“Thriving At Work” – The Stevenson/Farmer Report on Mental Health And Employers 2017:
To: All Branches
The independent review into workplace mental health, commissioned by the Prime Minister in January 2017 and led by Dennis Stevenson and Paul Farmer, was published in October 2017 entitled ‘Thriving At Work’. The review looks at how employers can better support all employees including those with poor mental health or wellbeing remain in and thrive at work.
Statistics from the Department of Work and Pensions reveal that 300,000 people with a long term mental health problem lose their jobs each year. Analysis by ‘Deloite’, commissioned by the reviewers, also reveals a demonstrable cost to employers, and quantifies for the first time how investing in supporting mental health at work is good for business and productivity.
Stevenson/Farmer outline in their report that they believe that the number of people leaving work with mental health problems could be reduced by 100,000 to bring the number in line with physical health conditions in the first instance.
Poor mental health costs the UK economy between £74 billion and £99 billion a year. ‘Deloitte’s’ analysis shows that the cost to employers is between £33 billion and £42 billion of this number. Evaluations of workplace interventions show a return to business of between £1.50 and £9 for every £1 invested.
Drawing on the accounts of over 200 employers of people with mental health problems and leading experts in mental health and work, Thriving at Work sets out core principles and standards that all employers should commit to. It highlights examples of some employers who are taking positive and innovative steps to support the mental health of their employees.
The reviewers Denis Stevenson and Paul Farmer are calling on all employers, regardless of size or industry, to adopt six ‘mental health core standards’ that lay the basic foundations for an approach to workplace mental health. These cover mental health at work plans, mental health awareness for employees, line management responsibilities and routine monitoring of staff mental health and wellbeing. Large employers and the public sector are expected to go even further, demonstrating best practice through external reporting and designated leadership responsibility.
Farmer and Stevenson confirmed in their report that they found that in many workplaces, mental health is still a taboo subject and that opportunities are missed to prevent poor mental health and ensure employees who may be struggling get the support they need. In many instances employers simply don’t understand the crucial role they can play, or know where to go for advice and support. They stated that the human cost of failing to address mental health in the workplace is clear. Workplace mental health should be a priority for organisations across the UK. Every employer in the UK has a responsibility to support employees with mental health problems and promote the mental wellbeing of their entire workforce.
Farmer and Stevenson added that in light of the demonstrable impact of poor workplace wellbeing on individuals, employers and the UK economy, their report calls on the Government to accept the recommendations in full, and to introduce the core standards in the public sector. They said that the right leadership was needed among employers in the public, private and voluntary sectors, and a mandate from policy-makers to deliver their ambitious but achievable plan. They concluded that it is time for every employer to recognise their responsibilities and affect change, so that the UK becomes a world leader in workplace wellbeing for all staff and in supporting people with mental health problems to thrive at work.
‘Deloitte UK’ who were commissioned by Farmer/Stevenson to provide the analysis stated at the report’s launch that their analysis indicates the potential impact poor mental health has on UK businesses and the wider economy and said it should spur employers into recognising that championing mental health and supporting employees makes good business sense and that inaction comes at a demonstrable cost.
The review took account of Mind’s Workplace Wellbeing Index. The Index is a benchmark of best policy and practice around mental health. It celebrates the good work employers are doing to promote and support positive mental health, and provides key recommendations on the specific areas where there is room to improve. Participating organisations undertake staff and employer surveys to help assess where the gaps lie between the organisation’s approach to workplace wellbeing and staff perceptions. 30 organisations took part in the first Index, with 15,000 of their employees completing the staff survey.
“Mental Health Core Standards”
To achieve the objectives of the report, it sets out what is described as “mental health core standards” – a framework for a set of actions which Stevenson/Farmer believe all organisations in the country are capable of implementing quickly.
These mental health core standards are as follows:-
• Produce, implement and communicate a mental health at work plan;
• Develop mental health awareness among employees;
• Encourage open conversations about mental health and the support available when employees are struggling;
• Provide employees with good working conditions and ensure they have a healthy work life balance and opportunities for development;
• Promote effective people management through line managers and supervisors;
• Routinely monitor employee mental health and wellbeing.
The report states that mental health core standards are drawn from best practice and, as far as possible, are evidence based, albeit there is a pressing need for more evidence. Annex A of the Report sets out guidance, suggestions, and tools to help with implementing the standards. The report also outlines a series of more ambitious ‘enhanced’ standards for employers who can and should do more to lead the way, building on the mental health core standards these are as follows:
• Increase transparency and accountability through internal and external reporting;
• Demonstrate accountability;
• Improve the disclosure process;
• Ensure provision of tailored in-house mental health support and signposting to clinical help.
The report sets out three other factors that will help the implementation of these “mental health core and enhanced standards”.
1 Increasing employer transparency presents the biggest opportunity to encourage a greater breadth and depth of employer action on mental health, and strong leadership is vital to ensuring this change is felt throughout organisations. Employer action on mental health is intrinsically measurable. Increased transparency will go a long way to generating a culture of measurement and will enable the development of voluntary ranking schemes to help drive accountability and further improvement.
2 While Stevenson/Farmer believe that it is clearly in the interests of all businesses and organisations to implement these mental health core and enhanced standards, they are calling on trade unions, industry groups, professional and regulatory bodies to help with the implementation of the ‘mental health core standards’.
3 Digital tools and products are an enabler of change and there is a significant opportunity for low cost, scalable interventions in workplaces. They refer to the explosion of such technology and it is vital that there is a firm evidence base that is accessible for employers and employees.
Annex B: Making workplace adjustments for employees with mental health problems
Annex B to the Report gives guidance on making workplace adjustments for employees with mental health problems. The report states that mental health problems can be experienced very differently by different people and as a result individuals themselves are best placed to identify what their needs are. Any workplace adjustments should be decided in consultation with the individual concerned. Some people may not know what might be helpful to them so exploring their options in a safe, constructive and supportive environment is recommended. It’s also a good idea to set a trial period after which the employer and employee can review together how effective the adjustment has been, and whether any other changes are needed.
Employers should be creative and flexible in considering and applying different workplace adjustments. Under the Equality Act, disability, which includes mental health, is a ‘protected characteristic’. Workplace adjustments themselves do not address the specific mental health problem, but are designed to address the disadvantage that the mental health problem might cause for a person in their role or the wider workplace. A number of good suggestions (not designed to be exhaustive) are made and provides ideas to help guide these conversations
The Report made 40 Recommendations in all and a copy of the full set of recommendations and Government response to each is attached. Apart from calling on all employers to implement the above detailed ‘Core Standards’, three other key recommendations include; Government should consider legislative change to enhance protections for employees with mental health conditions, particularly fluctuating mental health conditions and clarify the role of employers in providing reasonable adjustments. Government examines what more it can do to require employer compliance with existing equality and employment laws and Government funded mental health campaigns include information and support for improving workplace mental health, and that where possible their impact is evaluated.
The Report’s general Conclusion was that Workplace Mental Health should now be a priority for organisations across the UK with the right leadership amongst employers in the public, private and voluntary sectors, and a mandate from policy-makers to deliver the mental health core and enhanced standards, together supporting all employees, including those with mental health problems, to thrive in work.
Government Response (‘Improving lives: the future of work, health and disability’)
The Government response to the Stevenson/Farmer ‘Thriving At Work’ Report was published in a Joint DWP and DOH Policy paper entitled ‘Improving lives: the future of work, health and disability’ on 30 November. This paper sets out the Government’s plans to transform employment prospects for disabled people and those with long term health conditions over the next 10 years. The Government stated that “As Government we support these recommendations in full. Where it is for employers to act to take the recommendations forward we encourage them to do so. For the public sector, this includes working through sponsor departments and initiatives such as our planned Public Sector Summit, to be held in spring 2018. We will similarly encourage implementation of these recommendations by private sector businesses by using existing networks and through our role in providing information, advice and support to employers.”
HSE Impact & Response
The Government stated that it would “move forward” with all 40 recommendations in the Stevenson/Farmer review on mental health at work, including three that directly reference the work of the HSE. The Report stated that the HSE Work-Related Stress approach was too narrow. As a result of the Report and Government response, the HSE is now expected to be bound by the report’s recommendation to “revise its guidance to raise employer awareness of their duty to assess and manage work-related mental ill-health”. It will also have to “build on its Risk Assessment Guidance and Management Standards approach by highlighting how these actions will help employers deliver key parts of the mental health core standards”. Under a third recommendation, “Local Authorities should adopt the same recommendations as the Health and Safety Executive throughout its guidance and practices, and ensure join up between its public health and health and safety enforcement roles”.
Farmer and Stevenson stated that they viewed the HSE and enforcement as a “safety net”, protecting staff in workplaces with bad practice around stress, bullying and victimisation. The HSE have the responsibility to promote best practice, and we certainly see the HSE playing a role in raising employer awareness of their duties. The HSE has a role in being the safety net to protect staff where there are really appalling cultures, or bullying and harassment. They feel that is also core business for the HSE.
Responding to the Government announcement, The HSE stated that they fully recognises the vital role that employers can play in supporting their employees to maintain good mental health. Preventing work-related mental ill health is an important aspect, and the HSE provide guidance and tools to help employers implement effective actions. The HSE are building on this guidance to help demonstrate how it can contribute to the wider aspects of managing mental health in the workplace, as described in the review’s core standards. The HSE are also working on the provision of signposts to helpful resources, and promoting the guidance to employers using the HSE’s ‘Go Home Healthy’ campaign. Central to this is protecting people in proportionate, practical and effective ways which also supports innovation and productivity. While rightly proud of the UK record, the HSE knows that tackling mental ill-health is a must for Britain’s wellbeing and prosperity. The HSE is actively working with employers to promote these kinds of practical measures to tackle the causes of work-related ill health.
The Report Authors
Paul Farmer has been Chief Executive of Mind, the leading mental health charity working in England and Wales since May 2006. He is Chair of the Association of Chief Executives of Voluntary Organisations (ACEVO), the leading voice of the UK’s charity and social enterprise sector. Paul is also a trustee at Lloyds Bank Foundation which invests in charities supporting people to break out of disadvantage at critical points in their lives. Paul is Chair of the NHS England Mental Health Taskforce – bringing together health and care leaders and experts in the field, including people using services, to lead a programme of work to create a mental health Five Year Forward View for the NHS in England. Paul has an Honorary Doctorate of Science from the University of East London, is an Honorary Fellow of St Peter’s College Oxford and The Royal College of Psychiatrists, and was awarded a CBE in the New Year’s Honours 2016.
Lord Dennis Stevenson, Baron Stevenson of Coddenham, CBE, DL is a British businessman and former chairman of HBOS. He sits on the crossbenches in the House of Lords. Stevenson is a long time campaigner for greater understanding and treatment of mental illness informed by his own experiences of depression. He was the Founding Chair of MQ: Transforming Mental
Health, a charity which supports research into mental health; and he promoted a Private Members’ Bill – the “Mental Health (Discrimination) Bill” – the first key step in the UK to removing a number of the key discriminations against people who suffer from mental illness. He is currently a trustee of Inter Mediate which facilitates negotiation to help bring a sustainable peace in the most difficult, complex and dangerous conflicts where other organisations are unable to operate.
Stevenson/Farmer Stakeholder Groups:
• The Expert Advisory Group: A group of individuals who have contributed evidence, examples of good practice and practical advice to the Review. Dr Paul Litchfield Chief Medical Officer BT Group was a member.
• The Leaders Panel: A group of senior leaders across the public, private and voluntary sectors, who have acted as a support and guide to the Review, particularly around implementation. Moya Greene Chief Executive Officer Royal Mail Group was a member.
• Copy of the Stevenson/Farmer ‘Thriving At Work’ Report
• Copy of the Government Response Annex C of DWP/DOH Policy Paper ‘Improving lives: the future of work, health and disability’
National Health, Safety & Environment Officer