Managing Mental Health

The World Health Organisation predicts that depression will become the world’s most common illness by 2030. Their evidence suggests that depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease. These facts highlight the need for organisations to manage and invest in preventative and supportive methods where work is a contributory factor in mental ill-health.

Work is changing rapidly across the world and certain global factors can have a negative impact on mental health, such as:

• the globalisation of markets
• migration and urbanisation
• technological advances.

However, some changes such as wage increases, access to training and education and improved working conditions can create positive mental health impacts.

Organisations must make physical, environmental or working practice changes, and/or engage in recognition and supportive approaches. Rewards for such changes and approaches are highly beneficial and invaluable for the workplace and its workers.

With more understanding and knowledge of mental health, organisations will be able to implement more effective methods of mental ill-health control. They will also have a deeper understanding and be better able to rehabilitate workers with mental ill-health returning to the workplace.

Organisational benefits of managing health

Improving workers’ mental health can lead to benefits for organisations.

• An increased potential for financial gains, as workers are less dissatisfied, unhappy or disengaged and may:
  • take less time off work for sickness absence
  • be less late for work and more productive
  • incur fewer injuries and illnesses (due to bodily factors)
  • decide not to leave an organisation.
• A reduction in compensation claims due to early intervention or action and lower insurance costs for an organisation.
• Reduced absenteeism, resulting in:
  • less frequent sickness absence
  • shorter sickness absence periods
  • lower potential for recurrence of sickness absence.
• Reduced presenteeism and increases in productivity due to:
  • improved resilience
  • a potential reduction in early retirement
  • an increase in worker objective attainment.
• A positive organisational culture with:
  • higher productivity
  • better morale
  • loyalty
  • improved worker retention
  • improved social
  • A decrease in mental ill-health such as depression, which is as serious a condition as heart disease and one of the main factors for worker absence through disability and early death.
• An increase in job satisfaction, which can lead to higher levels of:
  • positivity
  • creativity
  • productivity.
• More efficiently functioning brain processes and a more positive emotional state that will help to promote:
  • innovation
  • better problem-solving skills
  • improved cognitive function
  • a physically healthier.
• Individuals will be happier and more productive at This can enable positive benefits in their personal lives too, such as:
  • Healthier lifestyles
  • Improved social relationships
  • An overall satisfied way of life.

Remember that most workers will have the desire to work for those who create rewarding social, cultural and financial values that can collectively improve workers’ mental health and wellbeing.

Using an occupational safety and health management system to manage mental health

Policy – organisations will usually have a general OSH policy that covers all OSH risks, including mental health. If the general OSH policy covers mental health, it may need to be supplemented with a proactive mental health-based strategy.

Strategy – a strategy is required to help plan and implement mental health objectives. A set of specific objectives translates policy into statements regarding what is to be achieved. For example:

• promoting mental ill-health awareness throughout the organisation
• providing support and treatment methods (including signposting) for those at risk
• making organisational changes where and when required
• welcoming and re-integrating those with mental ill-health back into the workplace.

Once a strategy has been created, a mental health action plan (MHAP) is required. The MHAP will detail any short-term objectives, initiatives and/or required actions in line with policies and the strategy.

IOSH has produced a tool that assists organisations when benchmarking the design of their mental health objectives. By evaluating the design and identifying areas for further development, organisations can devise a MHAP for improvement. Mental health in the workplace: benchmarking questions

Organisational – leadership, accountability and responsibility should be delegated to enable implementation of a mental health strategy and embedded objectives.

Risk analysis – risk assessments are used to identify safety and health hazards involved with work. They can be used to identify mental health hazards in the same way that one would for physical hazards.

Risk management – once risk assessments have been completed and analysed, identified controls will need to be implemented to mitigate the risks of mental ill-health in the workplace.

Controlling occupational-related factors

Merely putting in place reactive control measures to respond to workers with mental ill-health is insufficient. One of the key principles of OSH is to put in place preventative controls to avoid harm being caused. Preventative controls need to be introduced at the stage where a worker’s mental health is ‘healthy’. Such controls can be identified by measuring potential mental ill-health stressors in the workplace through risk assessment or other means. All  controls implemented after this stage (eg at a ‘struggling’ and ‘unwell’ stage) will be reactive as an individual has already begun to experience mental ill-health symptoms. Some prime examples of reactive controls are worker/employee assistance programmes (EAPs) and mental health first aid (MHFA).

Progression through a mental health continuum with proactive and reactive controls

Monitoring and measuring – one  aspects of a MHAP and strategy are implemented, it is important to measure and monitor them, to:

• ensure that all agreed actions have been implemented
• ensure that everything is working correctly and is effective
• help identify potential modifications - such as data gathering or further controls.

Gathering data is important for measuring and monitoring levels of mental health in an organisation. It enables evidence-based decisions that can help to improve mental health management arrangements. Methods to measure and monitor mental health could include gathering information and data on:

• individual return-to-work plans
• regular discussions with the workforce to find out whether implemented controls are effective
• follow-up surveys (effective for gathering information on worker’s current states of mental health)
• relapses in mental ill-health
• illness absence rates.

Investigating mental ill-health should be approached in the same way  as anything else OSH related. Close attention should be given to mental ill-health stressors – factors that can cause or exacerbate mental ill-health.

Key performance indicators (KPIs) can help an organisation to know ‘how they are doing’ internally, but also externally when benchmarked against other similar organisations or national/global standards.

Mental health management audits should be completed against a benchmark, eg legal requirements, organisational standards, international standards or good practice guidance. Findings will help to identify corrective actions required.

Reporting – it is important to report on mental health both internally and externally to the board, managers, workers and other stakeholders. Reporting also gives organisations the opportunity to celebrate and promote their successes.

Mental health training

Training managers and workers with a focus on mental health can help to promote a more positive wellbeing culture in the workplace.

Managers should be trained in mental health awareness and on the important role that they play in the organisation’s strategy/ MHAP. They should be trained with the skills that enable them to support workers who may be experiencing mental ill-health and to signpost them to appropriate care and healing methods. Early intervention with formal and informal conversations can help workers to build good rapport with managers and address potential issues.

Maintaining good, open and effective communication is crucial. For other workers, the training should be focussed on mental health awareness.

Mental health first aid

Many organisations see mental health first aid (MHFA) as an important aspect of their arrangements for managing and promoting positive mental health, as with physical first aid in the workplace.

Training aims to equip mental health first aiders with skills that enable them to offer help and signpost workers to further support as a reactive or recovery control.

Training does not enable mental health first aiders to become therapists or specialists.

Instead, training is focused on reacting to workers with mental ill-health. The worker must have developed and be experiencing symptoms such as anxiety or depression before seeking help.

IOSH has conducted research on MHFA MENtal health first aid in The wORkplace (MENTOR): A feasibility study

Returning to work following mental ill-health

IOSH has undertaken research in this area Return to work after common mental disorders. The research identified barriers and facilitators across the different stakeholder parties in the process – mental health professionals, occupational health professionals, general practitioners and managers.