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Mental health and wellbeing, moving forward

Recognising and measuring “workability” as a health outcome could improve the synergy between health and work in current health models. Most health practitioners and services are not assessed using workability as an outcome measure. Work and health should be much more closely linked in terms of outcome measurement as work has been shown to be health-supportive.

In 2022,  the UK Government launched a vital discussion paper for its Mental health and wellbeing plan. Calling for “bold, long-term action to build the mentally healthy society that we want to see in 10 years’ time”, the decision was taken to incorporate tackling mental ill health into a major conditions strategy.

The aim was to ensure that mental ill health is considered alongside other physical health conditions and that the interactions between them are reflected in any resulting commitments. A call for evidence to inform the major conditions strategy ran between May and June 2023.

The consultation sought to address important considerations which are especially timely now, with the government’s current focus on long-term sickness and access to workplace health support through its latest discussion paper, Occupational Health: Working Better.

Both consultations have the power to make a very positive difference to workers across the UK, provided there is recognition of the broader workplace health landscape to support mental health and other conditions, including the important role of vocational rehabilitation alongside occupational health.

But what are the priorities for employees and employers right now?

Prioritising wellbeing
For many employers, workplace wellbeing has become a key issue – thanks in no small part to the pandemic’s lingering impact.

The government recognises that individuals with lived experience of mental ill-health also see the workplace as having an important role in their wellbeing. Summarising their words: “We need compassionate employers who are able to meet us where we are at and can support us to meet our full potential.”

Such a huge, societal issue requires a range of areas to be addressed, and we duly suggested that these are:

  • People having early awareness of their issues and those of others – an education opportunity;
  • people seeking help – namely changes in behaviour;
  • access to services – with suitably varied access points, tools, and delivery methods;
  • the timeliness and availability of intervention; and
  • enough trained, qualified people to triage appropriately and to deliver remote and in-person support.

Two good examples of approaches to address these challenges are interventions that promote consideration of the “whole person”, and flexible service delivery via a combination of digital and human methods.

In the case of the former, there is much evidence that recognises the link between physical and mental wellbeing. It is therefore important to view and treat people holistically, and to design – and promote – services accordingly. Again, back to the voice of those with lived experience of mental ill-health, “we need to think about people as a whole… we should be striving for needs-based, not diagnosis-based, care and treatment”. In responding to the various consultations, Swiss Re has called on the Government to offer more support to employers who themselves provide these support services, irrespective of whether it is part of an insurance solution or other.

Flexible service delivery is now an expectation rather than unusual. And, importantly, digital service delivery has proven efficacy – as well as consumer engagement and support. Digital delivery can improve access and reduce costs though, in some cases and especially where mental health is concerned, person-person support is still very much required. This makes service selection (of only high quality, evidence-based digital services) and user triage (to the most appropriate service and delivery method) extremely important.

Social prescribing
Social prescribing is when a local agency refers someone to a link worker. They, in turn, connect people to community groups and statutory services for practical and emotional support. Given that people often have complex needs, this can mean a swift arrival at the root (often non-medical) cause of a presenting problem (such as mental or physical ill health stemming from social isolation, or financial distress).

A social prescribing model can be an integral part of a person-centred approach which is able to address complex issues as well as those whose roots are not health-related. Moreover, such a model is closely aligned with the stated needs of those with lived experience, whose preference is for a “care system which is focused on and curious about a whole person and their needs for recovery”.

If digital services become a greater and central access point, signposting and links to other services could be fed from there. For example, employer and insurer services could signpost to more local services. This, in turn, would increase awareness of – and access to – such services. Sectors would have to collaborate in the best interests of the individual, with better data sharing and outcome monitoring.

Work and health
People usually present challenging and overlapping reasons for both health issues and work absences. It follows, that the link between the DWP (work) and NHS (health) is also complex. While a person may be signed off work with mental health reasons as the cause, they are not always referred to appropriate support services at that point. Issues are likely to have escalated by the time they are referred and/or waiting lists passed.

Recognising and measuring “workability” as a health outcome could improve the synergy between health and work in current health models. Most health practitioners and services are not assessed using workability as an outcome measure. Work and health should be much more closely linked in terms of outcome measurement as work has been shown to be health-supportive.

The important role for insurers
The insurance industry has been placing increased focus on the link between work and wellbeing for some years – with many players seeking to adopt a more holistic and seamless approach to absence management (which can lead on to claims). This approach recognises individuals’ differences and circumstances, emphasises the complex inter-relationship between physical and mental health, highlights the role of the workplace, and acknowledges health and wellbeing as a continuum.

Good practice now very much encourages an evidence-based “biopsychosocial” approach to claims management, recognising the impact of biological, psychological and social factors on recovery. This whole-person view then leads to, where appropriate, providing tailored support to aid recovery and return to work.

We support a transformation towards such an approach across sectors. Nobody’s mental or physical wellbeing should deteriorate where it is avoidable or due to failure of the system or service.

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