· Features

Mental ill-health costs UK billions a year, say Unite and Mind

Unite, the country's biggest trade union, has recently teamed up with UK mental health charity Mind to examine how mental health is affecting workers. Unite estimates that 70 million working days are lost to absences due to mental health problems and that this costs British business £8.4 billion a year, says Pamela Gellatly.

The Centre for Mental Health paints an even darker picture, estimating that when the costs of sickness absence, non-employment, effects on unpaid work and output losses are combined that figure rises to nearer £26 billion. That's equivalent to £1035 for every employee in the UK workforce.

Clearly the development of mental health problems within the working population is becoming an increasingly costly issue for employers, but how effectively is it being addressed?

Evidence indicates many employers seriously underestimate the prevalence of mental health problems among their employers, when in fact at any one time one worker in six will be experiencing mental distress, depression or stress. Similarly, while the importance of mental ill health as a cause of sickness absence is generally acknowledged, it is often poorly or inaccurately recorded or measured. Yet the most significant issue is that, despite huge interest and investment in employee health and wellbeing initiatives and benefits by employers, much of it misses the point.

Employers have been too focused on treating the symptoms of workplace ill-health, instead of the causes. By failing to address the underlying causative and contributory factors affecting mental ill health, such as lack of appropriate exercise and poor nutrition, these absence management processes and healthcare benefits are costly, may drive inappropriate treatments and fail to resolve the health problem.

The latest CBI Absence and Workplace Health Survey found mental health issues were the greatest cause of long-term absence, followed by musculoskeletal disorders, back pain and treatment for cancer.

Yet mental health issues are often inefficiently managed both within the NHS and by the private sector, with patients often waiting many weeks for treatment, despite evidence that early intervention is crucial to a successful recovery. While medical professionals have traditionally been trained to identify and treat only the psychological aspects of mental ill health, clinical research into workplace absence has shown that there are often other personal, more complex factors which require attention and management.

Poor lifestyle choices, for example, not only impact on an individual's susceptibility to mental health but they also significantly increase the likelihood of diabetes, cancer, heart disease and other serious illness. Failure to address issues such as fitness and nutrition can lead to poor performance, long-term absence and increased costs for employers.

So what steps can employers take to improve the management of mental health in the workplace?

Carry out appropriate risk assessments

The HSE has highlighted the need to identify psychological hazards and risks at work in a similar manner to the identification of physical risks. However, very few organisations understand how to conduct such risk assessments, especially given individual differences. As an employer, understanding what causes stress and when it is likely to occur is critical in managing mental health in the workplace.

Identify a health problem early

Once employee health risks have been identified and understood, one of the first steps should be to develop a process to help early identification of any health problem. Ideally this should occur before any absence is taken and if not then, within the first week of absence. This does not necessarily mean intervening early, but rather assessing an employee swiftly to see whether he or she needs to be referred to a health professional. Often such referrals can now be telephone-based and low-cost, if introduced at the right time.

Place line managers at the heart of the process

It makes sense that line managers should be at the heart of this process. Providing them with training to help increase understanding of the clinical, legal, occupational and financial aspects of mental ill health, will in turn increase their ability to respond confidently and in a timely fashion to employees in mental distress. Working with the managers to manage a person at work – or back to work – is also crucial to effective management.

Help and support employees to self-manage a health problem

Provide employees with better access to help, particularly access to evidence-based psychological help which emphasises learning techniques to help prevent future problems and which wherever possible enables people to carry on working at the same time as receiving treatment and support. Self-help and guided self-help is often the first step in a programme and may be all that is necessary, if managed correctly.

Promote a healthier lifestyle

Half or more cases of mental ill health can be addressed by encouraging individuals to resolve to adopt active lifestyles and improve their diet. Research has identified that there is a relationship between exercise and mental health, both in terms of preventing problems such as stress, anxiety and depression and in managing such problems. In addition, lack of certain nutrients such as Omega 3 or abuse of substances such as alcohol can all contribute to mental health problems.

Supporting improvements in employees' health should be focused on adopting an organisational culture that actively promotes regular exercise, a good diet and a sensible alcohol intake. This can be done at relatively low cost through sponsored sports events, creating competitions between teams, departments or sites or setting up a lunchtime walking club. Assigning 'health champions' can also make a real difference and help generate buy-in from employees, as can 'job specific' exercise programmes and stress-coping strategies. Restructuring health benefits to support this, including using exercise and nutrition as a 'treatment' and therefore funded by healthcare schemes should also be considered.

In taking these steps, not only will absence rates decline, but the costs associated with providing health benefits should reduce substantially over the long term and employees should be happier, healthier and more productive.

Pamela Gellatly, Chief Executive, Healthcare RM