1. Mentally Healthy Workplace Training
A One Day Training Programme For Managers 1

2. Aims of The Course
Identify the key factors that contribute to a mentally healthy workplace
Give employers and line managers a broad understanding of mental health in the workplace
Ensure managers are aware of their responsibilities in relation to health and wellbeing
Improve managers skills and confidence in dealing with mental health in the workplace 2

3. Programme Outline
Definitions of mental health / mental health problems
Benefits of a healthy workplace
Attitudes to mental health / mental health problems
Common mental health problems
Stress in the workplace
The Equality Act
Promoting a mentally healthy workplace 3

4. Definition of Mental Health
“Mental health influences how we think and feel about ourselves and others and how we interpret events. It affects our capacity to learn, to communicate and to form, sustain and end relationships. It also influences our ability to cope with change, transition and life events: having a baby, moving house, experiencing bereavement”
(Friedli 2004)
WHO definition features in the online course
Friedli definition features in the two day course 4

5. The Mental Health Continuum
Positive mental health
Has diagnosis of a mental
illness but copes well and
has positive mental health
No diagnosed illness or
disorder and positive mental
health
Diagnosis of a mental illness
No diagnosis of a mental illness
Has diagnosis of a mental
Illness and has poor mental
health
No diagnosed illness or
disorder but has poor mental
health
Poor mental health 5

6. Current Workplace Attitudes
A recent survey by SAMH found that 79% of people with serious long term mental health problems are not in employment
The same survey found that less than 40% of employers would employ someone with a mental health problem
Many employees with mental health problems are reluctant to disclose their condition to their employer. A recent report by SAMH indicated that of those who disclosed their condition only 40% felt satisfied with the support they received 6

7. The Business Case
Each case of stress-related ill health leads to an average of 29 working days lost per person per year
Mental health problems at work cost Scottish employers over £2 billion per year
In the course of a year, the total cost of mental health problems per employee for Scottish employers is £970
Every £1 spent on improving health can generate savings of £10 in reduced absence and presenteeism
SAMH, 2011 7

8. Features of a Mentally Healthy Workplace
Some control over pace and style of working
Consultation on key changes
Clarity about role / expectations
Supportive management
Regular supervision / appraisal
A healthy physical working environment
Contributions are acknowledged / valued
Collaboration on key issues
Socially inclusive environment
Effective communication 8

9. The managers role in creating a mentally healthy workplace
The managers role is to:
Encourage, motivate and support team members
Communicate clearly and effectively
Provide a healthy physical environment
Provide regular support and supervision
Give clear direction and leadership
Ensure clarity of roles and expectations
Provide development opportunities
Chartered Institute of Personnel and Development (CIPD)
From communication, to clarity of job role, as a line manager you can influence the success of a team.
More importantly, as a manager you can have a huge impact on work-related stress affecting your employees.
(Taken from managers resource- online) 9

10. Benefits of Good Practice
Providing support at an early stage can prevent escalation of a condition
Low cost interventions to staff can increase return on investment to organisations
Staff will feel supported and valued resulting in a healthier, more motivated and productive workforce
Employment or other valued activity is key to maintaining positive mental health
Your reputation and profile will be enhanced as a responsible and well managed organisation helping to attract and keep employees 10

11. Mental Health Problems and Work
1 in 4 people in Scotland experience a mental health problem
More than a third of absences from work are mental health related
Employers should expect that at any one time nearly 1 in 6 of their employees is affected by a mental health problem such as anxiety or depression
There is compelling evidence to show a positive link between mental health and employment
SAMH 11

12. Depression
One in four people in Scotland will experience depression at some point in their life.
Symptoms can include: prolonged depressed mood, loss of interest, fatigue or decreased energy, loss of confidence or self esteem, feelings of guilt, thoughts of death or suicide, poor concentration, agitation, disturbed sleep and loss of appetite.
Everyone can feel sad or blue from time to time but this is not depression – depression is longer lasting, more severe and interferes with daily life. 12

13. Anxiety
All of us will experience anxiety from time to time but 10% of adults in Scotland will experience an anxiety disorder at some point in their lives.
Symptoms can include: constant restlessness, disturbed sleep, apprehension, headaches, irritability, muscle tension and palpitations, nausea, loss of appetite, poor concentration, irritability, excessive fear, mind racing or going blank.
Anxiety and fear make us alert and motivated but if feelings become too strong or prolonged it can interfere with our lives. 13

14. Forms of Anxiety Panic Attacks Generalised Anxiety Disorder
Post Traumatic Stress Disorder
Obsessive Compulsive Disorder 14

15. Bi-Polar Disorder
Approximately 1% of the population are diagnosed with Bi-Polar disorder.
Bi-polar disorder can involve repeated changes in mood from elation to depression to periods of feeling well.
Symptoms in the manic phase can include: talking quickly, having difficulty concentrating and having lots of energy and creative ideas. At the extreme end people can have delusions or hallucinations. The periods of depression can have the symptoms as discussed earlier.
It is estimated that 20% of people who experience a first episode do not get another. Many people learn to manage their symptoms and stay well. 15

16. Schizophrenia Approximately 1% of the population is affected.
Nearly three quarters of people are diagnosed between the ages of 16 and 25 years.
Symptoms can include: hearing and seeing things that others don’t (hallucinations), feeling everything is wonderful and important or frightening and strange. People often experience a loss of motivation, may become withdrawn and can stop looking after their appearance.
About one third of people who develop schizophrenia will have one episode and completely recover. Those who have repeated episodes can often manage their symptoms and have a good quality of life.
Schizophrenia affects male and females equally however males tend to be diagnosed earlier. 16

17. Recovery Key Principles: What helps:
People can and do recover
Mental health problems are a common human experience
Recovery is a process
More than an absence of symptoms
Different things help different people
What helps:
Self direction, control and responsibility
Relationships
Finding meaning and purpose
Treatment and supports
Activity
(Scottish Recovery Network)
Self Direction, control and responsibility- many people report that taking responsibility for their won recovery was the most important step for them. In some cases the realisation by the person that they have the ability to shape their own future is very empowering.
Relationships- These include relationships with friends, family, colleagues and professionals. When people are unwell sometimes friendships are neglected and it is a real effort to make social contact. Good strong supportive relationships can serve as the foundation for recovery.
Finding meaning and purpose- There is increasing evidence that spending time doing something you are interested in aids recovery. Finding something meaningful to do, whether paid or unpaid, can be helpful to recovery and also provide structure to your day/week.
Treatment and supports- Treatments vary from person to person and can include medication, talking therapies, CBT and alternative therapies such as acupuncture or massage. Supports include good healthcare from professionals, support from family and friends and participating in self help groups.
Activity- Physical and mental activity are a vital part of the recovery process. This could include gentle exercise like gardening or walking or something more strenuous like cycling or running. Activity could also include social contact through various groups or getting together with friends or may simply involve doing a crossword or sudoko. 17

18. Wellness Recovery Action Plans (WRAP)
Wellness Toolbox
Daily Maintenance Plan
Triggers
Warning Signs
When things are breaking down
Crisis Plan
Post-Crisis Plan

19. What is Stress?
‘The adverse reaction people have to excessive pressures or other types of demands placed on them’
Health and Safety Executive
The effects of stress:
Physical
Cognitive / Emotional
Behavioural
Stress happens when demand exceeds ability to cope
Too much for too long is damaging 19

20. Human Function Curve
Adapted from P. Nixon 20

21. Stress - Effects at Work
Emotional – tearfulness/irritation
Absenteeism
Presenteeism
Poor time keeping
Inability to deal with usual workload
High staff turnover/job dissatisfaction
Increased forgetfulness, accidents and mistakes
Reduced productivity
Indecisiveness or rash decision making 21

22. Responsibilities as a manager
CIPD Absence Management survey found that respondents cited management style in the top three causes of work-related stress overall. For instance:
Your behaviour towards employees can prevent or cause stress
Your influence may mean employees can be protected from, or exposed
to, stressful working conditions
Working closely with your team, you are well positioned to identify
stress in others at an early stage
If one of your employees suffers from stress, you, as their
manager, are likely to be involved in the solution
Increasingly managers are responsible for the uptake and roll-out
of risk assessments for work stress within their team/department 21

23. The Management Standards
The Management Standards Approach has been developed by the Health and Safety Executive (HSE) to reduce the levels of work-related stress reported by British Workers
Demands
Includes workload, working hours and targets
Control
How much say an employee has in the work they do
Relationships
Includes relationships between line managers and staff
Change
How organisational change is handled and communicated in the workplace
Role
The extent to which there is clarity around job roles
Support
Such as encouragement, resources and training to meet the needs of the job 23

24. Additional Methods of Identifying Workplace Stress
Consult staff
Use staff reviews or performance appraisals
Consider recruitment, sickness and turnover patterns
Consider feedback given at return to work and exit interviews
If an organisation wide risk assessment is necessary consider using Work Positive (workpositive.org.uk) 24

25. Management Competencies for preventing and reducing stress at work
The CIPD / HSE have produced a set of competences to prevent and or reduce stress at work. The competences are:
Managing emotions and having integrity
Managing and communicating existing and future work
Managing the individual within the team
Reasoning/Managing difficult situations
Developed by CIPD and the HSE
Integrity- being respectful and honest to employees
Managing emotions- behaving consistently and calmly around the team
Considerate approach- being thoughtful in managing others and delegating
Proactive work management- monitoring and reviewing existing work, allowing future prioritisation and planning
Problem solving- dealing with problems promptly, rationally and responsibly
Participative/empowering- listening to, meeting and consulting with the team providing direction, autonomy and development opportunities to individuals
Personally accessible- available to talk personally
Sociable- relaxed approach, such as socialising and using humour
Empathetic engagement- seeking to understand each individual in the team in terms of their health and satisfaction, motivation, point of view and life outside work
Managing conflict- dealing with conflicts decisively, promptly and objectively
Use of organisational resources- seeking advice when necessary from manager, HR and occupational health
Taking responsibility for resolving issues- having a supportive and responsible approach to issues and incidents in the team 25

26. The Equality Act (2010)
Replaced existing equality laws from October 2010
Brings together all the equality groups that were protected by prior legislation; age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership and pregnancy and maternity (referred to as ‘protected characteristics’)
Disability:
Aims to remove discrimination on grounds of disability
Makes such discrimination unlawful
Applies to all employers regardless of size 26

27. Who is Covered? The Act protects all workers including: Part – timers
Casual workers
Agency temps
Sub – contractors’ staff
Apprentices and Trainees
Volunteers 27

28. The Scope of the Act The Act applies:
At every stage of the recruitment process
During employment
In relation to harassment
At termination of employment
During any redundancy programme 28

29. Definition of Disabled
“Someone who has a physical or mental impairment which has a substantial and long term adverse effect on his / her ability to carry out normal day to day activities” 29

30. Recruitment Discrimination
It is unlawful to discriminate:
In the arrangements for determining who should be offered employment
In the terms on which a disabled person is offered employment
By refusing to offer, or deliberately not offering, a disabled person employment
By asking a candidate to complete a pre-employment health questionnaire
THESE PROVISIONS ALSO APPLY TO INTERNAL RECRUITMENT AND PROMOTION 29

31. Examples of Reasonable Adjustments
Adjustments to the job itself
Hours and schedules
Ways of working
Supervision and performance management
Accommodating changes in behaviour 31

32. Issues to consider Respect Confidentiality
Focus on what would help the individual
Where necessary seek professional advice
Consider the impact on the team
Consider the impact on the service
Consider the costs
Set a review date 31

33. Managing Return to Work
Managers should expect that employees will return
Confidentiality and trust are essential
Ensure communication between all parties
Conduct return to work interviews
Individually tailored return to work programmes
Ensure on-going support following return to work
When in doubt seek professional advice 33

34. Managing Return to Work
Managers should expect that employees will return
Confidentiality and trust are essential
Ensure communication between all parties
Conduct return to work interviews
Individually tailored return to work programmes
Ensure on-going support following return to work
When in doubt seek professional advice 33

35. Factors that improve job retention
A positive perspective on mental illness
Job satisfaction
A good fit between the job and the individuals skills and abilities
A mentally healthy workplace for all
Facilitating natural supports in the workplace 33

36. Factors that improve job retention cont.
Supportive and well trained management
Regular support and supervision
Individually tailored return to work programmes and workplace adjustments
Early intervention and sufficient time off work to aid recovery 33

37. Creating a Healthy Workplace
Take steps to reduce the stigma of mental health problems by educating staff
Create a no blame culture where difficulties can be comfortably aired.
Provide adequate working conditions – space, light, heat and ventilation
Actively promote healthy lifestyles
Encourage open and honest communication 36

38. Creating a Healthy Workplace
Carry out a regular stress risk assessment, inform employees of the findings and involve them in solutions
Help employees to identify and cope with sources of stress both inside and outside work.
Ensure staff have opportunities to feedback - how they are feeling
Be positive about reasonable adjustments 37