Greater efforts to promote mental health and improve early diagnosis and treatment of those with mental illness would improve the lives of millions of Europeans and contribute to stronger economic and employment conditions, according to a recent joint OECD/European Commission report.

'Health at a Glance: Europe 2018' says that mental health problems, such as depression, anxiety disorders and alcohol and drug use disorders, affect more than one in six people across the European Union in any given year. Besides the impact on people’s well-being, the report estimates the total costs of mental ill-health at over EUR 600 billion – or more than 4% of GDP – across the 28 EU countries.

This article looks at ways to not only deal with your current employees suffering with mental health issues - and how to effectively manage them - but also how to properly approach the initial recruitment process with those battling a mental health issue.

Many people effectively manage their mental health condition alongside the demands of a job and daily life, sometimes with treatment and support. Others may experience symptoms of poor mental health but may never be diagnosed with a condition. The crucial thing to remember is that everyone’s experience of poor mental health is different – two people with the same condition may have entirely different symptoms and coping mechanisms. That’s why working with people on an individual basis is so important.

“On average, people with mental disorders die 20 years younger than the general population”

Good practice in recruitment selection and assessment

Employing the right person for the job and getting the staffing right on particular projects in the first place is crucial to help prevent stress and promote individual resilience.

A key source of work-related stress and poor mental health is a misfit between the individual and the role, or between the needs and values of the person and those of the work environment, or between the individual’s skills and abilities and the organisation’s demands on them. Selecting recruits based on competence and/or potential, combined with realistic job previews, is therefore not only important for performance, but also for managing and supporting mental health. Realistic job previews provide potential applicants with information on both positive and negative aspects of the job.

Experience of poor mental health is not an indicator of poor performance, so it is important that employers do not discriminate consciously or unconsciously against people on the basis of prejudiced and unjustified assumptions regarding the employability of people with mental health issues. 

Recruitment should focus on hiring the most suitable candidate for the job. Therefore, appointment decisions should be objective and based on whether candidates have the necessary qualifications and competence required for the role. Employers and those involved in recruiting should take great care not to allow assumptions about health or disability (which may be subconscious) to cloud judgements about each candidate’s skills and abilities.

“14.7% of people experience mental health problems in the workplace during their career”

​

Job and person specifications

Distinguish carefully between essential and desirable requirements for the job to allow for flexibility in making adjustments. Focus on what is required to get the job done (for example knowledge or experience), not how it will be done (for example method of delivery), as this gives flexibility for achieving output in different ways.

Make it clear what mental and emotional elements are required to meet the requirements of the role, but don’t overemphasise the need for a certain type of personality.

Improving recruitment processes

• Communicate the organisation’s commitment to equal opportunities during the recruitment process, including in the job advert.
• Provide guidelines and training for all staff involved in recruitment to ensure that candidates are not discriminated against at any stage.
• Make it clear in adverts and interviews that the organisation promotes good mental well-being and supports people if they experience poor mental health, as this sends a signal that disclosure will not lead to discrimination. For example, include a statement such as: ‘As an employer we are committed to promoting and protecting the physical and mental health and well-being of all our staff.’
• State clearly that reasonable adjustments are available – for the interview and the job itself – so applicants understand why disclosure might be beneficial.
• Ensure people can disclose a mental health and/or well-being problem confidentially and that any information about health or disability is kept separate from the application form, so the recruitment panel does not see it. 

Supporting current employees

Well-being in the workplace influences health and productivity. A negative work environment or excessive job strain – a result of the interaction between high job demands and inadequate job resources – may lead to physical and mental health problems and increased substance abuse.

Various factors can impact the mental health of workers. Most risk factors are related to inadequate managerial and organisational environments, stressful occupations, lack of support, and lack of individual skills and competencies.

Interventions to promote and protect mental health in the workplace should consist of raising awareness of the importance of mental health, informing employees of the help available, involving employees in decision-making, offering programmes for career development, and recognising and rewarding work performance.

How to create a culture that supports staff to be open about their mental health

If you take proactive steps to create a more open and supportive culture, staff should then gradually begin to feel more confident to talk to managers about their mental health. However, it’s important to remember culture change doesn’t happen overnight and the individual relationships between managers and employees are the key to getting this right. If people are able to receive support quickly, this can often help steer them away from developing a more serious problem. For this reason, it’s vital that organisations have clear, well publicised channels in place for employees to raise concerns and take positive action promptly when staff seek help.

​“Women in full-time employment are nearly twice as likely to have a common mental health problem as full-time employed men”

How to have a conversation with an employee about their mental health

Just as you would with physical health, a good place to start is simply to ask someone how they’re doing. The first step is to establish open communication (which should be maintained if people take time off for sickness absence) leading to understanding and appropriate support. How will you know if someone’s experiencing a mental health problem? The manager will know the people in their team, and they may notice changes in them. However, it’s important to remember everyone’s experience of a mental health problem is different and there may be no outward sign – this is why it’s so important to create an environment where people can be open.

You should never make assumptions about people’s mental health, but clues might include:

• Changes in people’s behaviour or mood or how they interact with colleagues.
• Changes in their work output, motivation levels and focus.
• Struggling to make decisions, get organised and find solutions to problems.
• Appearing tired, anxious or withdrawn and losing interest in activities and tasks they previously enjoyed.
• Changes in eating habits, appetite and increased smoking and drinking.

Work is often the most stressful factor in people’s lives, but people generally don’t feel able to ask for help when they’re struggling. This silence feeds misunderstanding and prejudice which can make it harder for people to be open. 

How to manage an employee’s time off sick and their return to work

Sometimes an employee may be so unwell they need time off work to recover. The way organisations manage a period of sickness absence is key in shaping how well and how quickly people are able to return to work and get back to peak performance. To effectively support staff to recover and return to work as quickly as possible, employers should:

• Be proactive and get involved as early as possible if someone is unwell.
• Take a person-centred approach and be sensitive to the individual’s needs.
• Be positive, professional and supportive throughout the process.
• Maintain supportive contact with people throughout their sickness absence.

The way employers manage a period of sickness absence also sends a message about the organisation’s values. Trust and integrity are key drivers of engagement, and organisations that support staff reap the benefits in terms of loyalty and commitment from all employees. If sickness absence is managed poorly, the relationship between employee and employer can break down. In some cases, people may lose confidence to return to work – leading to the loss of a valuable member of staff and damaging morale across the organisation. 

Managing performance

Often, the reasons for poor performance are not properly explored, even where a mental health issue is suspected, so the approach from managers or HR is only performance-based, when it should also recognise any health factors. This is sometimes driven by misunderstanding or prejudice, as poor mental health can be viewed as an ‘excuse’.

Mind’s 'Workplace Well-being Index' assesses the impact poor mental health has on performance through a staff survey. Of those who reported experiencing poor mental health while at their current employer, only 8% said it did not affect their performance. However, the majority of respondents did feel it had an impact:

However, many people with a condition continue to go into work and thrive. There could be times when performance could be affected, particularly if they are afraid of disclosing their condition and accessing the support they might need at certain times. An effective performance management process should be responsive to people’s needs and take into account any health issues they may be experiencing.

"15% of employees had faced dismissal, disciplinary action or demotion after disclosing a mental health condition".

The '2017 Mental Health at Work' survey adds: ‘Scaled up to the general working population, this could mean as many as 1.2 million people are negatively affected for speaking out about their mental health’.

________________

In 2019, the World Health Organisation plans to begin development of a guideline on mental health in the workplace, working closely with the Wellcome Trust, the International Labour Organisation and organisations that have already accumulated vast experience in this area. The guidelines will address the actions required to help prevent, manage and overcome mental health conditions. This new guidance for workplace well-being will be another important step towards better mental health for all people around the world.