Stressing the bottom line


The IoD attempts to grasp the nettle of mental health at work

The recent IoD policy report into mental health in the workplace is another welcome indicator that the conversation around mental health is starting to gather momentum.  They are to be applauded for grasping the nettle.  As they rightly state there is both a moral and a business case for workplace mental health provision with the socio-economic costs of mental ill health in London alone estimated at £26 billion annually.

Mind The Gap

Around 1 in 6 UK adults feel the effects of a common mental health disorder each week – 10 times greater than the number of people who attend a professional football match.  72% of employers state that they would refer a colleague with a mental health problem to their GP.  Yet the view from the charity MIND that GPs are not as effective as they should be in managing mental health problems gives cause for concern.  As an experienced GP, having worked in hospital psychiatry and at the coal-face of primary care for many years, these assertions need some qualification.  The majority of GPs are keen and highly trained to accurately diagnose and manage mental health problems and mental illness represents a huge proportion of general practice consultations. GPs find themselves caring for a number of patients with mental health problems, but a lack of funding leads to excessive waiting times for psychological therapies which are approved by the National Institute of Clinical Excellence for their treatment.   This leaves a gap in provision, and one that employers should play more of an active role in providing.

Beware Compartment Syndrome

The IoD report also rightly highlights the need for a “whole-life” approach towards good workplace mental health. In my experience, it is imperative to recognise the importance of non-work stressors and give people effective tools to manage these too. We must be careful not to compartmentalise work and non-work stress. It’s the same person – the two are inter-related and each has the potential for spill-over.

Mind AND Body

The report also argues that physical health is easier to plan for than mental health and this is indeed often the case. However, physical and mental health are intricately linked.  We know that mental health problems often present with physical symptoms and that long-term physical conditions carry an increased risk of mental illness. Too many organisations are failing to ensure that their people practically and effectively address the physical aspects of good health which underpin performance and robust mental health. All too often interventions only focus on avoiding negative outcomessuch as sickness absence and attrition or are guilty of “free fruit” tokenism.  They fall short of providing people with an evidence-based toolkit which enables them to be ready to perform both physically and mentally. With increasing pressures on the NHS and reduced capacity to deliver the kind of support and care that is needed in a timely way, enlightened organisations need to find ways to provide additional effective support.  This is not altruism, it’s in their own interests.

Stressing… the evidence

The IoD makes some sensible recommendations that business leaders institute formal mental health and wellbeing policies and that mental health advocates in top teams ensure that mental health openness is culturally installed across organisations.

Much of the advice that is currently incorporated into workplace wellbeing programmes can be simplistic and generic or faddish and piecemeal.  I am passionate to see more organisations adopt an evidence-based approach, which is under-pinned by the latest scientific research and which equips those in the workplace, at whatever level, to manage themselves, and their physical and mental health effectively to ensure that they remain in the best possible state to perform and manage others.

Dr Sarah Hattam is a GP in West Yorkshire with an interest in applying evidence-based health research to improve work-place performance. She also runs ConcilioHealth, an organisational health consultancy.


Does Your Organisation Need De-Worming?

In 1990 I spent my medical elective, whilst training to be a doctor, working in a rural hospital in northern Kenya.  My learning curve was so steep as to be almost vertical.  During this time I treated many children, the vast proportion of whom were emaciated and lethargic, suffering from effects of malnutrition or dehydration, compounded by the effects of the intestinal parasites that had taken up residence in their small bodies.

A few years later, health economists, perturbed by the poor educational attainment in Kenyan school children, undertook some research to determine which interventions were having the greatest impact on learning outcomes.

Contrary to expectations, their data showed that the introduction of free text books and visual aids had little or no impact on learning outcomes.  Such interventions missed the mark.  The researchers determined to trial a different approach, simply that of de-worming school children.  This proved to be immensely successful, not only increasing school attendance and educational outcomes, but also demonstrating that treated children went on to perform better in adult working life.

It strikes me that there is a direct parallel here with many companies who invest in a whole range of initiatives in their endeavours to improve individual, team and organisational performance and increase engagement.  Many of these have positive aspects but lack real evidence of efficacy and return on investment perhaps because their organisations need a form of “de-worming”; to address some basic pre-requisites which are holding back performance in a hidden way.

As a doctor, I have seen at first hand the effects of organisational culture and practices on the performance of individuals. Many businesses choose to ignore a simple but obvious truth,  that  human performance is directly affected by our physiological and mental state. Too many organisations are investing heavily in a range of performance initiatives whilst their organisational culture and practices leave their people in physical and /or mental deficit.

The result?  …… continued poor performance.

The good news is that organisations can “de-worm” their practices and culture through the application of simple educational and behavioural change interventions.

Taking action here may be just as important to unlocking performance and resilience across our organisations, as de-worming was to educational improvement in Kenya.

Dr Sarah Hattam is a GP in West Yorkshire and is Director of Concilio Health, an organisational health consultancy specialising in applying health research to improve performance in the workplace.