Mental health as a business asset

In What next for health at work? Professor Dame Carol Black has collated a series of essays for UNUM outlining current thinking about the relationships between people’s health and wellbeing and their working lives.

One of the essays featured is from myself, highlighting the need for businesses to create a culture in which mental health is valued: where disclosure is encouraged, support is present, and everyone feels that their work and the benefits they receive contribute to their wellbeing.

A business environment that supports and values employees living with mental health problems is a significant part of the solution to the problem of people falling out of work, losing income and risking a fall into poverty. It is also the key to businesses thriving and making the most of the skills and talents of their people.

Mental health is a fundamental asset for individuals, communities and organisations. Protecting and improving mental health is vital for keeping staff working well, helping those who have taken sick leave to return to work successfully and, of course, for retaining and attracting talent.

Added value - shifting the focus

The Mental Health Foundation’s recent research report Added value: mental health as a business asset, completed with Unum and Oxford Economics, concluded that the gross value added to the UK economy by people who experience mental health problems is around £226 billion - that is 12.1% of total GDP. This is nine times more than the cost of mental health problems to economic output – an estimated £25 billion. We believe that it is time for the debate to shift from a narrative of cost and burden to one promoting the value and case for protecting, nurturing and improving mental health at work. 

The OECD in Making Mental Health Count estimated that between one third and one half of all sickness and disability caseloads are related to mental health problems, with mild to moderate problems affecting 1 in 5 of the working age population. Mental ill health is one of the defining societal problems of our time. 

All good employers are concerned to recruit and nurture talent. Nurturing talent means that staff opportunities for career progression should not be undermined by periods of ill health. A substantial component of sickness absence is directly related to mental health problems. This must be addressed as an explicit priority by employers, trade unions and government.

Equally, we now know that many long-term conditions are associated with comorbid mental health problems and challenge personal resilience so it makes sense to address mental health proactively as a potential factor in all long term sickness absence. 

Recent ACAS research points to the risks inherent in the 'anxious organisation', characterised by repeated changes in demand, resource, and working practice and where risk of psychological injury and distress is high. Culture and relationships are key to both productivity and health at work.

The figures

We conducted a major survey of working people with mental health problems and line managers as part of the Added value report. This research revealed that some 86% of survey respondents considered that work was important or very important in protecting and maintaining their mental health – a conclusion borne out by the qualitative interviews conducted. The people interviewed regarded work as key to their identity and critical to maintaining their recovery.

Around half of those who had a diagnosed mental health problem chose to disclose this to their employer. On the whole this had been positive, resulting in more support but 29% experienced discrimination as a result. All employers need to create a 'disclosure premium', where staff see tangible benefits from coming forward. 

The report reveals the extent of distress at work. While most people with experience of mental health problems have been through times when they felt stressed, overwhelmed or unable to cope at work, so did 4 in 10 of employees with no experience of mental health problems.

Almost half of people with mental health problems reported having come to work whilst experiencing suicidal feelings and these are also reported by 1 in 20 without mental health issues. This underlines the challenge employers face in recognising and engaging with 'below the waterline' distress. 

It is vitally important that line managers are trained to recognise distress, to feel confident in opening up a discussion with staff about how they are feeling and to know how to respond appropriately. This needs both compassion and the right practical steps to help reduce the distress and, where possible, the causes. 

The causes may be external to the workplace, such as relationship problems, financial pressures, caring responsibilities or bereavement, in which case good direct routes to advice specific to the problem should be available. Where the causes are work-related, the right immediate practical steps to reduce contributory factors in the workplace are essential, in addition to the psychological support or self-management techniques to deal with the symptoms. 

Just as importantly, the organisation needs to be proactive and systematic in learning from the circumstances and to make adjustments to reduce the risk of the same factors creating health risks for the same or other employees. This makes for a working environment that attracts and keeps good people. It requires decisive leadership messages to emphasise that the culture of our workplaces will support people in emerging distress or recovery and that we are open and keen to learn how to prevent workplace related stress for the future. 

Public policy also has an important contribution to make. We know that mental health problems increase the risk of people being unemployed for a long period and falling into poverty. National policies that support employers to recruit and then sustain people with mental health problems in work are good for business, good for people and good for our society.