Happier employees = better business

Tackling work-related stress and common mental health problems

The topics of employee health and wellbeing, and the associated impacts on work performance and absence have been receiving welcome attention of late, especially with the release of the Government-commissioned and much-anticipated Thriving at Work report on 26 October.

So this seems like a great opportunity to discuss the subject in greater depth. Here we’ll be taking a closer look at sickness absence, with a focus on:

  • work-related stress, and the effect of common mental health problems (CMHPs)
  • how businesses and organisations can take proactive steps to counter stress, and its knock-on effects for employees and employers.

How much does sickness absence really cost?

the collective business cost of sickness in the uk

Being absent from work through illness is to be expected. And in a fair, modern society, employers obviously respect individuals’ need to rest and recuperate fully before returning to work. But when you look at the collective cost – around £29 billion a year for UK businesses covering sickness absence1 – it makes sense to consider more closely the underlying causes, and ways to mitigate the effects.

What do we mean by sickness absence?

Firstly, though, let’s set the widely accepted parameters and definitions. These may differ slightly from employer to employer, but sickness absence is typically categorised in the following way:

duration of short, medium and long term absence at work

The majority of sickness absence falls into one of these six categories2:

  • Minor illness
  • Back pain and musculoskeletal issues
  • Stress
  • Recurring medical conditions (often linked with ‘presenteeism’ – working while sick)
  • Home/family responsibilities
  • Mental health issues

Then, let’s look at the direct financial costs that sickness absence can incur.

The cost of sickness absence

  • Statutory Sick Pay (£92.05 a week for up to 28 weeks, after at least four days’ consecutive absence).
  • Occupational sick pay.
  • Potential outlay for temporary cover, and overtime for colleagues taking on aspects of absentees’ roles.

In addition, there’s the ruling from employment appeal tribunals that employees can ‘carry over’ up to four weeks’ leave if a long-term illness prevents them from taking it. And with long-term sickness absence, you can refer employees for an occupational health assessment.

Indirect costs of absence

Already, we begin to appreciate the costs involved. But these are the direct and defined financial implications. The myriad indirect costs are often case-unique, so it’s much harder to predict or build a clear picture of the associated effects. For example, indirect costs can include:

the indirect costs of sickness absence

All this might seem a little business-focused and unsympathetic, but it illustrates the importance of developing a deeper understanding of employees’ wellbeing, so you can take more effective preventative measures – especially when it comes to the more mental health-related issues, such as low morale or stress, that are harder to gauge in terms of their triggers and consequences. With better-informed policies, procedures and support systems for mental health issues, you can not only avoid some of the direct and indirect costs described here, but also offer your employees a much improved experience of their day-to-day, and the reassurance that you’re ‘there for them’ in a range of ways. In itself, this can help tackle some of the triggers of sickness absence.

Mental health at work and work-related stress

With this in mind, let’s focus on some common mental health problems (CMHPs), and how they can relate to, and affect, people’s occupational performance.3

one in four people will suffer from a mental health issue

While mental health problems are common, most are mild – CMHPs tend to be short-term, and are treated successfully with prescribed medication, support such as counselling, or a combination of both.

The Thriving at Work report4, released on 26 October 17, suggests the following:

mental health statistics from the thriving at work report

It also claims poor mental health costs the UK economy up to £99bn each year, and includes a detailed analysis that explores the significant cost of poor mental health to UK businesses and the economy as a whole.

However, it also quantifies how investing in supporting mental health at work is good for business and productivity.

Anxiety and depression

These are perhaps the most common mental health issues we face in Western society. Anxiety is defined as feeling worried, uneasy or fearful a lot of the time, and finding it hard to control or rationalise worries to a point where they become distressing and disrupt daily life at home and at work. Anxiety can have both psychological and physical symptoms, and sufferers often become even more anxious when they feel others can sense their unease – hence it has a tendency to escalate in certain situations where people sense scrutiny or judgement.

Depression, meanwhile, is more than simply feeling unhappy or fed up for a few days…it’s about feeling persistently ‘down’ for weeks or months, and it can affect sufferers physically as well as psychologically. Depression affects people in many different ways, too – from lasting feelings of unhappiness and hopelessness, to losing interest in the things they used to enjoy, and feeling very sad and…well, like there’s little point to anything. Physical symptoms can include feeling continuously tired yet, sleeping badly, losing appetite or sex drive, and various ‘psychosomatic’ aches and pains.

Depression and anxiety often come hand in hand. They may be a reaction to a difficult life event, such as bereavement, but the root causes can be complex and difficult to identify. That said, it is important to be able to recognise the physical and mental symptoms of both conditions:

the symptoms of anxiety and depression 

What’s the link between CMHPs and work-related stress?

Work-related stress and CMHPs like anxiety and depression often go together. The symptoms are similar, such as loss of appetite, fatigue and exaggerated emotional states. What’s more, work-related stress can aggravate an existing mental health problem, making it more difficult to control. In other words, when work-related stress reaches a point where it triggers an existing or latent mental health problem, it becomes hard to separate one from the other. And it’s important to note that long periods of work-related stress can cause mental health problems.

Of course, we also need to recognise that CMHPs and stress can exist independently – people can experience work-related stress and physical changes such as high blood pressure, without having anxiety and depression. They can also have anxiety and depression without stress. The most effective strategies for dealing with either, or both, lie in understanding the key differences between the two:

  • Stress is a reaction to events or experiences in someone’s home or work life, or a combination of the two.
  • CMHPs typically have a single or primary cause beyond the workplace, such as bereavement, divorce, postnatal depression, a medical condition, or a family history of the problem – but these causes aren’t always easy to identify. Many people develop CMHPs for no obvious reason.

However work-related stress and mental health problems develop and manifest themselves, they can cause lasting or permanent damage to people’s lives, so it’s hugely important you learn to identify, understand and deal with them appropriately.5

days lost at work due to mental health issues

Absence management

Tackling absence through work-related stress and/or CMHPs

Research by Office Genie6 suggests that provisions for mental health in the workplace are still falling short overall. Lack of understanding and trust is one the biggest issues when monitoring and managing sickness absence, particularly when it’s related to workplace stressors or CMHPs.

Increasing understanding about mental health

Let’s look at some key ways to build your understanding of workplace stress and CMHPs, and key strategies for dealing with them more effectively.

It’s a good idea to record and monitor absence, and for both parties to have access to this information. Over a period of time, some employees – and indeed, employers – may not be aware of the regularity of absence, or of patterns emerging. There are many simple software-based and online tools for monitoring absence. For example, the Health and Safety Executive’s free sickness management tool is ideal for SMEs.

Discussing mental health7

mental health insights

Also, most employers will admit they don’t give fit notes – Statements of Fitness for Work from a GP, formerly called ‘sick notes’ – more than a cursory glance as confirmation their staff member was indeed ill and not ‘pulling a sicky’. Yet these can offer useful insights into employees’ health, and the support they might need to tackle potential work-related stress. Let’s not forget that people suffering work-related stress and/or CMHPs might not realise it in its early stages, and this might be where you can step in, start conversations, and begin to offer support. Return to work interviews and sickness absence meetings are a great platform for such conversations, and can benefit both parties immensely when approached with sensitivity and honesty.

Do we incentivise?

It may be that employees feel undervalued or ‘anonymous’, so recognition of their attendance and contribution with incentives and rewards such as cash bonuses and extra holiday entitlements might help. But such methods of encouragement should be approached with caution…they may work for happy, healthy employees, yet they may put staff with CMHPs or work-related stress under even more perceived pressure, and you must ensure that reward systems don’t unwittingly discriminate through a lack of awareness of employees’ circumstances.

What about flexible working?

Some employees may be experiencing stress through difficult time-management, at and beyond the workplace. For example, some people may be more productive during certain times of day, or if they have the flexibility to do longer shifts when they’re busy, and shorter spells when they’re not as busy. Or it may suit them to work some of their hours at home, or closer to home.8

number of organisations offering flexible working in the uk

Family commitments, such as both parents working and juggling childcare, clashing schedules, illness, and so on, can cause people’s stress levels to rise, and may trigger anxiety and/or depression that affects their attendance and productivity at work. In which case, asking the right questions and being aware of such issues – and offering flexible options that can ease the strain while protecting people’s hours and productivity – can tackle one of the key causes of sickness absence.

Mental health training

Formal training in the art of identifying, understanding and helping others manage stress can be an invaluable tool in reducing stress-related sickness absence. Not only that, but if employees are even aware that there is qualified support on hand, this alone can put their minds at ease, and they’re perhaps more likely to discuss and deal with issues than take time off – which can often add to the problem. Manufacturers’ organisation EEF – among many others – offers a range of consultancy and training options to help you identify and manage stress or CMHPs in the workplace.

Inspiring the small changes that can prevent stress and CMHPs

Sometimes employees simply need inspiration to make a change, and the benefits of improved diet, exercise, better sleep and social activities are well documented. There are many ways to encourage this, from simple information boards to setting up gym discounts, providing on-site facilities and supporting running or walking clubs.

ways to improve life and health at work

Income protection for the longer term

You might also consider income protection products that provide your employees with greater reassurance for the longer term. It’s easy to overlook that work-related stress can have a snowball effect when combined with worries about income, or not being able to take extended periods away from work to deal with stress or mental health issues – whether caused or aggravated by work, or otherwise. Meanwhile, it can relieve you of some of the financial risk and responsibility.

Sick pay insurance

This is a similar option to income protection, but focuses solely on enhancing employees’ income if they need to be absent from work for long periods to recover effectively from illness. For as little as £17 a month, it can be structured to pay employees up to 80% of their salary, for up to a year – and can take effect after just one week of absence if medical or professional advice recommends long-term recuperation. It also includes free access to legal expertise, and is moderated externally to ensure consistency and ease administrative pressures on HR departments.

how sick pay insurance can help manage absence

Employee Assistance Programmes

Many employers now provide Employee Assistance Programmes (EAPs). They’re designed to help employees deal – in confidence – confidentially with personal problems that might be affecting their health and wellbeing, and therefore their performance at work.9

number of managers receiving mental health training

Proactive mental health support

Such programmes are helping employers move away from passive, reactive and unstructured responses to employees’ mental wellbeing, to the more proactive and interventional support that benefits both parties in more meaningful and effective ways. Essentially, employee engagement in its broader sense means things are far less likely to reach crisis point for them, and you tend to avoid the direct and indirect financial implications of sickness absence that’s related to stress. What’s more, it’s there to help people deal with non-work-related stressors and problems – not just work-related stress, and EAPs can refer directly to wider healthcare services for counselling and treatment options.10

number of people at work with symptoms of existing mental health condition

What about ‘just talking’?

There are many simple and straightforward ways to monitor your employees’ stress levels – and to do so ‘pre-emptively’, rather than wait for issues to begin affecting their wellbeing, performance and attendance. We’ll go into more detail about this below, as it’s a really effective way to start an open conversation with employees that they might otherwise avoid, and to begin building a clearer understanding of the triggers of stress, and ways to manage and reduce it.11

eight out of ten managers report no cases of mental health

Monitoring stress levels

The Health and Safety Executive provides extensive information and resources on work-related stress. This includes specific guidance for employers, but it’s worth noting here the legal duties you have to your employees:

health and safety at work facts

What are the signs of stress?

You should be vigilant for signs of stress among your teams, which can include uncharacteristic lateness, drops in the quality or typical output of people’s work, shortening of temper and mood swings, and noticeable changes in their workplace sociability. Of course, there are the more obvious signs, such as increased sickness absence and overt complaints of being stressed, but all are valid signs of heightened stress among colleagues, and it’s important you monitor these in formal and informal ways so you can find the right strategies to tackle stress as early as possible – for everyone’s ultimate benefit.

Clues in the data you already have

You can also find insights in data that already exists from a variety of sources, and from data the business generates as part of the everyday running of a team of people. For example, you can look for trends in employee turnover, and perhaps match them to specific events or policies, or even projects that put pressure on particular teams or individuals. Meanwhile, a retrospective look at employee appraisals might indicate early signs of stress – and planning future ones accordingly can often be the start of conversations that give you further insights, and give employees the often-welcome opportunity to discuss their experiences.

Exit interviews can also be revealing, as departing employees probably feel more at liberty to reveal any misgivings they had about their working environment, workload, policies and people management. The same applies to ‘return to work’ interviews, where the employee is refreshed and ready to get back to their role, and can probably be more objective and candid about the reasons they needed to take time off in the first place.

The information is there – it’s just how you find and use it

It’s also worth pointing out that there’s plenty to be gained from informal talks with individuals or groups about how things are going and how everyone’s doing. One-to-ones ‘in passing’ will give individuals the chance to speak more openly and ‘off the record’ than in appraisal situations, while group chats where you start the conversation can make people aware that they’re not suffering in isolation.

You can also use surveys and focus groups to develop a much better picture of employees’ experiences, and there’s plenty of guidance and support for this on the Health and Safety Executive website. This website also includes an example of a comprehensive but easy-to-implement stress policy in the workplace, which you can find here.

Make ‘work’ a better place to be

You can always help manage and prevent stress proactively by improving conditions generally at work, and there are many ways to do this. You can also make specific adjustments to improve individuals’ comfort and reduce work-related stress – or help them cope more effectively with a mental health problem that may be exacerbated by aspects of their environment or routine.

In practice, distinguishing ‘stress’ and ‘mental health problems’, and knowing exactly how work-related stress can cause or amplify CMHPs like anxiety or depression at work, isn’t always straightforward. But there are many sources of useful information and guidance online.

For example, you can find out more about anxiety at Anxiety UK, a national charity for people affected by anxiety disorders, and those close to them. And there’s plenty of useful information and resources relating to depression at MIND, the national charity for mental health.

For managers

Managerial roles come with responsibility. Not just for efficiency and results, but also for people. Looking after those people, and ensuring they’re suitably comfortable and happy with their roles, will go a long way to keeping them present, productive and proactive.

The art of informed conversation

Developing such communication and trust – on any subject – is one of the most effective ways to put people at ease enough to discuss what they may otherwise feel unable to, and therefore to understand and deal with issues relating to stress or mental health. You may even be able to offer employees insights and access to resources they weren’t even aware of, and the willingness to engage on the subject ‘human to human’ can be invaluable to someone otherwise suffering privately.

Increasing awareness about mental health and stress

In short, managers have a duty to raise awareness of mental health and stress issues. Making them a regular part of dialogue with teams and individuals will have several benefits.

For one, it will reduce or remove any stigma surrounding mental health – a topic Time to Change covers brilliantly in its 2016 report Creating mentally healthy workplaces12. In short, we’d like to think that the days when people suffering stress are perceived as ‘mad’ or a ‘stress-head’ are far behind us, but it’s still a difficult topic for some sufferers and non-sufferers. You therefore have a responsibility to address and overcome any lingering stigma – and this can be achieved through discussions and information sharing.

‘Pre-talking’ will also make prevention and management far easier and effective, as people will feel more comfortable describing persistent experiences of stress or potential mental health issues. If you can then respond with wisdom and access to resources and support, then the issue is already being dealt with in its early stages.

how isolation and shame affects mental health sufferers

As soon as managers become aware of a mental health issue in the workplace, whether it’s related to work or not, talking is the first response. Acknowledging a problem might be initially difficult, but it’s the first and most important step to doing something about it. But then what if that person doesn’t want to discuss it, or denies there is anything wrong? Well, this is when you can suggest other avenues open to the employee, even if that’s simply talking to someone else, in confidence. Often, people need to feel free to discuss their struggles in their own time and on their own terms – so simply telling them that they have options can be a great relief to them, even if they don’t follow them up immediately.

What are the next steps?

Then it’s time for line managers to make reasonable adjustments at work while the employee takes advantage of the specialist resources and help available to them. An employee’s GP, or a medical support professional can offer useful advice on what adjustments you can make. There’s also plenty of helpful information available online, through the HSE and various other sources.

Stay in touch

If an employee does need to take time away from work, a lack of contact or involvement from their manager may make them feel isolated, like they’re not needed, or even that they’re being replaced. This may make them less likely to return. Even if it’s just to say hello, keep them up to date with what’s happening at work, enquire how they’re doing and see if there’s anything the company can do to help – it can make a big difference to the individual experiencing mental health issues. It eases any distorted sense of pressure to recover, extends a helping hand, and can encourage them to return to work, knowing that you’re providing support and resources.

Qualify each other

There are Mental Health First Aider courses for managers, HR staff and other interested employees, which can be invaluable in identifying and starting conversations with people showing signs of stress or mental health issues in the workplace. There are also training modules for employers and employees that raise awareness of such issues and offer initial strategies for getting people to share their experiences.

Put each other in touch

As discussed earlier, that first conversation is all-important, so you need to make sure people know who they can speak to – internally and externally – if they’re struggling with stress or mental health issues.

Absence Management Strategy

Essentially, this all boils down to managing absenteeism. But hopefully it’s clear that it’s not just another way to prevent people taking time off and affecting your bottom line. Especially when we’re dealing with such complex issues as stress and mental health – and the highly unpleasant experiences they can mean for your employees.13

amount of sickness absence attributed to mental health issues

It’s an important aspect of managing sickness absence, but perhaps the most delicate and multi-faceted. Employees can often experience a hike in stress when you identify it or they disclose it. So, when creating a strategy to understand and manage absenteeism, it’s important to also be aware of some of the potential ‘side effects’.

You should also take into account the legislation that quite rightly surrounds disclosure of personal information and medical records. It also pays to be familiar with The Equality Act, and how this can come into play if there’s perceived preferential treatment for employees experiencing work-related stress or mental health issues that affect their work performance.

Isn’t ‘wellbeing at work’ expensive?

Far from it. In fact, simple awareness and modest investment can have a huge positive impact. If we go back to the direct financial costs of sickness absence, and factor in that stress and CMHPs tend to involve medium to long-term periods of absence, managing them in the ways described above can actually save businesses and organisations a significant amount. Even the simple adjustments, and a better overall understanding of stress and CMHPs can make the workplace a much easier place to be, and to seek support from.

ftse firms and mental health

This in turn, makes for a generally happier, more reassuring, and more productive workplace – and this is upheld by a growing volume of research on the matter. For example, City AM14  reports that new data from Soma Analytics suggests the most profitable FTSE firms are those leading the way when it comes to discussing mental health in the workplace.

Talk to the experts

There are numerous ways Jelf can help you raise your game when addressing sickness absence, dealing effectively with stress and common mental health problems in the workplace. We’re a leading UK consultancy providing expert advice on a range of corporate services, including risk management, employee benefits, insurance, commercial finance and financial planning. We have in-house, qualified employment law consultants, who can assist you with all employee related matters, including ill-health and absence. We also have an in house mental first aid trainer.

To talk to us about your needs, and to find out how we can help, get in touch.

Office of National Statistics, 2016
Office of National Statistics, 2016
Thriving at Work report, October 2017
Office of National Statistics, 2016
Office Genie, 2017
Thriving at Work report, October 2017
Virgin 'The seven rules of working from home'
9 Thriving at Work report, October 2017
10 Thriving at Work report, October 2017
11 Thriving at Work report, October 2017
12 Time to Change 'Creating mentally healthy workplaces' report, 2016
13 Office of National Statistics, 2016
14 City AM 'FTSE 100 firms focusing on mental health see financial results', 2017



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