Summary and acknowledgements




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Summary and acknowledgements


Fact Sheet 1 – Mental Health at Work: Making the Case

This fact sheet explains why mental health in the work place is so important, and explores the costs to employers, individuals and the economy of failing to tackle mental health issues at work. It provides a snapshot of London in terms of its population, employment patterns (including the employment of people with mental health problems in London) and the scale of mental health problems in the capital.


Fact Sheet 2 – About mental health and mental illness

This fact sheet aims to dispel some of the common myths about mental illness and to provide information about a range of diagnoses that people within your workplace may experience at some time in their lives. A number of action points are provided to help you plan ahead to ensure your organisation has the knowledge, skills and support mechanisms in place to promote mental well being and deal with mental health issues at work, and to know how to respond appropriately when staff become mentally distressed or experience a mental illness.


Fact sheet 2 explores what we mean by good mental health and explains some common and more severe mental illnesses, including information about prevalence, common signs and symptoms and possible treatment options.


Fact Sheet 3- Aiming for a Mentally Healthy Environment

This fact sheet explains a range of factors that are known to have an impact on mental health in the workplace and describes the possible effect on employees. Each determinant for mental health is matched with an action plan for good practice, providing you with a number of measures that you can take together with your staff to promote a mentally healthy environment at work.


Fact Sheet 4 – Creating a Mentally Healthy Workplace

This fact sheet explores a number of ways that you as an employer can contribute to a mentally healthy workplace by cultivating an organisation culture that is open to mental health issues, values diversity, tackles all discrimination at work and promotes communication across the organisation. It explains the advantages of developing a strategy for work-life balance, and explores ways of achieving this. Finally, it assesses your legal responsibilities towards mental health at work.


Fact Sheet 5 – Positive Recruitment Practice

This fact sheet aims to provide information and advice about positive recruitment practice for your workplace. This includes information which relates to the positive practice of supporting people with mental health problems to apply, to be appointed and to be supported in your workplace.


Fact Sheet 6 – Positive Retention Practice

This fact sheet aims to provide information and advice about positive retention policies and practice for your workplace. This includes information which relates to the positive practice of supporting people with mental health problems or people who may be experiencing a period of mental distress to retain their jobs and continue to contribute positively in your organisation.


Fact Sheet 7 – Disciplinary and Grievance Procedures

This fact sheet aims to provide information and advice about workplace rules and regulations, disciplinary, grievance and dismissal procedures. This includes information relating to the practice of supporting people with mental health problems through these procedures, informing colleagues and ensuring as positive an outcome as possible for individuals and the organisation.


Fact Sheet 8 – Rights, Roles and Responsibilities

This fact sheet aims to provide information and advice about employees and employers rights, roles and responsibilities within the workplace. Some rights are considered in more detail as they may have more relevance to people with mental health problems or they may be used to support the mental health of all employees. This includes information for human resources professionals, occupational health professionals and managers to support people with mental health problems effectively in the workplace.


Fact Sheet 9 – Useful organisations and resources


These fact sheets were written by mentality.


Acknowledgements

We would like to thank the following people for their contributions as steering group members:

Simon Allard, Director, Usec Limited; Madie Chapman, Development Manager, Mindlink;

Helen Davies, Policy Manager, Health, Greater London Authority; Sharon Field, Policy Officer, Greater London Authority; Elizabeth Gale, Acting Chief Executive, mentality; Thea Gordon, Human Resources Adviser, Greater London Authority; Marie Humphries, Strategy Manager, Equalities, London Development Agency; Elizabeth Manero, Chair, London Health Link, the regional association of London Community Health Councils; Brendan McLoughlin, Head of Resources & Development Manager, London Development Centre for Mental Health; Natalie Salmon, Co-ordinator – Disability, London Stakeholders Team, Greater London Authority; Katherine Smith, Marketing Executive, Greater London Authority; Nicki Tucker, Design & Publications Officer, Greater London Authority, Chiekh Traore, Health Inequalities Programme Lead, Greater London Authority;

Melba Wilson, Chair of Wandsworth Primary care Trust, Deputy Chair London Health Commission; African Caribbean Mental Health Commissioner.


We would also like to thank the following for their assistance:

Doreen Kenny – Senior Policy Officer, Greater London Authority; Sue McIntosh- Senior Policy Officer, Greater London Authority.


For further information and a downloadable version of the fact sheets see www.london.gov.uk or contact the Greater London Authority on 020 7983 4100.


= = =


  1. Mental health at work: making the case


About this fact sheet

This fact sheet explains why mental health in the work place is so important, and explores the costs to employers, individuals and the economy of failing to tackle mental health issues at work. It provides a snapshot of London in terms of its population, employment patterns (including the employment of people with mental health problems in London) and the scale of mental health problems in the capital.


Why is mental health in the workplace so important?

Good management of mental health in the workplace means good business. Everyone has mental health needs and one in four people will experience some kind of mental health problem in the course of a year. Over 25 million people in the UK spend a large part of their lives at work and therefore it is clear that a mentally healthy workplace and a supportive work environment will benefit staff and employers alike. Failing to deal effectively with mental health issues in the workplace can be costly for employers, individuals and the overall economy. It can lead to a lot of people being excluded unnecessarily from the labour market, their skills being lost to business, and individuals in work not contributing their best.


What’s in it for employers?

For employers, finding ways to protect the mental health of all staff, to look after staff experiencing mental health difficulties, and to support people returning to work after a mental illness can make great business sense because it contributes to:

l More effective recruitment of staff, drawing from a wider pool

l Better staff retention

l Reduced staff absences and associated savings

l Better working conditions for all staff

l Compliance with the Disability Discrimination Act

l Enhanced reputation as an employer


In a survey of 800 companies carried out by the Confederation of British Industries, 98 per cent of respondents said they thought the mental health of employees should be an organisation concern.1

The majority (81 per cent) considered that the mental health of staff should be part of a company policy, and yet less than one in ten of those companies had an official policy about mental health.2


Mental health – how big is the problem?

Work-related stress is estimated to be the biggest occupational health problem in the UK, after musculoskeletal disorders such as back problems. Nearly three in every ten employees will have a mental health problem in any one year. Mental health problems account for the loss of over 91 million working days each year, and half of all days lost through mental ill health are due to anxiety and stress conditions.


Promoting mental health in the workplace and giving consideration to employees with mental health problems makes good business sense as mental ill health among the workforce costs British industry a substantial amount of money.


l 2.2 million people suffer from ill health (physical and mental) due to, or made worse by work3

l The cost of sickness absence attributable to mental health problems was estimated to be £4 billion annually in the UK in 2001 (the equivalent of £3.9 billion in England in 2002/03).4

l Lost employment constitutes 37 per cent of the total cost of mental ill-health in England (£11.8 billion).

l The CBI estimates that 30 times as many days are lost from mental ill-health as from industrial disputes.

l In addition to sickness absence, ineffective working and poor interpersonal relations can substantially reduce productivity.

l Increased staff turnover leads to increased recruitment costs.

l Administrative as well as personal costs are involved in covering for absent employees.

l The cost of staff taking early retirement or medical severance on health grounds.

l A survey5 indicated that changes in UK work patterns have resulted in a 90 per cent increase in claims for compensation arising from mental health problems over the last five years.


How individuals can benefit

Paying attention to mental health issues at work can benefit individuals in a number of ways. It will promote a working environment that protects the mental well being of all staff; ensure staff receive the support they need if they develop a mental health problem while in employment; and help individuals to get back to work after a period of absence due to a mental illness.

An Industrial Society survey6 showed:

l Only about 13 per cent of people with mental health problems are in employment, compared with around 33 per cent of people with other long-term health problems.

l 70 per cent of people with mental health problems have been put off applying for jobs for fear of unfair treatment.

l 30 per cent of people with mental health problems felt they had been dismissed or ‘forced to resign’ because of discrimination .


How work benefits people with mental health problems

Most people with mental health problems want to work, both in paid and voluntary jobs. As many as 90 per cent of unemployed people with mental health problems would like to work.7 Work has been shown to have a beneficial effect on mental health8, while unemployment has been found to adversely affect mental health.9 People with mental health problems who are employed report that work is both a distraction from symptoms and a way of managing them. It helps them structure their time and avoid boredom, increase financial security, feel productive and normal, improve their self esteem and socialise with others.10 Use of support services and periods of ill-health decline when a person is at work.11


People with mental health problems are more likely to become unemployed, establishing a downward spiral of job loss, deterioration in mental health and consequent decreased chances of gaining employment.12 The effects of mental illness and job loss on an individual result in financial costs associated with loss of current and potential income, costs of treatment and medication, as well as psychosocial costs resulting from social exclusion, stigma and costs to carers and family members.13


Increased length of time off work has an increasingly negative effect on mental health and decreases the likelihood of ever returning to work. After six months off there is a 50 per cent chance of ever returning to work, after 12 months there is 25 per cent chance of return, and after two years the chance of return is practically nil.14

How work can have a negative impact on mental health

Although work is largely positive it can also have a negative impact on mental health. Many jobs or particular tasks cause stress to individuals15 and unmanaged job stress can exacerbate mental illness16. Approximately two out of three people with a mental illness believe that unrealistic workloads, high expectations, long hours and bad management caused or exacerbated their mental health problems.17 Another one in three felt that unhealthy working conditions, the work culture or bullying at work had caused or contributed to their mental health problem. Work-related and environmental factors can also contribute to increased stress and mental ill-health for the general population.18


Mental health in London

With a population of 7 million, London is the largest city in western Europe and approximately a further million people commute to London each working day.19 The gross domestic product per head of population is 30 per cent higher than the UK average20 and the average household income is also higher by similar levels However, there is a large variation in weekly income and London has some of the poorest areas in the country and higher unemployment.


The capital has higher levels of serious mental illness than any other city in the UK. The capital has the highest rates of factors known to increase the risk of mental illness, including unemployment, and the proportion of the population aged 15 – 30 (the highest risk years for psychotic illness). The NHS in London spends £7 billion per year, making up six per cent of the London economy compared with 14 per cent by the wholesale and retail trade and just four per cent by education. Over a billion of this NHS spend in London goes on mental health. Each borough has more than 4,500 NHS staff, as well as social services and social care staff.21


NHS mental health services use a measurement known as the ‘Mental Illness Needs Index’ (MINI) which is based on a number of indicators with an established association with rates of mental illness, including social isolation, poverty, unemployment, sickness and quality of housing. In London, ten boroughs have below the English average MINI score, one is on the average, and 22 are above average (a high score indicates an area with greater need for mental health service provision).22


Employment in London

In 2002, the unemployment rate in both London and the UK increased for the first time since 1993, and both unemployment and long-term unemployment remain higher in London than for the rest of the country. There is considerable variation in unemployment rates in different London boroughs, with a range from two per cent in Havering to 12 per cent in Tower Hamlets. In Inner London boroughs, 42.5 per cent of unemployed persons have been so for more than six months, and in outer London the figure is 32.8 per cent. There has been a slight increase in unemployment among 16 – 24 year olds, and over one quarter of male teenagers in London continue to be unemployed.23


The NHS is a bigger employer by far than any individual company, employing 140,000 people in London - an average of over 4,000 jobs per London borough, or 7,000 including contract staff. The number of NHS jobs is highest in the most deprived London boroughs. The total number of jobs dependent on the NHS and other health providers is between 350,000 and 400,000 – around ten per cent of London’s four million jobs.24
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