, Mind commissionedRobertson Cooper, leading consultantsspecialising in occupational stress, to produceresearch on the extent of the problem ofstress in the workplace in England and Walesand what can and should be done about it.

The report looks at the issue from a genericpublic interest perspective (employers andemployees, in particular), as well as from theperspective of mental health service users. It looks at workplace stress as a trigger formental ill health and covers issues of concernto service users such as Disability Discrimination.

Mind's key recommendations

● Employees should be provided withgenuine control over their work and anappropriate degree of self-managementof workload.

● Roles should be clearly demarcated withdefined responsibilities and expectations.

● Employees should have a say in planningand decision making.

● The physical workplace environmentshould be of a high standard, including natural light where possible,good ventilation, good health and safety practices.

● Employees should be actively discouragedfrom working excessively long hours.

● A supportive working environmentshould be provided for people withmental health problems.

● Flexible hours schemes should beintroduced to take account of regularhospital check-ups.

● There should be a gradual return to workfor those who have had to take time outafter illness.

● Positions should be kept open duringsickness absence.

● There should be on-the-job support andmentoring schemes.

● There should be ways of tacklingemployment discrimination andproviding support during periods of ill health.

● There should be government support forproactive recruitment of people withmental health problems.

● There should be better legislation toprotect people with mental healthproblems from discrimination, includingprovision for those who experience episodesof depression of less than 12 months.

● There should be improved mental healthassessment for people applying for the two new benefits to replaceIncapacity Benefit.

Stress in the workplace: some facts

● In a Health and Safety Executive (HSE)report on work related stress, 20 percent of respondents suffered from stressat levels described as “very” or“extremely stressful”.1

● Workplace stress is estimated to be thebiggest occupational health problem inthe UK after musculoskeletal disorders.

● The most common stress related complaintspresented to GPs are depression andanxiety and are reported to affect 20 percent of the UK working population.

Executive summary

1 “The Scale of Occupational Stress: The Bristol Stress and Health at Work Study”, HSE Contract Research Report 265,HSE Books (2000).

2 “Long term sickness absence”, British Medical Journal, 330, pp 802-3.

3 Health and Safety Executive (2004) Health and Safety Statistics Highlights 2003/04. Available at www.hse.gov.uk/statistics/overpic.htm

Summary v6 29/4/05 19:57 Page 4

● Mental health problems, such asdepression and anxiety, now account formore Incapacity Benefit (IB) claims thanback pain.2

● It has been estimated that nearly 10 percent of the UK's gross national product(GNP) is lost each year due to jobgenerated stress.

● Stress is the highest cause of absenceamong non-manual employees, with anestimated 12.8 million working days lostin Britain in 2003/04 due to stress, anddepression or anxiety ascribed to workrelated stress.3

● Nearly three in every ten employees willhave a mental health problem in any oneyear, the great majority of which will beanxiety and depressive disorders.

● The Confederation of British Industry(CBI) estimates that 30 times as manyworking days are lost due to mental ill health as from industrial disputes.

● Mental health problems account for theloss of over 91 million working days each year.

● Half of all days lost through mental ill health are due to anxiety and stressconditions.4

● In a CBI survey of over 800 companies, 98 per cent of respondents said mentalhealth should be a company concern,with 81 per cent of those saying that themental health of employees should be acompany priority.5

● But fewer than one in ten of thecompanies surveyed had an officialpolicy on mental health.

Workplace stress in the public andprivate sectors

Despite the common perception that publicsector employees enjoy shorter hours and aless ruthless culture than their private sectorcolleagues, a survey of TUC Safetyrepresentatives revealed:

● In the public sector, 64 per cent of publicsector employers were concerned aboutoverwork or stress at work, compared to48 per cent of private sector employers.

● Stress was the top ranked concern inboth sectors.6

However, the difference in sickness absencerates between the two sectors is marked.The 2004 Chartered Institute of Personneland Development employee absencesurvey revealed:

● Highest levels of sickness absence in publicservices, with 4.7 per cent of working dayslost per year on average or 10.7 days lostper employee per year overall.

● Lowest rates were found in the privatesector, 3.4 per cent of working days lostper year on average or 7.8 days lost peremployee per year, and equate to a costof £588 per year per employee.7

This imbalance could be due in somemeasure to the fact that the culture withinthe public sector is more accepting of highersickness absence rates relative to the privatesector. Tesco, for example, made headlineswith an initiative to cut short term sicknessabsence by withholding sickness pay for thefirst three days of absence. Such schemes areunlikely to be adopted by heavily unionisedpublic sector organisations.

4 Gray, P. (2000) Mental Health in the Workplace: Tackling the Effects of Stress, London, Mental Health Foundation.

5 CBI, cited by Gray, P., in Mental Health in the Workplace: Tackling the effects of stress, The Mental HealthFoundation (2000).

Summary v6 29/4/05 19:57 Page 5

Mental health in the workplace:the lawDisability is defined by the DisabilityDiscrimination Act 1995 (DDA) as a“physical or mental impairment which hasa substantial and long term adverse affecton a person's ability to carry out normalday to day activities”. Employers have aduty not to discriminate directly againstdisabled applicants and staff, or treatthem less favourably, because of theirdisability, and also have a duty to makereasonable adjustments.

● Fewer than four in ten employers saythat they would consider hiringsomeone with a history of mental healthproblems, compared to more than six inten for someone with a physical disability.8

Stress prevention and management

All organisations should have a stressprevention policy which lays down the waythe organisation deals with stress issues. Allpolicies should include:

1. Why the policy is important and why thebusiness needs the policy.

2. Who is responsible for what.

3. A definition of stress.

4. An indicator of what the businessstrategy is for dealing with stress, inparticular, the general activities thebusiness will be undertaking as a matter of course.

Stress interventionThere are three levels of intervention whenit comes to dealing with workplace stress:

● Primary interventions aimed ateliminating or modifying environmentalstressors to reduce their negative impacton individuals, for example, job redesign,culture change, flexible working or worklife balance policies.

● Secondary interventions focus onincreasing the awareness, resilience andcoping skills of the individual, forexample, stress management training,health promotion activities and skillstraining more generally (without tryingto eliminate or modify the stressors).

● Tertiary interventions concerned withthe treatment and rehabilitation ofdistressed individuals, for example,counselling or return to work policies.

6 TUC (2004) Biennial Survey of Safety Reps. Available at www.tuc.org.uk/h_and_s/tuc-9056-f0.pdf

7 Chartered Institute of Personnel and Development (CIPD) (2004) Employee absence 2004: a survey ofmanagement policy and practice, London, CIPD. Available at www.cipd.co.uk/surveys

8 Social Exclusion Unit (2004) Action on Mental Health - A Guide to Promoting Social Inclusion. Available atwww.socialexclusion.gov.uk/downloaddoc.asp?id=300

Stress and mental health in the workplace

Managing for mental health: theMind employers' resource pack

This fully revised edition is a must forall employers who want to ensure bestpractice in mental health promotion atwork. It includes a complete guide togood practice and policies onemployment and mental health, as wellas essential background information onmental illness. Order the pack fromMind publications at £14.99, contactdetails overleaf.

Summary v6 29/4/05 19:57 Page 6