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Thriving at Work – the Stevenson/Farmer review of mental health and employers

November 2017

Background

In January 2017 the Prime Minister commissioned Paul Farmer, Chief Executive of Mind, and Lord Dennis Stevenson, former Chairman of HBOS (amongst other things), to undertake an independent review into how employers can better support and promote the mental health of their staff.  The Review was published on 26 October, and provides an excellent summary of the current state of mental health within the workplace, together with 40 recommendations for what the Review’s authors perceive to be significant challenges.

A link to the review is here, but for those of you who do not wish to read the full 82 pages, we hope you find this summary useful.

Mental health in the workplace - findings

One in four of us will be diagnosed with a mental health condition in our lifetime. In spite of the increasing frequency of mental health issues, it remains stigmatised and poorly understood by employers. It is, however, a serious issue and, undoubtedly, both work and the workplace environment can affect mental health.

The nature of the job also makes a difference: for example, the suicide rate for men working in the construction and decorating industry is 35% above the national average; the female suicide rate of nurses is 24% above the national average.

Whilst there are various initiatives to combat mental health conditions and illnesses, the Review has found that the initiatives that are working are small-scale and fragmented. The Review concludes that this has contributed to the fact that 300,000 individuals with mental health issues leave the workplace every year (as compared to 100,000 who leave the workplace due to physical health conditions).

It is no surprise, therefore, that the authors believe that failing properly to deal with mental health issues has a significant cost for employers, and for the economy at large. Research undertaken by Deloitte, and quoted by the authors, suggests that the cost to employers of poor mental health is between £33 billion and £42 billion per year (which equates to between £1205 and £1560 per worker).  This cost is a combination of days lost through sickness, presenteeism and increased staff turnover.

Also, it appears as if absence due to mental health issues is on the increase.  The Review found that there has been an increase of 5% in the amount of absence due to mental health conditions since 2009; in the same period general overall sickness absence has fallen by between 15 and 20%.

The authors have also found that stigma associated with mental health conditions remains common. 35% of those surveyed believed that their progression at work would be adversely affected if they had depression.

So, the Review paints a fairly pessimistic picture as to how employers approach mental health conditions.

Action plan

The Review, however, strikes a more optimistic note in suggesting ways of improving our approach to mental health.

At its heart sit six proposed mental health standards, labelled “Core Standards”. The Review recommends that all employers could, and should, adopt the standards in their workplaces. The standards are as follows:

  1. Produce, implement and communicate a mental health at work plan that promotes good mental health of all employees and outlines the support available for those who may need it.

  2. Develop mental health awareness among employees by making information, tools and support accessible.

  3. Encourage open conversations about mental health and the support available where employees are struggling, during the recruitment process and at regular intervals throughout employment, offer appropriate workplace adjustments to employees who require them.

  4. Provide employees with good working conditions and ensure they have a healthy work-life balance and opportunities for development.

  5. Promote effective people management to ensure all employees have a regular conversation about their health and well-being with their line manager, supervisor, or organisational leader, and train and support line managers and supervisors in effective management practices.

  6. Routinely monitor employee mental health and well-being by understanding available data, talking to employees and understanding risk factors.

In addition, the review proposes a further four standards, described as "Enhanced Standards" for public sector employers, and for those private sector organisations employing more than 500 employees. These Enhanced Standards are:

  1. Increase transparency and accountability through internal and external reporting, to include a leadership commitment and outline of the organisation's approach to mental health.

  2. Demonstrate accountability by nominating a health and well-being lead at board or senior leadership level, with clear reporting duties and responsibilities.

  3. Improve the disclosure process to encourage openness during recruitment and throughout, ensuring employees are aware of why the information is needed and make sure the right support is in place to facilitate a good employer response following disclosure.

  4. Ensure provision of tailored in-house mental health support and signposting to clinical help, including digital support, employer purchased occupational health or employee assistance programmes, or NHS services, amongst other sources of support.

The Review also recommends that larger organisations use their influence as customers and contractors to change the behaviour of smaller employers within their supply chains.

The Review touches upon a range of other initiatives. It suggests that the Health and Safety Executive revisits its mental health guidance, and in particular reviews its management standards on stress at work. It recommends that specific objectives be set for senior leaders within the public sector relating to well-being at work, and also recommends that the Government look at incentives for those employers who are prepared to implement the Core Standards.

Some changes to legislation are also recommended. The Review does not believe that the Equality Act adequately deals with mental health issues, and in particular recommends looking at the reasonable adjustments provisions with regards to disability discrimination .  The Companies Act, it recommends, should be amended so as to require employers to report on mental health issues, very much in the same way as large organisations must now report on modern slavery and gender pay gap issues.

The Review is consistent with the recent Taylor Review on Modern Working Practices, and the authors specifically acknowledge that review with their assertion that "good work is good for mental health". The Review also gives a nod to the fact that the mental health of both the self-employed and gig economy workers must be considered, although it is much lighter in its proposals.

Conclusions

Will much change? There are 40 recommendations in the Review. These are all eminently sensible, as indeed were most of those within the Taylor Review.  If taken together, then the two Reviews set out a vision for the modern workplace which is, culturally, very different to that which continues to exist in the majority of organisations. Both Reviews deal with significant, and growing, structural and costly problems for employers, and both can be seen as signals of a rapidly changing working environment, with which current law and culture are struggling to keep pace.

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