Mental Health Awareness Week: What can pan-European collaboration do for mental health?

Mental Health Awareness Week #EuropeanMentalHealthWeek is running across Europe from 10-16 May 2021 [https://www.mhe-sme.org/emhw/].

The programme of events has been set up by Mental Health Europe, a network of 73 member organisations across 30 countries, including the British Psychological Society in the UK, EU-wide groups like Clubhouse Europe, charities and NGOs.

This year’s theme is ‘Mental Health Matters’ #MoreThanEver and how “we are all experiencing a different pandemic”, with different kinds of strains on our wellbeing: “The week is a chance for people to talk about all aspects of mental health, share personal stories of how people are coping with difficulties during the coronavirus crisis and highlight the need for action focusing on advice and support.”

What’s happening

Online events include today’s launch event for Mental Health Europe’s Mental Health Advocacy Platform – advocating a comprehensive EU Mental Health Strategy as a means of bringing about sustainable change across Europe; and a series of conversations about mental health and recovery.

“Mental health is in the spotlight as one of the biggest social issues of our time,” says EAPA UK chair Eugene Farrell.

“Awareness is growing alongside levels of understanding among business leaders. But what’s needed now is more understanding about the best forms of support for different people and issues, and how to provide access to them. In other words, there’s a great deal of diversity involved, how do we know what really works?

“It’s more important than ever that we come together and collaborate as a body of committed professionals, with so much experience to share, in order to broaden our perspective and to ensure best practice and new insights are being shared.”

What does the year’s stress hangover mean for HR?

Levels of absence from stress have risen by 113% since March 2019, according to a study of data from absence management platform e-days, relating to 1,500 employees. The average number of people taking leave because of stress is up by 74%.

At the same time, the recovery time for staff dealing the stress-related issues has grown longer. e-days research has also shown that 58% of employees ‘feel exhausted’.

Money or health?

The study provides more supporting evidence for how staff attitudes to benefits have changed. Wellbeing has shot to the top of the list of priorities. Asked whether they would prefer extra money or time for themselves, 62% of employees said they would take an additional day off each year.

The Stress Management Society, in its analysis, has concluded that the pandemic has led to three main strands of stress that HR need to be aware of: a sense of disconnection with work, uncertainty and loss of control. It has advised that all staff need to be able to openly discuss stress and its effects on them, talk about their coping mechanisms, and be allowed to take time out when needed.

Road back to normal

“While the UK continues to make strong progress along the road back to normality, workplaces have to be aware of the aftershocks from prolonged periods of heightened anxieties and uncertainty,” says EAPA UK chair Eugene Farrell.

“The risks are clear: exhaustion and burnout for people who have needed to battle through increased workloads and constant change, bottling up stress in ways that lead to threats to mental wellbeing. More people looking to make major changes to their way of life. More people wanting to change jobs, change their routines. Evidence from Aviva this month has suggested that three in five UK staff intend to make change to their career in some way.

“EAPs will help people through this period of psychological fallout from the pandemic, when we’re struggling with the big questions about what we want from our jobs and lives more generally. EAPs help people open up and make sure they’re addressing issues with stress – but with the range of advice available, they can also ensure employees aren’t making knee-jerk decisions about their future.”

Stress hangover mean for HR

Can we talk about death?

Almost a quarter of UK employees experienced a bereavement in the period from September 2019 to  September last year (7.9 million staff). A survey of 1,000 people by the Sue Ryder charity has shown that a third of those people didn’t receive any kind of communication about the bereavement from HR or their manager.

Death continues to be a topic that employers – and people in general – find too difficult to talk about. Rather than say the wrong thing, we prefer to say nothing at all. But in the case of relationships with employees, that can lead to damaging effects on levels of trust and confidence. In a separate study by Hospice UK, 56% of employees said they would consider leaving their employer if they didn’t provide ‘proper’ bereavement support.

Bereavement policy

A range of approaches have been suggested for HR as the basis of a policy that can outlined to staff so they know what to expect in terms of leave and work patterns.

A policy might also include help with the grieving process by encouraging staff to have conversations about their feelings, giving space and time to share their experience with colleagues; being flexible to temporary adjustments in work routines, moving them from dealing with difficult customers, being able to start later or leave early or generally take on lighter duties.

Companies will often offer three to five days of compassionate leave as a standard part of an employment contract – but there is an argument for longer periods of paid bereavement leave.

Support or intrusion?

EAPA UK chair Eugene Farrell said: “When an employee is grieving they have every right to be selfish. They get to choose whether they want to talk or if they want to be left alone. They should never feel obliged to conform to rules of behaviour around dealing with death – to want to open up, to be grateful for people’s expressions of sympathy – it’s just too personal and hard a thing for anyone else to have any say on what’s right and what’s wrong.

“That’s what makes the role of HR and managers in bereavement so challenging. And why a formal bereavement policy can’t be prescriptive, it needs to stay a loose guide. People, of course, don’t want to feel like their situation is being ignored, they need to know there is empathy and sympathy for what’s happened. But sometimes arms around the shoulder and constant invitations to talk can be intrusive.

“The great benefit of an EAP service is that it’s always there for staff – anonymised, professional help on dealing with any aspect of dealing with the fall-out from bereavement – so that HR don’t need to push support onto people, leaving them to make their own choices during the hardest of times.”

Is a ‘Chief Empathy Officer’ there to help employees or just the business?

Microsoft and LEGO have both claimed to be putting empathy at the heart of their senior leadership approach. Not only does an emphasis on empathy lead to happier employees, they say, but it also means better performance, higher levels of customer satisfaction and a stronger brand.

Josh Bersin, HR and management guru in the US, has coined the term ‘Chief Empathy Officer’ to emphasise the growing importance of a caring attitude to building a sense of belonging in the workforce, particularly in the wake of the Covid-19 pandemic, and the need for engagement and resilience. Employers need to prove that they are a shoulder to lean on, he has concluded. As the most visible people, business leaders need to take on that role: people first, economics second.

Empathy in action

During 2020 there were a number of instances when CEOs were shown to be demonstrating their credentials as Chief Empathy Officers. For example, Marc Benioff, CEO of Salesforce, and his call for CEOs to follow in his footsteps of making a “no layoff pledge” for 90 days, to give more security to employees and build more confidence. When redundancies were needed, CEOs like Mark Hoplamazian at Hyatt Hotels have been pointed to as models of leaders doing their very best to minimise the anxiety: decisions were made quickly to reduce any waiting period, and wide-ranging support provided for everyone affected.

According to Dr. Elizabeth Yuko, the Professor of Ethics at Fordham University, a culture of empathy generally at work leads to greater productivity. When people feel more comfortable and secure, knowing that their issues are being understood, the workplace is transformed, because “there is a people issue behind nearly every problem in a company,” said Bersin.

EAPs keep it real

EAPA UK chair Eugene Farrell said: “Empathy is a valuable quality for everyone in the workplace – something simple and fundamental, staying human, caring about other people and how they’re feeling.

“Making empathy a focus for business leadership and decision-making, however, is something more difficult and complex. Staff want empathy from their manager, they want it from HR; and when they have particular challenges they know they’re going to experience empathy from professionals delivering services on behalf of an EAP. But the CEO and other senior leaders have to make the hard business decisions that are essential for resilience and security. They have to get the balance right between economics and people.

“It’s important that the principle of empathy isn’t de-valued though mis-use. No-one wants to get to a situation where employers use the idea to boost their employer branding, for good PR, when behind the scenes exactly the same hard decisions are being made.

“In reality, the support for staff and their sense of psychological security comes from conversations with their peers, their line manager, knowing that they have the option of contacting an EAP and getting professional advice and guidance. In the difficult months ahead, as workplaces try to return to something close to normal ways of working, all employees need to know that the caring and the everyday support they receive is real, not window-dressing.”

Is talking about money problems now harder than mental health?

A new CIPD poll among 420 employers in the UK has shown how 49% did not have a policy on financial wellbeing – and that figure was higher (64%) among sectors where staff are traditionally on low pay: retail, hospitality and leisure, catering and cleaning.

At the same time, it was employers in the lower paid sectors who were most likely to admit that their staff finances had been badly affected by the Covid-19 situation. Only 46% said they had looked at exactly how the pandemic might have impacted their people financially, and the problems that might have resulted.  Only 12% said the turmoil of 2020 had led them to introduce a financial wellbeing policy.

Money in mind

In response, the CIPD has questioned whether HR has prioritised mental health – the symptoms of problems – over a likely cause, the practical nuts and bolts of finances.

“For too long [financial wellbeing] has been considered the poor relation to wellbeing but we know the two are intrinsically linked and should have parity,” said Charles Cotton, senior performance and reward adviser at the CIPD.

“While we fully acknowledge how tough it is for businesses right now, with many just focusing on surviving, we think there’s a strong case for employers to be doing more to support their people’s financial wellbeing. It may well be that even light-touch steps, such as signposting to independent money and debt advice, can start to make a difference.” 

Even a taboo?

“Money worries aren’t just something for people who have been made redundant or without work. Figures from debt charity StepChange showed that almost half the people coming to them during the first lockdown were in jobs,” said EAPA UK chair Eugene Farrell.

“There can be a sense of shame and awkwardness when it comes to talking about money problems. We live in a culture where our finances, our ability to be carefree consumers with the latest smartphone, expensive cars and holidays, is used as a very visible measure of personal ‘success’.

“So while it’s become more acceptable to be open about stress, anxiety and depression, in some ways it can be harder to admit that our finances are a problem. EAPs are a critical source of support for employees with any money-related issues or queries, and it will be increasingly important that the financial advice services are promoted to employees in the coming months.”

Have treatments for mental ill-health been put on hold through lockdown?

mental ill-health: Employees took significantly less time off work during the first lockdown between March and July, according to research carried out by NTT Data for NHS Digital. The number of fit notes dropped by 34% compared with the average for the year.

The proportion of those notes, however, shows a steep rise in mental health-related illnesses resulting in time taken off work. Mental health problems now account for four in 10 (41 per cent) of all sick notes signed by GPs during the pandemic.

Employer role

Vicki Chauhan, head of public services at NTT Data UK, pointed to the increased importance of employers in ensuring mental health is seen as a priority among line manager and their reports.

“These are extraordinary times and until we can return to a level of normality, employers must remain conscious of the challenges that remote working poses to mental health and continue to support their staff as this pandemic evolves.”

In its response, the CIPD has called for HR to make sure managers provide regular one-to-ones alongside virtual team gatherings, to be flexible and empathetic.

Other new research from Benenden Health has suggested that almost half UK employers have seen an employee leaving their company because they perceived their mental wellbeing was not being cared for. 55% of employees in the study said they would look for a new employer if they believed mental wellbeing wasn’t being supported (78% among the 18-24  age group).

Plugging the workplace wellbeing gap

EAPA UK chair Eugene Farrell said: “Understandably people have been cautious about making appointments with GPs. We’ve stayed away from surgeries and hospitals for anything we’ve believed to be non-urgent – to protect ourselves from risks of Covid-19 infection, but also so we don’t feel we’re taking up NHS time unnecessarily.

“Early signs of mental ill-health are all too easy to ignore, to try and brush aside. That’s the problem here. Access to support via the NHS has also been perceived to be difficult, even before the pandemic. The danger is that many of the people going to their GPs for sick notes have been doing so as a last resort, when problems with anxiety and depression have reached a more serious stage.

“At a time when so many more people in the UK workforce are facing additional strains – from the isolation of working from home, from increased work and financial insecurities, from the impact of the virus on the health of family and friends – it’s critical that employees know there are straightforward ways to access support. Good information as a fundamental, but also someone they can talk to for reassurance and to flag the best next steps for them as individuals.”

The winter health policy paper from Government (Staying mentally well this winter: click here) is important recognition of the challenges of the darker months ahead. At the same time, the paper potentially misses out on a crucial point: that work, workplaces and EAPs are an essential platform to the nation’s mental wellbeing.

Christmas, heralding the start of winter, will be a welcome chance for a break for employees from all the alien stresses of 2020 – a respite from workplace infection worries, the downsides of WFH and days filled with Zoom calls, the threats of burnout. But as it is every year, Christmas is also still a challenging period given the strains on finances, on relationships; feelings of isolation and loneliness; the sheer pressure of expecting every moment to be merry and bright.

The biggest challenge signalled by Government and the NHS is awareness of mental health problems and a willingness and opportunity to get help. ONS figures suggest the numbers of referrals to the NHS for mental health conditions has been falling during the pandemic. It appears people don’t want to go to GPs or hospitals: they don’t want to waste NHS resources, or expose themselves to greater risk of Covid-19 infection.

Instead there’s perhaps been a battening down of the hatches, similar to what happened during wartime. We stay safe, shut out our worries. The problem with this is that the ‘losses’ are felt most keenly when the war ends, in our case when the vaccine programme is well under way in springtime. The crisis might be over, but that’s when people see and feel the loss of family and friends; the loss of jobs and financial securities. There’s also going to be strong sense of loss of time, lost chances for keeping up social connections, for fulfilment of hopes and plans.

The proportion of the population having to deal with Covid-19 infection will always be relatively small compared with the numbers affected financially and/or psychologically. Just as has been recognised with the economy, the fall-out from the pandemic in terms of psychological wellbeing will be long-term.

Work plays a critical role in the mental health of every nation. Providing money yes, but it’s just as important in giving people a sense of purpose, status, structure and routine, as well as friendships, the feeling of being part of a community. That’s why the furlough scheme and the efforts of employers to keep as many people in work as possible have been invaluable, being flexible, offering WFH, making modifications to ensure workplaces are Covid-safe. EAPs have been – and will continue to be – an essential part of what work means and offers to so many employees.

EAPs are helping to ease the burden on NHS services, offering easier access for employees to mental health support, when and how it’s needed, and at an earlier stage. A recent EAPA study compared the use and waiting times for NHS services (via the Improving Access to Psychological Therapies programme (IAPT)) with EAPs. Although caution should be paid as the data is from different studies/different groups of clients, it showed an average waiting time from referral to treatment of 20 days through IAPT, compared with 8.8 days with an EAP. Clients who completed treatment with IAPT needed an average of 6.9 sessions; with EAPs this was four.

Public Health England’s Better Health campaign is all good in terms of advice and awareness. In practice though, for the working population, there is easier to access support via employer funded EAPs, providing more immediate availability of professional support online, by phone, and through video calls.

Andrew Kinder, Vice Chair of Employee Assistance Professionals Association (EAPA), on health policy paper www.eapa.org.uk

Even in a pandemic, health benefits are being forgotten and under-sold

Only around half of employers believe staff know and understand the range of health benefits available to them, according to a study by the group risk body GRiD.

A third of employers said they didn’t think staff understood the benefits on offer; 10% thought they were only aware of some of the offering. 35% of staff claimed their organisation had not communicated the benefits range (or couldn’t remember if they had). 38% of employers communicated a change in benefits when it happened; 29% at the recruitment stage; 21% just once a year; and 8% not at all.

Unappreciated

GRiD also looked at the issue of whether employers understand which benefits are most valued by their people. 54% of small and medium-sized firms don’t bother to measure staff appreciation of employee benefits – and one-third of larger organisations (with more than 250 employees) are the same. The figure rises to 68% among micro-businesses (with fewer than 10 employees).

When feedback is gathered, 34% said this was carried out via a formal survey. 31% of HR teams just used informal feedback. A third used a ‘suggestions box’. 27% based their understanding of staff appreciation on the level of usage.

In its analysis of the findings, GRiD has warned HR against relying on usage rates – particularly in a context where awareness levels appear to be low. HR need to be pro-active in asking employees regularly about their experiences and attitudes towards specific benefits.

Measure to improve

EAPA UK chair Eugene Farrell [https://www.eapa.org.uk/] said: “EAPs have never been more important. It’s critical that all staff are aware of the full range of expertise and support that an EAP offers across the spectrum, from everyday worries around finances and relationships, to access to professional counselling. An EAP isn’t just for help dealing with crises after they’ve happened – just one of the misapprehensions that comes from a lack of communication.

“Measurement of effectiveness and ROI is fundamental. As EAPA’s recent study has shown, it’s the employers who are most engaged and interested in the performance of their EAP, who provide regular management reports using the EAPA calculator, who look at the potential for evolving the offering to best suit their workforce, who see the biggest ROI.”

Get ready to beat the darker days

Clocks going back is traditionally a signal for the start of autumn comforts: an extra hour in bed in the morning, cosy evenings in, Halloween treats, Christmas on the horizon.

As per many of the other annual routines we’ve become dependent on, Covid-19 means that’s changed too. Seasonal Affective Disorder (SAD), a form of depression caused by a lack of sunlight, is reported to affect 1 in 3 of the UK population. This year the shorter darker days are going to make more of us understand what SAD really means and feels like. 

WFH and living under higher tier restrictions will mean fewer opportunities for being outside. Getting out after work is more difficult. Going to the gym in the rain may seem too much of a bother, walking the dog is a chore. Low mood tends to create a vicious circle of low motivation to get out at all.

What if-Christmas

For hundreds of years Christmas has been used as a release valve, a celebration that takes advantage of the dark days as a time for rest and feasting – as well as the solstice marking the beginning of the return of the light. But this year we have a “what if” Christmas – what if we’re not allowed to celebrate together, what if we go into a national lockdown, what’s it going to be like being at home alone? The pressures of the festive season can be tough enough in themselves but the new uncertainty may cause significant anxiety and other mental health issues, as well as encouraging rule-breaking and risk-taking over health.

Mindset matters

It’s worth looking to Scandinavia and populations who have a culture of coping with what might be only two to three hours of light a day. How do they do it? Research suggests it’s all about attitude. If you just think in terms of the benefits that the winter months bring – the cosy feelings, the particular charms of winter light and scenery, the chance to do things you can only do in cold weather, whether that’s outdoors or indoors – then you are going to build a positive mindset that sees you through.

And, of course, talking always helps, being open about how you’re feeling, accepting that simple things like a lack of sunlight can have a real impact on our state of mind. Then it’s possible to start finding straightforward, practical ways to thrive through the winter.

Cut hours not people and prevent a mental health crisis, says the University of Cambridge

Some level of employment – even just one day a week – plays a fundamental role in securing mental wellbeing and prevent a mental health crisis, according to new research. 

The Cambridge sociologists found that UK employees who were either furloughed or shifted to a part-time position during April and May 2020 were at the same risk of poor mental health as full-time colleagues. But those who’d lost all their working hours were twice as likely to suffer from poor mental wellbeing. The work was carried out as part of the Employment Dosage project among more than 7,000 UK people.

Sharing hours

In the wake of their findings, researchers have called for the UK government to encourage more employers to share out available working hours rather than cut jobs. This would be in line with the ‘short-time working’ approach being used across Europe – seen as a less expensive option than furlough schemes and less likely to cause a long-term legacy of damage to mental health from redundancies.

“As well as the individual misery caused, the costs of poor mental health to the UK’s productivity and health service are vast, and cannot be afforded at this critical time,” said Professor Brendan Burchell.

Stay together

EAPA chair Eugene Farrell said: “We’ve always known that while workplaces can be a serious source of stress, any negatives are far outweighed by the benefits. Being part of a team, sharing a mission, overcoming challenges, the recognition and status; as well as all the day-to-day pleasures that come from just being among people, being part of something together, even if it’s only digitally for the moment.
“That’s what EAPs have been doing all these years: helping people stay at work, able to keep the benefits from being in work and contributing, while also managing to deal with all kinds of personal issues. EAPs help save people from long term absence. Getting the equilibrium right, between work and home lives, is going to be essential to everyone as we work our way though the pandemic age.”