Publication
Employee perspectives on mental health in the workplace
| Contents: | Summary Introduction Methodology Findings Discussion Recommendations References Appendices |
Appendices
The study has indicated that improving mental health and well-being of employees relies heavily on the skills, competence and confidence of managers in effectively handling relationships with and among staff. Managers need to be operating within a framework of good business and employment practice that supports them in this role, reinforced through the organisation's policies and procedures.
There are also implications for management education and professional development. The research points to the need to review the extent to which management training and development programmes are geared to creating managers that have skills and confidence to deal respectfully with people, to communicate effectively and to listen sensitively. Consideration should be given to the development of in-company mental health awareness raising.
Appendix 1 - Research Advisory Group
Iain Grieve, Edinburgh Chamber of Commerce
Sheila Durie, SDC Employment Programme
Andy Crawford, Scottish Association for Mental Health
Christine Taylor, Box of Delights
Rory McKail, Federation of Small Businesses
Ian Tasker, STUC
George Shand, Intowork
Fiona Ross, National Schizophrenia Fellowship (Scotland) Employment Support Service
Lynne Davidson, Scottish Health at Work
Matthew Farrow, Confederation of British Industry in Scotland
Leona McDermid, Social Firms Scotland
Miriam O’Connor, HEBS
Fiona Tyrrell, Scottish Executive Health Department
Appendix 2 - Data collection
1. Focus groups
The focus groups concentrated on issues that could be addressed safely and sensitively in an open setting by people who share the same workplace. Data collection for the focus groups took place in three stages.
Preparatory questionnaire: Members of sample were asked to complete a confidential, preparatory semi structured questionnaire on key workplace stressors as mental health risk factors in their work place prior to their focus group. In their publication "Tackling work-related stress", 2001, the Health and Safety Executive identified seven key stressors in the work place; culture, demands, control, relationships, change, role, support, training and factors unique to the individual. Participants were asked to describe how the key stressors might impact in the short and long term. The questionnaire acted primarily as a tool to give the SDC research team insight into employee's experiences prior to the focus groups.The findings from this questionnaire are given in Appendix 3
Focus group format:
The focus group discussions were designed to include the following topics:
- definitions and understandings
- promoting mental health and well-being in the workplace, including work/life balance
- addressing mental health problems in the workplace
- examples of and incentives to change in the workplace.
The following Framework and Topic Guide provides detail of the format of each focus groups.
Framework and Topic Guide for Focus Groups
The programme for each focus group will be:
- Arrival - tea and coffee and labels with first names
- Introductions and explanation of research, aims for focus group and any questions
- 'Dumping' question
1. Definitions
Give out sheet with 'mental health, well-being, mental health problems, mental illness, stress' and ask participants to briefly note what they think the words mean before looking at them together. 'There are no right and wrong meanings - perhaps different meanings for different people'. Allow couple of minutes and then open up using flipchart.
Vignette
Hand out copies of vignette to aid discussion. Vignettes to be size 14 fonts for easy reading but also read out in case anyone has undisclosed reading problems. Use each vignette in turn
2. Imagine an ideal workplace, what should happen for this person?
3. Are there any ways that it might have been prevented from happening?
4. What would be the wrong way to deal with this situation?
5. What might encourage employers to take positive action?
6. Would there need to be incentives for employers? What?
7. Would there be any barriers?
Promoting mental health and well-being in the workplace
Thinking now about your own workplace:
8. What official policies are in place that demonstrate a positive approach to mental health and well-being? (For instance, good recruitment policies, family-friendly policies, duvet days, sickness provision, return to work interviews, provision of counselling or other support services, supervision systems)
9. What unofficial things promote mental health and well-being? (E.g. values like respect for individuals; the way people relate to each other at work, physical aspects of the workplace etc)
10. Can you give me examples of actions within your workplace to reduce stress or promote mental health at work?
11. Can you identify any further changes that need to be made in your workplace to provide a more positive approach to mental health and well-being?
Work/life balance
12. How do you balance your work and life outside work?
Addressing mental health problems in the workplace
The Disability Discrimination Act requires employers to make "reasonable adjustments" to help people with disabilities stay in their jobs. This includes people with substantial or significant long-term mental health problems, for example, depression, that may affect their abilities in day to day life.
13. What does "reasonable adjustment" mean to you?
14. How supportive is / would your workplace be in recruiting people with mental health problems? Examples?
15. Would someone receive support to get back into work after a period of absence?
16. [Only if used vignette about John] What would be the wrong way to deal with someone with mental health problems at work?
17. If there were one thing you could change in your workplace to make the experience more positive, what would that be?
Mental Health in the Workplace: The Employees' Perspective
Focus Group Vignette 1
John: John is 54 and has worked for a large company as a middle manager for 10 years. The company has recently brought in a new computerised accounting system which has significantly impacted on the way John has to work.
John was not used to using computers, he received a half day's training on the new system at work which he found difficult to understand. John has started to fall behind with his work and has become very worried about this to the extent of losing sleep at night.
He has tried to approach his manager to discuss his concerns, however she didn't seem to have much time to talk to him. John is starting to feel that he cannot cope at work and in other areas of his life and this is disrupting his relationship with his wife and family. John knows that his colleagues are aware that his behaviour has changed.
Mental Health in the Workplace: The Employees' Perspective
Focus Group Vignette 2
Karen: Karen is 27, she began to suffer from depression whilst studying at university and was prescribed medication for this. Karen had great difficulty continuing her studies and decided to leave university and travel for a year. Karen returned from her travels to make a fresh start and found a job with a small company.
She did not disclose her previous mental health problem at her interview or to her colleagues. This was because she was worried about being stigmatised and was unsure of how her disclosure would be received and whether her employer and colleagues would support her.
Karen has been in her job for two years now and has recently been experiencing some 'bad days' when she has called in sick and put it down to migraines or stomach upsets. Karen feels that she may be becoming depressed again and that this may impact on her performance and attendance at work in the near future. However she doesn't know how or whether to broach the subject at work.
One to one interviews
The face-to-face interviews with members of samples 2 and 3, provided an opportunity to explore in detail individual experiences and perceived needs in relation to mental health in the workplace. The interviews were tape recorded to ensure accuracy of recording and to facilitate in-depth qualitative analysis.
The main areas that were addressed in the interviews are as follows:
- individuals were asked to give a definition of mental health problems and were asked whether they had experienced mental health problems at work
- how does mental health impact on work performance and attendance? What were the individuals' own experiences?
- how supported do/did people feel at work and what support would they like / have liked from peers, colleagues and immediate line mangers?
- what are the main stressors for people at work and what coping mechanisms do they employ?
- what relative importance do home life and work life have in terms of individual's mental health? How does this balance change?
- perceptions of mental health and well-being in the workplace. How does the workplace contribute to their own well-being? In what ways does work make people feel positive and good about themselves?
- perceived barriers and enablers that influence employer readiness and capacity to promote mental health.
- what could their employer do / have done to improve their mental health and well-being in their workplace?
Stakeholder workshop
A stakeholder workshop was held at the conclusion of the fieldwork. Material from the workshop was used as an additional source of data for the proposed study as well as acting as a sounding board for preliminary conclusions.
The workshop entailed facilitated discussion structured around the key themes and issues emerging from the interviews and focus groups. The workshop focused on developing ideas and priorities for action to address these themes and issues and on identifying strategies to support implementation by considering the drivers, incentives for change.
Analysis
Analysis of the qualitative data collected from the third part of the focus groups and from the one to one interviews developed the main themes of interest to the research aims. Both systemic organisational issues and solutions and those that require an approach to meet the needs of the individual were explored.
Data collected in the second part of the focus groups were used to identify features and conditions required to implement the key changes suggested to improve mental health in workplaces. The data from each source: the two sets of interviews and the focus groups were each analysed with reference to common themes and care was also taken to consider disparities or divergences of view among the three sets of participants. The stakeholder group produced insights into the how the main findings and themes of the research might realistically be applied either in policy or in guidance to employers.
Appendix 3 - Focus group participants questionnaire
Focus group participants were asked to complete a brief questionnaire regarding the main work-related issues that may have a bearing on how people might become stressed at work. Participants were asked to describe how each of the stressors affected them in their current job. Their responses are summarised below
Culture of the workplace, i.e. the general attitude in your work place towards work-related stress:
- respondents who reported a positive attitude felt well supported by their peers and / or line managers and some were aware of formal stress policies
- those with negative experiences felt that they were restricted by workplace procedures and by the stress on task completion and by expectations of more effort in less time.
Demands of the workload - for example, the size of your workload and/or risk of physical danger:
- workloads that fluctuated and were unpredictable caused anxiety
- excessive workloads have a detrimental effect on home life and relationships with managers
- regular discussions with line managers help to keep workloads manageable.
Control - this is how much say you have in the way you do your work
- nearly all respondents felt they had a satisfactory degree of control. Those who did not found this a cause of stress.
Relationships at work - for example relationships which involve bullying and / or harassment
- most respondents had not experienced bullying or harassment at work although a few respondents felt that they were exposed to a bullying environment, which was difficult to address openly or formally.
Change - how changes at work are managed and communicated to you
- most respondents felt well informed about changes at work. Those who were not well informed felt that a lack of communication caused uncertainty and resentment.
Role - this is whether you understand your role you have in the workplace
- understanding their role gave some respondents confidence. Clear job descriptions and regular appraisals help, although some were uncertain of their role within the bigger picture
- not knowing what is expected of you at work can lead to stress, although a degree of flexibility in role can provide added interest to a job.
Support from peers and line management
- support from peers and managers was essential to the respondents feeling motivated, encouraged, listened to and valued. Support seems to depend on shared goals and values.
Training - for you to be able to undertake the core functions of your job
- staff had mixed experiences of training, many felt that they needed more training and more choice in their training.
The workplace catering for individual differences in the way you do your work
- respondents welcomed the chance to feel like an individual at work and to enjoy a degree of autonomy, knowing where the boundaries lie. Encouragement from management was considered important in this regard
- respondents could feel constrained by organisational cultures and procedures. Some felt that their ideas were not taken on board.
Appendix 4 - Criteria for assessment of good practice in mental health in the workplace
A written mental health policy or a policy statement which recognises the mental health needs of employees.
- A dedicated occupational health unit or staff, with mental health expertise.
- An Employee Assistance Programme with specific mental health components or access to equivalent.
- A risk assessment, stress audit or other process, which assesses the overall employee group’s risk of stress or mental health problems, and can identify individuals at risk.
- A sickness management plan which establishes procedures for managing employee absence due to stress or mental ill heath.
- A system for early detection and intervention when a person goes off sick for stress or mental health problems.
- A system for return to work planning for those absent through stress or mental health problems.
- Initiatives to encourage informal supports in the workplace for those with a recognised mental health issue.
- Evidence of preparedness to make workplace adjustments as part of a return to work agreement, e.g. a modified work programme.
- A recognised mediation service for teams within the organisation which are not functioning well, due to inter-personal difficulties.
- A performance management/appraisal system which invests managers with responsibility for workplace mental health and well-being.
- Achievement of standards relevant to workplace mental health, e.g. 'Positive about Disability' symbol user, 'Investors in People'.