What happens if police no longer respond to mental health calls?

From this September, the Metropolitan Police will no longer attend situations relating to mental ill-health (unless there is a clear threat to life), allowing them to focus on crime.

The Met commissioner has argued that in London alone officers — untrained in dealing with mental health — are needing to spend time “babysitting” people between 500 and 600 times a month. They spend an average of 10 hours with each patient before they are sectioned under the Mental Health Act.

Back to the NHS

Mental health service leaders don’t believe the NHS is in a position to cope with any new responsibilities.  “I think it would be really, really dangerous if the police were just to unilaterally withdraw from attending mental health crisis calls right now,” said Former Inspector of Constabulary Zoe Billingham, now chair of NHS mental health services for Norfolk and Suffolk.

Sarah Hughes, chief executive of Mind, said: “I am not persuaded we have got enough in the system to tolerate a shift to this new approach. I think we’ve got a huge way to go before the system is working together on behalf of very distressed individuals.”

The need for options

EAPA UK Chair, Karl Bennett said: “The reason why police forces receive so many calls relating to mental health is because people just don’t know who to turn to. In a crisis it’s not clear who’s best placed to provide immediate support. NHS services can be difficult to access and involve long waiting times.

“This is why EAPs have seen such steep increases in demand, particularly when it comes to serious red flag cases and more demand for ongoing support from counselling. In this context, EAPs are increasingly valuable to employers and their staff, but can only ever be one part of the system of services.

“The sheer scale of the challenge around mental health needs to be acknowledged, looking at how services can best work together, the combination of EAPs, the NHS, the police and access to other professional expertise. The success of the Humberside Police initiative, Right Care, Right Person, is a good example of how this can work. Humberside uses a triage system, where calls relating to mental health are directed to professionals from Mind in the control room to make an initial assessment, similar to the role played by EAP helplines, and then directed to the most appropriate service. 1,100 hours of police time are said to be saved each month.”

Why we still can’t open up at work

Around 51% of employees feel uncomfortable about talking about their sensitive issues with anyone at work.

The research by Unmind suggests the most difficult topics to raise include personal finances (37%), grief (25%) and women’s health issues (23%). With all the debate of recent years, progress has been made when it comes to mental health — but 21% continue to feel there is a taboo around opening up about experiences of anxiety and depression.

Employees flagged the importance of being able to trust their employer. 68% said they needed to be able to open up about their issues, with 44% saying they would look to leave their current place of employment if it was unable to handle sensitive topics appropriately.

Fear of repercussions

There are still fears of implications. 36% worried they would be ‘judged’ by managers or colleagues; 24% thought being open could impact their career. When employees do speak up, they mostly go to their friends and peers at work (51%), 29% to line managers and just 18% to HR. Younger staff are more conscious of the need for support: 80% of under 34s said it was important they could open up about personal problems at work, compared with 53% among those aged over 55.

As a conclusion, the report authors point to the importance of trained wellbeing champions as a go-to resource for staff to talk: “Providing avenues for people to be open about their physical and mental health helps with employee engagement, productivity, retention and impacts the bottom line. When done correctly, peer-to-peer programmes like wellbeing champions help tackle stigma, better promote existing wellbeing resources, and drive grassroots cultural change.”

Mindful changes

EAPA UK chair, Karl Bennett said: “The reality is that whatever training people internally may have had around mental health or other sensitive topics, people just don’t feel able to share some personal issues. It’s a barrier — and a serious one when it means problems are hidden, bottled up, leading to the potential for far more difficult and ongoing psychological illness that can’t be supported internally.

“Employees need to be able open up from the start, without having to think about confidentiality or who’s going to mention something to who. Which is why an early chat with an EAP, some independent, confidential support, is so important.”

Is working from home bad for your health?

The numbers of employees now suffering from a long-term condition has hit a record high, says the Office for National Statistics: in the first quarter of 2023, 2.5 million employees were off sick with an ongoing condition.

In its report, the ONS has pointed to the figures as being driven by more people working from home, as well as problems being caused by a lack of access to NHS services.

Different at home

The two biggest causes in the rise are said to be musculoskeletal problems alongside a spike in “depression, bad nerves and anxiety”.

Rather than issues with desks and chairs and posture, the back and neck problems are believed to have been caused by a basic lack of movement: no commute involving walking, no going up and down stairs to meetings etc.

The increase in mental health problems has been most common among younger employees, perhaps less used to spending time on their own and needing the day-to-day support and social contact of being in a workplace.

Mindful changes

EAPA UK Chair, Karl Bennett said: “Right from the early days of the Covid-19 pandemic and the surge in remote working there were signals that being at home wasn’t for everyone. For many people it’s the most practical option and comes with advantages when it comes to looking after children or family members, or just for the sheer sense of freedom and not losing time in a car or on public transport.

“But we’re all different. Some personality types need the constant buzz and stimulation of a workplace for their health, to keep them motivated and active; others appreciate more quiet time, or at least more of a balance. Dealing with the issue of long-term absence involves making sure flexible working is backed up by flexible support and conversations, taking into account all the different characters and circumstances that people have at home. Good relationships and opportunities to talk are essential for making sure there are early interventions.”

Why we need neurodivergence-aware workplaces

Around one in six people are neurodivergent, they are hardwired to deal with the world differently, in how they think, process and respond to information and experiences differently: because of autism, attention deficit hyperactivity disorder (ADHD), dyslexia or dyspraxia.

Workplaces though have always been designed for the ‘neurotypical’. According to a CIPD study, only  7% of employers say they have attempted to make their organisation inclusive when it comes to neurodiversity. Rather than a kind of disability, neurodiversity has been found to be an important source of skills and talents that add to the mix in teams and leads to new thinking and ideas.

Mental health and neurodiversity

Founder member of GAIN Johnny Timpson OBE, former Disability and Access Ambassador in government, said: “A significant number of people – particularly women – have been diagnosed as having anxiety. But the root cause of that, in reality, can be the fact that they are actually neurodivergent with undiagnosed autism and/or ADHD…Neurodivergent people are often thought to be mainly male. This is far from the case. It’s just that women and girls are in many cases simply far better at masking.”

The pressure on staff to hide their neurodivergence, not talk about it, not let it affect their behaviours or reputation among colleagues, leads to stress and anxiety

Mindful changes

“Under the 2010 Equality Act, neurodivergence is considered as a form of disability, with the same conditions in terms of discrimination, said EAPA UK chair, Karl Bennett.

“There are simple ways in which HR can make sure they recognise the needs of different people. For example, GAIN talks about the value of undertaking an audit to better understand how individual workplaces relate to cognitive diversity and experiences. Make adjustments such as providing alternatives to the typical noisy, open plan offices, avoid ‘loud’ colours, offer flexibility on working hours, avoid situations where staff are ‘put on the spot’ and providing thinking time.”

Worker absence reaches 20-year high

New figures from the ONS show that 185.6 million days were lost to sick leave during 2022, around 2.6% of the total, up from 2.2% in 2021. On average, employees were each absent for 5.7 days. Women employees are slightly more likely to take sick leave (with a 3.2% absence rate), compared with men (2.2%).

Getting sicker

From the information provided, employees most often gave reasons of minor illnesses such as flu, diarrhoea, coughs and colds.

The ONS suggests that the main reasons are these kinds of minor causes, as well as muscle pains and mental health. Mental health was the most common cause of absence in 2021, but has been overtaken by respiratory illnesses in the past year (with the continuing impact of the Covid-19 virus). More than half of workers experiencing two or more periods of sick leave due to mental illness were then subsequently found to have left their jobs.

EAP roles

EAPA UK Chair, Karl Bennett said: “The ability of people to take time off for sickness is an important part of the modern employer/employee relationship. Sometimes we all need that bit of time to look after ourselves and recuperate — it’s just the only way.

“What HR need to be more concerned with is helping staff avoid longer-term conditions that lead to extended absences and losing their experienced people. Evidence has repeatedly shown the deep-rooted connections between stress and psychological issues and physical illness. Promoted and used in the right ways, EAPs can play a critical role in opening up conversations about illness and the, often complex, root causes, the combinations of worries about finances, housing, relationships etc, that lead to more vulnerability to long-term conditions.”

Can the UK be the world’s healthiest country by 2050?

Illness has a major impact on the personal finances and job prospects of the UK population, the IPPR has found. Researchers for the IPPR Commission on Health and Prosperity looked at five years of data from the period just before the Covid-19 pandemic, and the two years after.

The main headlines are that someone with a new physical illness experienced (on average) a fall of around £1,800 in their annual earnings, before the pandemic. Those with a new mental illness faced a fall in annual earnings of around £2,200. Since 2020, the figures are falls of £1,400 for someone with a chronic physical illness and £1,700 for the onset of a mental illness. The study also found that illness generally led to consequences for other members of the same household, who saw an average reduction in annual earnings of around £1,200. 

Preventable losses

Loss of earnings was found to have been caused by people needing to leave their job and work reduced hours as well as pay for healthcare, travel to appointments and costs for energy from staying at home. Poor health was a factor for more than half those who left their jobs in the period (56%).

The IPPR has argued that the majority of sickness in the UK is preventable, and could be addressed by changes in policy and investment: into “better housing, better jobs and action on public health challenges like obesity, or access to the best treatments and social care.”

The research body has called for a Health and Prosperity Act modelled on the Climate Change Act of 2008 with ambitious targets and plans to deliver radical change within the next 30 years.

Engaging early

EAPA UK chair, Karl Bennett said: “Wellbeing is fundamental to the life of a society, just as it is for workplaces. Any national campaign and strategy to improve mental health would be an important step, with huge potential benefits for everyone.

“At the same time the complexities of what makes for good mental wellbeing will have to be recognised. It’s long been understood that work can be both a source of serious anxiety in people’s lives but also a critical platform of identity, providing a sense of purpose and community. There will need to be close co-operation with organisations and employers in terms of creating those ‘better jobs’ and good places to work, ensuring there are more early interventions and access to professional support on mental health.”

Why younger employees won’t talk about mental health

Around 50% of the 20 to 29 age group of employees is concerned about the implications of admitting to a mental health condition to their career, according to a survey by TELUS Health.

Rather than new generations of employees being more vocal, concerns about speaking up were found to decrease among older staff: they were lower among 50-59 year-olds (34%), and lowest among the over 60s (29%).

Discrimination fears

The issue is one of perceptions, claims research lead at TELEUS Health, Paula Allen, a problem of a lack of trust: “The employer might have no stigma, they might not discriminate against anyone, but young workers fear that it will happen to them.”

Younger employees are more likely to value wellbeing support. In the survey, 35% of under 40s said they would take improved benefits in this area over a 10 per cent hike in their salary, compared with 22% of over 40s. 

Engaging early

EAPA UK chair, Karl Bennett said: “It’s in the early stages of their careers when they don’t have a track record of delivery that people most feel the need to impress, to demonstrate their value and their strengths. So it’s not surprising that talking about mental illness feels like a no-go area.

“EAPs can play an important role in helping HR support younger employees who are wary of admitting to stress and psychological ill-health. Actively promoting EAPs means staff know they can talk to a professional in confidence, at any stage of their concerns, be more proactive about making sure they find a healthy work/life balance and better understand and manage stress.

“HR should, in particular, be promoting the app-based options to engage with an EAP, as well as thinking about making use of younger role models in their promotional campaigns.”

Government warned of the dangers of prioritising Mental Health First Aid

When MP Dean Russell first put forward his private members bill to make the training of Mental Health First Aiders a legal obligation, the move was welcomed as a means of “saving lives”.

Since January, former members of the board of Mental Health First Aid England have flagged their concerns over unintended consequences. MHFA should only be one part of the “jigsaw”, they say.

Ticking boxes

The board members have warned that using legislation to push employers to focus their energies and investment onto MHFA could lead to more of a “tick box exercise” around mental health. It would encourage organisations to train just a small number of people rather than look at broader support.

There would be issues of confidentiality around discussions of suicide, as well as a great deal of pressure put onto the First Aiders; and what happens after a case of mental illness has been identified?

Longer-term aid

EAPA UK Chair, Karl Bennett said: “Experience over the past decade or so has shown the value of having trained MHFA staff within the workplace. Peer relationships can make it easier for people to speak up and take the all-important first steps in recognising and talking about wellbeing issues.

“But employees need to know there is somewhere to go next with their concerns, more than being entered into the queue for overstretched NHS mental health support. As EAPA’s new report, Holding it together, has shown, more and more employees are relying on their EAP for immediate mental health support and counselling.

“MHFA is important for early interventions, but employers need to ensure they are thinking in terms of their specific needs and a mental health and wellbeing strategy — and avoid a dangerous situation where people are just being identified as having a problem.”

How EAPs have become an essential pillar to the UK’s mental health provision

Data from a ‘state-of-the-market’ survey among members of the Employee Assistance Professionals Association (EAPA UK) reveal how more people are turning to their workplace EAP.

Holding it together: UK mental wellbeing and the role of Employee Assistance Programmes points to huge growth in the EAP over the past 20 years, up to £118 million compared with £32.2 million in 2003.

An estimated 640,250 employees contacted their EAP in the period between January 2022 and January 2023 — of which, 434,250 (68%) were offered counselling as a result of concerns over their mental health. EAPs delivered more than 1.375 million counselling sessions. On average, 1.7% of counselling cases came with a ‘red flag’ (involving an immediate and serious risk of suicide). This translates to more than 10,000 lives at serious risk from suicide each year. Some EAP providers report red flag cases as being at levels above 3%.

Extended roles for EAPs?

Commenting on the figures, Sir Cary Cooper CBE, 50th Anniversary Professor of Organisational Psychology and Health at the ALLIANCE Manchester Business School said: “It’s critical that the Government, the NHS and other healthcare stakeholders, understand the role the EAP industry has been playing in supporting mental health, providing immediate access to counselling and professional assessment for millions of people every year.

“Given the limitations to NHS resources and both the scale and complexity of dealing with people’s mental wellbeing, more thought and discussion is needed around the place of EAPs — including how else they can help. Maybe there’s a need for extensions to EAP services, to ensure there’s provision for longer-term counselling programmes through to recovery.”

What’s next

EAPA UK Chair, Karl Bennett said: “EAPs have become a pillar of mental health provision for the UK, providing rapid access to professional support for the majority of the workforce, and delivering value-for-money for employers. The question now is what happens in the next 20 years.

“Sir Cary suggests that maybe there’s a need for an extension to EAP services, ensuring there’s provision for longer-term counselling programmes through to recovery. This would mean looking at the impact to providers and a model that adopts a more psychological approach as our core offering, with standardised clinical outcomes.

“Is this something we as providers are equipped to do and if so, is there the appetite to do it? I think once upon a time the answer to this would have been ‘yes’. But when the average cost of an EAP per employee has seen a significant decrease, and with the reliance on our services becoming much higher, I think the answer might be, how can we? If EAPs take on more of a role in supporting the NHS, how do we protect out resources, including our therapists, and what should our standard nonclinical EAP services be?”

A copy of the Holding it together 2023 report can be downloaded from www.eapa.org.uk

The cost of poor mental health at work reaches £28 billion in 2022

New figures from AXA UK and Centre for Business and Economic Research (Cebr) point to the vast financial costs to employers caused by stress, burnout and poor mental health.

The AXA Mind Health Study involved a survey of 30,000 people from 16 countries in Europe, Asia and the Americas. The UK, alongside the USA, was found to have the largest proportion of employees struggling with mental health issues: 21% were in a state of ‘emotional distress’; 26% had an ‘absence of positive wellbeing’. Compared with the previous year, there had also been an improvement in the numbers of people with very good mental health (up from 18 to 23%), pointing to a widening gap in experience between groups of employees.

Cost consequences

Previous studies have suggested that burnout leads to an increase in the number of sick days by 21%. At the same time, stress in general has been found to lead to reductions in productivity and performance, as well as an increase in healthcare costs for organisations.

The AXA/Cebr study also showed differences in terms of the level of issues by sector. Public sector workers are more likely to experience work-related stress; health and social sectors are more likely to feel worried about their job, while higher earners are more likely to experience work-related stress and low moods. Just over half of workers surveyed felt their company provided good support to employees on mental health.

Looking to the positive

EAPA UK chair, Karl Bennett said: “The key stat in the report is not around the costs to employers but relates to the other side of the story. Employees who feel they are being actively supported with their mental health at work are twice as likely to be ‘happy’, and almost three and a half times more likely to be ‘flourishing’.

“Rather than seeing employee issues around mental health as just a source of rising costs — people as a problem and support as a cost-reduction measure — organisations need to think in terms of the positives of a healthy workplace culture, providing a better experience, demonstrating a genuine commitment and care for people, which all leads to benefits for everyone involved with an organisation.”