Mental health and wellbeing has been a growing concern for many employers over the past few years and a key priority for people professionals. The CIPD 2023 Health and wellbeing at work report supported by Simplyhealth, found that 91% of organisations’ wellbeing activity focuses on mental health to a large or moderate extent, and over three-quarters (78%) are taking steps to identify and reduce stress.

The fact that many workplaces are taking an organisational approach, combining a range of methods to support mental health, is encouraging. However, we need a rebalance of where and how organisations are focusing their efforts. The use of mental health first aid training has increased substantially over the past six years and is now the second most used approach. And yet just 43% train line managers to support people with mental health and even fewer (25%), opt for greater involvement of occupational health (OH) specialists.

As the new policy paper The value of occupational health and human resources in supporting mental health and wellbeing in the workplace published by the Society of Occupational Health and CIPD and written by Dr Kevin Teoh makes clear, improving mental health outcomes for workers requires a systematic approach to address the main health risks, accompanied by the implementation of evidence-based interventions.

Employers need to adopt evidence-based approaches

The policy paper highlights the wellbeing industry that has developed to support organisations’ increased focus on health and wellbeing. However, as a mostly unregulated area, products and services do not always reflect a robust evidence base, ‘making it difficult for well-intentioned organisations to navigate this space effectively.’

The paper uses a three-level framework to map interventions to support mental health and wellbeing:

  • Primary interventions aim to identify potential risks and hazards within the working environment to remove, reduce, or mitigate their effects, such as a form of risk assessment. The emphasis here is on the working environment and the organisation.
  • Secondary interventions focus on the individual and aim to support them to improve their levels of self-care, to better manage their working environment, and to alleviate the effects of poor working conditions.
  • Tertiary interventions focus on the restoration and rehabilitation of workers struggling with their mental health such as talking therapy, return-to-work programmes, treatment medication, and are therefore also focused on the individual.

The evidence generally shows that interventions which focus on the primary level tend to have stronger effects than those that solely focus on individual level (secondary and tertiary). For example, one influential study showed that, in contrast to the benign wellbeing impact of interventions focused on the individual, working conditions such as having the right training, being consulted on change, fair pay, fair promotions, flexible work, and good collaboration were all associated with better wellbeing.

The paper provides a summary of the research evidence relating to six popular wellbeing activities:

  1. health promotion
  2. line manager training
  3. mental health first aid
  4. mindfulness training
  5. physical activity and exercise
  6. resilience training.

While most of these interventions are individually focused, there is some evidence that “they can work in specific circumstances or for specific outcomes”. For example, “there is plenty of evidence supporting the effectiveness of line manager training, but only where this is set within an evidence-based framework, where the training is accompanied by further and ongoing support for line managers, and where the training extends beyond identifying team members who are struggling to also consider creating healthy working environments”. The evidence relating to mental health first aid links to raising awareness and reducing stigma, thus underlining the need for employers to develop an organisational framework.

To support organisations to take an evidence-based approach, the paper offers three contemporary frameworks to manage employee mental health and wellbeing:

  1. HSE Management Standards
  2. Mental Health at Work Commitment (the CIPD has a webpage of resources to support the Commitment)
  3. ISO 45003 Psychological health and safety at work.

These systematic and holistic frameworks draw on the relevant research evidence on how best to manage workplace mental health and have been developed by relevant subject-matter experts and bodies, in collaboration with employer groups and trade unions. They also reflect all three levels (primary, secondary and tertiary) as part of a holistic approach to support mental health and wellbeing.

HR and OH: scope for closer collaboration

The policy paper says it remains the case that many organisations are still unclear about the role that HR and OH have in relation to managing workplace mental health and wellbeing, the value that they bring, and how best to work together.

HR and OH practitioners are the two professional groups most concerned with the health and wellbeing of people at work. As such, the strength of the working relationship between the two is critical, and it’s time to evaluate whether a fuller appreciation of each profession’s role by the other could encourage stronger collaboration, to achieve the mutual aim of a more strategic and preventative approach to employee health and wellbeing.

From HR’s perspective, we also need to consider how we can benefit more from the valuable specialist knowledge that OH offers. CIPD research consistently shows that employers and HR professionals view OH services as a valuable resource to manage employee health at work, with access to OH services identified as one of the most common and effective interventions for managing sickness absence. For example, the 2023 CIPD Health and wellbeing at work report supported by Simplyhealth, finds:

  • OH involvement is the fourth main method for managing long-term absence (73% of employers)
  • Offering OH assessments is the top way organisations support people with long COVID (72%).

However, the prevalent view of OH is as a reactive referral service for long-term sickness absence rather than a specialist and valuable resource to develop a strategic and preventative approach to employee health. For example, 2020 CIPD research found that:

  • the majority (68%) agree that their OH services are primarily used for referral in cases of long-term sickness
  • Just 1 in 3 employers use OH specialists to prevent/mitigate risks to mental health or to develop a mental health policy
  • Just 29% agree that HR and OH work closely at a strategic level to help prevent ill health.

These findings suggest that many employers, and HR professionals, tend to view OH predominantly as a referral service, to deal with complex cases of sickness absence when ill health issues have already escalated. There could be clear benefits from involving OH in health-related issues at an earlier stage where appropriate, for example identifying main health risks, ill health prevention, developing strategy and policy for workplace health interventions, effective reasonable adjustments, developing guidance for line managers.

Recommendations

The policy paper notes that the rapidly evolving world of work presents new risks, challenges, and issues for workers’ health that OH and HR practitioners may struggle to keep up with. With this in mind, it recommends HR and OH practitioners:

  • Adopt a systematic approach to managing mental health and wellbeing in the workplace, based on ill health prevention and managing the main risks to workers’ health. This means recognising that ‘good work’ is good for health, and that organisational decisions, processes, activities, and policies impact on the working experience of individuals, and in turn their mental health and wellbeing.
  • Develop effective working relationships, with mutual trust and credibility at its core. There also needs to be a clear understanding of where the respective roles and responsibilities of HR and OH for health and wellbeing stop and start, as well as other groups in the organisation, particularly leaders and managers.
  • Recognise the boundaries of their competence in relation to mental health and wellbeing, and to work to increase the resource available to manage workforce mental health and wellbeing. This could be in the form of personal development, improving capacity within the organisation, or developing appropriate external support. As part of this, to not only recognise the value of OH but to support and champion access to this service within their organisations.
  • Increase the influence within their work practices, to advocate and encourage their potential to input into mental health and wellbeing strategy and initiatives across the primary, secondary, and tertiary levels.

You can download the policy paper from the Society of Occupational Medicine website or access the CIPD’s range of wellbeing and mental health resources on our wellbeing resources page.

About the author

Rachel Suff, Senior Policy Adviser, Employee Relations

Rachel Suff joined the CIPD as a policy adviser in 2014 to increase the CIPD’s public policy profile and engage with politicians, civil servants, policy-makers and commentators to champion better work and working lives. An important part of her role is to ensure that the views of the profession inform CIPD policy thinking on issues such as health and wellbeing, employee engagement and employment relations. As well as conducting research on UK employment issues, she helps guide the CIPD’s thinking in relation to European developments affecting the world of work. Rachel’s prior roles include working as a researcher for XpertHR and as a senior policy adviser at Acas.

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