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In January 2017 the Prime Minister appointed Paul Farmer CBE to co-chair a review on mental health and employment practices with Lord Dennis Stephenson. The Review consolidates, somewhat belatedly, the government’s mental health outcomes strategy published under the Coalition government which stated rightly that: “Mental health is everyone’s business – individuals, families, employers, educators, communities”.

The Review is welcome news and comes at a time when the absentee burden from poor mental health is a key issue for employers. The fact that 70 million working days are lost to due to poor mental health alone should be seen as a call to action. A recent Mental Health Foundation survey found that one in five line managers agreed that a person disclosing a mental health problem in their organisation would be less likely to progress. In light of this, below are seven recommendations for the review that can help bridge the cultural and organisational barriers the review will contend with in order to be impactful.

1)    Invest in gig economy workers

RSA research tells us that one in seven workers are now self-employed and there are over a million workers in the gig economy. So if the Review is looking for large-scale impact, a shift away from a traditional occupational health approach focused on salaried employees is urgently required. Indeed, workers are facing new challenges. The battle to ‘switch off’ from work not bound by the 9-5 is beginning to emerge through different forms of stress in workers. Partnering with platforms such as BigWhiteWall, an online mental health support tool, can act as a great first tier of support for gig workers.

2)    Deploy design thinking

This review has an enormous potential to help reshape employer and employee expectations and to clarify the role of workplaces and employment in improving our mental health.  Design thinking can help uncover root causes of problems by placing an emphasis on the process rather than just the outcome of identifying an intervention. The RSA is supporting this work with its latest student design award brief ‘Working Well’, sponsored by NatWest, aiming to create a robust business case for greater wellbeing at work.

3)      Reform work experience placements

The most common entry point of interaction with the workplace is work experience. Mandating a requirement for work experience placements to report and record employer’s strategies to support positive mental health cultures in the workplace could be a significant signal to both students’ understanding of the workplace as well as the employer's literacy on the issue. Incentivising organisations that have signed the Time to Change pledge to lead this work in creating a tool kit for SME's might ensure we don't see drop off from placements that could percieve this as a burden.

4)    Mind Your Language

It's worth reiterating the brilliant opportunity that comes with this review. It's one which has not been seen in the workplace since 2008 when the Black Review brought the term ‘presenteeism’ - the practice of turning up to work in sub-optimal health - into the mainstream vernacular. Challenging the widespread misuse of medicalised language such as ‘schizophrenic’ in the workplace might be a good start but there is a larger issue of conflation of mental health and illness. We all have mental health, and using the term as a catch-all term for problems is holding us back from moving from reactive or proactive approaches.

5)    Clarify between mental wellbeing and physical health initiatives

The Review should also be cognisant that interest in health from employers in the workplace can have unintended consequences. The widely cited trope that most CEOs run marathons underlines a tendency to use wellness at work as a moral signifier and not a substantive measure of health. This is something that social ethnographer Camila Long calls ‘body work’. Long’s research confirms that senior leaders often refer to employee’s physical physique and overt displays of fitness as a way of identifying commitment and competency in the workplace.

6)    Pay attention to SMEs

Relatively new and small organisations such as IndyCube are going to be the key partners in driving up this type of action but there are difficulties with engagement with SMEs that the Review will need to overcome.

The first difficulty is that their size means prioritising time and money into employee mental health can be difficult. The second is that the size of the business can lead to improvement in subjective wellbeing through increased efficacy and ownership of production by their staff– but that overwork and stress due to higher commitment can lead to latent health problems. 

7)    Reform health and safty committees

Reforming the staid and sturdy healthy and safety committee might be a way to help create a culture shift within core operating structures in businesses. The Review should consider guidelines for employers to instate workplace mental health as a statutory responsibility for workplace health and safety committees, which will help mainstream the issue as core business.  

One warning

History tells us increased provison is followed by an acknowledgement of greater need.  There will very likely be louder calls from employers to invest in clinical services due to a likely increased awareness of acute need. The Department for Health needs to ready itself if it’s serious about investing in workplace mental health.

Follow Tom on twitter @_Tom_Harrison

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