At the beginning of September I received a call from a young relative who was clearly distressed about a family member in Ireland – let’s call him Jim. She explained that his telephone messages and Facebook entries were becoming increasingly erratic and she thought they were a “cry for help”.
Jim is a senior manager in his late fifties who has a wide circle of friends, is well travelled, lives in a leafy part of town and had never previously displayed any apparent signs of mental illness.
My relative trusted her instinct, spoke to her employer in London to take some urgent time off and travelled over to Ireland to meet up with Jim. Within 48 hours Jim had been admitted to a mental health unit suffering from a severe psychotic episode which had radically affected his behaviour. The trigger point for this was troubles in his marriage which had come to a head whilst on a family vacation.
Jim is now recovering and continues to be treated sympathetically by his employer.
This really had an impact on me. I could associate myself with Jim, who I had met at my wedding in Dublin four years ago. Somebody who seemed to be in full control of his life but who still did not have the resilience to cope with a breakdown in the thing that was most precious to him. Fortunately Jim had the support, both financial and from his family, to deal with his crisis quickly. How many other people in Jim’s position would be dealing with their crises alone and with the added worry of whether they might lose their pay or even their jobs and accommodation as a result of their absence from work?
One in six adults of working-age will experience a mental health problem at any one time. 53% of employees with poor mental health say they always go into work despite this. A further 41% say they sometimes do, and also reported that their mental health impacted on their concentration, learning, customer service skills, decision-making and ability to deliver complex tasks, and made them more likely to get into conflict with colleagues.
Supporting staff mental health and wellbeing makes hard business sense; we need our staff to be productive, we need them to work coherently in teams and we need to recognise that they don’t work well when their mental health is damaged.
Public Health England, like many other organisations, has been going through rapid transition, is facing the impact of austerity and is working through the challenge of bringing together staff from different professional backgrounds under a common vision and purpose. As Director for Human Resources, I meet every day with staff across our organisation who are facing these very real challenges and doing their best in circumstances that aren't going to change overnight. We know there is still a job to do, and the reality of the economic climate is that we are having to do more with less staff and fewer resources. That can be stressful, but we know that there are things we can do to make this stress more manageable and reduce the impact it has on people’s lives in work and at home.
Last week PHE signed two public commitments to address the issue of staff mental health and wellbeing in our own workforce. In signing the Time to Change Commitment we have made a public pledge to tackle the stigma and discrimination of mental health in the workplace, reviewing our policies and our internal messaging to support staff. We also signed the Public Health Responsibility Deal Pledge on Mental Health, Wellbeing and Resilience, setting out a public commitment to doing more to train line managers to support staff early and, as an organisation, making sure we have put support initiatives in place like Big White Wall and Mental Health First Aid to allow staff to access support in a range of ways that meet their needs.
Alongside the work we are doing internally we are working with partners in the private and public sectors to draw together the evidence base about interventions which can support health and wellbeing in the workplace. We have commissioned the Liverpool Health and Work Centre to refresh the national health and work charter standards and accreditation process that underpin many local authority workplace wellbeing schemes and we will be developing a series of briefings to support business and local government to see how they can work together to improve health in the workplace.
We need to start being more proactive in engaging employers, large and small, in recognising and supporting the health and wellbeing needs of their staff. The majority of businesses in England are small and medium enterprises, employing fewer than 50 staff. The current growth sector is sole traders: these are local people doing local jobs. This makes health at work a community issue, a population health issue and a public health issue.
It would be nice to live in a world where people, including Jim, never have these crises, but life being what it is that will be impossible. Instead, how can we as employers support people when they need it? And how can we as PHE do more to ensure that the public health system and all the key players see action on health in the workplace as good business for themselves and the populations they serve?