Supporting employees with mental health issues: What managers need to know

Three out of five employees have experienced a mental health issue in the last year either because of work or related to work, while 31 per cent have been formally diagnosed with a mental health condition.  Yet despite these alarming figures from Business in the Community/Mercer research, stress, anxiety and depression still remain taboo subjects in many workplaces, with only one in ten employees saying they felt able to talk about mental health issues with their line manager.

Dealing with an employee who you suspect has a mental health issue isn’t easy. Managers have to strike the right balance between being caring and supportive to their people, while at the same time making sure business needs continue to be met.  Often, they have had no formal training in how to appropriately support employees and are worried about how to broach the subject without making the situation worse. Managers who work in smaller businesses without an HR function can feel particularly vulnerable and unsure of where to turn to find best practice.

So as a manager, what do you need to be aware of and what can you do to make sure employees who are struggling with mental health issues get the right kind of help?

 

Improve your knowledge

Given the prevalence of mental health issues, it makes sense for managers to improve their knowledge of the common conditions. As an occupational health specialist, employees often tell me that “their manager doesn’t understand” or has just told them to “stop worrying” or “pull themselves together”. It’s not about becoming an expert overnight – but about being aware of some of the symptoms, and developing a basic understanding of what employees may be going through, so that you can approach the situation more sensitively. Knowing a bit about sources of external information and support will also help you signpost people to the right kind of help if and when they need it.

 

Recognise the signs

We all experience stress at work from time to time, but if the pressure is prolonged and there is no let-up, there is a danger people will buckle under the strain or tip over into anxiety or depression. The key is for you as a manager to spot the signs at an early stage, so that you can offer support and take action to reduce any stress, where possible, before the situation deteriorates. If an employee is suffering with stress, they may be more irritable, moody and quick to anger than normal. They may start to make mistakes, miss important details or struggle to make decisions. Someone who is suffering from anxiety will probably appear unsettled and will worry about things that wouldn’t normally bother them. They may be experiencing physical symptoms such as a racing heart or panic attacks. With depression, people become withdrawn, demotivated and can struggle to look after themselves and complete normal daily tasks. They often have trouble sleeping and as a result, come into work exhausted. As a manager, you are in a good position to spot these symptoms, because you are likely to know what an employee’s normal behaviour and performance looks like and will quite quickly see if something is different.

 

Start a dialogue

Managers are often reluctant to talk to an employee about their mental health, because they are concerned they may be seen as interfering or straying onto personal territory. They worry that if they open the door, the person may become upset and that they won’t know how to deal with it. The conversation may well feel uncomfortable – but it’s important to get issues out in the open. Only the individual themselves can tell you how they are feeling and what they need, whether that’s a bit of leeway for a few weeks while they sort out a personal situation that is causing them stress, or a serious issue that requires professional help. Recognise that people may be reluctant to open up because they don’t want to admit they have a problem, or because they fear it will have a negative impact on their job or career. Try starting the conversation by asking people how they are coping with work in general and mentioning that you are worried they may be experiencing stress. Make it clear the conversation is coming from a place of concern and that you want to support them – not punish them because their performance has decreased..

 

Make simple adjustments

Sometimes, quite small changes to people’s role or responsibilities can make a big difference to their ability to get through a difficult time. It’s about taking a common sense approach and looking at what simple adjustments you can make that will help them, and which are also reasonable from a business point of view. Typical adjustments might include reducing someone’s working hours on a temporary basis, or allowing them to work more flexibly or occasionally from home. In some instances, you might want to reduce their workload, extend deadlines or set less challenging targets. Taking the opportunity to improve communication in general is also important. Often, people become stressed at work because they are unsure of what is expected of them, have been given tasks they are not properly equipped to carry out or are not receiving positive feedback about their efforts. As a manager, try to think creatively about what you can do to alleviate the problem and stop the situation deteriorating any further.

 

Know when to seek external help

If the common sense approach isn’t working – or you can see that someone needs more help than you can give them – you need to seek external support. Be wary of getting too embroiled in the details and becoming the employee’s sole source of support. This is not only emotionally draining and time-consuming for you, but also gets in the way of the individual getting the professional help they need. The key is to be supportive, but keep it business-like – otherwise managing that person’s performance going forward can become difficult. An occupational health specialist can be a great support in this situation. They will be able to provide a confidential ear for the employee and signpost them to the right kind of support, while also advising you about the medical aspects of the condition, how it is likely to develop and what kind of adjustments might help. If your business doesn’t have access to an Occupational Health Advisor or Employee Assistance Programme (EAP), you can suggest the individual goes to their GP or look at some of the self-help resources that are widely available.

MIND have a great website with free resources for line managers and HR professionals to help manage mental health at work, including how to promote wellbeing and tackle the cause of work-related mental health problems, as well as how to support staff who are experiencing a mental health problem. Mental health resources for managers.

 

If you have an employee experiencing difficulties or would just like to talk through how to manage stress in your workplace, please feel free to call me at any time.

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OnNovember 7, 2017, posted in: Occupational Health Posts by

Are standing desks worth the money?

It is well documented that a sedentary lifestyle and sitting still for long periods during the day can have an adverse effect on health.  The effects can include heart disease, diabetes, obesity, cancer; and prolonged static postures can contribute to backache, depression and muscle degeneration. Our bodies are designed to stand and move for long periods of time. Even when standing still, we automatically shift our weight and move around while standing, which helps exercise the muscles,  and prevents the repetitive stress and muscle degeneration caused by sitting for long periods.

There are lots of debates currently about the benefits of standing desks, or sit/stand desks which allow the individual to alter the height of the desk so that some of the time can be spent sitting, some time spent standing. For people with certain musculo-skeletal conditions, such as back pain or neck pain, this would improve comfort and offer them the flexibility to alter their working position to maintain the best comfort levels. Both sitting and standing desks have their advantages and disadvantages.  A standing desk wouldn’t necessarily suit everyone as all individuals are different, and some people find sitting desks more comfortable and some find standing desks more comfortable.

The important point to note is that it isn’t just ‘sitting’ that causes health problems, it is the absence of movement, so that would be whether you sat for long periods of time or stood for long periods of time. Therefore, regardless of the type of desk it is important that individuals factor in some movement time into their working day. Instead of making financial commitments to change all desks to standing desks, encouraging more movement built into the working day.

An expert consensus statement commissioned by Public Health England and the Active Working Community gives guidelines for employers on how best to help workers avoid long periods of sedentary work.  They advise employees to build up to standing for between two to four hours during the working day. This time should also include ‘light walking’ and incidental movement such as walking to the photocopier, going to talk to a colleague.  The important point is to break up periods of sitting regularly throughout the day.  To encourage this, there are simple low cost strategies that people could adopt, which include using a timer to remind them to move, arrange standing or walking meetings, or book meeting rooms which involve a longer walk to get to.

A good solution to the expense of providing everyone with sit/stand desks that are height adjustable, or with just standing desks, would be to offer a number of standing desks, or height adjustable desks, which could be used for short periods of time during the working day by different people. This gives flexibility for changes in working posture for a number of people without the expense of changing all the equipment for everyone. For those with back conditions or musculo-skeletal conditions that are aggravated by sitting, a height adjustable desk would be a sensible option to consider. There are also desk raisers that can be used to raise the level of the keyboard and screen on the existing desk, which may well be a cheaper suitable alternative that can be used for other other employees if necessary in the future.

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OnJanuary 31, 2016, posted in: Occupational Health Posts by

Do you have trouble sleeping? Getting a good night’s sleep.

Sleep is an essential part of feeling well and feeling happy, but almost everyone experiences problems sleeping at some part of their life. Lack of sleep robs you of needed rest. Paying attention to good sleep hygiene is the most important thing you can do to maintain good sleep. The term sleep hygiene refers to a series of habits and rituals that can improve your ability to fall asleep and stay asleep.

There are many medications which are used to treat insomnia, but these tend to be only effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits independent of medication, thereby prolonging sleep difficulties.

The following list of sleep hygiene tips can be used to promote sleep:

  • DO
  • Go to bed at the same time each night and get up at the same time each morning
  • Set a bedtime early enough to allow you 7 hours of sleep
  • Make sure the bedroom is a quiet, dark, and relaxing environment, which is neither too hot or too cold
  • Make sure your bed is comfortable and use it only for sleeping and not for other activities such as watching TV. Remove all TVs, computers and other ‘gadgets’ from the bedroom
  • Get regular exercise (good evidence that regular exercise improves restful sleep)
  • Use a relaxation exercise just before sleep or a relaxation tape
  • Try muscle relaxation to help de-stress and unwind e.g. warm bath
  • If you lie in bed awake for more than 20-30 mins, get up, go to a different room (or different part of the bedroom) and participate in a quiet activity (e.g. reading), then return to bed when you feel sleepy. Do this as many times as you need
  • Establish healthy sleep rituals before bed e.g. warm bath, meditation or quiet time
  • Reduce fluid intake before bed
  • DON’T
  • Have large meals before bedtime
  • Have caffeine in the afternoon or evening
  • Have alcohol or nicotine just before bed
  • Exercise just before bed
  • Engage in stimulating activity just before bed e.g. playing computer games, watching an exciting TV program or film
  • Take daytime naps or doze off in front of the TV
  • No clock watching
  • Command yourself to sleep, this only makes the body and mind more alert

For further advice on sleep or other occupational health and wellbeing needs, contact us today for an informal chat.

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OnJanuary 19, 2016, posted in: Occupational Health Posts by

Reducing absence length by 17% with early intervention

A new report by the Centre for Economics and Business Research looked at the cost of long-term absence for a typical business of more than 500 employees. It estimates the cost of absences over six months to be £4.17 billion to private sector businesses in the UK. Mental health conditions account for a large proportion of this, with 1 in 4 people are estimated as experiencing mental health problems at some time in their life, causing over 70 million working days lost per year, and a cost of £1.17 billion per year.

The research showed that businesses who step in early to provide support at an early stage of a health problem, rather than waiting until it gets more serious, reduced the duration and length of the sickness absence.  Actively using early intervention services such as vocational rehabilitation can reduce the average length of absence by 17% for all conditions and 18% in mental health conditions. This equates to turning an absence of seven months into six.

Vocational rehabilitation is using the workplace to aid recovery. In terms of mental health conditions, a gradual reintroduction to the workplace at a pace that is manageable for the employee, and with possibly adjusted duties, is likely to improve their general recovery as well as confidence. It is a win-win situation. The employee feels valued and is able to contribute to the workplace during their recovery, and the employer will have some output and productivity from the employee who would otherwise not be at work.

Occupational health advisors are well placed to identify vocational rehabilitation plans. They will have a good knowledge of the health condition, understand the health as well as psychosocial aspects and or/barriers involved in helping an employee back to work, and understands the demands of the business and what adjustments are possible and can be accommodated. Occupational health assessments should be conducted as early in the process as possible, ideally no longer than one month after the initial absence, to ensure that the appropriate support can be identified and put into place as soon as the employee is well enough to be able to come back to work in some capacity. For further advice on helping your employees back to work and reducing length of absences at your workplace, please call us now.

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OnJanuary 11, 2016, posted in: Occupational Health Posts by

10 reasons to be active at work

  1. Energy
    Activity perks you up, giving you more enthusiasm
  2. Mood
    Activity stimulates the ‘happy hormone’ noradrenaline, which makes you feel good. Everything seems easier and more enjoyable
  3. Stress
    Staying active while you cope with life’s ups and downs relaxes the mind and body, and helps to reduce the build up of tension
  4. Health
    Activity is the best investment you can make in your future health. It can help to protect you from heart disease, diabetes, osteoporosis and some cancers
  5. Self-esteem
    Lots of physical activities also build confidence and new skills
  6. Metabolism
    You can burn more energy at work and at rest as a result of being active, so it’s great for maintaining or losing weight
  7. Concentration
    Even a short active break helps to re-focus the mind and improve the quality and quantity of work that you do
  8. Strength
    You only get weaker as you age if you are inactive. Keeping bones and muscles strong, including the heart, protects you from disease, accidents and loss of independence
  9. Immunity
    Activity boosts the immune system, preventing minor illnesses, allowing you to enjoy work and play throughout the year
  10. Social life
    Activities with your team is great for getting to know your work colleagues better and expanding your network of friends

 

So now you know why, all that is left is for you to do is get up from your desk, take a walk round the block, or up and down the stairs, and keep active. Taking a 30 minute walk at lunchtime is great for giving your mind and body a break, allowing you to be more productive in the afternoon. Pick up the phone for other wellbeing or occupational health advice that could help your employees boost productivity at work.

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OnJanuary 3, 2016, posted in: Occupational Health Posts by

The “sitting disease.” The epidemic affecting sedentary workers

The WHO (World Health Organisation) has ranked physical inactivity as the fourth main risk factor for causes of death, after high blood pressure, smoking and high blood glucose.  Sedentary behaviour has also been associated with many serious health conditions including high blood pressure, depression, diabetes and musculoskeletal conditions and therefore increases the risk of ill health. As many people spend much of their working day sitting in the office, the workplace can be considered as a root cause of the “sitting disease”.

It is important to understand that a sedentary person is different from an inactive person. An inactive person is someone who does not meet the recommended guidance of 150 minutes of moderate physical activity every week. Therefore regardless of how much exercise an individual does, even active individuals are at risk of ill health if they are sedentary for long periods of time.

The risks of sedentary behaviour can be considerable. After just 90 minutes of continuous sitting, the effects of gravity can cause poor posture, forcing the body to lean forwards and down. Electrical nerve activity in the leg muscles shuts off, calorie burn drops to one per minute, enzymes that break down fat drop by 90% and blood flow is restricted in the lower body. Unfortunately all this happens whether you exercise every day or do no activity at all.

As absence through ill-health can be considerably costly to businesses, and employees spend so much time at work, Employers need to consider their role in providing workplace strategies to help improve health and wellness at work. In the long term, healthier, happier employees are likely to be more productive and engaged at work.

Encouraging more movement at work doesn’t have to be costly. Simple measures can be implemented to encourage employees to get up from their desk and move regularly throughout the working day. Cultural change needs to occur to show employees that it is ok to move around, to be seen to move around and not be a slave to their desk at all times.  The following strategies are simple ideas that can be implemented cheaply and quickly in many workplaces:

  • Turn meetings into walking meetings
  • Every 90 minutes walk up and down 2 flights of stairs or briskly round the block
  • Put a note up near the lift to encourage use of the stairs
  • Set a 15 minute time slot for everyone to get away from their desk
  • Set a mile-a-day challenge – encourage everyone to record when they have walked for a mile or more in a 30 day period and give a prize to the person who has done the most
  • Setting an hourly timer to encourage employees to stand, stretch, or change position
  • Consider providing a standing desk which employees can share for short periods each during the day

As individuals spend so much time at work, and absence can be so costly, employers are recognising that workplace wellness programmes are becoming higher on the agenda. Occupational health professionals are well placed to advise on suitable initiatives.

For help identify strategies to get your employees on the move, call us now.

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OnDecember 30, 2015, posted in: Occupational Health Posts by

Supporting menopausal women at work

A new report is due to be published soon calling for more help for women coping with the menopause at work. The menopause can cause symptoms such as, hot flushes, difficulty in sleeping, palpitations, headaches, mood swings, anxiety and depression, as well as problems with memory and concentration. On average, symptoms can be present for approximately four years, but for 10% of women it can last up to 12 years.  There is treatment available in the form of HRT (Hormone Replacement Therapy), which can reduce some of the symptoms, however, this treatment is not suitable or available for every woman. Other treatment options are aimed at keeping the symptoms as manageable as possible.

Each individual’s experience of the menopause is likely to be different. For some, the symptoms are minimal, for others it can be quite debilitating. In 2011 a study by the British Occupational Health Research Foundation explored women’s experience of working through the menopause. The findings showed that many women were little prepared for the arrival of the menopause, and even less equipped to manage its symptoms at work.  Heavy and painful periods, hot flushes, mood disturbances, fatigue and poor concentration posed significant and embarrassing problems for some women, leaving them feeling less confident. Women felt that workplaces and working practices are not designed with menopausal women in mind. Due to the nature of the symptoms some women said they worked really hard to overcome their perceived shortcomings, while others considered working part-time, although they were concerned about the impact on their career if they did so, or even thought about leaving the labour force altogether.

Although many women find their own coping strategies (such as obtaining fans, opening windows, bringing a change of clothes, sleeping longer at the weekend), employers could provide more assistance and support during what is, for many, a difficult time. Employers can help by communicating to their workforce that health-related problems such as the menopause are ‘normal’.  This could include:

  • greater awareness of managers about the menopause as a possible occupational health issue for women
  • increased flexibility of working hours and working arrangements
  • better access to informal and formal sources of support, such as their GP or occupational health advisor
  • improvements in workplace temperature and ventilation
  • Risk assessments should consider the specific needs of menopausal women and ensure that the working environment doesn’t make their symptoms worse, such as temperature and ventilation, toilet facilities and access to cold water.

More information can be found in this useful  TUC booklet and BOHRF guide for managers on supporting people through the menopause. For any advice on managing the menopause in your workplace or for any other occupational health advice, call us now.

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OnDecember 7, 2015, posted in: Occupational Health Posts by

Supporting people with anxiety at work

Anxiety is one of the most common mental health problems in the UK. It is estimated that one in four people in the UK will experience a mental health problem and one in six will be diagnosed with a disorder such as anxiety or depression.

Most people feel anxious from time to time, however, anxiety can become abnormal if it interferes with normal daily functioning. Anxiety can cause symptoms such as feeling fearful, tense but can also cause other unpleasant symptoms such as a fast heart rate, feeling sick, headaches, feeling shaky, fast breathing, dry mouth, difficulty in sleeping or panicky. Anxiety is normal in stressful situations but becomes abnormal if it is out of proportion to the situation, continues when the stressful situation has gone, or appears for no apparent reason when there is no stressful situation.

There are many different causes for anxiety and each individual may experience it differently. The cause may be related to personal issues, work issues or a combination of both. Regardless of the cause, the symptoms are likely to impact on an individual’s normal functioning, which can be both at home and at work. Work performance may be affected as the individual may have trouble with decision-making, complex thought processes and their work speed may be slower.

Many individuals with anxiety remain at work and may be undiagnosed. There are effective treatments available for anxiety, which include medication or talking therapies such as CBT (cognitive behavioural therapy), or a combination of both. Ideally, an employee should be encouraged to seek help through their GP to obtain a diagnosis and to discuss appropriate treatment options. Many people are able to function at work with anxiety, but may benefit from some temporary adjustments to their work until their symptoms are under control. Many individuals will be able to identify what would specifically help them at work, so having a conversation with them is the first step in helping them to manage their anxiety effectively at work.

Obtaining an occupational health assessment would also help identify adjustments that could be considered (such as reduced hours, reduced responsibilities, slightly later start time if sleep affected), provide you with advice on the likely consequences of the condition on the individual’s ability to perform their normal duties in the short and long-term, and advise on the organisation’s responsibilities if the anxiety is likely to be caused or aggravated by work factors. An occupational health nurse can also advise the employee on treatment options available and signpost them in the right direction.

If you would like to understand how anxiety may affect your employees and what can be done to minimise the impact on their work, pick up the phone to speak to one of our occupational health specialists for more information.

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OnMarch 29, 2015, posted in: Occupational Health Posts by

Fitness for Safety Critical Work

Safety critical work can be defined as a task where the ill health of an individual may compromise their ability to do that task, therefore posing a significant risk to the health and safety of others, as well as plant, premises and the environment. Types of safety critical roles involve operating machinery such as cranes, or driving passenger vehicles such as trains or planes. Other safety critical roles include managing safety critical control systems such as air traffic controllers, working within the railway industry or nuclear industry.

Medical fitness standards apply to certain safety critical roles and there are specific industry standards for certain industry groups, such as the railway, airline and construction industries. Safety critical roles rely on the employee being medically fit for that role as well as technically competent. It is therefore important that safety critical workers are not suffering from medical conditions or undergoing any medical treatment which is likely to cause sudden loss of consciousness or incapacity, impairment of awareness, concentration, balance or coordination, or significant limitation of mobility.

A safety critical medical will need to be conducted prior to any individual starting in a safety critical role.  The occupational health provider will work with the employer to understand the specific nature of safety critical roles of their staff and identify appropriate industry standards. A medical assessment is likely to include a detailed questionnaire to understand the health history and current conditions and treatment, as well as a number of tests including eyesight, hearing test, urinalysis, blood pressure and any other industry specific tests. Medical requirements may vary in frequency depending on the industry and as an individual’s health may change over time, a reassessment is recommended for any significant change in health status or for sickness absence due to a condition that may affect fitness for safety critical work. To understand the occupational health assessment requirements for your industry and organisation, please get in touch today, for more information.

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OnMarch 22, 2015, posted in: Occupational Health Posts by

Are you doing enough to manage stress at work?

stress at workAn individual who feels stressed at work may feel stressed solely due to work issues, but in many instances there is likely to be a combination of home and work pressures. Sometimes the home pressures are the main issue, which then cause the individual to struggle with the normal work pressures, which can lead them to believe that the pressures are mainly work-related.

Regardless of the cause of stress, undertaking an individual stress risk assessment will help identify the work issues or concerns the individual has with coping with certain work factors (even if they are not the main cause of the stress). Once the work factors have been identified, actions need to be identified to help reduce those pressures, until the individual’s symptoms have improved. Having a documented conversation with the employee will ensure that a record is kept of the issues/concerns from the individual’s perspective, along with actions the Organisation has taken to address the concerns.  The HSE have a number of useful tools to help shape the conversation, including the return to work questionnaire, which is a useful template that lists a number of questions to help the manager identify the specific areas which are causing the individual concern.

Work-related stress is a complex issue. It may be due to inherent factors in the work or job design, or may just be that tan individual has reduced resilience, or the job is not a good fit for that person.  If there is any double about what support an individual needs, then an occupational health assessment is recommended. Sometimes feel more comfortable having a more frank conversation with an occupational health professional than their manager, and the real issues can often be more easily identified.

As with general risk assessments, Organisations need to be doing an Organisational stress risk assessment, looking at each job or role, or each department, to identify potential areas of stress so that control measures can be put in place to ensure that their staff are not exposed to unacceptable levels of pressure. The HSE have produced a stress indicator tool that can be done with groups of people to identify the key stressors, which managers can use as a starting point to help manage pressures at work. The HSE also have a number of other really useful tools and templates which can help tackle work-related stress, as well as information on how to secure management commitment for dealing with stress at work.  For help in tackling stress at your workplace or general advice on how to use the HSE tools, please call us today.

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OnMarch 15, 2015, posted in: Occupational Health Posts by