Occupational Health

by Anna Harrington

Mental health at work

Maybe you or a close friend or family has experienced mental ill health? If so think about how you felt with respect to

  • Disclosing it at work
  • Gaining meaningful employment
  • Telling those close and dear to you
  • Anyone finding out, without you knowing who those people are and being in control.

It is likely you felt fearful about any or all of the above situations. Fear is not good for mental wellbeing and it limits people. Mental ill health has a level of stigmatism attached to it. People feel ashamed; they are at risk of being discriminated against, or even bullied and harassed. The reactions from society, friends and family have a big impact on those with mental ill health.

Mental ill health affects one in three of us. It is common; therefore it is of significance to workplaces. Research and anecdotal evidence shows that stigmatism in the workplace prevents employees from disclosing that they have a mental health problem. Research conducted by the Shaw Trust has revealed that half of the employers surveyed say they wouldn’t hire somebody with a mental illness, and the majority still don’t have policies in place to support people with mental health problems.

Working with a mental health problem

Most people with mental ill health are able to hold down employment and contribute to the workplace. Unfortunately, negative cultures within organisations and the societal stigmatism of individuals with mental ill health mean that it is a challenge for individuals with a mental health problem to obtain and remain in work.

In reality, it is beneficial to an organisation to have a workforce that is diverse and represents the population as a whole. However, the workplace needs to have an appropriate culture. An organisation’s culture controls the behaviours and actions of the members (employees) with in it. A culture which demonstrates acceptance of all, embraces diversity and nurtures individuals will not only benefit those with a mental health problem, but will benefit all and allow individuals to have a greater chance of performing well and being engaged. Cultures which exhibit acceptance only of certain individuals, tolerate behaviour which inhibits communications, and identify certain employees as ‘weak’ will cause mental harm to all within it, whether they have a mental illness or not.

Training line managers and the senior management team in diversity, positive workplace culture and mental health problems can go some way towards reducing stigmatism and creating a culture which engages all. It is the interaction of the individuals within the workplace culture that affects mental health, so workplaces need to make sure that this is generally positive for the majority of people.

Mental health problems result from a complex interaction of biological, social and psychological factors, but are still usually discussed in medical terms. Mental ill health covers everything from major psychotic symptoms (see below) to general unhappiness.

Common mental health disorders

Most mental health symptoms have traditionally been divided into groups called either ‘neurotic’ or ‘psychotic’ symptoms.

‘Neurotic’ or mood disorders cover those symptoms which can be regarded as severe forms of ‘normal’ emotional experiences, such as depression, anxiety or panic. Conditions formerly referred to as ‘neuroses’ are now more frequently called ‘common mental health problems’. They are depression, depression and anxiety, panic attacks and phobias. Mixed anxiety and depression is the most common mental health disorder. Bi-polar is a severe swinging of moods between elation and depression.

Less common are ‘psychotic’ symptoms, which interfere with a person’s perception of reality, and may include hallucinations, such as seeing, hearing, smelling or feeling things that no-one else can. Schizophrenia is a psychotic illness. Some mental health problems feature both neurotic and psychotic symptoms.

Mental ill health can also be categorised, according to the symptoms, into mild to moderate and severe and enduring/long-term. These terms are used to assist in the selection of the most suitable type of treatment. For mild to moderate symptoms, therapy, self-help, community and social ‘treatments’ are recommended. Severe and long-term conditions will generally also require medication.

From a work perspective, it is only necessary to understand how the person interacts with and is affected by the work role and culture. It may also be necessary to be aware of the side effects of some medications, as they may prevent the individual from undertaking safety-critical tasks. Occupational health can advise you on this and on what can be done to ensure that the individual is able to perform to the best of his/her ability.

Medication

Medication used for mental ill health is used to treat the symptoms. It is not thought that medication can cure mental ill health. There are many drugs available; for example, there are over 30 types of anti depressants. Medication is often used in addition to some form of therapy, such as psychotherapy.

Everyone reacts differently to the drugs: for some, a short course of medication is sufficient; for others, there may be a need for long-term use.

There are side effects from all drugs, which will affect individuals differently. It is important to talk with an employee about the side effects of medication, and to take these into consideration when conducting risk assessments.

Supporting individuals with mental health problems

People with mental health problems are able to work efficiently. However, they may have difficulties due to the stigmatism attached to mental illness. Managers need to be sensitive to the affects of this and to consider the workplace culture and practices, including the possibility of discrimination, bullying/harassment and other barriers.

Note

The management of the individual must be the key focus, not the management of the illness.

Clarity should be given over expected levels of behaviour. The Equality Act 2010 requires employees to make reasonable adjustments for an individual with mental ill-health. The organisation needs to display sympathetic and fair management as this will create a culture where employees are able to admit difficulties.

In addition to the points raised in the Management of sickness absence (return to work) the main points are:

  • Line managers should know about common mental health conditions
  • The workplace culture should nurture and support individuals
  • Managers should have the ability to engage with and listen to their team members and should know them
  • Managers should ensure confidentiality, yet agree with the employee what can be disclosed to the rest of the team
  • Employees with mental health problems should be treated with integrity, honesty, empathy and care
  • Keep in touch with employees who are off sick
  • Draw up an advanced statement*
  • If a member of your team has a mental health problem, you should make an analysis of their job tasks, redistributing some tasks, if necessary.
*
An advanced statement is a document that some organisations require all employees to draw up and is used in acute or crisis situations to provide appropriate support and care. It gives details of any symptoms that they may present when ill, the best form of care and who should be contacted.

For more, see Psychological Health.