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For the good of the nation

There has been an unprecedented level of interest in mental health recently, both from the public and the national media.

This has included a season of programmes on Channel 4 (‘4 Goes Mad’), courageous speeches about individual own experiences of mental illness by MPs, the launch of a national dementia challenge by the Prime Minister and, most recently, coverage of the launch of a new mental health implementation framework by Deputy Prime Minister, Nick Clegg.

The element of the government’s new strategy that was reported on most widely was a call for employers to ensure that at least one member of staff in their workplace was trained in mental health first aid.

The idea is that, in the same way as each workplace has a nominated individual responsible for dealing with physical mishaps, so there should be an identified employee who can spot the signs of mental ill-health and administer relevant first aid.

This is a proposal that should be lauded for a number of reasons.

Firstly, the headlines generated around Mr Clegg’s interesting concept add to the critical mass of attention that mental health sorely needs in order to break down stigma and make people suffering from such conditions feel less alone. The idea also builds on the image of mental health as more than just mental ill-health, but something that can be improved and managed.

In addition, as campaigners, politicians and health strategists have repeatedly stressed, mental health is important to all, with one in four people affected by some form of condition during their lifetimes.

Whether consciously or unconsciously, by tying improved mental health to the workplace Mr Clegg has reminded us that people with mental health conditions can often enjoy meaningful, successful and sometimes highly stressful careers with Alistair Campbell, Stephen Fry and even Winston Churchill being notable examples.

Indeed, employment can actually help people to manage their illness, as productive and meaningful activity can have a profound positive impact on mental health and wellbeing.

The idea of having an effective approach to mental illness in the workplace also makes sense from a financial standpoint. According to some figures, more than 70 million days are lost each year in the UK as a result of mental ill-health; so it follows that employers should have a financial motive as well as a moral responsibility to maintain and improve their employees’ mental health.

Finding an effective approach to mental illness in the workplace can greatly improve productivity, as evidenced by the work that some of the nation’s larger employers such as BT, Marks & Spencer and the John Lewis Partnership have carried out within their organisations.

However, for all the positives of such an approach, it must be stressed that there are a number of preconditions which would need to be in place for this to work. Coming up with a good, headline-grabbing policy is one thing. Making it effective and sustainable is something entirely different.

For example, the successful implementation of this scheme would need an already receptive organisational culture, something that would clearly be more readily available in some workplaces than others.

There is also a cost versus value argument to be won with businesses in these straitened times when resources are stretched. There would be an undeniable “on cost” of training these staff to look for, identify and manage signs of mental ill health, although given the financial implication of poor mental health within an organisation over the long term, it is difficult to over-estimate the value of investing for the future. Nevertheless, as with any change in culture, this sort of long-term commitment would need buy-in from the leadership at the highest level.

We also need clarification on what exactly would be expected of the workplace “mental health officer”. It should not fall on the shoulders of an employee with basic mental health training to diagnose illnesses or provide interventions. The role should simply be to signpost individuals to the services they need, with no responsibility for diagnosis or suggested therapies.

This being the case, it might be appropriate to adopt the widely accepted template within business for in-house health and safety representatives or first aiders, if only as a “starter for ten”.

Finally, and most importantly, there are confidentiality issues around mental illness that would have to be addressed and embedded in governance structures. All training would also have to be standardised and regularly updated by third sector organisations that have experience and expertise in the field. The success of such a scheme would require a commitment to fostering good mental health which was embedded into organisational values in the same way that ‘respect’ or ‘treating colleagues with dignity’ might be.

If these issues could be addressed and a realistic specification defined, then the approach suggested by the Deputy Prime Minister might offer a triumvirate of benefits: an increase in productivity for businesses; a serious step towards the de-stigmatisation of mental health illness and associated conditions; and, ultimately, a reduction in the number of people referred to secondary care mental health services due to late diagnosis and intervention.

It may be a tall order, but it is just possible that this germ of an idea could flourish into something quite significant if taken forward seriously?

Now, in a time of austerity, the government has a great opportunity to act for the greater long-term good. At the very least, businesses should be encouraged to introduce employee activities that are conducive to good mental health, because that is good for business and good for the general health of UK plc.

Whether or not employers rise to Mr Clegg’s challenge remains to be seen, but what is clear is that world-class businesses here in the UK are already implementing effective mental and physical health policies. And they are doing so not only for the benefit of their balance sheets, but for the good of the nation as well.

Adrian Childs is director of nursing & therapies for Manchester Mental Health & Social Care Trust

Readers' comments (4)

  • Might it not be better to focus on prevention - designing satisfying, secure jobs which pay a living wage? Admittedly this is unlikely in the current climate, as it doesn't align with either the interests of big business or the ideology of our political rulers...

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  • Stress at work is only a tip of the iceberg of mental health issues, most of which probably start outside of work, and may prevent access to a wage-paying job altogether. Therefore a mental health first-aider, whilst it might be a good idea in theory, will not be a significant appointment in practice, and will make little difference overall.
    Designing satisfying and secure jobs will help, but only if the post-holders feel empowered to influence positive changes to improve working practices.

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  • Stress is rife in the NHS because of the jobs-for-life tradition, which being is so slowly and painfully deconstructed. This is also the cause of all the care failures - more so than staffing levels or poor management. If people felt they truly deserved to have their jobs, through sheer effort and quality of work, rather than by right, they would feel better.

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  • Pie in the sky.

    Perhaps if staff started claiming industrial injuries because working in a bullying environment has made them ill then things might change.

    Why do I have the feeling that this suggestion is just another way for organisations to put a sticking plaster (and tick a box) on the serious problems of culture that really affect staff, but can then claim they are helping?

    How many people work in an organisation that says it values and respects its staff, and yet the actions of the organisation on a day to day basis indicate the contrary?

    For example, I see over a third - in fact, 38% of staff in 2011 in Manchester Mental Health and Social Care Trust reported suffering work-place related stress. 38%! Why is this - surely not just for a want of mental health first aiders?

    Should a "world class" business expect a figure below this ?

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