Improving mental health at work

December 19, 2019

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by Richard Wynne, Work Research Centre

The Carnegie UK Trust-TASC Ensuring Good Future Jobs essay collection describes many of the key challenges faced by workers in Ireland today, and proposes a series of policy and practice changes to ensure good future jobs. First published on 28 November, as a coordinated response to the Irish Government’s first Future Jobs Strategy, this blog series showcases the contributions by key social partners in Ireland to the collection.

What do we know about mental health, wellbeing and work?

The issue of mental health in the workplace is receiving more and more attention in public health circles and in general discourse today. Much of the coverage of the issue is concerned with acknowledging the reality of mental ill health for significant proportions of the working population, and the need to raise awareness of its impact on the individual. And while this acknowledgement is needed, there are many facets to the issue in the workplace context that don’t receive enough attention. Primary among these is the interaction between work and mental health and wellbeing.   The development of good jobs in the future in Ireland will contribute to the maintenance and promotion of good mental health amongst the population.

Even though there is no widely accepted definition of what constitutes a “good” job, we can point to a number of characteristics of jobs that are positive. These include high levels of control over working conditions, fair treatment, supportive environments, good communications, opportunities to develop personally, clarity about the job roles to be fulfilled and being able to manage workload effectively. Other factors such as job security and good physical working conditions are also important.

Employment and working conditions can have both a positive and a negative effect on mental health and can play a big role on the management of employees’ mental health, even if work is not the only factor in any problems that they may have. We know from research that, on average:

  • Employment is generally good for mental health – people in work generally have better mental health than people who are unemployed. Levels of mental distress among unemployed people can be as much as 3 times higher than working populations in good jobs.
  • Poor working conditions can contribute to poorer mental wellbeing – factors such as high levels of job demands, low levels of capacity to make decisions and chronic or high levels of stress at work are associated with symptoms of anxiety, depression, fatigue and wellbeing. Our data suggest that high levels of stress at work, for example, lead to levels of mental distress that can be 2 or 3 times as high as the general working population.
  • Poor work organisation is also associated with poorer mental wellbeing – factors such as shift and night work, and precarious work contracts are all associated with lower levels of mental health. Rotating Night workers, for example, (especially those who have not chosen to work nights) may report disruption to mental wellbeing at up to 3 times the rate they do when on days.

Of course, many people develop mental health problems independent of the kind of work they do. Other factors are also important – general lifestyle factors, living conditions, social interaction, genetics and some physical illnesses may all play a role in the development of mental health problems. The World Health Organisation estimate as many as 25% of people will experience a mental health problem at some stage in their adult lives (WHO, 2001).

Not all mental health problems are the same – they vary in severity from relatively minor disruptions in mood to full blown mental illnesses such as schizophrenia or severe depression. Depending on factors such as severity, whether the person was working at the time of its onset, and the policies and actions of the employer, the prospects for the individual of remaining in work and recovering from illness can be significantly affected (Wynne et al., 2015).

So, what can the employer do?

Employers have some legal responsibilities that they must take under health and safety legislation while there are also some voluntary actions that can significantly influence recovery and employment for people who develop a mental health issue. These can be labelled under the banners of prevention, promotion and (re)integration.

Health and safety legislation demand that employers take “reasonably practicable” preventive actions in relation to any factor that may cause damage to employee health. In practice this means identifying the hazards in the workplace that may contribute to poor mental health (e.g. high job demands, violence at work, night work, psychoactive substances), assessing the risk to health associated with them, and taking a range of possible measures that can prevent damage from occurring, or can protect the workers from damage (though this is not seen as an alternative to prevention). The kinds of action that might be taken include reducing jobs demands (e.g. reallocating work to others, providing better equipment or training), redesigning shift schedules or replacing toxic chemicals with non-toxic alternatives. Employers may also promote mental wellbeing in the workplace. This may be done by addressing workplace issues, e.g. improving opportunities for social support and interaction; or by using the workplace as a venue and social environment to undertake wellness programmes and training, e.g. social or sporting activities, wellbeing training or cultural activities.

The third type of action is needed when mental health issues for the individual are sufficiently serious as to cause significant absence from work, or when it prevents the person from finding employment in the first place. Research shows that when an employee develops a more serious mental health problem that causes absence from work, they tend to be absent for longer periods and have a lower chance of returning to work at all when compared to people with a physical health problem. Here, actions that aim to return the person to work (either to their old job or another one), or, in cases where the mental health problems are so severe as to preclude a return to work, actions that mange a dignified exit from the workplace are needed. Employers can also take action to help people with mental health problems find employment, often in conjunction with labour market agencies, through such instruments as social employment schemes.

Employers that undertake all of these actions well are hard to find, but there are some examples of good practice that show what can be done[1]. One example of company level good practice from the UK is provided by BT, who have implemented a comprehensive programme for a number of years that focuses on prevention, early intervention and rehabilitation (MQ, 2019). The challenge now is to seek to grow this small pool of workplaces, so that the potential for employment to promote mental health and wellbeing is realised while at the same time helping to mitigate the many negative impacts of mental health breakdown. Fundamental to growing this pool of active employers is the need to increase awareness of what is possible. In addition, the provision of incentives can also help, as would better enforcement of health and safety legislation (to address the lack of action on psychosocial workplace hazards). Employers would also benefit from greater awareness and usage of the tools that are available to promote mental health at work – these include awareness campaigns, training, tools for assessment, and tools that support workplace interventions, whether they come from the health and safety or health promotion approaches[2].

 

[1] See, for example, Models of Good Practice from around Europe gathered by the European Network for Workplace Health Promotion. https://www.enwhp.org/?i=portal.en.8th-initiative-work-in-tune-with-life-models-of-good-practice. Other national level examples can be found at: http://ec.europa.eu/social/main.jsp?catId=716&langId=en.

[2] See, for example, the toolkit to support employers developed as part of the ProMenPol project in which the Work Research Centre was a leading partner – http://www.mentalhealthpromotion.net/?i=promenpol.en.promenpol-tool-kit