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Karen Steadman

Working for better mental health - results from a survey of employees

Authors: Karen Steadman Senior Researcher

09 October 2015

One in every eight UK employees– some 4 million people - are working with a mental health condition. Ahead of World Mental Health Day (10th October), we take a moment to look at some of the numbers around mental health and work, and the provision of workplace support to help people to stay in their jobs.

In 2014 NatCen and The Work Foundation undertook a large survey for the Department for Work and Pensions on employee health and wellbeing. This was to update and expand upon a similar exploration of employee health from 2011. So, what did this teach us about mental health at work?
Key findings:

  • Last year, 12% of employees had a mental health condition
  • Over half (51%) of employees with mental health conditions felt their health affected their work, with 20% reporting that it affected work "a great deal"
  • One in five employees with a physical health condition also have a mental health condition
  • 21% of employees with a mental health condition reported very low life satisfaction compared to just 3% of people with a physical health condition
  • A quarter of employees said they would be uncomfortable discussing their mental health with their employer
  • 51% of all employees have access to occupational health, and 39% to independent counselling. Access is reduced to 21% and 11% respectively for those working in organisations with under 50 employees

Working with a long-term health condition is not uncommon – a third of UK employees are doing it, with many of whom working with more than one health condition. We know that 1 in 4 people will experience a mental health condition in their lifetime, but what maybe is less well recognised is that 1 in every 8 employees are currently working with a mental health condition – almost 4 million people.

Having a mental health condition does not necessarily have major, or indeed any implications for work. Indeed, a third of employees with long-term health conditions reported that their health had no effect on their work at all. This is influenced by numerous individual reasons – such as symptom severity, self-efficacy, and access to appropriate support. Mental illness is heterogeneous, with conditions presenting differently in different people with different jobs.

However, we found that half of employees with mental health conditions (a similar result for employees with musculoskeletal disorders) felt their health did affect their work, with 1 in 5 saying it affected their work “a great deal”. This effect was even stronger among employees with both a mental and a physical health condition. This is no small number: 1 in every 5 employees with a physical health condition have a co-existing mental health condition. Of these almost a third (29%) felt their health affected their work a great deal, and almost two thirds (64%) felt that it affected work at least to some extent.

The relationship between health and work is complex. Work can both help and harm health, with the psychosocial quality of the job (ie. the extent to which it is ‘good work’) a key determining factor. Over half of employees with a mental health condition felt that work had made their health worse, far more than for employees with physical health conditions. The cause of this is again complex – it may be influenced by the psychosocial quality of the job, the relationship with colleagues, and a range of non-work factors which exacerbate work-related stress, as well as the symptoms of the mental health condition, for example, where there is negative thinking.

Employees with mental health conditions also reported much lower levels of life satisfaction than those with physical or no health conditions, with 21% reporting very low life satisfaction compared to just 3% of people with physical conditions. This figure leaps up to 23% for those with both a physical and a mental health condition.

Managing health in work

Stigma around mental health is seen as preventing employees from getting the support they need to remain in work, to work productively, and to manage their health in the workplace.  Different attitudes about physical and mental health were also apparent in this survey – when asked about their comfort discussing health conditions with their employer, 14% of employees reported that they would feel uncomfortable discussing a physical health condition, rising to 26% - over a quarter of employees - when it came to their mental health.

Many employers offer support to help prevent or manage poor health among their employees. Since a similar study in 2011 there has been a clear increase in employee reported access to occupational health – with 38% of employees reporting it was available to them in 2011, now up to 51%. The same increase has not been seen for the mental health focused independent counselling, reported access to which had actually dropped by 1% over the same period. This is not necessarily to say that employers place less value on mental health support services - it may  be that their occupational health service provides similar support, or perhaps employers do not feel the business case for investing in independent counselling (for example through Employee Assistance Programmes – EAP), has been substantially made.  Both types of support were also far less common in smaller organisations, a challenge which has long been recognised but so far we have little effective activity to resolve.

Making adjustments to the nature or work, to working hours, and to the support available through work is a legal obligation for employers managing people with heath conditions. People with mental health conditions were much less likely to have any adjustments made than those with physical conditions. This reflects earlier evidence which has indicated that employers struggle to know how best to support people with mental health conditions in work. Over half of employees with mental health conditions reported not having had any adjustments made, against one third of employees with physical health conditions. This was despite almost one in four (22%) reporting that adjustments would have been helpful.

Falling out of work

There were similar findings in the sister study (undertaken for DWP by IIF research) which looked at people who had recently transitioned from work to the welfare system due to ill health and were now claiming ESA. Again, they found that people with mental health conditions who had fallen out of work were “less likely to have discussed their condition with their employer or to find adjustments helpful; and more likely to feel employers had not been supportive.”  In terms of making workplace adjustments, the IIF report concluded that adjustments sought for those with mental health conditions were actually easier to implement than those for physical health conditions, focussing on flexible working and reduced hours, but these still did not happen in practice due to barriers “in initiating effective dialogue between employers and employees and understanding of how mental health issues might affect an individual’s work”.

Interestingly, the IFF research also found that despite these difficulties, participants with mental health conditions were “more likely to report an attachment to the labour market”, and showed “a greater appetite for accessing support services offered by employers”.

What does this mean?

Pulling this picture together, we see employees with mental health conditions that have a substantial effect on their work, feeling less able to disclose their health condition, feeling less supported by employers, and receiving less support than their colleagues with physical health conditions. This is despite keenness to access support, and often believing that there are things that could be done to help them to work. We might conclude therefore that there is some disconnect between employers and employees with mental health conditions about what can be done to support people to stay in work and to manage their health. It may not sound especially innovative, and it certainly isn’t new, but the clear message here is that if you want to improve your support for employees with mental health conditions, communication is key. It’s true that finding the right solution may be difficult, but through showing understanding, being open and willing to help, employers are at least getting themselves on the right path.

The full report is available here: Health and wellbeing at work: survey of employees 2014

The IFF research report is available here: Understanding the journeys from work to Employment and Support Allowance

The 2011 employee survey is available here: Health and well-being at work: a survey of employees 2011