Managing and Supporting Employees experiencing Mental Health Problems

1. Managing and SupportingEmployees experiencing Mental Health Problems IOSH – Yorkshire Branch Seminar ‘Putting the H back into ‘ealth and Safety’ Holiday Inn, Warmsworth, Doncaster 12 June 2008 Amanda Dowson RGN RSCPHN(OH) BA(Hons) CMIOSH Occupational Health Advisor

2. 1 person in 4 will suffer from a mental health problem at some point in their life. World Health Organisation 2008 Locating mental health facilities in a residential area downgrades the neighbourhood (20%) ‘Attitudes to Mental Illness 2008’ National Statistics Office Most women who were once patients in a mental hospital can not be trusted as babysitters (77%) ‘Attitudes to Mental Illness 2008’ National Statistics Office I wouldn’t want to live next door to someone who has been mentally ill (12%) ‘Attitudes to Mental Illness 2008’ National Statistics Office People with mental illness don’t deserve our sympathy (15%) ‘Attitudes to Mental Illness 2008’ National Statistics Office Mental ill health accounts for almost 20% of the burden of disease in the European Region. World Health Organisation 2008 Nine of the ten countries with the highest rates of suicide in the world are in the European Region. World Health Organisation 2008 1 in 3 people with a serious mental health problem are in debt. Office for National Statistics 2002 Debt can make a mental health problem worse triggering a vicious cycle. Drentea & Lavrakas (2000) “Improving public attitudes to mental health will take time, but if you’re suffering from the effects of stigma today then that’s time you don’t have.“ Dr Andrew McCulloch Chief Executive of the Mental Health Foundation May 2009 At least one million adults in the UK are out of work with mental health problems Bird A (2006) 1 in 10 persons surveyed consulted their GP in the last 12 months with symptoms of anxiety or depression National Statistics Office 2008

3. Perceptions of Mental Illness • Someone who has a split personality (59%) • Someone who cannot be held responsible for his or her actions (49%) • Someone who is incapable of making simple decisions about his or her own life (37%) • Someone who is prone to violence (36%) National Statistics Office 2008

4. Delirium Schizophrenia Mania and other psychoses Depression and other mood disorders Anxiety, phobias, panic attacks and other neuroses Personality Disorders and Character Traits Hierarchy of symptomatology of mental disorders Davies (2001)

5. Good mental health is characterised by a person’s ability to fulfil a number of key functions and activities, including: • the ability to learn • the ability to feel, express and manage a range of positive and negative emotions • the ability to form and maintain good relationships with others • the ability to cope with and manage change and uncertainty Mental Health Foundation

6. The report 'Working for a Healthier Tomorrow' calculated the cost of sickness absence and worklessness associated with working-age ill health to be £100bn a year, or enough to run the entire NHS. A total of 13.8 million working days were lost to work-related stress, depression and anxiety in 2006/07 Health and Safety Executive Each case of work-related stress, depression or anxiety related ill health leads to an average of 30.2 working days lost. Health and Safety Executive Work-related stress accounts for over a third of all new incidences of ill health. Health and Safety Executive

7. Risk of stress should be assessed like other health and safety risks. HSE recommends using ‘5 Steps to Risk Assessment’ format. Mental Health Policy should be an integral part of the Health and Safety at Work policy. Recommend familiarisation with the HSE’s Stress Management Standards. Equal Opportunities Policy should emphasise commitment to ensuring that people with mental health problems are treated with equity and parity.

8. Sickness Absence Management Occupational Health and Health and / or Health and Safety professionals need to be involved where health problems may be caused or aggravated by work Sickness absence statistics may influence health and safety priorities Needs to be lead by Human Resources Suitably trained managers Requires commitment from Senior Management

10. Occupational Health Liaise with Personnel Fit Temporary redeployment restrictions or adaptations • Attempt • Redeployment • where not • possible • Capability • Procedure Resign Ill Health Retirement

11. Mental Health and Absence The Manager should: Keep in touch with the employee Reassure the employee about practical issues Ask if there is anything you can do to help. Explain what rehabilitation plans are available Ask if the employee wants cards, visits, calls from their colleagues at this time and what the employee wants their colleagues to know about their absence if anything. Offer Occupational Health support Give employee chance to explain the problem and what is happening by asking open questions (nicely!).

12. Monitor progress Are they coping with job? Are there any further modifications required? Whilst we acknowledge that you may still be experiencing some difficulties, are there any elements of the job that make it worse / better? Scoring method or benchmarking against own goals Monitoring following Return to Work

13. Mental Health – when return to work is unsuccessful • Go through full process of reviewing progress, making adjustments and talking to employee • Talk realistically with the employee about best way forward e.g. transfer to another job, retirement on grounds of ill health, resignation • Use normal procedures if it is a performance or a conduct issue rather than one relating to health or disability

14. Ill Health and Dismissal • Disciplinary procedure are inappropriate in genuine ill health cases • Decisions need to be based on competent medical evidence • Need to undertake risk assessment • Need to consider adjustments to the workplace / redeployment (Disability Discrimination Act) • Need to give warnings

15. Considerations Relating to Ill Health and Dismissal • Nature of the illness • Likelihood of it recurring or other illness arising • Length of absence and periods of good health between them • Need for employer to have work done • Impact of absence on those who work with them • Adoption and carrying out of policy • Emphasis on personal assessment in ultimate decision • Extent to which the difficulty of the situation and position of the employer have been explained to the employee

16. Peritus Health Management 46a Bradford Road Brighouse West Yorkshire HD6 1FY Tel: 01484 722444 Fax: 01484 722032 www.peritushealth.com amanda@peritushealth.com