When good intentions for employee health go bad

A disjointed approach to mental health is failing to deliver

Research shows that the health of the nation continues to deteriorate. In fact, the average number of working days lost due to absenteeism or presenteeism has risen from 23 to 30 days. That's according to Britain's Healthiest Workplace survey.

This is worrying given the increasing efforts by employers to address falling health, and in particular mental health. The Mental Health at Work Report 2017 shows that:

  • three out of every five employees have experienced a mental health issue in the past year where work was a related factor, and 
  • 31% had a mental health issue where work wasn’t a related factor.

But, there is still a worrying gap between how leaders think they are supporting mental health and how it’s actually supported. According to the study:

  • 61% of CEOs and managing directors believe that employees’ mental health is being looked after. 
  • This compares to only 40% of non-managers who believe that employees’ mental health is being looked after. 
  • Yet only 11% of employees felt able to disclose a mental health issue to their line manager.

Mental health remains one of the most difficult topics to talk about at work. Those surveyed said they felt more comfortable talking about other equality and social issues, including race, age, physical health and religious belief. A shocking 15% of respondents faced dismissal, disciplinary action or demotion for choosing to disclose a mental health issue to their employer.

Why is mental health still taboo?

People don’t want to talk about their mental health to their line manager because there’s still a fundamental issue with the way we talk about it. If someone is sick with influenza we say “they have flu”, never “they are flu”. The implication is that this is something from which they can recover. Yet if someone is sick with depression, we say “they are depressed”, as if this now defines them. It would be far better to say “they have depression”, with the implication that there is a clear treatment pathway in place.

Also, if someone has a physical problem, such as a back issue, there is a clear care pathway. But most companies lack clear mental health pathways that the manager can use to direct people towards appropriate support. Instead, they have a range of disjointed tactical initiatives, such as one-off mental health days or work/life balance classes. The result is that most managers have no idea what to do with someone struggling with a mental health issue. What use is a standalone mindfulness seminar to someone who can’t come into work because of a crippling anxiety disorder?

The need for joined-up strategies

If the latest research teaches us anything, it’s that disjointed, tactical wellbeing initiatives are failing to deliver. Instead, we must create and use strategic mental health pathways to normalise people’s experience of managing and recovering from mental health issues. Such mental health pathways should include proactive elements, such as:

  • training managers to spot the early warning signs of stressed employees, and 
  • resilience training to educate people how to maintain good mental health.

As well as reactive elements, such as:

  • a triage model to ensure employees receive appropriate referrals into relevant treatment options.

Management information is critical to the design of these pathways. This can include analysis of how people are currently using existing health services, such as: 

  • medical plans, 
  • employee assistance programmes, 
  • group income protection, and 
  • occupational health or existing rehabilitation programmes.

At the same time, we need to start viewing people as “joined-up” humans, whose physical and mental health are linked. That way, we can start creating policies that address wellbeing as a whole. Instead of attempting to address physical or mental health in isolation. Only then will leaders looking to improve the health of the workforce start to see an impact.

Joined-up health for joined-up people

The tendency to treat physical and mental health in isolation has led to disjointed policies. And this can put too much pressure on people to talk about their mental health in isolation.Critical to normalising mental health is treating it like any other aspect of health. People aren’t afraid to talk about joint pain or sleep issues. What’s more, people don’t feel like they need to have experienced these issues to be able to empathise with someone affected by them.

Dimensions of wellbeing

Instead, we need to stop trying to divide humans into two halves — their physical and mental components. And start creating people-shaped policies that look at their health as a whole.

This is important because if someone is struggling to manage their income, they are likely to not only experience stress and anxiety but also sleep loss. Causing them to have poor diet because they feel tired. Even if an employee might not yet have any physical or mental health issues, by encouraging them to look at their financial health you can support them to identify and prevent future problems.

  • 2/3 of employees have concerns about finances
  • 62% of employees are not eating healthy diets
  • 30% are getting less than seven hours sleep a night
    Source: 2017 Britain’s Healthiest Workplace

By taking a step back and looking at all dimensions of wellbeing, employers have an opportunity to create people-shaped policies that prevent problems from arising in the first place.

Why are we less healthy?

Wellbeing is now a boardroom issue, but good intentions are not filtering down.

Few, if any, organisations are planning to set less challenging targets than they did last year, yet productivity is suffering. Add to that the encouragement for us to always be 'on', it’s no surprise that people are struggling to find the time to look after themselves.

France has introduced laws to give workers the right to disconnect from work and switch off their mobile devices, so that they can recharge at home. But, few UK employers have opted to follow suit.

In the absence of a solution that will work for all organisations, employers need to consider the culture they’re creating and gather insightful wellbeing data. If behaviours are detrimental to people’s health, then managers must step in to help change this. For example, they could address the toxic blame cultures or stop employees from extending their working day in unhealthy ways.

Creating a culture of health

Each year, Britain’s Healthiest Workplace benchmarks organisations against six HSE Management Standards, which can impact the health of employees. By training new managers to live up to these standards you can empower them to create a culture of health.

  1. Demands - People receive adequate and achievable work. Their skills and abilities are also matched to job demands. Any concerns about their work environment are addressed.
  2. Control - Individuals have some say over their workloads and deadlines. They are allowed to play to their strengths and feel able to manage their day in healthy ways.
  3. Relationships - People can have “water cooler conversations”, enjoy social spaces and are able to foster good workplace relationships to help and support each other.
  4. Role - It’s clear what’s expected of individuals: they understand their role and objectives, and don’t feel like the goalposts are being changed.
  5. Change - Change and the need for change are effectively communicated. People understand the probable impact of any change to their job and the timetable for changes.
  6. Support - Managers understand their duty of care to others, make time to talk to people one-to-one and know how to direct them towards appropriate support whenever needed.


An explicit focus on mental health has failed to deliver the desired results. Employers must now normalise mental health by creating people-shaped policies that look at all dimensions of wellbeing.

Critical to success is:

  • educating managers about their role in creating a culture of health, and 
  • putting in place clear treatment pathways, so that managers can easily direct people towards appropriate support as needed.

Only by making mental health an aspect of health, like any other, will people finally feel safe enough to ask for access to the support that is still so clearly needed.

Top Tips

  • Don’t only look at physical or mental health in isolation. 
  • Don’t copy one-off tactics that might have worked for others. 
  • Don’t expect employees to want to talk about their mental health. 
  • Don’t underestimate the role of managers in optimising workforce health. 
  • Do create policies using all the dimensions of wellbeing. 
  • Do create strategic joined-up solutions based on your own data. 
  • Do put in place clear treatment pathways for those in need of support. 
  • Do educate managers to use the HSE standards to create a culture of health.

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