The public sector should lead the way in protecting workers' mental health, says a long-awaited government-commissioned review.
All UK employers should be encouraged to adopt some key “little or no cost” good practice approaches to employee mental health to reduce the estimated 300,000 people who are forced to leave their jobs annually due to long-term mental health conditions, according to a much-anticipated government-commissioned review.
The review – commissioned earlier this year by the prime minister Theresa May and led by Paul Farmer, CEO of the mental health charity Mind, and Lord Dennis Stevenson, a leading mental health campaigner – calls for all employers to be given help to adopt six ‘mental health core standards’ setting basic good practices for protecting employees’ mental health. The core standards cover steps such as encouraging open conversations about mental health at work and routinely monitoring employee mental health and wellbeing, and “most” can be implemented at little or no cost, says the report.
The review also calls for all public sector employers and the 3,500 private sector companies employing more than 500 staff to implement more enhanced standards, including a commitment to reporting internally and externally on their progress around protecting workers’ mental health.
In total, the report makes 40 recommendations for government, regulators and employers to support good mental health at work as part of a 10-year strategy. These include the government creating a free online information platform to help employers implement the new mental health standards; the government considering amending legislation such as the Companies Act to encourage employers to report publicly on their approach to workplace mental health on their website or other channels; and the government exploring how public sector procurement could encourage take-up of the new standards among government contractors and suppliers.
Launching the report, Lord Stevenson said: “In light of the demonstrable impact of poor workplace wellbeing on individuals, employers and the UK economy, we are calling on the government to accept the recommendations in full, and to introduce the core standards in the public sector.
“We need the right leadership among employers in the public, private and voluntary sectors, and a mandate from policy-makers to deliver our ambitious but achievable plan.
“It’s time for every employer to recognise their responsibilities and affect change, so that the UK becomes a world leader in workplace wellbeing for all staff and in supporting people with mental health problems to thrive at work.”
The Thriving at Work report reveals that 300,000 people with a long term mental health condition – or 6% of the UK workforce – are forced to leave their jobs every year, compared to 4% of workers with a long term physical health condition.
It also contains new analysis from Deloitte showing that mental health problems costs UK employers between £33-£42 billion annually – higher than previously estimated. However, an accompanying literature review by Deloitte shows an average return on investment of £4.20 per £1.00 spent on workplace mental health interventions.
Other recommendations include:
- Chief executives of public sector organisations should have a specific performance objective relating to ensuring the mental wellbeing of all employees, and accountability for adopting the core and enhanced mental health standards
- Industry groups – such as employer associations, trade unions and professional bodies – should help employers to better understand and compare products such as Employee Assistance Programmes and occupational health services by developing standards and online comparison tools
- Government should align the “fragmented” occupational health and practical support available currently from Access to Work, the Fit for Work Service and other NHS services to create an integrated in-work support service to “better support the needs of those with mental illness, and other physical health conditions and disabilities”
- Government should protect and promote the current tax relief for employers to invest in the mental health of their employees
- The government and NHS bodies should enable and encourage patient mental health services, such as the Improving Access to Psychological Therapies (IAPT) programme offered by NHS England. to provide quick and convenient access to care around employment
- NHS bodies should provide clear effectiveness ratings for apps and other digital platforms offering mental health support to affected individuals, which have the potential to provide low cost, scalable support for employees with mental health problems
- The government should consider legislative change to enhance protections for employees with mental health conditions - particularly fluctuating mental health conditions - and clarify the role of employers in providing reasonable adjustments under the Equality Act 2010.
The review also recommends the government “explores the potential to incentivise employers, particularly SMEs, to implement the mental health core standards”. This includes evaluating a recent ‘Wellbeing Premium’ pilot offering tax incentives to West Midlands employers who can demonstrate commitment to employee mental health and wellbeing.
The report also calls for HSE and local authorities to increase their focus on workplace mental health and safety during their inspections; and for HSE to “build” on its risk assessment guidance and stress Management Standards approach by “highlighting how these actions will help employers deliver key parts of the mental health core standards”.
The report was broadly welcomed by stakeholders and commentators, though some highlighted the importance of providing adequate support for SMEs to manage mental health and wellbeing and to help those with long term mental health conditions.
Louise Ward, policy, standards and communications director at the British Safety Council, said: “We believe that employers will welcome the proposed core standards, and supporting guidance, as this will help to establish a benchmark for good practice. However, we are concerned about the ability of businesses, particularly SMEs, to resource the interventions required to achieve this benchmark. We also welcome suggestions that the government should consider financial incentives to support this work.
“Employers are likely to require information and advice to support development of mental wellbeing programmes and it will be important to provide a mechanism to facilitate access to ‘quality assured’ tools and providers. The proposed single online portal would be welcomed, but would need to be properly resourced to ensure that it delivers effectively against expectations.”
She added: “The recommendations set out in the report will place significant demands on the already stretched NHS and public sector. We are concerned that additional resource will be required to meet these demands, and care will be required to mitigate the impact that workload increases could have on the mental wellbeing of staff employed in these areas.
“We recognise the complexity of regulatory activity in the field of mental wellbeing, and welcome the report’s call for improved clarity in this area. Regulatory resources are already stretched, particularly at the local authority level. Therefore, it will be necessary for the Government to ensure that resources and training are available for regulators if they are to take on additional accountabilities.”
Stephen Martin, director general of the Institute of Directors, said: “Clearly more needs to be done to ensure that mental health policies and procedures are embedded across the workplace. However, driving change will not simply be achieved through amplifying the Government’s voice on this topic. With the amount of time people spend in work, business leaders must put themselves at the frontier of addressing these challenges.”
The Unite union, which represents mental health nurses and applied psychologists, said: “It is all very well the government welcoming the report but ministers need to invest in mental health services which have been cut to the bone since 2010.”
Responding to the review, the prime minister Theresa May said that NHS England and the Civil Service would “abide” by the report’s recommendations, including introducing the core and enhanced mental health standards and having "support in place" to help prevent mental illness caused or made worse by work and to help employees suffering problems to "thrive". May added she had written all metro mayors and key business groups, including the CBI, IoD and Federation of Small Businesses, to draw attention to the review and encourage them to implement the recommendations in their organisations and across their networks.
May said: “I have made it a priority of this government to tackle the injustice of mental illness. Vital to this is the need to have a comprehensive cross-government plan which transforms how we deal with mental illness not only in our hospitals or crisis centres but in our classrooms, shop floors and communities.
“That’s why I commissioned this important review which starkly illustrates the cost of untreated mental illness - around 300,000 people with a long term mental health problem are losing their jobs each year.
“And that has a big impact on businesses which are losing up to £42 billion each year as a result.
“So we need to take action. That’s why I am immediately asking NHS England and the Civil Service – which together employ more than two million people – to accept the recommendations that apply to them.
“With so many of our leading businesses leading the way in this area – and reaping the rewards as a result – I am sure that the private sector will follow suit.
“It is only by making this an everyday concern for everyone that we change the way we see mental illness so that striving to improve your mental health – whether at work or at home – is seen as just as positive as improving our physical wellbeing.”
The government added it would "consider the wider recommendations and respond in due course".
The full report, Thriving at Work. The Stevenson/Farmer review of mental health and employers, is here.
Deloitte’s review of the cost of poor mental ill health to employers and the ROI to employers from mental health interventions in the workplace can be found at: www.deloitte.co.uk/MentalHealthReview
The initial response to the report from the British Safety Council and its Mates in Mind mental health initiative for the construction industry can be found here.
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