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Miranda Frost from Grassroots on Mental Health in the Workplace
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- 1. Mental Health in the workplace © Grassroots Suicide Prevention 2014
- 2. Scope • Wellbeing, mental health, mental ill health? • What might we notice? Do? • Legislation, responsibilities and best practice • Recovery approach • Tools and practices that can support mental wellbeing in the workplace • Creating a positive workplace culture
- 3. What is wellbeing? • Wellbeing is more than the absence of ill-health. It includes feeling valued, having security, positive relationships, work-life balance and interests. • We may measure it in terms of a sense of fulfilment and control in our lives. • There is a connection between work and wellbeing
- 4. Mental ill health... • feelings, experiences, behaviour - changes to and extremes of • physical signs - changes in sleep, appetite, energy levels • frequency, intensity, duration • distress, dysfunction
- 5. What is mental health?
- 6. A mentally healthy workplace: • managers have excellent people skills • employees feel valued and involved • appropriate health services are used • attendance culture promoted • flexible and well designed jobs • common health problems are managed • promotion of an open culture in which employees feel able to discuss their problems
- 7. A holistic approach (Heron & Teasdale)
- 8. When are employers allowed to ask about mental health? Health Questionnaires once a job offer is made Equal Opportunities forms that are anonymous and separate from the job application Returning to work after absence Health and Safety Reviews connected to your duties
- 9. When are employers not allowed to ask? On job applications, unless the role has ‘fitness to practise’ criteria, such as the armed forces. At interview – a person may choose to discuss health, but an employer should not ask you direct questions In public spaces, such as the corridor or at staff meetings
- 10. What might we notice? • Feelings / thoughts / behaviour different from usual. E.g. tearful, more stressed than usual, short with people, quiet, withdrawn, unusually chatty • Being late or staying late • Physical changes due to over or under sleeping / eating • An increase in unexplained absences or sick leave – poor performance – poor timekeeping – poor decision-making – lack of energy – uncommunicative or different communicative style than usual
- 11. And what might we do? • Manage mental health issues the same as physical health issues – effective line management with the employee and others. Good practices re support while off work, good return to work protocol • Talk. Offer to listen. Reflect on what you know about your colleague: – is their mental health generally good? – are they usually happy to come to you with problems? • Awareness of the issue (education). Understanding – empathy. • Developing a rapport with the employee will help you get a deeper understanding of their problem and identify: – the best coping strategies for them to adopt – any specific triggers that set off symptoms with the employee • If the mental health condition is classed as a disability you have a legal duty to consider reasonable adjustments to help them stay in work or get back to work quickly • Remember: you are not there to ‘cure’ people, only to help them manage their own conditions
- 12. Approaching people at work • private space • establish confidentiality boundaries • say what you see, be specific • ask open questions • explore what person needs • offer suggestions • regular contact / review of any adjustments
- 14. Best practice • Great progress has been made with Health and Safety, which needs to be extended to wellbeing at work • ‘Good work’ which is safe and offers some influence and a sense of self-worth far exceeds risks of unemployment • Myth that you have to be 100% fit to be able to work and work impedes recovery • Employers are in a position to positively influence health by using early intervention and tacking stigma • Increased awareness of well being and mental ill health contributes to better productivity for everyone.
- 15. Fit note
- 16. Relevant legislation • The Equalities Act (April 2010) • Human Rights Act 1998 (HRA), incorporating the the Data Protection Act 1998 • Management of Health and Safety at Work Regulations (1999) • The Health and Safety at Work Act 1974 (HASWA)
- 17. Who does the Equalities Act protect? Mental illness doesn’t have to be a clinically diagnosed to be covered, as long as the experience of ill-health has been: • Long-term, over 12 months • Had a “substantial and adverse affect on day-to-day functioning” This means if a person has been too anxious to seek help, they could still be protected from discrimination.
- 18. What is discrimination? The Equalities Act recognises four types of discrimination • Direct discrimination – failure not to consider reasonable adjustments is direct discrimination • Indirect discrimination • Harassment • Victimisation
- 19. Reasonable adjustments • Disabled people have the right to ask for ‘reasonable adjustments’ to working arrangements • An adjustment is considered ‘reasonable’ if it is effective without being too disruptive, costly or impractical for the employer to provide • Adjustments don’t have to be expensive; many deal with awareness and attitudes, and promoting a culture of openness
- 20. Examples of reasonable adjustments • flexible working hours • phased return to work • support to manage workload • change of workspace Reasonable adjustments may not be permanent and should be reviewed.
- 21. Downloadable resources for Employers: • Business in the Community • Health and Safety Executive • Mindful Employer • Shaw Trust – Tackling the last Workplace Taboo
- 22. Support for employees and people seeking work • Two Tick ‘Positive about Disabled People’ scheme • Access to Work • Mindful Employer charter • Disability Employment Advisers
- 23. Recovery model of mental health aims to: • decrease and prevent intrusive or troubling feelings and behaviours • increase personal empowerment • improve quality of life • assist in achieving own life goals and dreams
- 24. Five key concepts • Hope • Personal responsibility • Education • Self advocacy • Support (Copeland, M.E. 1995 - 2009), http://www.mentalhealthrecovery.com
- 25. WRAP Wellness Recovery Action Plan
- 26. Key elements of WRAP • Wellness tools • Daily Maintenance Plan • Identify triggers and action plan • Signs that things are breaking down, and action plan • Crisis plan • Post-crisis plan
- 27. Advance agreement • A tool to increase well-being and manage mental ill health in the workplace • Created when well, reviewed after periods of illness • Sets up clear communication, • Increases trust in the relationship
- 28. Content • Specific diagnosis or symptoms and how present and impact at work • Signs may be becoming unwell • How someone would like to be approached • Reasonable adjustments • Absence protocol and contact during absence • Confidentiality and consent
- 29. Creating a positive culture • Regular management processes • Encourage an open culture • Everyone should be treated with respect and dignity • Discuss staff mental health at work • Implement changes such as flexible working • Support the managers too
- 30. © Grassroots Training 2014
Hinweis der Redaktion
- Into self. GSP. Importance of guidelines re mh in workplace generally.
- Different perspective to consider – employee, manager, organisational – all need attention.
- Mental wellbeing is an integral part of how we feel about our jobs, how well we perform and how well we interact with colleagues and customers. It affects the productivity of every organisation.
- If I were to ask you to scale your mh you would think about - feelings / thought / behaviour Explain M ill health re …….. Spectrum
- This diagram demonstrates that the diagnosis or medical label attached to a mental health experience does not automatically mean that a person is less likely to be able to cope in life or at work. In the top left you can find people who have found self management techniques that mean that they might be described as highly functioning. We are moving away from the definition of mental health being 24/7 and 365 days a year, there may be episodes and relapses but a person can find their own methods to get back on track with appropriate and early intervention and support. The Mental Health Continuum The state of mental wellbeing is fluid – it changes over time and, as the diagram above shows, it can be misleading to attach too much meaning to labels. For example: • an employee with a diagnosis of a serious mental health condition may in fact have very positive mental health • an employee with no diagnosis of a mental health condition may have poor mental health over many years. Many people may fluctuate between different states of mental health or be on the border between one state and another.
- Health and Saftety Executive defines a mentally healthy workplace as… It’s easy to recognise signs such as: poor management, bullying, high levels of absence and unreasonably high work demands. ACAS, ACAS, the Advisory, Conciliation and Arbitration Service, a body that promote positive and productive workspaces suggests there are 6 features of a health workplace and provides an audit tool to assess your organisation against these competencies. line managers are confident and trained in people skills employees feel valued and involved in the organisation managers use appropriate health services (e.g. occupational health where practicable) to tackle absence and help people to get back to work managers promote an attendance culture by conducting return to work discussions jobs are flexible and well designed managers know how to manage common health problems such as mental health and musculoskeletal disorders.
- Pre-employment health questions on Job application forms Health questions during the recruitment process will be banned (but are permitted once an employee has made the job offer ). Equalities Act August 2010.
- On job applications, unless the role has ‘fitness to practise’ criteria, such as the armed forces. At interview – you may choose to discuss health, but an employer should not ask you direct questions In the corridor or at staff meetings – discussions about health should be held in a confidential environment
- In terms of day-to-day management in the workplace, many managers and employers already have many of the skills needed to successfully manage the mental health of their employers. How we approach someone may depend on whether they have disclosed their mh condition Spot the signs Engage Keep communication open Getting help (EAP), Occ Health, external services
- ask open questions like ‘I was wondering how you were doing?’ – give them time to answer – keep an open mind – give advice and support, where appropriate – agree what needs to be done and a review date. • Refer to the Health and Safety Executive’s Management Standards for tackling stress – www.hse.gov.uk/stress If the problem is very serious, the employee may need to seek specialist help.
- Managers may be concerned will get drawn into areas they are not equipped to deal with, because of this may not talk about it. Cycle. Helpful to break cycle by identifying factors can control / influence and those cant.
- Best practice guidelines come from various sources (working for a healthier tomorrow, 2008 Research and info on work and well being, legislation, factors contributing to a health workplace., tools for a health workplace – organisationally and for employees and managers, schemes for people to have support to find and retain work http://www.dwp.gov.uk/docs/hwwb-working-for-a-healthier-tomorrow.pdf 2008 (working for a healthier tomorrow, March 08, presented to DWP A move to put the slant on fitness rather than sickness Early intervention equals good business – if people feel confident to talk about their issues at an early stage this can prevent situations escalating and longer absences from work
- Government agenda - History of the FIT note/sickness benefits reform, which replaced the sick note looking at what people can do, rather than cannot Dame Carol Black wrote a report in 2008 to promote that: Are people using them, what experience do they have of them?
- The Equalities Act (April 2010), incorporating the Disability Discrimination Act 1995 & 2005 (DDA) Human Rights Act 1998 (HRA), incorporating the right to privacy under the Data Protection Act 1998 Management of Health and Safety at Work Regulations (1999) and The Health and Safety at Work Act 1974 (HASWA) On 6 April 2010 the Equality Bill completed its final stages in Parliament, and is now law. Autumn 2010, employers will no longer be allowed to ask job applicants about their mental health history prior to interview. It is clear that some employers have used pre-employment questionnaires to filter out candidates they “don’t like the look of”, and to date it has been almost impossible to prevent this type of covert discrimination. The Human Rights Act, includes the right to privacy under the Data Protection Act, which requires all organisations that collect personal information, including staff records to keep the information secure and process it only for limited, specifically stated purposes. The Health and Safety Executive (HSE) recommends that a mental health policy should be an integral part of any organisation's health and safety at work policy, which includes both a physical and psychological risk assessment. Traditionally health and safety policies have focused on physical aspects of safe work environments such as: manual handling, hazardous materials, work station assessments, and passive smoking. An employer now has responsibilities for doing a stress audit and ensuring that an employees psychological well-being is protected within their role and workspace.
- 1. This means that people who have not sought help or received a diagnosis, could still be eligible for legal protection if their experience of mental ill-health has been a.) longterm for over a year and b.) adverse affect on day to day functioning 2. Definitions of ‘long-term’ vary, but are generally agreed to have lasted 12 months or longer. Within a mental health context, some people may have conditions which are ongoing, whilst others may have episodic or fluctuating conditions such as Bipolar or Schizophrenia a person has a disability if their health has “a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities
- Direct discrimination occurs where, because of disability, a person receives worse treatment than someone who does not have a disability. This provision is intended to stop people being denied a service, or receiving a worse service, because of prejudice. Example: if a person with schizophrenia is not allowed to stay at a caravan park because the manager believes it is unsuitable accommodation for a person with a mental health issue Or: An employer who turns down a disabled applicant with a severe facial disfigurement because the employer considers that the other employees will be uncomfortable working with him. (or could say scared of person with schizophrenia) Indirect Discrimination is where there is a rule, a policy or even a practice that applies to everyone but which particularly disadvantages people with a disability compared with non-disabled, and cannot be shown to be justified or meeting a legitimate objective Example: if you organised a team away day with active activities that required a medical certificate, a person with mental health conditions may not be able to get a certificate that considers them ‘in good health’ despite the fact this may not mean they cant physically take part Harrassment is unwanted behaviour related to disability that has the purpose or effect of violating a person’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for them. Example: if someone is being bullied at work due to their disability, especially after a period of absence, use of offensive language, if care staff are laughing or mimicking a person with learning disabilities This also extends if a person is harrassed due to a percieved characteristics – if they are bullied for being gay, even if they are not gay This includes people who may not be disabled but are perceived to be: ‘discriminatin by perception’ and ‘by association’ partners, family members of spouses who experience harassment ‘by association’ Victimisation protects you if you decide to take action and make a complaint or allegation against an employer or service provider. If your allegation is genuine, then you are Further provision – discrimination arising from disability The Act includes a new protection from discrimination arising from disability – namely that it is discrimination to treat a disabled person unfavourably because of something connected with their disability (e.g. a tendency to make spelling mistakes arising from dyslexia). Guidance on the Equalities Act, (2010) is in your resources
- Disabled people have the right to ask organisations to make ‘reasonable adjustments’ to working arrangements, including the recruitment and interview process- which may mean bringing a supporter, bringing notes, or asking for interview questions in advance if you get very anxious in an interview environment. Adjustments don’t have to be expensive; OR PERMANENT many are strategies dealing with awareness and attitudes, and promoting a culture of openness where people feel safe in discussing their needs before problems escalate. This means that the employer has effective ways of dealing with issues of bullying, gossip and identifying possible causes of discrimination. What is reasonable for the employer will be judged according to the following factors: The extent to which the adjustment will prevent the problem; The extent to which it is practicable for the employer to make it; The financial and other costs, and the disruption it would cause to any of the employer’s activities; The extent of the employer’s financial and other resources; and The availability to the employer of financial or other assistance (e.g. grants) to make the proposed adjustment.
- Rethink has a leaflet on suggested adjustments, its best not to start with a blank page flexible working hours phased return to work after a period of absence support to manage workload, e.g. weekly check-ins, coaching or mentoring change of workspace, working from home or using email to communicate. using a job retention service to support line manager and employee to identify adjustments, seek funding and review them over time. In your resource list there are websites with suggested lists of reasonable adjustments that you can adapt for your own use Access to Work Details of WORKSTEP scheme are in resources Define WORKSTEP It is important to start with the individual, ask them directly what they think would enable them to carry out their job duties, and not to make assumptions based on their condition. Ask group for some examples of adjustments they would find useful
- The good news is there are lots of free and easy to use resources for employers on the internet, in your resource list Some examples are: Business in the Community has a workplace wellbeing tool that estimates the financial implications of poor health in the workplace, case studies and develop a plan for action. Health and Safety Executive, HSE has a toolkit for managers for absence management, rehabilitation and job retention. SHIFT (anti stigma organisation) has a Line Manager’s guide and a variety of toolkits and videos. Mindful Employer.net provides a charter for employers to sign up to and resources to help meet the standard. More descriptive details needed on the tools and reference them in the resources emailed to the participants Business in the community aims to increase UK business competitiveness through improving employee health” and has downloadable guides ways to do this SHIFT - toolkits and videos can be used at staff meetings, shift reviews all new resources in the mental health and employment area and provides a direct link to free resources
- Two Tick scheme The disability symbol is made up of two ticks and the words 'positive about disabled people'. You will see the symbol displayed on job adverts and application forms, many public sector organisations such as the City Council are on this scheme. If an employer uses this symbol, it means they have agreed to interview all disabled applicants who meet the minimum criteria for a job vacancy and to consider them on their abilities. Organisations must also make every effort to retain workers if they become disabled whilst in employment. Access to Work is a government funded scheme that may help you if your health or disability affects the way you do your job. It gives you and your employer advice and support with extra costs which may arise because of your needs, or if your disability or health condition stops you from being able to do parts of your job. You need to speak to a disability employment adviser for further details Access to Work might pay towards the equipment you need at work, adapting premises to meet your needs, or a support worker. It can also pay towards the cost of getting to work if you cannot use public transport. Explain 6 week rule Mindful Employer charter - This is a voluntary scheme which organisations can sign up to promote mental wellbeing in the workplace, their website list organisations who have signed up. Members agree to: positive statements in their recruitment literature, including training all staff involved in recruitment in disability awareness and interview skills. Ensure line managers receive appropriate information and training in managing mental health in the workplace – see Line Managers Guide Disability Employment Advisors work at jobcentres and act as gateways to support services, they can help disabled people find work, retain positions and get entitlements such as back to work grants, tax credits and AtW. They can give specialist support to find self employment or use Pathways to work agencies to help you find work after a period of illness.
- Hope Personal responsibility Education Self advocacy Support Hope Personal responsibility Education Self advocacy Support
- There are five key recovery concepts that have been found to be essential to effective recovery work. They are: Hope - People who experience mental health difficulties get well, stay well and go on to meet their life dreams and goals. Personal Responsibility - It's up to you, with the assistance of others, to take action and do what needs to be done to keep yourself well. Education - Learning all you can about what you are experiencing so you can make good decisions about all aspects of your life. Self Advocacy - Effectively reaching out to others so that you can get what it is that you need, want and deserve to support your wellness and recovery. Support - While working toward your wellness is up to you, receiving support from others, and giving support to others will help you feel better and enhance the quality of your life.
- "WRAP is a tool that can aid an individual’s recovery and its underpinning principles support the recovery approach. WRAP is a systematic way of monitoring wellness, times of being less well and times when experiences are uncomfortable and distressing. It also includes details of how an individual would like others to support them at these different times.” www.mentalhealthrecovery.com Also, Advance Agreements, which can be a workplace tool to support recovery.
- Wellness & Recovery Action Plan – Can be used within systems such as CPA, Advance Directives, crisis plans or other recovery plans. Services in Brighton & Hove are moving towards using WRAP Completed by the person, shared with others as appropriate. It has no legal status but should be respected, in line with best practice. There are several key elements to a WRAP and these are: ….on slide We’ll be doing: Exploring part of wellness tools and DMP Big document (show); also possible to do a mini-WRAP – come back to this later. Designing WRAPs with service users briefly describe sections, one at a time take as long as needed per section some sections may cause uncomfortable feelings. It’s important not to leave a session with a half-completed section crisis/post-crisis plans may take weeks. be mindful of which section you end a session on review completed plans regularly consider mini-WRAP if short of time
- Can be reviewed at other times such as appraisals, quarterly supervision,
- This is not your whole health picture, specific to your job description
- A manager needs to use regular management processes to monitor their staff’s mental well-being; A culture where people can discuss their mental health issues openly needs to be encouraged; Everyone should be treated with respect and dignity and issues such as bullying and harassment should not be tolerated; An important step to improving the mental health of staff at work is to discuss the issue with them so that they become more aware of things that might have an impact on their mental well-being; A manager can implement changes such as flexible working arrangements so that employees can balance the demands of home life with work; A manager also needs support and needs to know where to access it for themselves and for others.