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Christine is the Managing Director of RedArc, a specialist company providing long-term help and support to employees, individuals and families suffering from serious illness, disability or bereavement, through its team of highly qualified, registered nurses.  She is proud to be helping so many people at often the most difficult times of their lives, whilst at the same time adding value to a wide range of clients, including employers and insurers.

Mental health is clearly high on the agenda for employers, not surprising due to awareness campaigns by people such as the royal family, high profile reports of recommendation such as the recent independent review into workplace mental health; Thriving at work report[1] and the government’s response (Improving Lives).

The charity Mind tells us that 1 in 4[2] of us will experience some form of mental health problem in any given year, 20% will have suicidal thoughts at some point in their lives and almost 7% will actually attempt suicide[3].

I would suggest that the term “Mental health” is not a very helpful label as it actually covers an extremely wide variation of conditions, symptoms and severities. These can range from mild depression through to serious disorders such as bi-polar and schizophrenia.

Due to its very nature, mental ill health is often hidden. The symptoms can fluctuate and be unpredictable; there is no clear treatment and recovery pathway in the way that there is with a physical health condition.

Recent research from Heads Together found that only 2% of employees would feel comfortable speaking to their employer about their mental health.

So it is not surprising that employers find mental health difficult to identify, manage and support in the workplace.

Mental Wellbeing
It is of course important  that employers need to have good quality solutions in place to give line managers the skills to notice when an employee may be having problems, and know how to have an appropriate conversation and direct them appropriately to any support that might be needed.

However, another important aspect is creating an environment which allows for good mental wellbeing. Policies, procedures and culture are of course important factors but increasingly health and wellbeing initiatives are being used, often utilising technology in the form of apps that employees can use in their own time.

Self-management of mild to moderate stress and anxiety through regular use of online guided meditation, mindfulness, breathing and relaxation techniques can increase the mental wellbeing of employees.

The need for additional help at an early stage
With the NHS mental health services under severe pressure, it is not unusual for a patient to wait three months for a course of counselling or therapy to commence. GPs can diagnose some forms of mental ill health by the use of clinical mood questionnaires (e.g. PHQ9 Depression, GAD7 Anxiety) but they are not mental health experts. Consequently, they are often unsure what form of therapy would best help the individual, so they may for example refer people for counselling when another treatment may have been more beneficial, such as Cognitive Behavioural Therapy (CBT).

During the long wait to commence therapy, it is not surprising that the mental state of the individual can deteriorate significantly. Self-help tools can be helpful but not a sufficient substitute for a course of professional face-to-face therapy.

Access to professional help at an early stage is key to a timely recovery and this is provided by some support services and also enabled by some mental wellbeing apps by taking people through mood questionnaires such as the PHQ9 and GAD7. Those with adverse scores can be signposted to appropriate services with people who have the clinical expertise to assess the most appropriate pathway for each individual.

External Support Services
In our experience, employees find the opportunity get confidential help from a service external to their employer invaluable.

Employers can provide external support services either by sourcing directly from a supplier or more frequently from an Employee Assistance Programme (EAP) or through insurance products such as Group Income Protection, Critical Illness or Private Medical Insurance.

When selecting support services, employers should take care to ensure that the service is of high quality, for example services can range from a light touch helpline for a one-off telephone call through to long term support from a dedicated nurse, some purely offer counselling and others make a clinical assessment to determine the most appropriate therapy which could be a specialised form of counselling, Neuro-linguistic programming (NLP), psychotherapy or others.

Even though mental health may be on the agenda, many employers may not know what to do after opening the conversation. But support is available, early intervention is key, as is having access to specialists that can direct employees to the most appropriate support for them.

Christine Husbands, managing director, RedArc Nurses

[1] Thriving at work, Lord Dennis Stevenson and Paul Farmer of Mind October 2017.

[2] Published in April 2017: McManus, S., Meltzer, H., Brugha, T. S., Bebbington, P. E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for health and social care.

[3] Published in April 2017: McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016). Mental health and wellbeing in England: Adult psychiatric morbidity survey 2014. Leeds: NHS digital.

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