Download Stress

Welcome to
Managing Mental Health at Work
For the CIPD South London Branch
14 November 2012, 12.00-14.00
With Stephen Brogan
Structure of the Session
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Introduction to mental health
The causes, signs and symptoms of stress
Supporting and treating stress
Stress and anxiety
Why manage mental health at work? The
Equality Act (2010)
 Reasonable adjustments
 Q and A, discussion
Learning Contract
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Conditional confidentiality
Equal Opps
Timekeeping
Phones switched off and put away, and only used during
breaks
Monitor output
Avoid interruptions
No private conversations when someone is addressing the
group
Stick to the subject
Look after yourself
No such thing as a stupid question
The World Health Organisation (1999)
defines mental health as:
• A positive sense of well being
• A belief in one’s own worth and the dignity and worth
of others
• The ability to deal with the inner world of thinking,
feeling, managing life and taking risks
• The ability to initiate and sustain mutually satisfying
personal relationships
• The ability of the mind to recover from shock and
trauma
• Someone with a mental illness can
experience problems in the way they think,
feel or behave. This can significantly affect
their relationships, their work, and their
quality of life. Having a mental illness is
difficult, not only for the person concerned,
but also for their family and friends and
anyone else who is around them, such as
work colleagues
• Mental illnesses are some of the least
understood conditions in society. Because
of this, many people face prejudice and
discrimination in their everyday lives
• Mental illnesses do not relate to
intelligence
Some Statistics
• Findings vary, but approximately 1 in 4 of us will
have some sort of mental distress at any one time
• Around 300 people out of 1,000 will experience
mental health problems every year in Britain
• 230 of these will visit a GP
• 102 of these will be diagnosed as having a mental
health problem
• 24 of these will be referred to a specialist psychiatric
service
• 6 will become inpatients in psychiatric hospitals
Reference: Mind http://www.mind.org.uk/help/research
The Most Common Mental Health
Problems in Britain
• The Office of National Statistics says 9.2 % of
adults in Britain have a combination of anxiety
and depression
• The most common symptoms are sleep
problems, fatigue, irritability and worrying
• Mental health exists along a spectrum
• Explanatory models include medical and
psychological perspectives
• Recovery
• Language
• Stigma and discrimination
The Psychiatric Classification of Mental
Illnesses
• The neuroses or common mental health problems:
stress, anxiety, phobias, obsessive compulsive
disorder (OCD), depression
• The psychoses or severe mental health problems:
schizophrenia, bi-polar disorder, psychotic
episodes
• Post traumatic stress disorder (PTSD)
• Personality disorders
Stress
Right now, 1 in 6 workers is experiencing
depression, anxiety or stress and costing the
UK economy £26 billion each year.
Work-Related Stress
‘The adverse reaction people have to excessive
pressure or other types of demand placed
upon them’
Health and Safety Executive, 2004
The Effects of Stress at Work
• Reduced Productivity
Employees who remain in work without the
support they need cost UK businesses up to
£15.1 billion a year
• Lost Working Days
70 million working days are lost every year
due to mental ill health, with 10 million
working days directly caused by work-related
problems
• Recruitment
Staff turnover as a result of employees leaving
their jobs due to mental ill health costs £2.4
billion.
Understanding Stress
Stress, however, means different things to
different people. Our life experiences and
personality partly determine how we appraise
and interpret events and whether a situation is
seen as stimulating or intolerable varies
greatly from person to person.
Causes of Stress
There are many sources of stress, both inside
and outside work. Life changes, bereavement,
negative social conditions, poor housing,
noisy neighbours, relationship problems and
conflict can all affect our wellbeing and cause
stress.
Research shows that prolonged stress is linked
to psychological conditions such as anxiety
and depression, as well as physical conditions
such as heart disease, back pain and
headache.
What is Anxiety?
• ‘A state of uneasiness or tension caused by
apprehension of possible future misfortune,
danger etc’
• Anxiety is the what we feel when we are faced
with stressful, difficult or threatening situations
• We often use words like fear, stress and worry to
describe anxiety
• People usually feel anxious when faced with new
or challenging tasks, when going through
changes especially those over which we don’t
have much control, and generally when we face
any kind of physically or psychologically
threatening experience
• Short-term anxiety can be useful. Feeling
nervous before an exam can make you feel more
alert, and enhance your performance. However, if
the feelings of anxiety overwhelm you, your ability
to concentrate and do well may suffer
Types of Anxiety
• Generalised Anxiety Disorder (GAD)
• Phobias
• OCD
Physical Symptoms of GAD
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Feeling restless and being on edge
Rapid breathing
Rising blood pressure and pounding heart
Tense muscles which can cause pain and
headaches
• Sleep disturbance
• Nausea , sickness and urgent need to use the
toilet
• Tiredness
Psychological Symptoms of GAD
• Feeling worried all the time
• Difficulties with motivation, concentration and
decision making
• Feeling low or weepy
• Heightened alertness
• Needing lots of reassurance
Panic Disorder
This involves recurring and unexpected panic
attacks – an exaggerated stress reaction that
happens very quickly. The person may also feel:
• That they are going to die
• Frightened of ‘going mad’ or losing control
• Short of breath
• That they are choking
• That they must avoid situations/places/people in
case a panic attack happens
In addition, the person experiences:
• Persistent worries about further attacks
• Worries about the consequences of the
attacks such as having a heart attack
• Significant change in their behaviour, such as
avoiding situations in case a panic attack is
triggered
Supporting an anxious person
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Learn about anxiety
Talking, informally or counselling
Structure the day, week, or month
Exercise
Healthy diet
Not too much alcohol
Physical relaxation techniques (deep breathing,
meditation, yoga, soothing music, complimentary
therapies etc)
• You may want to see your GP
• The National Institute for Health and Clinical
Excellence (NICE) suggests that for particular
kinds of anxiety, such as panic, social phobia and
obsessions, GPs should prescribe
antidepressants, especially certain SSRIs
(selective serotonin reuptake inhibitors)
• Doctors may also suggest beta-blockers to deal
with symptoms such as palpitations, although the
success of this treatment is variable
Anxiety is usually chronic, whereas
stress is usually acute
• This means when we are stressed we usually
need short term intervention to remove the
stressor(s)
• But when we are anxious, we need longer
term help too, such as confidence building,
help with being assertive, and being around
good role models
The Equality Act (2010)
• The Act requires employers to make reasonable
adjustments in order not to discriminate against
someone with a disability. Most mental health
conditions are covered by discrimination law
• The Act applies to everyone who provides a
service to the public, whether or not a charge is
made for that service. It covers statutory, private,
voluntary and community sector organisations. It
also covers employment.
The Act asserts that everyone has the right to be treated
with dignity and respect. It prohibits discrimination on
named grounds, or nine ‘protected characteristics’.
These are:
• Age
• Disability (physical and mental)
• Gender reassignment
• Marriage and civil partnership
• Pregnancy and maternity
• Race
• Religion or belief
• Sex (or gender)
• Sexual orientation
Disability
• Disability is defined as impairment that has long term effect
on the person’s ability to carry out day to day activities
• It says that long term means it has lasted, or is likely to last,
at least 12 months
• This means that even if a person is well at the moment, they
may still be covered if adverse effects are likely to recur
• If someone takes medication or has treatment that keeps
them well, they are still to be treated as having a disability if
there is evidence that adverse effects would recur if they
stop medication or if their treatment has ended
• The Act states that you no longer have to show that a
particular capacity is effected e.g. memory, concentration,
only that you have a condition that qualifies as a disability
Forms of Discrimination
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Direct discrimination
Indirect discrimination
Discrimination by association
Discrimination by perception
Harassment
Victimisation
Disability discrimination
– Discrimination arising from disability
– Failure to make reasonable adjustments
Reasonable Adjustments
• Adjustments to the work area
• Flexible working hours
• Allowing absence during working hours to attend medical or
therapeutic appointments
• Providing additional supervision and support
• Transferring the employee to fill an existing vacancy
• The employee does not have to come up with suggestions, but it
will help if they do; the employer must consider any suggestions
made
What do we mean by
‘reasonable’?
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The extent to which the adjustment will prevent the problem
How practical it is for the employer to make the adjustment
The financial and other costs
The disruption it would cause to the employer’s activities
The extent of the employer’s financial and other resources
The availability to the employer of financial or other assistance
e.g. grants to make the proposed adjustment
The SHIFT Holistic Model for
Managing Mental Health at Work
There are 5 important stages:
• Recruitment
• At Work
• Getting Distressed
• Off Sick
• Returning to Work
The HSE Management Standards
• The Management Standards define the
characteristics, or culture, of an organisation
where the risks from work related stress are
being effectively managed and controlled
• The Management Standards cover six key areas
of work that, if not properly managed, are
associated with poor health and well-being, lower
productivity and increased sickness absence
• Demands – this includes issues such as
workload, work patterns and the work
environment
• Control – how much say the person has in
the way they do their work
• Support – this includes the encouragement,
sponsorship and resources provided by the
organisation, line management and
colleagues
• Relationships – this includes promoting
positive working to avoid conflict and dealing
with unacceptable behaviour
• Role – whether people understand their role
within the organisation and whether the
organisation ensures that they do not have
conflicting roles
• Change – how organisational change (large
or small) is managed and communicated in
the organisation
The Principles of Managing
Mental Health
• Identify signs of distress early and act on them as soon as
possible
• Use the usual management procedures to identify problems and
needs and act on them
• Make talks positive and supportive
• What can we do to help?
• What has helped in the past?
• Agree plans of action and review on a regular basis
• Is someone reluctant to talk? Think about why this is and offer
reassure regarding confidentiality; highlight the benefits of
disclosure but be realistic
• Suggest an advocate or friend or another manager attends the
meeting
• Liaise with HR
• If someone is reluctant to disclose anything to colleagues –
consider the pros and cons
• Support other colleagues and manage their reactions
• Performance issues? Act as soon as possible
• Take a twin track approach: disciplinary and usual mechanisms
PLUS adjustments and support
Resources
• Mind www.mind.org.uk
• Mind Workplace www.mind.org.uk/workplace
• The Health and Safety Executive
www.hse.gov.uk
• SHIFT www.shift.org.uk
• Time to Change www.time-to-change.org.uk