Management of mental health in the workplace is not just an ethical concern, it also has real implications for productivity, performance and staff turnover. As well as being a major cause of sickness absence it can also result in presenteeism. A review conducted by Deloitte estimates that presenteeism attributable to mental health problems costs the UK economy £17bn to £26bn per annum.
It should also be remembered that mental health is an equality issue and there is a legal obligation on employers not to discriminate against employers with, or with a history of, recognised mental health conditions.
There are, therefore, sound business reasons for ensuring staff who manage people have access to the right expertise, and mental health training is now a priority for many industrial sectors. Available training programmes are diverse, variously addressing topics such as mental health literacy, stress management and resilience, while some centre on self-management techniques such as CBT or mindfulness.
Mental Health First Aiders or ‘Champions’ are becoming commonplace in recognition of the importance of having a trusted point of contact for workers experiencing distress or those in need of an informed source of support more generally.
Why train line managers?
There is increasing acceptance that there is no ‘one-size fits all’ mental health training and that different sectors - and roles within those sectors - require different approaches.
In terms of role, line managers and supervisors are key targets for training as they arguably represent the ‘frontline’ of wellbeing management and act as a gatekeeper to referrals or other pathways to support.
Ideally they should lead by example with respect to healthy ways of working, and create an environment that is open to dialogue around mental health.
Due to the stigma and unease around mental health, there is a risk that even well-meaning managers will avoid or mismanage mental health issues. It is essential to equip people managers with the skills they need to identify, discuss and effectively deal with any problems employees may have.
There is evidence that the right kind of training can bring about a significant reduction in work-related sickness absence in the medium term, not to mention better awareness of mental health conditions and improved behaviours towards those affected.
What line managers need to know
For many individuals the first step to helping them manage mental health at work more effectively is to tackle misperceptions and dispel stigma. Line managers need to be able to separate facts from myths and in some cases overcome their own prejudices.
This can mean challenging mistaken beliefs about the causes of mental health problems and questioning assumptions about the ‘type’ of person who is prone (or not prone) to being affected. A basic awareness of the prevalence of mental health problems is helpful, as well as a working knowledge of the types of conditions that are most common, and their effects and treatments.
It’s also important line managers are aware of typical symptoms and signs of someone who may be struggling with their mental health, not only as useful contextual knowledge, but also so they can be appropriately watchful of their staff.
Day-to-day managers are potentially in a good position to do this because spotting subtle signs of distress often requires knowing what is ‘normal’ for that particular person.
If a direct report doesn’t seem themselves the next step could be a potentially difficult conversation that begins with ‘is everything all right?’ That conversation needs to be handled sensitively and followed up appropriately.
This is an area where a lot of managers understandably lack confidence about what to say (and what not to say) and formal training can take some of the fear and awkwardness away.
The role of self-management and people-management skills
Good training will be holistic and emphasise a whole-organisation approach to mental wellbeing. It should also address how line managers can ‘lead by example, raise awareness, promote dialogue, tailor job design, and create an open environment around mental health’.
Naturally, the mental health of line managers themselves is of concern too and they should be encouraged to be aware of their own state of mind and adopt healthy coping styles.
The ability to deploy effective coping techniques puts individual managers in a better position to support others and this can be addressed directly through a component to the training that includes building resilience.
In some respects the competencies required to manage the mental health of staff overlap with basic principles of good people management and, inevitably, some individuals will have more development requirements than others.
With respect to keeping a watchful eye on staff, managers who have regular contact with their reports are at an advantage. Moreover, those who can cultivate an open and honest relationship with their staff are much better placed to pick up on problems.
If a manager has effective soft skills then an employee is more likely to disclose that they are struggling with (for example) anxiety, and to disclose this sooner rather than later.
Clearly the earlier disclosure takes place the earlier employees can be signposted to the right support (from their GP for example), or where available put in touch with an EAP, or referred to an occupational health professional.
Naturally the functions of specialist forms of support and scenarios that should trigger referrals are another important aspect of training content.
Approaches to training
Effectiveness of any chosen training will not depend on subject matter alone: preferred learning style of individuals, the prevailing organisational culture and logistics of training delivery should be considered.
Technology offers alternatives to traditional ‘classroom’ training in the form of webinars, podcasts or videos.
These options offer a means of reaching a high volume of users and can be ideal for site-based or peripatetic (rather than office-based) workers may need to be trained remotely. There are several high-quality online resources available for free, such as those produced by Business in the Community and Mind.
While technological methods can be effective for factual learning; many people’s experience is that in-person training is most effective for learning skills that require interaction and communication with others.
Generally learning in a group can also be motivating and normalises the learning experience; in particular, interactive methods of training can be helpful when attempting to shift mind-sets.
Delivery needs to be given some careful thought however. Mental health is an emotive, triggering issue for some and there can be advantages and disadvantages to a classroom environment; some people can feel ‘exposed’ when receiving training with immediate colleagues.
Above all training has to be suited to its audience. In a wide-ranging academic review Hanisch et al suggest that there is potential for tailored workplace-based interventions to be a more effective route to engender a change in mental health stigma than other means such as public campaigns.
In recent independently-authored report for Government on mental health and employment ‘Thriving at Work’, the authors suggest that line manager training is most effective when it provides practical examples and is tailored to the specific practices of the organisation in question.
Too serious to overlook
Cost is clearly a consideration, especially when bespoke face-to-face training is outsourced, but the hypothetical human costs of not providing training should be a major driver.
Quantifying the financial benefits of training interventions is always difficult (although, as noted earlier, academic research has shown compelling evidence does exist) as cost savings can take a long time to manifest. Moreover some individuals may not have the opportunity to apply new skills and knowledge until significant time has elapsed and they have forgotten elements.
Therefore, a commitment to keeping knowledge ‘live’ needs to be made to ensure it becomes embedded. This need not be of huge cost: a ‘train the trainer’ model can be an efficient means of disseminating knowledge and ensuring it is retained in the medium- to long-term, provided there is adequate quality assurance of the process.
Given the sensitivities around the topic and the need to pitch any intervention correctly, the decision to roll-out mental training for managers in organisations should not be taken lightly.
But by equipping line managers with mental health knowledge and relevant soft skills, an organisation can signal to all employees, whatever their position in the management chain, that they take their mental health seriously.
About Sally Wilson
Sally has more than fifteen years’ experience of applied research in health and wellbeing and currently leads on this area of policy research at IES. Her work spans occupational health and safety, stress and mental health, as well as chronic illness and disability. Sally has a particular interest in workplace mental wellbeing, including interventions to manage workplace stressors, as well as measures to help people return and re-enter work who have lived experience of mental health conditions. More broadly her expertise also extends to quality of work, work-life balance and working while caring. She recently project managed a large evaluation for the Social Care Institute for Excellence looking at local interventions to support carers in employment.
Sally has a background in behavioural and health sciences having completed a PhD in neuropsychology at the MRC Cognition and Brain Sciences Unit in Cambridge, which involved case study work with patients at Addenbrooke’s Hospital. Within IES, Sally has worked with a wide range of clients including the Ministry of Defence, the Health and Safety Executive, the Social Care Institute for Excellence (SCIE), Mind, Macmillan and the Police Federation of England Wales (PFEW). In a European context she has managed a number of research projects for EU-OSHA (the European Agency for Occupational Safety and Health at Work), including an evaluation of an EU-wide initiative to raise awareness of health and safety among school-age children.
At a more local level, Sally worked with a London Borough to evaluate a health mentoring and referral scheme for young people, delivered in a youth centre setting. Currently she is leading an evaluation of Mind's Workplace Wellbeing Index for employers and advising on the remit of a Public Health England project on worklessness.
Before joining IES she worked at the Health and Safety Laboratory (part of the Health and Safety Executive) and at the Sheffield Institute for Studies on Ageing, as well as the Age and Cognitive Performance Research Centre at the University of Manchester.