Head Rush

Dozens of mental health initiatives launched in 2017. What are we meant to do with them all? asks Belinda Liversedge.

‘Everybody’s talking at me, can’t hear a word they’re saying’. This year in 2017, it seemed everybody was talking about mental health – from celebrities, to business leaders and politicians – while campaigns launched in their droves to encourage us to break the silence about mental health and talk about the issues that affect one in four of us at some point in our lives.

But, as the 1969 Nilsson lyric just quoted goes, are we in danger of losing the message in the noise? In order to get some clarity, we look back at the most significant initiatives of 2017 and consider what they offer the workplace and why they’re so needed.

Talking about it

Talking about our mental health was one of the solutions that featured so prominently in new campaigns this year. Time to Change’s video You Don’t have to be an Expert was moving in delivery of its message that it’s enough to show your support for a colleague suffering from depression, anxiety or any number of conditions, to make a difference. In the film, a paramedic describes how he was pulled back from the brink of suicidal depression by colleagues helping him ‘to talk about what was going in inside his head’.

Detailed resources have also provided practical assistance to workplaces and employees. For example, Mental Health First Aid England created posters for World Mental Health day based on the initiative of Take Ten Together. They offer tips to start a 10-minute conversation with a colleague and how to discuss a problem. For example, showing empathy, being aware of your body language and keeping the chat positive.

An ambulance driver shares the message that you do't have to be an expert in mental health to help a colleague in need. Photograph: Time to Change

Specific campaigns have been launched, targeted to different audiences’ needs. Mates in Mind, for the construction sector, offers a 45 minute awareness session revolving around a conversation on mental health. Under the government’s five year forward view on mental health, NHS hospitals must make it easier for their staff to ‘ask for and receive help’ announced Health Education England in September. Generally, there has been a proliferation of social media campaigns. Heads Together’s #oktosay campaign released 10 films featuring people from all walks of life talking about the life-changing conversation that helped them cope with mental health problems.

So, what are the talking initiatives’ purposes and objectives? With only 11 per cent of employees prepared to talk to their line manager about a mental health problem, according to Business in the Community’s October 2017 survey of 3,036 UK employees, perhaps we need a reminder. There are many reasons. Firstly, speaking about mental ill health is an important way for employees to seek support from their workplaces for their condition.

Time To Change’s web page on ‘telling your employer’ spells out that employees have rights to be supported with their mental health condition if they choose to disclose it (which is always a personal decision). “If your boss is unhelpful or dismissive, remember they have legal duties under the Equality Act to make ‘reasonable adjustments’ and not discriminate in recruiting, retaining or promoting staff,” it says. The Stevenson/Farmer review of mental health and employers, gives employers an incentive too.

It says that 300,000 people with a long term mental health problem lose their jobs each year and that mental ill health costs UK employers between £33-£42 billion every year. How much of this cost could have been avoided? Time to Change reminds that ‘with the right help people experiencing mental health problems can – and do – stay and perform well at work.’

On a simply human level, talking helps encourage a culture of openness and acceptance. This year, the Olympic athlete Kelly Holmes spoke of how she struggled to talk about her own mental ill health problems: “People are more receptive [to mental health] nowadays, but you have to be brave. It takes a strong person to come out and be honest – but you can help so many people by doing that.”

Talking is also one of the oldest forms of medicine for a troubled mind. The Mental Health Foundation says: “If you turn a worry over and over in your mind, the worry can grow. But talking about it can help you work out what is really bothering you and explore what you could do about it.”

Spot the signs

Almost a third of the workforce have been formally diagnosed with a mental health issue. It’s not so much a shocking statistic – indeed, being shocked could be said to perpetuate the stigma that it’s not okay to have mental ill health – as it is troubling when we consider that many of these workers will be battling miserably through their issues without telling anyone.

This year, some new services were introduced to help such workers, by giving their colleagues the tools to direct them to seek proper medical help when problems are at a serious level. The Department of Health and Public Health England announced it will be investing £15 million into training one million people in basic mental health ‘first aid’ skills. The programme, which runs from autumn 2018 until March 2021, will help people recognise and respond effectively to signs of mental illness in others, as well as improve personal resilience.

Almost a third of the workforce has been formally diagnosed with a mental health issue. Photograph: iStock / kieferpix

Recent evidence shows that signposting is not happening enough however. Britain’s Healthiest Workplaces survey looks at the approach to health and wellbeing of 370 companies and 124,000 employees. The 2017 survey results highlighted that employees, particularly more junior employees, would rather speak to friends, family or a GP about a mental health concern than access the formal structures that the employer had established for this purpose, such as an employee assistance or occupational health programme, explains Shaun Subel, director of strategy at VitalityHealth.

Shaun tells us: “This is a highly-concerning trend, as while these people occupy a position of trust with the employee, they are often not trained to appropriately support someone with a mental health issue. It is therefore critically important that employers create a culture where employees feel safe and supported to discuss mental health issues, and adequately train line managers to identify the early signs of mental ill health among their direct reports”. 

Despite the importance of signposting, it’s hugely important to remember that even in serious cases, we must not be afraid to be forthcoming when we see someone in trouble, whatever our position in the work hierarchy. The Samaritans campaign Small talk saves lives  powerfully demonstrates that just a simple question to someone who is visibly distressed on public transport could stop them committing suicide.

High tech

But perhaps not all of us want to speak face to face about our personal issues. This year, we saw several interesting uses of technology. A mobile phone app designed to track and improve mental health was trialled successfully by teachers as part of the Girls’ Day School Trust pilot. Teachers said it enabled them to map their moods to understand triggers and solutions. A programme called SlowMo was launched with a trial of 360 people in August this year to help people with psychotic illnesses like schizophrenia. Developed by Oxford university the website and mobile app help people slow down their thoughts and thus reduce their distress.

However, evidence for effectiveness of technology in treating mental health is not yet established. “We are witnessing an explosion of such technology and it is vital that there is a firm evidence base that is accessible for employers and employees,” says the Stevenson/Farmer review, recommending that NHS bodies start by providing ratings for apps and other digital platforms.

There are also other considerations. Professor Andrew Curran, chief scientific advisor at HSE, says it’s important to consider the ethics of using apps that encourage workers to track their moods for example, because of where the information could go and how it could be used: “Certainly the understanding of the individual who is pressing the button as to what the consequence of pressing the button will be is really important – there’s an ethical issue there.”

In the community

A workplace is a community of people, so it’s worth looking outside the workplace at the many excellent projects that have started in communities and become a success this year thanks to their capacity to capture people’s sympathy and imagination. With the support of Marks & Spencer, mental ill health awareness campaigner, Ruby Wax, launched fortnightly ‘Frazzled Café’ meetings throughout the UK.

Their purpose is to provide a safe, anonymous and non-judgemental environment where people who are ‘feeling frazzled’ – the ‘four in four’ of us who will suffer burnout as opposed to the one in four with mental ill health – can meet on a regular basis to talk and share their personal stories.

Therapy took to the streets in a year long initiative from Owls, a social enterprise set up by clinical psychologist, Dr. Charlie Howard and based in London.  ‘Problem Solving Booths’ simply invited members of the public to sit in chairs opposite one another and take it in turns to be the ‘problem solver’.  Looking at the videos it’s interesting to see that the process also empowers people – a homeless man explains his pride in helping a policeman with his problems, saying “I’m wise too” – showing that empathy is a valued skill.

Problem solving booths in Camden. Photograph: Camden Market

Looking ahead, new community projects of relevance to the workplace are expected to launch next year, including workshops for men to help them with the confidence needed to stay in or re-enter work. Step by Step will see 94 workshops run across England for men to meet, learn new skills and engage in hands on activities in order to improve mental and physical health and wellbeing.

Thomas Molloy, senior project manager of the European Regional Development-funded project, told us that it aims to decrease the number of work days lost to poor health and to help give men the confidence to get back into work. “It is designed to address internalisation and isolation issues that men have when it comes to issues of mental and physical health. Whereas women will talk to their friends and go to the doctor, men typically internalise it and then it becomes too late to do anything about it.”

The workshops won’t be geared around talking about mental health, rather, there will be workshop leaders who are trained to help explore these issues. “The idea is that there is self-support between the guys that helps [because the issues surface].” The project was approved in July this year and activity is expected to start in 2018.

Of course, these have only been a very small percentage of the many fantastic interventions on offer for employers and employees to manage and respond to mental ill health in the workplace. It’s great that there are so many, and many that have captured our imagination and passion for change.

The next step is having a plan, says Shaun. He sees that the best companies are those that offer a ‘portfolio of interventions that target multiple risk factors, rather than a disparate set of uncoordinated wellness initiatives.’ “This makes the wellness programme more relevant to a broader group of employees, and provides options in how they can engage to address their risk factors,” he says.

Here’s to a happy and mentally healthy 2018.